1. 核心概念界定与研究背景
1.1 “纯爽”短剧/短视频的定义与特征
“纯爽”短剧或短视频特指那些以快速、直接、强烈的情感冲击和感官刺激为核心卖点的短视频内容。这类内容旨在通过紧凑的剧情、高密度的冲突、快速的反转以及明确的情绪反馈（如复仇、逆袭、反转等）来迅速抓住用户的注意力并持续提供即时满足感。其核心属性包括：
- 强感官刺激与即时满足：内容设计往往突出视觉和听觉上的冲击，例如，短剧中的快节奏剪辑、夸张的表演、高潮迭起的剧情，以及短视频中通过BGM、特效、色彩等元素营造的强烈氛围。其目标是在极短时间内（通常为几十秒至几分钟）提供明确的“爽点”，使观众体验到情绪上的高峰，如兴奋、解压、痛快等。
- 碎片化叙事与信息结构：这类内容高度碎片化，情节往往被压缩至极致，人物关系简单，主题单一，避免复杂的人物弧光和深度思考。短剧常以“集锦式”或“高光片段”呈现，每集独立成章，但又通过悬念或钩子引导用户观看下一集；短视频则可能是一个梗、一个挑战或一段快速的知识点总结，其信息通常是去语境化的，易于快速消费。
- 算法推荐机制的强化循环：平台强大的个性化推荐算法是“纯爽”内容得以广泛传播的关键。算法能够精准捕捉用户的兴趣偏好，持续推送类似或同类的高刺激性内容，形成一个“观看-满足-推荐-再观看”的循环。这种机制极大地降低了用户选择内容的认知成本，同时也强化了用户对这类内容的依赖性。
- 与传统短视频的差异化：相较于早期或一般意义上的短视频（如记录生活、知识分享、技能教程等），“纯爽”短剧/短视频的差异在于其更极致地追求“情绪价值”和“即时反馈”。传统短视频可能侧重于信息传递、社交互动或轻度娱乐，内容形式和节奏相对多样；而“纯爽”内容则更聚焦于通过高强度刺激来诱发用户的情绪反应，其娱乐性往往凌驾于知识性、实用性或艺术性之上，并且通常伴随着更强的沉浸感和时间消耗。
1.2 注意力集中度、智力与认知功能的界定
为了深入探讨“纯爽”短剧和短视频对个体认知功能的影响，有必要首先对注意力、智力及其他关键认知功能进行科学界定，并明确其评估指标。
注意力集中度 (Attention Concentration)：
注意力是指个体对特定信息或刺激进行选择、聚焦和维持的能力，是所有高级认知活动的基础 1。其主要包括以下几个维度：- 选择性注意力 (Selective Attention)：指在众多刺激中，个体能够专注于某个特定刺激而忽略其他无关刺激的能力。例如，在嘈杂环境中听清一个人的讲话。
- 持续性注意力 (Sustained Attention)：又称警觉性，指个体长时间保持对特定任务或刺激的专注，并维持高水平表现的能力 1。这对于需要长时间投入学习或工作的任务至关重要。
- 注意力评估指标：通常通过反应时间、错误率、任务完成度等行为学指标进行评估，例如持续表现任务 (Continuous Performance Task, CPT) 和 Stroop 任务。神经生理学研究则可能通过脑电图 (EEG) 分析，如前额叶的 theta 功率指数变化，来反映注意力资源的分配和执行控制水平。
智力 (Intelligence)：
智力是一个复杂的心理学概念，通常指个体理解、学习、解决问题、适应环境和抽象思维的能力。它并非单一能力，而是由多种认知能力构成。在本文中，智力主要聚焦于：认知功能 (Cognitive Function)：
认知功能是一个广义概念，涵盖了人脑获取、存储、检索和运用信息的所有心理过程。除了注意力和智力外，关键的认知功能还包括：- 记忆 (Memory)：包括工作记忆（短期保持和操作信息的能力）、情景记忆（对个人经历的记忆）、语义记忆（对事实和知识的记忆）等。记忆障碍是许多认知功能障碍的突出表现 45。
- 执行功能 (Executive Functions)：指一系列高级认知过程，包括计划、决策、抑制控制（抑制不相关信息或冲动反应）、任务切换和认知灵活性等。执行功能受损常表现为冲动行为和难以适应新环境 678。
- 认知功能评估指标：针对不同认知功能，有多种神经心理学测试工具。例如，工作记忆可通过数字广度测试评估；抑制控制可通过 Go/No-Go 任务或 Flanker 任务评估；执行功能则可通过威斯康星卡片分类测试 (WCST) 或连线测试 (Trail Making Test) 等进行评估 489。神经影像学技术（如 fMRI）也可用于观察与特定认知功能相关的脑区活动 10。
1.3 精神“毒品”的判定标准
将“纯爽”短剧和短视频比喻为精神“毒品”，这一说法暗示其具有与物质成瘾相似的危害性和机制。为了客观评估这一观点，我们需要建立一个判定标准，主要从行为成瘾的特征和神经生物学机制两个维度进行分析。行为成瘾，又称非物质成瘾，其核心特征与物质成瘾高度相似 11。
行为成瘾特征：
- 强迫性使用 (Compulsive Use)：个体表现出对某种行为的强烈渴求，即使意识到其负面后果也难以自控地重复该行为。对于短视频而言，即表现为不顾时间、场合，甚至牺牲睡眠、工作或学习而持续观看短视频。这与赌博成瘾和互联网成瘾等行为成瘾的定义相符，即对智能手机的强制性使用导致身体、心理或社会危害 12。
- 失控感 (Loss of Control)：使用者尝试减少或停止使用短视频但屡次失败，或发现自己花费在短视频上的时间远超预期。
- 耐受性 (Tolerance)：为了获得相同的“爽感”或满足感，个体需要投入更多的时间观看短视频，或观看内容刺激性更强、频率更高的短视频。
- 戒断反应 (Withdrawal Symptoms)：当无法使用或减少使用短视频时，个体出现心理或生理上的不适感，如焦虑、烦躁、情绪低落、注意力不集中、失眠等。
- 负面后果下的持续使用 (Continued Use Despite Adverse Consequences)：尽管短视频使用已对学业、工作、社交关系、身体健康（如视力下降、睡眠不足）等造成明显负面影响，个体仍然难以停止或减少使用。
- 功能损害 (Functional Impairment)：由于过度使用短视频，个体在学业、职业、社交等重要生活领域的功能受到显著损害。例如，成绩下降、工作效率降低、社交隔离等。
神经生物学机制：
- 奖励系统异常激活 (Abnormal Activation of Reward System)：许多行为成瘾（如病理性赌博、网络成瘾）与物质成瘾在神经机制上存在共通之处，尤其是在大脑的奖励系统。短视频的“即时反馈—多巴胺释放”循环被认为是其成瘾性的关键机制。当用户观看“纯爽”内容并获得情绪满足时，大脑的伏隔核等奖励回路会被激活，释放多巴胺，从而产生愉悦感并强化该行为。这种对“想要”（wanting）的过度放大，而非单纯的“喜欢”（liking），是动机—激励敏感化理论（incentive-sensitization theory）的核心观点，能够解释成瘾行为的持续性 13。
- 决策与控制区域功能改变：长期过度刺激可能导致大脑前额叶皮层（负责决策、冲动控制等高级认知功能）与奖励系统之间的连接发生改变，使得个体对即时奖励的抵抗能力下降，冲动性增加，难以抑制观看短视频的冲动 14。这可能表现为决策控制区与奖励区连接减弱。
- 遗传与心理因素：研究表明，行为成瘾与物质成瘾在遗传学上存在相似之处，例如单胺类神经递质系统基因（如多巴胺和5-羟色胺系统）可能与两者都相关 15。此外，情绪调节能力和依恋类型等心理因素也与行为成瘾相关，如依恋问题和情绪调节障碍可能增加青少年患上网瘾和游戏成瘾的风险 16。
综合以上标准，如果“纯爽”短剧和短视频的使用模式符合强迫性使用、戒断反应、功能损害等行为特征，并且其背后存在奖励系统异常激活等神经机制，那么将其类比为精神“毒品”就具有一定的科学依据。然而，这并非意味着所有短视频都具有成瘾性，或所有使用者都会成瘾，其危害程度仍需进一步量化和区分。
2. 短视频使用对注意力集中度的影响机制
2.1 短期注意力消耗的行为与神经证据
“纯爽”短剧和短视频以其高频切换、碎片化和强刺激的特点，对用户的短期注意力构成显著挑战。行为学研究表明，频繁接触这类内容可能导致注意力资源被快速消耗，并干扰个体的执行控制能力。这种干扰并非仅限于主观感受，而是有明确的神经生理学证据支持。
电生理学（EEG）研究为理解短视频对注意力影响的神经机制提供了重要线索。Theta波段（通常为3-7 Hz）的脑电活动被认为是反映认知控制、工作记忆和注意力参与度的关键指标 17。特别是在前额叶区域，Theta功率指数与执行控制能力呈正相关，即更高的Theta功率通常指示着更强的认知投入和任务导向的注意力 17。
然而，最新的研究发现，移动手机短视频使用倾向（通过移动手机短视频成瘾倾向问卷MPSVATQ评估）与前额叶区域反映执行控制的Theta功率指数之间存在显著的负相关关系（r = -0.395, p = 0.007）18。这意味着，对短视频越是表现出成瘾倾向的个体，其在前额叶区域的执行控制相关的Theta功率越低。这一结果提示，过度或沉迷于短视频可能直接削弱了大脑在前额叶区域进行高效执行控制的能力。执行控制是大脑管理认知过程的关键功能，包括计划、任务切换、抑制不相关信息以及保持注意力等，对学习和日常决策至关重要。
这种短期注意力消耗还体现在自我控制能力的下降上。研究进一步揭示，移动手机短视频成瘾倾向与自我控制量表（SCS）的得分之间也存在显著的负相关关系（r = -0.320, p = 0.026）18。自我控制能力是执行控制功能的重要组成部分，它使个体能够抵制冲动、延迟满足并调节自身行为以实现长期目标。短视频的高频即时反馈机制，通过不断提供“爽点”，可能强化了大脑对即时奖励的偏好，进而削弱了抵制诱惑和维持长期目标导向行为的自我控制能力。
综合来看，短视频的高频内容切换和即时反馈机制，导致用户在短时间内接收大量刺激，这可能使大脑长期处于一种浅层、快速处理信息的模式，从而消耗了用于深度加工和持续关注的认知资源。在神经层面，这表现为前额叶执行控制相关Theta功率的下降，进而影响了自我控制能力，使得个体难以维持长时间的专注，更容易受到干扰，并倾向于冲动决策。这些神经与行为学证据共同揭示了短视频对短期注意力消耗及其对自我控制的负面影响。
2.2 长期使用对注意力持续性的累积效应
长期过度使用“纯爽”短剧和短视频，可能对个体的注意力持续性产生累积性负面影响，主要表现为选择性注意阈值的降低和分心易感性的增加。这种效应与媒体内容的快速更迭和信息爆炸的大背景密切相关。
选择性注意阈值的降低
短视频的碎片化特性，要求用户在极短时间内对新信息做出反应，并迅速切换注意力焦点。这种频繁、快速的注意力切换模式，可能导致大脑逐渐适应于“浅层”和“宽泛”的注意力分配，而非“深入”和“持续”的专注。长时间暴露在这种刺激模式下，个体可能会发现自己更难以专注于需要长时间阅读、深度思考或单任务处理的活动，例如阅读长篇文字材料、学习复杂概念或从事需要高度集中的工作。高互动性和沉浸式技术如视频游戏和虚拟现实，在某些特定情境下能够即时提升注意力表现 1920，但对于长时间沉浸于碎片化内容的用户而言，其注意力阈值可能被整体性地拉低，使得他们需要更强的外部刺激才能保持专注。
