Food addiction and lifetime alcohol and illicit drugs use in specific eating disorders

Background and aims Food addiction (FA) and substance use (SU) have frequently been reported in patients with eating disorders (EDs). Our study aimed to assess the prevalence rates of FA and/or lifetime problematic alcohol and illicit drug use among patients with specific ED, such as: bulimia nervosa (BN), binge eating disorder (BED), and other specified feeding and eating disorder (OSFED). We sought to identify clinical, psychopathological, and personality profiles involved in these addictive behavior-based phenotypes. Methods The total sample was 527 patients (176 BN, 115 BED, and 236 OSFED). FA was assessed through the Yale Food Addiction Scale 2.0. To determine lifetime SU, a semi-structured clinical interview was carried out. Results Patients with BN had the highest rates of FA both with and without SU. No gender differences were obtained for the prevalence of current FA and/or lifetime SU. Patients reporting at least one addictive-related behavior exhibited increased clinical severity compared to those who reported none. Increased impulsivity (such as high lack of premeditation, sensation seeking, and positive urgency) and low self-directedness were differentiating factors for presenting one or two addictive behaviors. Discussion and Conclusions Overall, patients presenting with at least one addictive-like behavior reported a poorer clinical status than those without. Also, patients with FA and SU exhibited a more dysfunctional profile characterized by high impulsivity and low self-directedness. These findings would support the need for targeted treatments to reduce impulsivity and increase self-directedness, especially in patients with any addictive-related behavior, as a step towards improving their treatment outcome.

Compulsive sexual behavior, religiosity, and spirituality: A systematic review

Background and aims In recent years, increasing attention has been given to the relationship between compulsive sexual behavior (CSB), religiosity, and spirituality. This review summarizes research examining the relationship CSB has with religiosity and spirituality, clarifying how these constructs inform the assessment and treatment of this syndrome. Methods The present paper reviews research published through August 1, 2021, using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Only studies providing quantitative analyses were included. Results This review identified 46 articles, subsuming 59 studies, analyzing the relationship between CSB and religiosity or spirituality. Most studies used cross-sectional designs with samples primarily composed of heterosexual White men and women. Generally, the studies found small to moderate positive relationships between religiosity and CSB. Studies considering the mediating or moderating role of moral incongruence identified stronger, indirect relationships between religiosity and problematic pornography use (PPU), a manifestation of CSB. Few studies examined the association between spirituality and CSB, but those that did either reported negative relationships between indicators of spiritual well-being and CSB or positive relationships between CSB and aspects of spiritual struggles. Discussion and conclusions Although research examining CSB and religiosity has flourished, such growth is hampered by cross-sectional samples lacking in diversity. Moral incongruence assists in explaining the relationship between religiosity and PPU, but future research should consider other manifestations of CSB beyond PPU. Attention should also be given to examining other religiosity and spirituality constructs and obtaining more diverse samples in research on CSB, religiosity, and spirituality.

Altered connectivity in the right inferior frontal gyrus associated with self-control in adolescents exhibiting problematic smartphone use: A fMRI study

Background With the continued spread of smartphones and development of the internet, the potential negative effects arising from problematic smartphone use (PSU) in adolescents are being reported on an increasing basis. This study aimed to investigate whether altered resting-state functional connectivity (rsFC) is related to the psychological factors underlying PSU in adolescents. Methods Resting-state functional magnetic resonance images were acquired from 47 adolescents with PSU and 46 healthy control adolescents (the CON group). Seed-based functional connectivity analyses were then performed to compare the two groups with respect to rsFC in the right inferior frontal gyrus, associated with various forms of self-control, and rsFC in the left inferior frontal gyrus. Results Compared to the CON group, the PSU group exhibited a reduction in rsFC between the right inferior frontal gyrus and limbic areas, including the bilateral parahippocampal gyrus, the left amygdala, and the right hippocampus. In addition, a reduction in fronto-limbic rsFC was associated with the severity of PSU, the degree of self-control, and the amount of time the subjects used their smartphones. Conclusion Adolescents with PSU exhibited reduced levels of fronto-limbic functional connectivity; this mechanism is involved in salience attribution and self-control, attributes that are critical to the clinical manifestation of substance and behavioral addictions. Our data provide clear evidence for alterations in brain connectivity with respect to self-control in PSU.

Fear of missing out (FoMO) and internet use: A comprehensive systematic review and meta-analysis

Background and aims FoMO has been considered a predisposing factor toward excessive internet use, and a great deal of literature has investigated the link between FoMO and internet use. However, there is still a lack of cohesion in the literature. Methods The current study have been conducted and reported in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Results In the current systematic review and meta-analysis of 86 effect-sizes, representative of 55,134 participants (Mean age = 22.07, SD = 6.15, females = 58.37%), we found that the strength of the trait FoMO- internet use association significantly varies from r = 0.11 to r = 0.63. In some populations, FoMO appears to increase with age and it is reverse in other populations. Facebook use was unrelated to FoMO in some populations, and higher FoMO was linked with stopping Instagram use for some individuals. The FoMO- internet use association was independent of their severity, as the interaction was not significant, and this association was neither linear nor curvilinear. The FoMO-internet use association does not appear to be associated with depressive, anxiety, and stress symptoms or level of life satisfaction. The COVID-19 pandemic was the only significant moderator of the FoMO-internet use association, strengthening this relationship. Discussion and Conclusions FoMO demonstrates a considerable role in internet use; however, there is no evidence of interaction or bi-directional association between the mentioned. Overall, we still don’t know what factors contribute to individuals exhibiting distinct patterns in the FoMO-internet use association.

Is the I-PACE (Interaction of Person-Affect-Cognition-Execution) model valid in South Korea? The effects of adverse childhood experiences (ACEs) on internet gaming disorder and the mediating effect of stress on adolescents

Background and aims The purpose of the present study was to investigate the effects of adverse childhood experiences (ACEs) on internet gaming disorder (IGD) and the mediating effect of stress based on the Interaction of Person-Affect-Cognition-Execution (I-PACE) model. Methods The 2017 survey data from one community addiction management center in South Korea were analyzed. A sample of 3,593 adolescents (mean age = 13.75 years, SD = 2.22) were recruited from 23 elementary, middle and high schools and 11 local children’s centers. The mediating effect was analyzed by the three-step analysis method. Results Our study found that ACEs had a significant effect on the stress score (B = 1.420, P < 0.001) and the stress scale score had a significant effect the IGD score (B = 0.127, P < 0.001). After adjusting for the stress score in the model, ACEs had a significant effect on the IGD score (B = 0.328, P < 0.001), and the stress score had partial mediating effects (B = 0.1802, 95% C. I: 0.131–0.239). Discussion We found that ACEs directly affect IGD and that ACEs directly affect IGD through stress in support of the I-PACE model. In the sensitivity analysis, the mediating effect of stress in the low-risk IGD group was significant, but the mediating effect of stress in the high-risk IGD group was not significant. Prior ACEs should be considered when interviewing IGD clients. In addition, enhancing stress management skills would be beneficial to IGD clients with a history of ACEs, and actions reducing exposure to ACEs in childhood are necessary.

Potentially addictive behaviours increase during the first six months of the Covid-19 pandemic

Background and aims In this study we aimed to assess multiple potentially addictive behaviours simultaneously for an extended period of time during the Covid-19 pandemic and their relation to distress. Methods Data were collected every three days from Amazon’s MTurk between 26.03.2020 and 02.10.2020 in repeated cross-sectional samples of 25 participants resulting in a total sample of 1430 US adults (60% men, mean age 36.6 years, SD = 11). General distress and Covid-19 related fear were assessed as well as self-reported frequency of eight potentially addictive behaviours: shopping (compulsive buying), alcohol, smoking, legal substances, illegal substances, gambling, gaming and overeating. Results We found a positive relationship between time and the frequency of each self-reported potentially addictive behaviour ( = 0.15–0.23, all P < 0.001), and their frequency is linearly related to the intensity of (Covid-19-related and general) distress ( = 0.12–0.28, all P < 0.001). Most popular activities were gaming and compulsive buying, and the relative frequency of the behaviours remained about the same during the data collection period. Discussion It is possible that people seek other maladaptive substitutes when other coping mechanisms (e.g. social recreation) are hindered depending on their level of distress. Conclusion Given the evidence for the increasing frequency of potentially addictive behaviours and their relevance to distress, special attention needs to be paid to reduce potential harmful effects of maladaptive coping during and after this demanding period.