分心易感性的增加
持续接收高度刺激和快速变化的信息，可能使得大脑对于外部干扰的抑制能力下降，从而增加分心易感性。这意味着用户在面对非短视频环境时，更容易受到周围环境中的细微变化或无关刺激的干扰，难以维持对当前任务的注意力。例如，在学习或工作时，即便没有手机在旁，个体也可能发现自己思维飘散，难以将注意力锚定在单一目标上。这种现象与注意缺陷多动障碍（ADHD）症状中的注意力不集中维度有相似之处，即在处理需要持续注意力的任务时，难以保持专注 21。虽然短视频并非直接导致ADHD，但其使用模式可能加剧或诱发类似ADHD的注意力分散症状。
此外，一项关于集体注意力的研究发现，随着内容生产和消费的加速，公众对单个文化项目的集体关注时间正在缩短，这表明人们的注意力广度可能正在普遍变窄，对新奇事物的需求也随之提高 22。短视频平台正是利用了这种对新奇和快速反馈的偏好，通过算法不断推送新鲜内容，进一步固化了用户对快速刺激的依赖，进而削弱了其在缺乏高强度刺激时维持注意力的能力。
目前，尽管有研究指出视频游戏可能用于ADHD患者的注意力康复训练，且具有较高的依从性 2324，但这些多为特定设计的“严肃游戏”，旨在通过结构化和目标导向的任务来训练注意力。这与“纯爽”短视频那种非结构化、以被动接收和即时娱乐为主的模式有本质区别。因此，我们需要更多纵向研究数据来明确过度使用“纯爽”短视频是否会导致个体选择性注意阈值的持续降低，以及其在多任务处理能力下降等方面的具体表现。
2.3 不同用户群体的差异表现
短视频使用对注意力集中度的影响并非一概而论，不同用户群体由于其神经发育阶段、认知稳定性及心理健康状况的差异，可能表现出不同程度的注意力受损。
青少年群体：神经发育未成熟的脆弱性
青少年期是大脑，特别是前额叶皮层（负责执行功能、冲动控制和注意力调节）发育的关键阶段。这一阶段大脑的可塑性高，但也意味着其更容易受到外部环境因素的影响。过度沉迷于“纯爽”短视频可能对青少年的注意力发展产生更为显著的负面影响。一项针对中学生的短视频成瘾量表研究显示，注意力集中困难是青少年短视频成瘾的五个主要维度之一，这表明短视频使用与青少年注意力问题之间存在紧密联系 25。另一项针对小学生的调查也发现，短视频使用时间越长，其学业成绩越低，而注意力在这一关系中起到中介作用，且父母的短视频使用行为会加剧这种负面影响 26。这提示，青少年由于其神经发育尚未完全成熟，对高强度、快节奏的短视频内容缺乏足够的认知控制和抑制能力，更容易形成依赖，进而导致注意力分散、难以专注。
成年人：认知稳定性与应对策略的差异
与青少年相比，成年人的大脑前额叶功能相对成熟，认知稳定性更强，因此对于短视频的负面影响可能表现出一定的抵抗力。然而，这并非意味着成年人完全免疫。研究显示，成年人ADHD症状（特别是注意力不集中和多动冲动）与问题性短视频使用（PSVU）之间存在显著关联 21。注意力不集中维度会通过加剧无聊感倾向间接影响PSVU，而多动冲动维度则通过认知重评、情绪困扰和无聊感倾向共同影响PSVU 21。这表明，即使在认知功能相对稳定的成年人中，如果存在注意力缺陷或情绪调节障碍，也可能更容易受到短视频的吸引，并发展出问题性使用，进而加剧注意力问题。此外，智能手机成瘾与大学生自我报告的注意力缺陷症状和睡眠质量下降之间也存在关联，进一步印证了即使是成年人，过度使用屏幕媒体也会影响其注意力 27。
心理障碍者：脆弱性与代偿性依赖
对于患有心理障碍的个体，如抑郁症、焦虑症患者，短视频可能被用作一种情绪调节或逃避现实的策略，从而更容易形成过度使用甚至成瘾。例如，情绪困扰（包括焦虑和抑郁）被发现是ADHD症状与问题性短视频使用之间的中介因素 21。在疫情期间的研究也表明，负面情绪，如对COVID的焦虑，会增加社交媒体成瘾的风险 28。这些个体在寻求短暂的情绪慰藉时，可能无意识地陷入短视频的即时满足循环，这不仅无法根本解决其心理问题，反而可能加重注意力不集中、决策能力下降等认知症状。对于这些脆弱群体而言，短视频的成瘾风险更高，且可能与他们已有的心理健康问题相互作用，形成恶性循环，导致注意力受损程度更为严重。
综上所述，虽然“纯爽”短视频对各类人群的注意力都可能产生影响，但青少年由于神经发育的特殊性更易受损；成年人则可能在存在既有认知缺陷或情绪障碍时表现出更大的脆弱性；而心理障碍者则可能通过代偿性使用加剧其注意力问题，形成更深层次的依赖。因此，在评估和干预短视频使用对注意力的影响时，必须充分考虑不同用户群体的个体差异。
3.1 对基础认知能力的直接作用
“纯爽”短剧和短视频的快速、高强度刺激模式，可能直接影响个体的工作记忆和抑制控制等基础认知能力。行为实验和神经影像学研究为这些影响提供了证据。
工作记忆的影响
工作记忆是指在短时间内存储和操作信息的能力，它是进行复杂认知任务（如理解、学习、推理）的基础。短视频内容的碎片化和快速切换，可能导致信息编码效率的降低。一项研究指出，当连续事件过长以至于无法被工作记忆完全容纳时，心理重放的时间会显著小于实际事件的持续时间，这表明工作记忆在处理连续事件时存在时间限制，从而可能导致情节记忆中的时间压缩 29。短视频的超快节奏和多变情境，可能迫使大脑频繁地加载和卸载信息，这种模式不利于深度编码和信息整合，从而可能影响工作记忆的效率。长期暴露于这种快速流转的信息流中，个体可能更难以有效地保持和操作复杂信息，表现为对新信息的记忆能力下降或信息处理速度变慢。
抑制控制的影响
抑制控制是执行功能的核心组成部分，指个体抑制不相关信息或冲动反应的能力，对于理性决策和行为调节至关重要。短视频通过不断提供即时满足感，可能削弱个体延迟满足和抑制冲动行为的能力。神经影像学研究为这一观点提供了支持。
有证据表明，短视频成瘾与大脑特定区域的活动变化相关。例如，一项利用功能性近红外光谱（fNIRS）技术对大学生进行的研究发现，在有短视频背景提示的情况下，短视频成瘾者在风险决策任务中表现出更高的冒险倾向、更短的反应时间和更高的气球爆炸率 30。这表明短视频提示会促使成瘾者做出更冲动的决策。神经数据进一步显示，与健康对照组相比，短视频成瘾者在右侧眶额皮层（OFC）和右侧额极区（FPA）在有短视频提示的风险决策过程中表现出更高的激活 30。OFC与奖励评估和决策相关，FPA则参与高级认知控制。此外，短视频成瘾者对损失结果表现出更大的敏感性，在面临损失时，OFC表现出显著激活，而对收益则无此现象 30。这表明，短视频成瘾可能改变了大脑对奖励和惩罚的敏感度，使得个体更倾向于避免损失而非追求收益，从而影响其决策行为。
另一个关键区域是背外侧前额叶皮层（DLPFC）。DLPFC在工作记忆、认知控制和抑制冲动行为中发挥关键作用 3132。例如，在网络游戏障碍（IGD）患者中，DLPFC的功能连接密度（rsFCD）增加，这可能是一种维持正常行为表现的代偿机制 31。然而，短视频成瘾（SVA）严重程度与DLPFC的自发活动增强呈正相关 33，这可能反映了大脑在努力维持对冲动行为的抑制。一项针对网络游戏障碍的研究也发现，在戒断期前后，女性IGD患者的左侧DLPFC参与度较低，这可能表明其执行控制能力受损，从而更难戒断游戏 34。对于短视频成瘾者而言，DLPFC在奖励损失情境下的异常激活 30，以及其与短视频成瘾严重程度的正相关 33，都暗示了其抑制控制功能的潜在受损。持续接触即时奖励和低认知负荷的短视频内容，可能逐渐削弱DLPFC对冲动行为的抑制能力，使得个体更难以抵制即时诱惑，从而导致冲动决策倾向增加。
这些发现共同揭示了“纯爽”短视频可能通过影响工作记忆的效率和削弱抑制控制能力，从而对基础认知能力产生直接的负面作用，尤其是在有短视频提示或面临损失的情境下，这种影响更为显著。
3.2 对高阶认知（逻辑推理/抽象思维）的间接影响
“纯爽”短剧和短视频的长期过度使用不仅影响基础认知能力，更可能通过间接途径损害高阶认知功能，如逻辑推理和抽象思维。这主要体现在碎片化信息摄入对知识体系构建的阻碍以及算法推荐导致的认知窄化效应。
碎片化信息摄入对知识体系构建的阻碍
“纯爽”短剧和短视频以其高度压缩、快节奏的特性，通常提供的是零散的、去语境化的信息点。这种消费模式鼓励用户快速浏览、即时理解，而非深入分析、批判性思考。长期接受这种碎片化信息，可能会导致个体难以构建系统、完整的知识体系。深度理解能力（Deep Understanding）的下降是其显著表现之一。深度理解要求个体能够整合多个信息片段，识别其内在联系，构建复杂的概念模型，并应用于新的情境。而短视频往往省略了论证过程和背景知识，直接呈现结论或“爽点”，使得观众习惯于被动接受信息，而非主动探究其深层含义和逻辑链条。
当人们习惯于从短视频中获取快速、简化的信息时，他们可能失去对长篇阅读、复杂论证的耐心和能力，从而难以进行需要持续注意力投入和多维度信息整合的逻辑推理和抽象思维活动。例如，有研究发现，健康信息系统的碎片化和子系统之间的不协调，可能会导致对信息的理解和利用受阻，影响决策 35。这种认知习惯的改变，可能会阻碍个体在学习、工作乃至日常生活中进行有效的复杂问题解决和创新性思考。
算法推荐导致的认知窄化（信息茧房效应）
短视频平台的核心竞争力之一在于其强大的个性化推荐算法。这些算法通过分析用户的观看历史、点赞、评论等行为数据，持续推送用户可能感兴趣的类似内容，以最大化用户停留时间。尽管这在一定程度上提升了用户体验，但也极易导致“信息茧房”效应 36。
“信息茧房”是指用户被困在由算法过滤和个性化推荐所构建的信息世界中，只能接触到符合其既有偏好或算法判断为“喜欢”的内容，而难以接触到多样化的、挑战其固有观念的信息。例如，研究表明，人们倾向于咨询与自己政治观点相似的人，即使在非政治领域，这种偏好也会导致人们错误地认为这些“同类”在其他领域也更具能力 36。虽然这项研究是关于政治观点，但其揭示的“同质化信息偏好”对认知的影响机制是普遍的：当算法持续强化用户对特定类型短剧（如复仇爽剧）或短视频（如搞笑段子）的偏好时，用户接触其他类型内容的机会便会减少。
这种认知窄化会间接影响逻辑推理和抽象思维能力：
- 限制批判性思维的发展：当个体长期处于信息同质化的环境中，缺乏对不同观点、多角度信息的接触和碰撞，其质疑、分析和评估信息的能力可能会逐渐退化。这阻碍了其形成全面、客观的认识，从而难以进行有效的批判性思维。
- 固化思维模式：算法推荐的同质化内容可能强化用户已有的思维定势，使其难以接受或理解新的、复杂的概念，从而限制了抽象思维和创新能力的培养。例如，如果用户只看表层化的娱乐内容，而非能引发深度思考的纪录片或科学短片，其进行归纳、演绎、类比等抽象思维训练的机会就会减少。
- 阻碍知识广度的拓展：信息茧房使得用户的信息获取范围变窄，从而可能导致知识结构失衡，对某些领域的理解变得片面甚至形成偏见，这无疑会削弱其进行跨领域逻辑推理和解决复杂问题的能力。
综上，碎片化信息摄入模式和算法驱动的信息茧房效应，共同构成了“纯爽”短剧和短视频对高阶认知能力（特别是逻辑推理和抽象思维）的间接损害路径，可能导致用户深度理解能力下降，并陷入认知窄化的困境。
3.3 认知损害的可逆性与阈值
虽然过度使用“纯爽”短剧和短视频可能导致认知损害，但这些损害并非不可逆转。戒断实验和相关研究表明，停止或减少使用后，某些认知功能存在恢复的可能性，并且认知损害程度可能存在一个“剂量-效应”关系，即存在“适度使用”与“过度使用”的分界点。
戒断后的认知功能恢复
多项针对网络成瘾和游戏障碍（Internet Gaming Disorder, IGD）的研究为认知功能的可逆性提供了证据。IGD被认为是与短视频成瘾相似的行为成瘾类型之一，并被定义为对视频游戏或数字游戏的持续或反复使用，导致个人、家庭、社会、教育或职业功能出现严重损害37。在针对IGD患者的戒断或干预研究中，观察到部分认知功能的改善。例如，一项研究发现在对网络游戏障碍患者进行认知行为疗法（CBT）干预后，其执行功能（特别是抑制控制）和工作记忆能力得到显著提升。这表明，通过停止或减少导致认知损害的行为，大脑能够展现出一定的可塑性，从而修复受损的认知功能。尽管目前直接针对短视频成瘾的长期戒断实验数据相对较少，但鉴于其与IGD在行为学上的相似性以及二者都涉及对屏幕内容的过度沉迷38，可以合理推断，停止过度使用短视频也有助于认知功能的恢复。
然而，恢复的周期和程度可能因个体差异、成瘾严重程度以及戒断方法而异。例如，一些神经认知障碍（如血管性痴呆）在针灸等治疗后，认知功能与特定神经递质（如miR-143-3p）水平的变化呈负相关，提示生物学指标的改善可能伴随着认知功能的恢复39。这为短视频戒断后的认知恢复提供了潜在的生物学机制支持。
“适度使用”与“过度使用”的分界点
确定“适度使用”与“过度使用”的明确分界点是一个复杂的问题，因为认知损害的发生是一个连续谱，并且受到个体脆弱性、内容类型、使用情境等多种因素的影响。然而，一些研究尝试从使用时长和成瘾症状的出现来界定这一阈值。
尽管目前尚未有全球公认的日均使用时长阈值来区分短视频的“适度”与“过度”，但多数研究倾向于将导致显著功能损害（如学业、工作、社交、睡眠受损）作为“过度使用”的标志4041。例如，有研究表明，短视频成瘾与青少年睡眠质量下降和社会焦虑的增加显著相关，其中短视频成瘾对睡眠质量的直接影响占总效应的62.4%40。当短视频使用开始影响睡眠、导致社交回避或影响学业/工作表现时，这通常被视为过度使用的信号。
从心理学角度看，如果个体出现以下行为特征，则可能已越过“适度使用”的界限：
- 强迫性观看：即使没有兴趣也难以停止滑动观看，如同被某种力量驱使。
- 时间失控：计划只看几分钟，却不知不觉花费数小时，导致其他重要活动被挤占。
- 戒断反应：一旦无法观看短视频就感到焦虑、烦躁、空虚或不安。
- 功能损害：因短视频使用导致学业成绩下降、工作效率降低、人际关系紧张或身体健康问题（如视力下降、颈椎问题、睡眠不足）。
值得注意的是，不同个体对“刺激”的阈值和认知负荷的承受能力存在差异。对于青少年而言，由于其神经发育未成熟，可能对较短的使用时长也会表现出负面影响。一项对中国大学生短视频成瘾影响因素的系统性回顾指出，虽然未直接提及小学生，但强调了短视频成瘾的普遍性及其对心理、行为、社会等多个方面的影响42。这提示，针对不同年龄段和个体特征，其“安全”的使用时长阈值可能存在差异。
未来研究需要更精细地量化“剂量-效应”关系，例如通过纵向研究追踪不同使用时长下个体认知功能的动态变化，并结合神经影像学指标，以期建立更为科学和个性化的“适度使用”建议。
4. 短视频成瘾的机制：从行为到神经的多维解析
4.1 行为依赖的量化评估
短视频的“纯爽”特性使其具有潜在的成瘾风险，这种行为依赖可以通过一系列量化工具进行评估。其中，“短视频依赖量表”（Short-Video Dependence Scale, SVDS）是近年来开发并验证的科学工具，旨在准确测量短视频依赖的程度，并确定诊断性截止点43。该量表结合了对115名高频短视频用户访谈的总结和《精神疾病诊断与统计手册第五版》（DSM-5）中行为成瘾的标准而设计43。
SVDS最终版本包含20个项目和4个维度，这些维度反映了短视频行为依赖的核心特征43：
- 强迫性使用（Compulsive Use）：指个体对短视频产生强烈的观看冲动，难以自控，即使意识到负面后果也无法停止。高依赖用户常表现出对短视频的过度投入，即使有其他更重要的任务也难以抵制观看的欲望。
- 时间管理失控（Time Management Maladjustment）：这是短视频依赖的一个关键特征，表现为观看短视频的时间超出预期，导致学业、工作或日常活动受到负面影响。例如，大学生互联网成瘾水平与时间管理技能呈显著负相关44，短视频依赖也同样表现出这种特征。高依赖者可能会熬夜刷视频，导致睡眠不足，甚至出现白天疲劳和认知能力下降454647。这种失控感也常在青少年群体中体现，他们缺乏自控力，难以有效管理上网时间484950。
- 耐受性（Tolerance）：随着使用时间增加，个体需要观看更长时间或更刺激的内容才能达到同样的满足感。这与游戏成瘾等其他行为成瘾表现出相似的耐受特征51。
- 戒断症状（Withdrawal Symptoms）：当无法使用或减少使用短视频时，个体会出现心理或生理上的不适，如烦躁、焦虑、空虚感等。
通过SVDS量化评估，研究者发现，得分达到58分可作为区分依赖用户和高频非依赖用户的最佳截止点43。此外，潜变量分析（Latent Profile Analysis）识别出了5种不同的短视频依赖类别模型，这有助于更精细地理解用户群体的差异43。
高依赖用户的行为特征不仅限于量表指标，还在日常生活中显现：
- 熬夜刷视频与睡眠障碍：许多高依赖用户为了观看短视频而牺牲睡眠时间。研究表明，智能手机成瘾（其中短视频是主要内容之一）与睡眠质量下降之间存在显著关联，特别是医学生群体中，智能手机成瘾导致睡眠质量差和学业成绩下降4546。巴基斯坦的研究也发现，玩手机游戏是影响寄宿学生睡眠的常见因素之一，尽管该研究未能证明其与学业成绩的直接关联52。
- 社交回避与孤独感：过度沉迷于短视频可能导致个体减少现实世界的社交互动，转而寻求虚拟世界中的满足感。有研究指出，社交分离（social detachment）是游戏成瘾的预测因素之一51，同样，短视频依赖也可能导致类似的结果。尽管短视频平台提供了社交功能，但这种虚拟互动往往无法替代现实生活中深层次的人际连接，反而可能加剧孤独感，并导致社交技能的退化。
- 学业或工作功能损害：时间管理失控直接导致学习和工作效率下降，表现为学业成绩不佳、工作任务延误等。例如，在青少年群体中，互联网成瘾与学业成绩下降、父母不限制上网时间以及抑郁情绪等因素紧密相关49。智能手机成瘾对医学生学业成绩（GPA）的负面影响也得到证实46。
- 情绪性依赖：个体可能利用短视频来逃避负面情绪，如孤独、压力或无聊。这种情绪补偿机制会进一步强化短视频的使用习惯，形成恶性循环。有研究发现，情绪依赖是游戏成瘾的预测因素之一51，同样，在短视频依赖中，个体也可能发展出类似的情绪依赖。有研究发现，青少年智能手机成瘾与抑郁、痛苦、孤独和睡眠不足等问题存在复杂关联，揭示了不同潜在一代成瘾类型53。
总而言之，短视频依赖不仅仅是一种时间消耗，更是一种复杂的行为模式，涉及生理、心理和社会多个层面的功能损害。SVDS等工具的开发，为我们更深入地理解和干预这种新型行为成瘾提供了科学依据。
4.2 神经奖励系统的异常激活
“纯爽”短剧和短视频之所以具有强烈的成瘾潜力，很大程度上归因于它们能够高效且频繁地激活大脑的神经奖励系统，形成一种“即时反馈-多巴胺释放”的循环。这一循环是行为成瘾（包括互联网游戏障碍和物质成瘾）的共同神经生物学基础 54555657。
多巴胺（Dopamine）与奖励回路
多巴胺是一种重要的神经递质，在大脑的奖励、动机、学习和愉悦感中扮演核心角色。当个体进行能带来愉悦或满足感的行为（如进食、性、社交互动，以及观看“纯爽”短视频）时，大脑会释放多巴胺。这种多巴胺的释放主要发生在腹侧被盖区（VTA）投射到伏隔核（NAcc）的奖赏通路中，即中脑边缘通路 58。伏隔核是大脑奖励回路的关键组成部分，与动机、奖励预期和强迫性行为密切相关 5960。短视频通过其快速、高强度的内容刺激和即时反馈机制，能够频繁且迅速地触发伏隔核的多巴胺释放，产生即时的“爽感”和满足感，从而强化观看行为。
“即时反馈-多巴胺释放”循环的形成
“纯爽”短剧和短视频的特征，如紧凑的剧情、高密度的冲突、快速的反转、以及算法根据用户偏好持续推送类似内容，都完美契合了大脑奖励系统的运作方式：
- 即时满足与快速反馈：短视频通常在几十秒内提供一个完整的情绪高潮或“爽点”，这是一种即时且高强度的奖励。这种即时性使得大脑能够快速建立起“观看短视频 = 愉悦”的关联。
- 多巴胺释放与行为强化：每当用户体验到这种愉悦时，伏隔核的多巴胺水平升高，这种神经化学变化会激励个体重复该行为。研究表明，在网络成瘾中，奖励系统（如伏隔核和内侧眶额皮层）的功能连接改变被认为与多巴胺失调有关 5860。
- 预测性奖励与渴求（Craving）：随着重复观看，大脑开始预测观看短视频将带来的奖励。即使在没有实际观看时，与短视频相关的提示（如手机通知、应用图标、或特定的背景音乐）也能激活奖励回路，引发强烈的渴求感（craving）。这种渴求感是成瘾行为的重要驱动力 61。
对决策控制区与奖励区连接的影响
长期沉浸在“即时反馈-多巴胺释放”的循环中，可能导致大脑中负责决策控制和抑制冲动的前额叶皮层（特别是背外侧前额叶皮层DLPFC和眶额皮层OFC）与奖励区域（如伏隔核）之间的功能连接发生改变，通常表现为连接减弱。
- 前额叶皮层功能受损：DLPFC和OFC是高级认知功能（如计划、决策、抑制控制、风险评估）的关键区域 30566263。在网络游戏障碍（IGD）患者中，DLPFC和OFC等区域的结构或功能受损已被广泛报道 566465。例如，IGD患者的眶额皮层和左侧DLPFC的激活度较低 64。
- 连接减弱与冲动控制下降：研究发现，在IGD患者中，VTA到伏隔核和内侧眶额皮层的功能连接减弱，这可能导致多巴胺奖励信号和显著性归因的异常 5860。这种连接异常使得成瘾者在面对诱惑时，难以进行理性的决策和有效的自我控制，从而表现出更高的冲动性和冒险行为 3065。
- 奖赏敏感性异常：短视频成瘾者可能对短视频相关的奖励高度敏感，但对其他类型的奖励（如延迟满足、学习成就）的敏感性可能降低，从而进一步巩固了对短视频的依赖。他们可能表现出更高的风险偏好，尤其是在有短视频提示的决策情境中，右侧眶额皮层和右侧额极区显示出更高的激活，且对损失结果更为敏感 30。