Electrophysiological evidence of enhanced early attentional bias toward sexual images in individuals with tendencies toward cybersex addiction

Background and aims Attentional bias is a key factor in addictive behavior maintenance. However, whether attentional bias has a similar effect on cybersex addiction is unclear. We investigated differences in the attentional processing of sexually explicit images between individuals with high tendencies toward cybersex addiction (TCA) versus low tendencies using behavioral and electrophysiological indices. Methods Twenty-eight individuals with high TCA and 29 with low TCA performed an addiction Stroop task comprising sexual and neutral images in colored frames. Participants were asked to respond to the frame color and not the image contents, and behavioral and event-related potentials were recorded. Results Behaviorally, an addiction Stroop interference effect was found in the high TCA group, as shown by the longer reaction times to judge the frame colors of sexual images. Electrophysiologically, a P200 (150–220 ms) enhancement was present in response to sexual images compared with neutral ones, which was absent in the low TCA group. The event-related potential correlates with the addiction Stroop interference effect, indicating that the attentional bias underlying the addiction Stroop interference operates at an automatic level. A general, sexually related bias was found in the late positive potential (300–700 ms) amplitude, although between-group differences were insignificant. Discussion and conclusions These findings indicate that sexual stimuli grab the attentional resources of individuals with high TCA at early automatic stages of attentional processing. Increased cue reactivity to sexual stimuli may contribute to pornographic consumption and play a crucial role in sustaining problematic excessive use of online pornography.

Mindfulness buffers the influence of stress on cue-induced craving for Internet among Chinese colleges with problematic Internet use

Background and aims Stress is a common experience among college students with problematic Internet use, and it may exacerbate their cue-induced Internet craving. This study aimed to examine the influence of stress on cue-induced craving for the Internet among subjects with problematic Internet use and the buffering effect of mindfulness. Methods Sixty-eight college students with problematic Internet use were assigned to groups with a 2 (stress vs. no-stress) × 2 (high vs. low mindfulness) between-subject design. Results It was deduced that stress could significantly enhance cue-induced craving for the Internet, and mindfulness could buffer this effect. Specifically, the effect of stress on cue-induced craving for the Internet was weaker among subjects with high mindfulness as compared to subjects with low mindfulness. Discussion and Conclusions These findings contribute to understanding of the factors influencing problematic Internet use and how such factors interact. It also provides recommendations on how to prevent the progression of problematic Internet use and suggests possible interventions.

Money used in gaming is associated with problem gambling: Results of the ESPAD 2019 Finland

Background and aims The convergence of gaming and gambling may pose a risk for adolescents. Thus, it is important to find out how these behaviours are associated with other addictive behaviours in order to develop efficient preventive measures for youth. The aim of this study was to examine 1) whether problematic gaming and money used for gaming activities are risk factors for gambling, and 2) what kind of impact adolescents’ substance use along with other factors related to friends and parents have on this association. Methods The European School Survey Project on Alcohol and Other Drugs data, 2019 of Finnish adolescents aged 15 to 16 (N = 4595). Cross-tabulations with Rao-Scott’s chisquare tests were applied to study the associations of the background factors with gambling in the past 12 months. A multinomial logistic regression model was fitted for the outcome variable (gambling in the past 12 months) adjusted for all independent and background variables. Results Problematic gaming alone was not associated with gambling participation, whereas using money for digital games increased the risk of gambling. Boys gamble more than girls. The use of alcohol and drugs increased the risk of gambling. Parental monitoring reduced the risk of gambling, whereas hanging around weekly with friends increased the risk. Discussion and conclusions Using money on gaming sites may put some adolescents at risk of developing problems with either gaming or gambling. The link between using money in digital games and gambling participation calls for preventive measures, intervention and regulatory acts.