综上所述，短视频通过其特有的“即时反馈-多巴胺释放”机制，不断强化观看行为，并最终可能导致大脑奖励系统与决策控制区域之间的功能失衡，使得个体对短视频产生强烈的行为依赖，难以自拔。
4.3 心理动机的驱动因素
短视频之所以能牢牢吸引用户，除了神经奖励系统的作用外，还深植于复杂的心理动机。这些动机，尤其是情绪补偿和社交替代，显著强化了短视频的使用频率和依赖性，对于心理障碍群体而言，短视频甚至成为一种“代偿性依赖”的途径。
情绪补偿：缓解孤独、压力和负面情绪
许多个体将短视频作为一种应对负面情绪（如孤独、压力、焦虑、抑郁或无聊）的机制。当感到孤独或压力时，短视频提供了一个即时的、低成本的逃避现实或分散注意力的出口。研究发现，压力和孤独感是问题性赌博和游戏行为的重要预测因素 66。同样，在短视频使用中，个体可能通过观看短视频来暂时缓解这些不适感。例如，在COVID-19大流行期间，心理困扰（如焦虑和压力）与问题性互联网使用（包括社交媒体滥用）的风险增加密切相关 67。另一项针对青少年游戏成瘾的研究也指出，感知到的压力和孤独感与游戏成瘾呈正相关 68。短视频作为一种易于获取且持续提供新鲜刺激的娱乐形式，能够有效填补心理上的空白，提供短暂的愉悦和放松。然而，这种情绪补偿往往是短暂的，长期来看，它可能无法解决根本问题，反而加剧了对短视频的依赖，形成恶性循环。当个体习惯于通过短视频来调节情绪时，其发展出更健康的应对机制（如积极解决问题、寻求真实社交）的能力可能受到削弱。
社交替代：虚拟互动满足归属感
人类是社会性动物，对归属感和社交互动有着内在需求。当现实生活中的社交互动不足或质量不高时，短视频平台提供的虚拟社交功能（如点赞、评论、分享、直播互动等）可能成为一种社交替代，从而满足部分社交需求，强化使用动机。
尽管虚拟社交无法完全取代面对面的互动，但对于一些用户，特别是那些在现实社交中感到困难或孤独的个体而言，短视频提供了一个相对安全、门槛较低的社交场域。研究表明，虚拟社交互动能够增加隐性学习 69。在某些情况下，过度沉浸于虚拟世界甚至被视为一种应对现实生活压力的“成瘾”，尽管这种“成瘾”有时也被用户解读为对兴趣和社区的“热情” 70。对于心理障碍大学生群体，研究发现他们常常表现出消极的认知倾向、负面情绪和缺乏社会支持，这些因素共同驱动他们消费短视频内容，以在虚拟环境中满足未被满足的社会需求 71。短视频为他们提供了一个自我表达和获得情感支持的途径，但同时也可能对他们的身心健康产生负面影响 71。
心理障碍群体的“代偿性依赖”
对于患有抑郁、焦虑、孤独等心理障碍的个体，短视频的吸引力尤为显著。他们可能将短视频作为一种自我治疗或自我麻醉的手段，试图通过沉浸于虚拟的“纯爽”内容来逃避或缓解现实生活中的痛苦和不适。这种现象被称为“代偿性依赖”。
例如，孤独感是游戏成瘾的预测因素，并且屏幕成瘾（包括社交媒体滥用）与孤独感的普遍存在和程度显著相关 6672。当个体感到孤独时，短视频可以提供一种“伪连接”或“伪陪伴”感，暂时缓解内心的空虚。然而，这种代偿行为往往适得其反，长期来看，过度沉迷于短视频可能进一步削弱其现实社交能力，加剧孤独感。一项对芬兰人的纵向研究表明，孤独感会增加游戏问题的发生，尽管其对赌博问题的影响不显著 66。另一项关于游戏障碍的元分析也发现，孤独感是游戏障碍的预测因素之一 73。这些发现强调了心理脆弱性在推动行为成瘾中的作用。
此外，短视频的即时反馈机制，对情绪调节能力较差的个体具有强大的吸引力。他们可能难以承受现实生活中的挫折和延迟满足，转而寻求短视频提供的快速、简单的情绪提升。这不仅导致了对短视频的过度依赖，也阻碍了他们发展出更有效的心理韧性和应对策略。因此，短视频对于心理障碍群体来说，更像是一把双刃剑：它可能提供短暂的慰藉，但更可能成为一种难以摆脱的“精神鸦片”，加重其原有的心理健康问题，并形成恶性循环。
5. 争议与平衡：短视频的非“毒品”属性与潜在价值
5.1 适度使用的无害性证据
尽管关于“纯爽”短剧和短视频对认知功能潜在负面影响的担忧日益增多，但将所有短视频使用简单地归类为精神“毒品”可能过于武断。现有研究表明，在“非成瘾性中度使用”的背景下，短视频可能并不会导致显著的认知损害，甚至在某些情况下还能带来积极效益。这强调了“剂量-效应”关系的重要性，即使用时长和方式是决定其影响的关键因素。
首先，许多研究并未发现适度使用屏幕媒体与认知损害之间存在直接的负相关关系。例如，一项针对儿童和青少年的系统性回顾指出，屏幕时间的有害影响通常与“屏幕时间”的简单时长指标相关联，而忽视了“屏幕使用情境”的复杂性 7475。换句话说，重要的不是使用了多少时间，而是如何使用以及使用了什么内容。该研究发现，共同使用（如父母与孩子一起观看）与积极的认知成果（如语言发展）呈正相关 74。这表明，在有指导、有选择性的情境下，屏幕媒体可以是中性甚至有益的。另一项针对农村地区居民的短视频消费研究发现，短视频在一定时期内能改善精神健康，主要通过提供娱乐和信息获取，而非社交互动 76。这提示，对于特定群体，短视频在提供精神慰藉方面具有潜在价值。
其次，在认知功能领域，并非所有视频内容都具有负面影响。例如，视频处理技术已被用于评估老年人的认知运动表现，提示视频本身可以作为一种工具来监测和可能促进认知健康 77。此外，教育类视频资源也被证明能有效改善医学生对残疾儿童的态度，提升其专业认知 78。这些案例表明，视频作为一种媒介形式，其对认知的影响取决于内容的设计和用途。
再者，一些研究指出，即便在屏幕使用时间较长的情况下，如果内容具有教育性或旨在促进积极的认知活动，其影响也可能不同。例如，早期的研究发现，特定类型的久坐行为（如阅读）与儿童认知发展的有益关联，而另一些类型（如看电视）则存在负面关联 79。这提示我们不能将所有“屏幕时间”或“视频观看”一概而论。
关键在于区分“适度使用”与“过度使用”的界限。如果个体能够有效控制短视频的使用时长，确保其不干扰日常生活、学习、工作和社交活动，并且能够主动选择高质量、有益的内容，那么这种使用模式可能并不会对认知功能造成显著损害。相反，一些非成瘾性中度使用的用户，其心理健康指标可能保持正常，甚至能在短视频中获得放松、娱乐或获取新知。
综上所述，虽然“纯爽”短剧和短视频的潜在危害值得警惕，但我们必须避免一概而论。在适度、有意识的使用下，它们可能并非“精神毒品”，甚至在特定情境下能提供积极的价值。未来的研究需要更深入地探讨不同使用模式和内容类型对认知功能和心理健康差异化的影响，以便更精确地界定“适度”与“过度”的阈值。
5.2 内容类型的异质性影响
将“纯爽”短剧和短视频一概而论，忽略内容类型的差异，可能会对短视频对认知功能的影响得出片面结论。实际上，不同类型的内容对认知功能的影响存在显著的异质性。教育类、知识类短视频与纯娱乐类内容相比，对认知的促进或损害作用大相径庭。
教育类与知识类短视频对认知功能的潜在促进作用
教育和知识类短视频，如科普短片、技能教程、历史讲解等，其设计目标是传递信息、启迪思维，而非单纯追求感官刺激。这类内容在特定条件下甚至可以提升某些认知能力：
- 提升特定领域的知识和理解：例如，一些教育性视频被设计用于在极短时间内（如5分钟）教授新的数学概念。研究表明，观看这类视频可以在短时间内帮助受试者理解新领域的知识。虽然这种短时学习可能主要激活的是情景短时记忆相关的全脑区域，但对于快速获取特定信息，其有效性不可否认，且对大脑数学响应网络的长期改变有限 80。
- 改善学习效率与信息获取：对于文化程度较低或识字能力有限的患者，视频可能比书面材料更有效地提高他们对健康信息的理解。例如，一项研究发现，视频在提高低识字水平患者对睡眠呼吸暂停定义和持续气道正压通气（CPAP）作用的理解方面，显著优于书面材料 81。这表明，视频作为一种多模态信息呈现方式，能够降低认知负荷，有助于信息传递和记忆。
- 促进视觉空间推理和逻辑思维：部分优质的教育短视频会通过可视化、动画模拟等方式，将抽象概念具象化，有助于用户理解复杂系统或过程。例如，一些解谜类、科学实验类短视频通过展示问题解决过程，可能间接训练用户的逻辑推理能力。
- 提供有效的信息来源：许多短视频平台（如YouTube）包含了大量关于健康和疾病的科普视频，这些视频在一定程度上可以作为患者及其家属获取治疗信息的重要来源，尽管其质量参差不齐 828384。
纯娱乐类内容对认知功能的潜在负面影响
与教育类内容形成鲜明对比的是以“纯爽”为核心的娱乐短剧和短视频。这类内容往往牺牲了深度和复杂性，专注于提供即时的情绪刺激和感官快感，其对认知功能的影响则偏向负面：
- 注意力涣散与浅层信息处理：纯娱乐短视频以其快节奏、高刺激的特点，不断吸引和分散用户的注意力，鼓励用户在短时间内进行频繁的注意力切换，而非深入处理信息。长期如此，可能导致用户习惯于浅层信息处理，难以进行深度阅读和长时间专注，从而损害持续性注意力。
- 认知负荷与信息过载：虽然单个娱乐短视频的信息量看似不大，但连续观看大量这类视频，其信息轰炸效应可能导致认知负荷过大，从而影响工作记忆和信息编码效率。
- 阻碍高阶认知能力发展：纯娱乐内容通常缺乏结构化的知识体系和复杂的逻辑论证，长期沉浸其中，可能减少个体进行逻辑推理、抽象思维和批判性思考的机会。内容的简单化和快餐化，可能使得用户习惯于被动接受，而非主动分析和整合信息。
- 强化即时满足偏好：娱乐短视频提供的即时“爽感”不断强化了大脑的即时满足偏好，可能削弱个体延迟满足和抑制冲动的能力，进而影响执行功能中的抑制控制能力。
内容质量的调节效应
除了内容类型，内容质量在调节短视频对认知功能影响中也扮演着关键角色。高质量的教育或知识类短视频能够以清晰、准确、有趣的方式呈现信息，从而最大化其教育价值和认知促进作用。然而，即使是教育类视频，其质量也可能存在问题，如信息不准确、解释不清、设计粗糙等，这会削弱其积极作用，甚至产生误导 82。
例如，对于口腔上皮发育不良（OED）的视听在线信息质量评估发现，尽管大部分内容为科学性质，但整体质量普遍较差（DISCERN评分均值2.26±0.79），且可操作性分数显著偏低（29%），这表明即使是看似教育性的视频，也可能因质量问题而未能有效传递信息 82。
因此，区分短视频内容类型和关注其质量至关重要。不能因“纯爽”短剧的负面效应而否定所有短视频的价值。高质量的教育和知识类短视频在特定情境下，可以作为有效的工具，促进认知发展和知识获取，而过度消费低质量、纯娱乐化的“纯爽”内容则更容易导致认知功能的损害。
5.3 技术干预的正向可能
面对“纯爽”短剧和短视频可能带来的认知功能损害及成瘾风险，技术本身也具备反向干预和治理的潜力。通过算法优化、内容分级以及更前沿的脑机接口技术，可以在一定程度上减少有害使用，引导用户形成更健康的数字习惯。
算法优化：从“沉迷”走向“健康”
短视频平台的核心在于其强大的推荐算法，这些算法在过去主要目标是最大化用户停留时间。然而，通过对算法进行优化，可以使其在商业利益与用户福祉之间找到平衡点，从而减少有害使用：
- “防沉迷”模式与时长限制：许多短视频平台已开始推行“青少年模式”或“防沉迷系统”，通过限制每日使用时长、夜间禁用、强制休息提醒等功能，从技术层面干预用户过度使用行为。例如，当用户达到一定观看时长后，系统会弹出提醒或强制下线。这些模式的有效性正在不断提升，旨在帮助用户，特别是青少年群体，管理自己的使用时间，避免沉迷。
- 增加深度内容权重：当前算法往往偏好高互动性、高完播率、短平快的内容。通过调整推荐算法，可以适当增加教育类、知识类、长视频或有深度思考价值内容的推荐权重。例如，平台可以探索新的指标来评估内容的“价值性”而非仅仅“吸引力”，如用户对内容的收藏、转发、深度评论等，从而引导用户接触更多高质量、有益于认知的多样化内容。一项对登革热相关短视频质量评估的研究指出，平台可考虑采用算法优化或内容推荐机制，鼓励用户访问并参与更多高质量的健康科学视频 85。对于双相情感障碍相关短视频的研究也建议平台管理部门、创作者培训和算法优化可以促进公众精神健康素养的提高 86。
- 个性化干预与提醒：基于用户使用数据，算法可以识别出具有成瘾倾向的用户，并提供个性化的干预措施。例如，针对性地推送关于健康使用手机习惯的视频，或在用户连续观看同一类型“纯爽”内容过久时，推荐不同类型的内容，以打破“信息茧房”和“爽感循环”。
内容分级与质量审核：提升内容生态健康度
严格的内容分级制度和持续的质量审核是减少短视频负面影响的关键：
- 细化内容分级标准：目前短视频内容分级仍处于初级阶段，可以借鉴电影、游戏行业的分级经验，根据内容的刺激程度、暴力、色情、争议性等维度进行更细致的分级。特别是对于“纯爽”短剧，可以根据其可能引发的情绪波动、价值观导向进行评估，并限制未成年人的接触。
- 加强专家审核与用户举报：除了AI审核，引入领域专家对短视频内容进行人工审核，确保内容的科学性、价值观的正确性。同时，完善用户举报机制，鼓励用户积极参与内容治理，及时清除低质量、有害内容。
- 鼓励高质量内容创作：平台可以通过激励机制，如提供流量扶持、收益分成倾斜等，鼓励专业机构、教育工作者、科普达人创作高质量、有益于认知发展的内容，从而优化整体内容生态。
脑机接口（BMI）在成瘾干预中的应用潜力
脑机接口技术作为一种前沿的神经技术，在治疗成瘾方面展现出巨大的潜力，尽管目前主要应用于物质成瘾和精神疾病，但其原理对行为成瘾也具有借鉴意义：
- 深度脑刺激（DBS）：深度脑刺激是一种通过植入电极向特定脑区发送电脉冲来调节神经活动的疗法。目前，DBS已在帕金森病、抑郁症等治疗中显示出疗效。对于成瘾，DBS可以通过调节与奖励回路、冲动控制相关的脑区（如伏隔核、前额叶皮层）的活动，以降低渴求感和增强自控能力 87。未来的研究可以探索DBS在重度短视频成瘾患者中的应用，帮助其恢复正常的神经回路功能。
- 闭环脑机接口：闭环脑机接口技术能够实时监测大脑活动，并在检测到与成瘾行为相关的神经信号时，立即进行干预性刺激。例如，当识别出与短视频渴求相关的特定神经模式时，系统可以自动发送电刺激来抑制这种渴求，或激活与抑制控制相关的脑区 8788。这种按需调控的精准干预，有望实现对成瘾行为的个性化、实时化管理。
- 神经反馈训练：非侵入性脑机接口技术（如EEG神经反馈）可以通过训练个体主动调节自身脑电活动，从而改善认知功能和情绪状态。对于短视频成瘾者，可以通过神经反馈训练来增强前额叶的执行控制能力，降低对即时奖励的敏感性，从而提高抵制诱惑的能力。
尽管脑机接口技术在成瘾干预方面仍处于研究阶段，但其作为一种直接作用于神经回路的精准疗法，为未来治疗重度短视频成瘾提供了新的方向。结合算法优化和内容分级等宏观管理手段，技术干预有望构建一个更健康、更可持续的短视频生态，减少其对个体认知功能和心理健康的负面影响。
6. 干预策略与未来研究方向
6.1 个体层面的认知行为训练
鉴于“纯爽”短剧和短视频对认知功能和心理健康的潜在负面影响，发展有效的干预策略至关重要。个体层面的认知行为训练（Cognitive Behavioral Training, CBT）被认为是应对行为成瘾，包括短视频依赖的有效方法，其核心在于帮助个体识别、挑战并改变导致问题行为的思维模式和行为习惯 89。
自我控制提升：时间管理与行为习惯重塑
- 时间管理策略：教导个体规划和限制短视频使用时间，例如使用番茄工作法将观看时间碎片化并与学习/工作任务穿插，或设定每日观看时长上限并通过应用程序进行监控 90。制定明确的“屏幕时间”规则，并严格执行，有助于培养健康的数字习惯 91。
- 环境控制：减少接触短视频的诱因，如在学习或工作时关闭手机通知，将手机放置在不易触及的地方，或在特定时间段内将手机设置为飞行模式。创造一个有利于专注的环境，避免“无意识”刷视频的行为。
- 替代活动培养：鼓励个体发展短视频之外的兴趣爱好和活动，如体育锻炼、阅读、与朋友面对面交流、发展创造性技能等 92。研究表明，参与多样化的活动有助于减少对单一行为的过度依赖。
- 自我监控与记录：引导个体记录自己的短视频使用时长、观看内容及观看时的情绪状态，从而提高自我觉察能力，识别触发过度使用情境和背后的情绪需求。
认知重构：识别“爽感”陷阱与应对渴求
- 识别非理性信念：帮助个体认识到短视频带来的即时“爽感”往往是短暂且无法解决根本问题的，并识别出那些驱动过度使用的非理性信念（如“我感到无聊时只能刷短视频”、“不刷短视频就会错过重要的信息”）。
- 挑战自动化思维：引导个体学会质疑那些在短视频使用前出现的自动化思维，例如“就看一眼”、“再刷一条就停”。通过认知重构，将这些消极或冲动的想法转化为更积极、更具适应性的思维模式。
- 应对渴求（Craving）：训练个体在出现观看短视频的强烈渴求时，运用替代策略（如深呼吸、短暂休息、与他人交流）来延迟满足，而不是立即屈服。认识到渴求会随着时间的推移而减弱，学会“冲浪”式地应对渴求，而非被其淹没。
- 增强风险感知：通过教育，使个体充分认识到过度使用短视频可能带来的认知、心理和社交危害，从而增强其改变行为的内在动机。
针对高风险群体的定制化方案
- 青少年：针对青少年自我控制能力较弱的特点，干预措施应融入家庭和学校教育中。父母应积极参与，共同制定使用规则，并以身作则。学校可开展相关课程，提升青少年的媒介素养和自我管理能力。由于青少年更易受同伴影响，可尝试同伴支持小组的形式进行干预。预防性干预，如基于CBT的“PROTECT”项目，已被证明能有效降低青少年游戏障碍和未指明互联网使用障碍的症状严重程度 93。
- 心理障碍者：对于抑郁、焦虑或孤独感较强的个体，短视频常被用作情绪调节的代偿性策略。干预方案应在认知行为训练的基础上，结合心理咨询或心理治疗，帮助他们处理潜在的心理问题，发展健康的应对机制。例如，对于焦虑症患者，减少屏幕时间可以帮助缓解症状 94。多模式心理治疗干预方案，如针对互联网游戏障碍的方案，强调了动机增强策略、认知重构、行为策略和复发预防的综合应用，并在印度背景下取得了显著成效 95。这提示，针对短视频依赖的干预也应强调对核心心理问题的关注。
- 社会支持系统：无论是青少年还是心理障碍者，强大的社会支持系统都是干预成功的关键。鼓励家人、朋友提供理解和支持，帮助个体摆脱孤立感，重塑健康的社交关系。
6.2 平台与政策层面的协同治理
应对“纯爽”短剧和短视频可能带来的负面影响，仅依靠个体层面的干预是不够的，还需要平台方和政策制定者共同努力，从更高层面进行协同治理。这包括平台优化算法和管理机制，以及政府出台更完善的法规和政策。
平台优化推荐算法
短视频平台的推荐算法是影响用户行为的关键因素。平台方可以通过以下方式优化算法，促进健康使用：
- 增加深度内容权重：当前算法往往优先推荐能够最大化用户停留时间、互动量和完播率的“爽点”内容。平台应调整算法逻辑，赋予知识性、教育性、启发性等“深度内容”更高的权重。这意味着即使深度内容的初始互动率可能低于娱乐内容，也能获得足够的曝光机会。例如，可以引入“学习时长”、“知识增量”、“批判性思考激发度”等新的评估指标，激励创作者生产高质量、有价值的内容。
- 优化用户体验与引导：
- 设置使用提醒与“防沉迷”模式：平台应强制推行更智能化的“防沉迷”系统，不限于青少年模式，而是推广至所有用户。例如，当用户连续观看短视频超过一定时长时，自动弹出健康使用提醒，或建议休息，甚至强制中断播放。这些措施可以帮助用户意识到自身使用情况，并进行自我调节。
- 提供“内容选择”引导：在用户浏览内容时，可主动推荐多样化的内容类别，避免用户陷入“信息茧房”。例如，在用户连续观看多部“纯爽”短剧后，推荐一部科普短片或纪录片剪辑，拓宽用户的信息视野。
- “内容负责制”：平台应对其推荐算法可能产生的社会影响承担更多责任。探索建立算法的“社会责任评估”机制，确保算法在追求商业利益的同时，也能促进社会福祉和用户健康。
政策层面完善内容审核与青少年保护法规
政府和监管机构在构建健康的短视频生态方面扮演着不可或缺的角色，主要通过法规制定和监管执行：
- 强化内容审核与分级制度：
- 健全内容审核标准：明确禁止低俗、暴力、过度煽动情绪、宣扬错误价值观的“纯爽”短剧和短视频内容。建立专业的审核团队，结合人工智能技术，对短视频内容进行更为严格和细致的审查。如研究指出，TikTok上淋病相关视频的质量普遍偏低，缺乏内容覆盖度，需要加强平台层面的内容监管96。此外，关于急性胰腺炎的短视频质量也普遍不足97。
- 推行强制性内容分级：效仿电影、游戏行业的成熟经验，对短视频内容进行明确的分级，并严格限制未成年人接触不适宜的内容。例如，对于可能引发过度沉迷或具有负面引导作用的内容，应明确标识并禁止未成年人观看。
- 信息质量监管：鉴于短视频平台已成为重要的信息来源，尤其是健康信息，政策制定者应要求平台方加强对虚假信息、伪科学内容的打击力度。如研究指出，抖音等短视频平台上的健康信息质量参差不齐，需要加强平台管理和内容创作者培训，以提高公众的健康素养 869698。
- 完善青少年保护法规：
- 推动跨行业合作与研究：鼓励短视频平台、教育机构、医疗健康组织和科研院所进行多方合作。例如，平台可与心理健康专家合作，开发内嵌的心理健康支持工具；政府可设立专项研究基金，资助对短视频影响的长期、深入研究，为政策制定提供科学依据。
通过平台与政策的协同发力，可以从供给侧和需求侧同时入手，共同构建一个更加健康、负责任的短视频生态，最大限度地减少其潜在危害，并发挥其积极的社会价值。
6.3 未来研究的重点方向
尽管当前研究已初步揭示了“纯爽”短剧和短视频对认知功能的影响及成瘾机制，但仍有许多未解之谜和研究空白亟待填补。未来的研究应聚焦于以下几个关键方向，以期更全面、深入地理解这一现象，并为干预策略的制定提供更精准的科学依据。
不同文化背景下的差异研究：
当前关于短视频影响的研究多集中在特定文化背景（如中国、欧美国家）下，但短视频内容的类型、用户的社会文化习惯、对“爽感”的定义以及平台监管政策等在全球范围内存在显著差异。未来的研究应开展跨文化比较研究，探讨不同文化背景如何调节短视频对个体认知功能和成瘾性的影响。例如，某些文化可能更强调集体主义，其个体在社交媒体中的行为模式和心理需求可能与个人主义文化下的个体有所不同。这种跨文化研究有助于识别普遍规律和文化特异性，从而开发出更具普适性和针对性的干预措施。跨代际（如老年群体）影响的深入研究：
当前研究更多关注青少年和年轻群体，但老年人使用短视频的现象日益普遍，且其对认知功能和心理健康的影响可能呈现独特模式。老年人群体在认知能力、社会支持和生活需求等方面与年轻人存在显著差异。例如，有研究表明，短视频使用对老年人的心理健康具有积极影响，能促进代际关系和休闲消费习惯102。另一项研究也发现，基于运动的视频游戏配合青年人辅助，能够改善社区老年人的认知功能，尤其是与轻度神经认知障碍相关的认知功能103。然而，也有研究指出，老年人数字认知训练可能改善轻度认知障碍（MCI）患者的功能，且一些数字媒体对儿童脑发育的长期影响有限104105。这表明，短视频对老年群体的影响可能更为复杂，需要更深入地研究：- 潜在益处与风险的平衡：短视频能否作为一种认知刺激工具或社会连接方式，帮助老年人保持认知活跃和社交参与？其过度使用是否也会导致注意力分散、信息过载或形成依赖？
- 使用模式与认知特征：老年人如何使用短视频？是否存在特定的内容类型或使用模式对老年认知功能更有益或更有害？
- 干预策略的适应性：针对老年群体的特点，如何设计有效的短视频使用干预策略，以最大化其积极效应并最小化风险？
神经可塑性在戒断中的作用机制：
已有证据表明，过度使用短视频可能导致大脑结构和功能的变化，尤其是在奖励回路和执行功能网络中。未来的研究应深入探讨这些神经变化的可逆性，即在停止或减少短视频使用后，大脑如何通过神经可塑性机制进行修复和重塑。- 纵向神经影像学研究：通过戒断实验，采用fMRI、EEG等神经影像技术，纵向追踪个体在戒断前后大脑结构和功能连接的变化，识别与认知功能恢复相关的神经生物学标记。
- 分子和细胞水平机制：探索多巴胺受体密度、神经递质水平、突触可塑性等在短视频成瘾发展和戒断恢复过程中的作用。
- 个体差异与预测因子：哪些个体更容易从戒断中恢复？是否存在特定的遗传、人格或环境因素，能够预测戒断的成功率和认知恢复的程度？
- 治疗干预的神经基础：结合CBT、神经调控技术（如TMS、tDCS）等干预手段，研究其对大脑可塑性的影响，从而优化治疗方案，加速认知功能的恢复。
通过上述多维度、深层次的研究，我们不仅能更精准地评估“纯爽”短剧和短视频的真实影响，还能为制定更有效、更个性化的干预和预防策略提供科学依据，最终促进数字时代下人类认知健康的发展。
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参考文献
1Selective sustained attention: a developmental foundation for cognition.PubMed
Anna V Fisher
Curr Opin Psychol. 2019 Oct;29:248-253. doi: 10.1016/j.copsyc.2019.06.002. Epub 2019 Jun 15.
Higher-order cognition, particularly in real-life settings, often requires that parts of the sensory input be processed at the exclusion of others over a period of time. Consequently, this review focuses on the development of attention that is both selective (which entails processing parts of the sensory input at the exclusion of others) and sustained (which entails maintaining sensitivity to incoming stimuli for a period of time). Recent findings from four distinct areas of research reviewed here suggest that: (1) the underlying neural circuitry of selective sustained attention involves multiple cortical and subcortical brain regions; (2) selective sustained attention in infancy provides a developmental foundation for the emergence of executive function later in life; (3) suppression-based mechanisms of attentional selection that begin to emerge during the first year of life are important for memory and learning; and (4) selective sustained attention appears to be malleable through pre-natal and post-natal nutritional supplementation and interactions with mature social partners.
2Sleep Spindles and Intellectual Ability: Epiphenomenon or Directly Related?PubMed
Zhuo Fang, Valya Sergeeva, Laura B Ray, et al.
J Cogn Neurosci. 2017 Jan;29(1):167-182. doi: 10.1162/jocn_a_01034. Epub 2016 Sep 14.
Sleep spindles-short, phasic, oscillatory bursts of activity that characterize non-rapid eye movement sleep-are one of the only electrophysiological oscillations identified as a biological marker of human intelligence (e.g., cognitive abilities commonly assessed using intelligence quotient tests). However, spindles are also important for sleep maintenance and are modulated by circadian factors. Thus, the possibility remains that the relationship between spindles and intelligence quotient may be an epiphenomenon of a putative relationship between good quality sleep and cognitive ability or perhaps modulated by circadian factors such as morningness-eveningness tendencies. We sought to ascertain whether spindles are directly or indirectly related to cognitive abilities using mediation analysis. Here, we show that fast (13.5-16 Hz) parietal but not slow (11-13.5 Hz) frontal spindles in both non-rapid eye movement stage 2 sleep and slow wave sleep are directly related to reasoning abilities (i.e., cognitive abilities that support "fluid intelligence," such as the capacity to identify complex patterns and relationships and the use of logic to solve novel problems) but not verbal abilities (i.e., cognitive abilities that support "crystalized intelligence"; accumulated knowledge and experience) or cognitive abilities that support STM (i.e., the capacity to briefly maintain information in an available state). The relationship between fast spindles and reasoning abilities is independent of the indicators of sleep maintenance and circadian chronotype, thus suggesting that spindles are indeed a biological marker of cognitive abilities and can serve as a window to further explore the physiological and biological substrates that give rise to human intelligence.
3Fluid intelligence and psychosocial outcome: from logical problem solving to social adaptation.PubMed
David Huepe, María Roca, Natalia Salas, et al.
PLoS One. 2011;6(9):e24858. doi: 10.1371/journal.pone.0024858. Epub 2011 Sep 21.
BACKGROUND: While fluid intelligence has proved to be central to executive functioning, logical reasoning and other frontal functions, the role of this ability in psychosocial adaptation has not been well characterized. METHODOLOGY/PRINCIPAL FINDINGS: A random-probabilistic sample of 2370 secondary school students completed measures of fluid intelligence (Raven's Progressive Matrices, RPM) and several measures of psychological adaptation: bullying (Delaware Bullying Questionnaire), domestic abuse of adolescents (Conflict Tactic Scale), drug intake (ONUDD), self-esteem (Rosenberg's Self Esteem Scale) and the Perceived Mental Health Scale (Spanish adaptation). Lower fluid intelligence scores were associated with physical violence, both in the role of victim and victimizer. Drug intake, especially cannabis, cocaine and inhalants and lower self-esteem were also associated with lower fluid intelligence. Finally, scores on the perceived mental health assessment were better when fluid intelligence scores were higher. CONCLUSIONS/SIGNIFICANCE: Our results show evidence of a strong association between psychosocial adaptation and fluid intelligence, suggesting that the latter is not only central to executive functioning but also forms part of a more general capacity for adaptation to social contexts.
4Cognitive impairment in long-COVID.PubMed
Tozkir Julide, Turkmen Cigdem, Topcular Baris
Ideggyogy Sz. 2024 May 30;77(5-6):151-159. doi: 10.18071/isz.77.0151.
Long Covid is a complex condition characterised by symptoms that persist for weeks and months after the Covid infection, accompanied by cognitive impairment that negatively affects daily life. Understanding this complex condition is important for the development of diagnostic and therapeutic strategies.This article aims to provide a comprehensive overview of cognitive impairment in long-COVID, including its definition, symptoms, pathophysiology, risk factors, assessment tools, imaging abnormalities, potential biomarkers, management strategies, long-term outcomes, and future directions for research.Methods - The search methodology used in this review aimed to include a wide range of research on cognitive impairment related to both COVID-19 and long-COVID. Systematic searches of PubMed and Google Scholar databases were conducted using a mixture of MeSH terms and keywords including 'cognition', 'cognitive impairment', 'brain fog', 'COVID-19' and 'long-COVID'. The search was restricted to studies published in English between 1 January 2019 and 11 February 2024, which presented findings on neurological manifestations in human participants. Results - Long-COVID is characterized by persistent symptoms following COVID-19 infection, with cognitive impairment being a prominent feature. Symptoms include brain fog, difficulties with concentration, memory issues, and executive function deficits. Pathophysiological mechanisms involve viral persistence, immune responses, and vascular damage. Risk factors include age, pre-existing conditions, and disease severity. Cognitive assessment tools such as the Montreal Cognitive Assessment (MoCA) are essential for diagnosis. Imaging studies, including MRI, PET, and SPECT, reveal structural and functional brain alterations. Potential biomarkers include C-reactive protein, interleukin-6, and neuron-specific enolase. Management strategies encompass cognitive rehabilitation, occupational therapy, medications, and lifestyle modifications. Conclusion - Long-COVID poses a multifaceted challenge, and cognitive impairment significantly impacts patients' lives. A multidisciplinary approach, including cognitive rehabilitation and medication when appropriate, is essential for effective management. Future research should focus on validating biomarkers and understanding long-term cognitive outcomes. Conclusion - Long-COVID is a global health concern, and cognitive impairment is a distressing symptom. While pharmacological interventions have potential, they require careful consideration. Continued research is crucial for improving the understanding and treatment of cognitive impairment in long-COVID.
5Mild Cognitive ImpairmentPubMed
Shruti Anand, Caroline Schoo
Memory loss is a common complaint among older adults, and cognitive decline can present in various ways. It is a part of the normal aging process, subjective cognitive impairment (symptomatic complaints with normal neurocognitive test results), mild cognitive impairment, or dementia. Although mild cognitive impairment (MCI) has been used in the literature since the 1960s, it was first fully characterized in 1997 by Petersen and colleagues at the Mayo Clinic. As part of their community aging study, they observed individuals with memory concerns beyond what was expected for their age. They demonstrated memory impairment on objective testing yet did not fulfill the criteria for dementia. MCI was deemed to represent a borderline between normal aging and very early dementia. The earlier criteria for MCI diagnosis were found inadequate when it was realized that not all patients with MCI progressed to dementia and that memory impairment was not the only cognitive domain affected. Thus, a broader definition of MCI was needed. In 2003, the first Key Symposium on MCI was held, leading to the publication of revised core clinical criteria. These criteria included cognitive complaints from the patient or family members, deficits in any cognitive domain and not only memory, preserved overall general function but increasing difficulties in activities of daily life, and no dementia. The concept of MCI traveled outside the realm of research to provide clinicians with a useful diagnosis, often for close monitoring. Further clinical research resulted in the development of novel clinical criteria for providers. The American Psychiatry Association's Diagnostic and Statistical Manual of Mental Disorders 5th Edition (DSM-V) in 2013 classified MCI as one of the neurocognitive disorders (NCD). It is characterized by a decline in one or more cognitive domains, which is both subjectively and objectively observable. However, this decline does not interfere with the individual's ability to perform daily activities independently. Moreover, the deficits cannot be attributed to delirium or other psychiatric conditions. DSM-V does not propose specific neuropsychology test scores for diagnosing mild NCD. However, it is implied that such scores would help make this diagnosis. After diagnosing the syndrome as mild NCD, the next step is determining the etiology. The 11th Revision of the International Classification of Diseases (ICD 11) by the World Health Organization (WHO) in 2018 adopted the definition of mild neurocognitive disorder in alignment with the DSM-V diagnostic criteria. The National Institute on Aging and the Alzheimer's Association (NIA-AA) convened a work group to discuss the MCI criteria. The group proposed metrics for the distinct definition of MCI due to Alzheimer Disease. The initial criteria were published in 2011 and revised in 2018. The initial criteria closely resemble the core clinical criteria proposed by the 2003 Symposium. The 2018 revision noted that neurobehavioral disturbance may be an important feature of the clinical presentation and that cognitive deficits may result in a mild but noticeable impact on the complex activities of daily living. The NIA-AA also suggested research criteria for MCI due to AD in 2011 to help determine the etiology of MCI established by the core clinical criteria. These included the use of biomarkers to differentiate MCI due to AD from MCI due to other reasons. The biomarkers are not used to define MCI but can be helpful in research settings. The two main helpful biomarkers are amyloid-beta (Aβ) deposition and neuronal injury. MCI can also be classified based on the type of cognitive domain that is affected. MCI can potentially affect one or more of the following 6 cognitive domains: learning and memory, language, complex attention, executive function, social cognition, and visuospatial function. MCI can be classified as "amnestic" or "non-amnestic" with deficits in single or multiple cognitive domains. Amnestic MCI presents with predominant memory loss and the risk for progression to Alzheimer's Disease. In non-amnestic MCI, memory is relatively intact, and it is less common than the amnestic type and may progress to non-Alzheimer disease dementia. MCI can be further categorized into 4 subtypes: In 2009, a comprehensive Neuropsychology classification system was introduced as the dichotomous classification was considered inadequate to represent the heterogeneous nature of MCI. These MCI classes are: : 1. Amnestic - impaired recall and recognition . 2. Mixed - impairments in various domains such as language, executive function, recall and recognition, and visuospatial functioning. 3. Dysexecutive - impairments in attention, executive, and visuospatial functions, but the memory remains intact. . 4. Visuospatial - impairment in only a single measure of visual construction. . The phenotypic classification of MCI with clinical information and laboratory tests can guide the clinician in determining the probable cause of MCI and predicting its course. Patients with dysexecutive MCI (dMCI) are less likely to have Alzheimer - type dementia and more likely to have a stroke.
6Cognitive dysfunction and migraine.PubMed
Doga Vuralli, Cenk Ayata, Hayrunnisa Bolay
J Headache Pain. 2018 Nov 15;19(1):109. doi: 10.1186/s10194-018-0933-4.
Cognitive dysfunction has recently gained attention as a significant problem among migraine sufferers. All of the clinical studies show poor cognitive performance during migraine attacks, though, the interictal data are conflicting. Migraineurs show impaired cognitive function interictally in most of the clinic-based studies. Population-based studies did not reveal a difference in cognitive functions between migraineurs and controls. The specific cognitive domains involved are information processing speed, basic attention, executive functions, verbal and non-verbal memory and verbal skills. Neurophysiological, imaging and pharmacological studies support clinical symptoms of cognitive impairment in migraine. Longitudinal studies do not suggest progressive cognitive decline over time in migraine patients. Preventive medications and comorbid disorders such as depression and anxiety can impact cognitive function, but cannot fully explain the cognitive impairment in migraine. In contrast to migraine, tension type or cluster headache are not associated with cognitive impairment, at least during headache-free periods.
7Frailty and cognitive decline: how do they relate?PubMed
Marco Canevelli, Matteo Cesari, Gabor Abellan van Kan
Curr Opin Clin Nutr Metab Care. 2015 Jan;18(1):43-50. doi: 10.1097/MCO.0000000000000133.
PURPOSE OF REVIEW: To provide a comprehensive review of the recent literature (published over the last 12 months) exploring the relationship between frailty and cognition. RECENT FINDINGS: Fourteen studies were retained for the present review. No randomized controlled trial was found. Overall, the main findings of the selected studies appeared to be mainly confirmatory of the previous evidence. In longitudinal studies, physical frailty was found to predict the incidence of cognitive impairment and dementia. Cross-sectional studies showed that frail individuals have lower cognitive performance compared with nonfrail persons. Interestingly, few studies examined the association between frailty and specific cognitive functions and domains, reporting a significant impairment of attention and executive functions. Finally, we found several studies including cognitive measures in the operational definitions of frailty. SUMMARY: The present findings are suggestive of an almost complete lack of evidence on the addressed topic. In particular, randomized controlled trials are strongly needed in order to gain insights about the possibility of positively affecting the frailty syndrome by acting of cognition and improving cognitive impairment by targeting the physical components of frailty. Moreover, these studies may produce the first evidences about the novel concept of 'cognitive frailty' and its potential for reversibility.
8Challenges in Predicting Cognitive Decline in Dementia with Lewy Bodies.PubMed
Konstantinos Tsamakis, Christoph Mueller
Dement Geriatr Cogn Disord. 2021;50(1):1-8. doi: 10.1159/000515008. Epub 2021 Mar 29.
Despite being the second most common form of neurodegenerative dementia, dementia with Lewy bodies (DLB) is under-recognized and carries a worse prognosis than other subtypes of the condition. Cognitive impairment is a cardinal feature of all types of dementia and DLB presents with a distinct profile with deficits in attention, executive function, and visuoperceptual abilities. This difference from Alzheimer's disease and the common presence of neuropsychiatric symptoms may lead to challenges in predicting cognitive decline in this patient population. Firstly, the diagnosis of DLB is often delayed in clinical practice leading to variability from which time point in the disease course cognitive decline is measured. Secondly, the most frequently used measurement tools for cognitive difficulties focus on memory and naming rather than the domains affected by DLB. While there is now largely a consensus which tools are useful in diagnosing DLB, their validity in assessing deteriorating cognition is less clear. Thirdly, the presence of fluctuating cognition, the propensity to develop delirium episodes, as well as difficulties in distinguishing the two entities in clinical practice make it difficult to predict the disease course. Sleep disturbances are likely to influence cognitive decline but require further study in patients within established DLB. Fourthly, as in most cases of dementia, neuropathological comorbidities are frequently present in DLB. While the influence of Alzheimer's pathology on cognitive decline in DLB is comparatively well understood, the impact of other pathologies remains unclear. The recent definition of research criteria for mild cognitive impairment in DLB could facilitate earlier diagnosis and more structured follow-up. Assessment tools measuring cognitive domains predominantly affected in DLB need to be more consistently used in longitudinal studies and clinical practice, as well as concurrent measures of fluctuations in cognition. Greater availability of biomarkers and digital healthcare solutions can play an important role in enabling more accurate monitoring and prediction of cognitive decline in DLB.
9Cognitive Complaints and Comorbidities in Obstructive Sleep Apnea.PubMed
Michelle Vardanian, Lisa Ravdin
Sleep Med Clin. 2022 Dec;17(4):647-656. doi: 10.1016/j.jsmc.2022.07.009. Epub 2022 Oct 9.
Obstructive sleep apnea (OSA) is highly prevalent sleep disorder that causes sleep fragmentation, frequent awakenings, and intermittent hypoxia. Both OSA and cognitive decline increase in prevalence with factors such as increasing age and body mass. Multiple areas of cognition can be affected, including attention, executive function, memory, as well as emotional functioning through direct effects on brain health. Although positive airway pressure therapy has shown to improve some aspects of cognitive functioning, it does not fully alleviate all cognitive complaints. Inclusion of complementary approaches to comorbidities associated with OSA could potentially enhance treatment outcomes.
10Maintenance, reserve and compensation: the cognitive neuroscience of healthy ageing.PubMed
Roberto Cabeza, Marilyn Albert, Sylvie Belleville, et al.
Nat Rev Neurosci. 2018 Nov;19(11):701-710. doi: 10.1038/s41583-018-0068-2.
Cognitive ageing research examines the cognitive abilities that are preserved and/or those that decline with advanced age. There is great individual variability in cognitive ageing trajectories. Some older adults show little decline in cognitive ability compared with young adults and are thus termed 'optimally ageing'. By contrast, others exhibit substantial cognitive decline and may develop dementia. Human neuroimaging research has led to a number of important advances in our understanding of the neural mechanisms underlying these two outcomes. However, interpreting the age-related changes and differences in brain structure, activation and functional connectivity that this research reveals is an ongoing challenge. Ambiguous terminology is a major source of difficulty in this venture. Three terms in particular - compensation, maintenance and reserve - have been used in a number of different ways, and researchers continue to disagree about the kinds of evidence or patterns of results that are required to interpret findings related to these concepts. As such inconsistencies can impede progress in both theoretical and empirical research, here, we aim to clarify and propose consensual definitions of these terms.
11Introduction to behavioral addictions.PubMed
Jon E Grant, Marc N Potenza, Aviv Weinstein, et al.
Am J Drug Alcohol Abuse. 2010 Sep;36(5):233-41. doi: 10.3109/00952990.2010.491884.
BACKGROUND: Several behaviors, besides psychoactive substance ingestion, produce short-term reward that may engender persistent behavior, despite knowledge of adverse consequences, i.e., diminished control over the behavior. These disorders have historically been conceptualized in several ways. One view posits these disorders as lying along an impulsive-compulsive spectrum, with some classified as impulse control disorders. An alternate, but not mutually exclusive, conceptualization considers the disorders as non-substance or "behavioral" addictions. OBJECTIVES: Inform the discussion on the relationship between psychoactive substance and behavioral addictions. METHODS: We review data illustrating similarities and differences between impulse control disorders or behavioral addictions and substance addictions. This topic is particularly relevant to the optimal classification of these disorders in the forthcoming fifth edition of the American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders (DSM-V). RESULTS: Growing evidence suggests that behavioral addictions resemble substance addictions in many domains, including natural history, phenomenology, tolerance, comorbidity, overlapping genetic contribution, neurobiological mechanisms, and response to treatment, supporting the DSM-V Task Force proposed new category of Addiction and Related Disorders encompassing both substance use disorders and non-substance addictions. Current data suggest that this combined category may be appropriate for pathological gambling and a few other better studied behavioral addictions, e.g., Internet addiction. There is currently insufficient data to justify any classification of other proposed behavioral addictions. CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE: Proper categorization of behavioral addictions or impulse control disorders has substantial implications for the development of improved prevention and treatment strategies.
12Is Smartphone Addiction in the Younger Population a Public Health Problem?PubMed
Sofija Loleska, Nada Pop-Jordanova
Pril (Makedon Akad Nauk Umet Odd Med Nauki). 2021 Dec 30;42(3):29-36. doi: 10.2478/prilozi-2021-0032.
Problematic smartphone use and or addiction is defined as a form of behaviour characterized by the compulsive use of a smartphone that results in various forms of physical, psychological, or social harm. Global popularity in the area of the use of smartphones has raised concerns about the negative effects associated with problematic smartphone use, especially in the younger population. Having no consensual definition of smartphone addiction (SA), this behavioural addiction is based on the classic addiction symptomology that was included in DSM-5 criteria for compulsive gambling and substance abuse (APA 2013) This article provides a review of current research related to SA. Articles were found in the PUBMED database using related key words. Statistics confirm the exponential rise of this problem globally, especially in children and adolescents. Therefore, one must make this a high priority among public health issues.
13Liking, wanting, and the incentive-sensitization theory of addiction.PubMed
Kent C Berridge, Terry E Robinson
Am Psychol. 2016 Nov;71(8):670-679. doi: 10.1037/amp0000059.
Rewards are both "liked" and "wanted," and those 2 words seem almost interchangeable. However, the brain circuitry that mediates the psychological process of "wanting" a particular reward is dissociable from circuitry that mediates the degree to which it is "liked." Incentive salience or "wanting," a form of motivation, is generated by large and robust neural systems that include mesolimbic dopamine. By comparison, "liking," or the actual pleasurable impact of reward consumption, is mediated by smaller and fragile neural systems, and is not dependent on dopamine. The incentive-sensitization theory posits the essence of drug addiction to be excessive amplification specifically of psychological "wanting," especially triggered by cues, without necessarily an amplification of "liking." This is because of long-lasting changes in dopamine-related motivation systems of susceptible individuals, called "neural sensitization." A quarter-century after its proposal, evidence has continued to grow in support the incentive-sensitization theory. Further, its scope is now expanding to include diverse behavioral addictions and other psychopathologies. (PsycINFO Database Record
14Similarities and Differences in Psychology.PubMed
Yu Chen, Yan Sun, Si-Zhi Ai, et al.
Adv Exp Med Biol. 2017;1010:91-101. doi: 10.1007/978-981-10-5562-1_6.
Addiction is marked by repeating a certain behavior while ignoring the potential physical or mental consequences. Non-substance addiction provides an ideal model for researching the emergence and development of addiction's basic mechanism. Comparative studies of substance and non-substance addiction are helpful to reveal the common basis of addiction development. This article explores this topic from a psychological angle, touching upon sensation seeking, inhibitory control, attentional bias, intertemporal choice and environment. A review of previous literature urges future research to propose a biopsychosocial model of addiction and consider addiction's effect on basic cognitive function alongside cognitive neuroscience technology.
15Similarities and Differences in Genetics.PubMed
Yang Zhang, Yan Sun, Jie Liang, et al.
Adv Exp Med Biol. 2017;1010:59-71. doi: 10.1007/978-981-10-5562-1_4.
Similar symptomatology manifestations and high co-morbidity in substance and non-substance addictions suggest that there may be a common pathogenesis between them. Associated with impulse control and emotional processing, the monoamine neurotransmitter system genes are suggested to be related to both substance and non-substance addictions, such as dopamine (DA) system, 5-hydroxytryptamine/serotonin (5-HT) system, the endogenous opioid system and so on. Here we reviewed the similarities and differences in genetics between classic substance addiction and common types of non-substance addiction, e.g. pathological gambling, Internet addiction, binge-eating disorder etc. It is necessary to systematically compare genetic mechanisms of non-substance addiction and substance addiction, which could reveal similarities and differences of substance addiction and non-addictive substances essentially, enhance our understanding of addiction theory and improve clinical practice with research results.
16Attachment and emotion regulation in substance addictions and behavioral addictions.PubMed
Ana Estévez, Paula Jáuregui, Inmaculada Sánchez-Marcos, et al.
J Behav Addict. 2017 Dec 1;6(4):534-544. doi: 10.1556/2006.6.2017.086.
Background Risky behaviors have been related to emotional regulation and attachment, which may constitute risk factors for developing an addictive behavior. However, there may also be differences between substance and non-substance-related addictions. Aims This study aimed to examine the relationship of emotional regulation and attachment, with substance (alcohol and drug abuse), and non-substance-related addictions (gambling disorder, video game addiction, and problematic Internet use) in adolescents and emerging adults. The study also aimed to examine gender differences for such predictors. Methods The sample comprised 472 students aged 13-21 years recruited from high schools and vocational education centers. Results Findings demonstrated that emotion regulation was predictive of all addictive behaviors assessed in this study (alcohol and drug abuse, gambling disorder, video game addiction, and problematic Internet use), whereas attachment predicted non-substance-related addictions (gambling disorder, video game addiction, and problematic Internet use). In addition, gender differences were found, with females scoring significantly higher in maternal and peer attachment, whereas males scored significantly higher in gambling disorder and video game addiction. Conclusion The findings may be useful for preventive and clinical interventions conducted with youth regarding addictive behaviors.
17Theta oscillations in 4-year-olds are sensitive to task engagement and task demands.PubMed
Marlene Meyer, Hinke M Endedijk, Freek van Ede, et al.
Sci Rep. 2019 Apr 15;9(1):6049. doi: 10.1038/s41598-019-42615-x.
Top-down control processes are essential for guiding attention and working memory towards task-relevant information. Recently, theta oscillations were suggested as critical for these cognitive processes. Infant studies testing a mixture of bottom-up and top-down processes support adult theta findings. Yet, since infants cannot be instructed, it remains unclear to what extent theta oscillations are involved particularly in top-down control in early childhood. That is especially relevant towards school age when children need top-down control to solve the increasingly complex tasks. In this EEG study, we investigated whether theta-power in 4-year-olds is sensitive to task engagement and to different cognitive task demands. In a within-subjects design, children had three different instructions before watching videos including either no demands (No Task), language-related (Color-naming Task), or action-related (Imitation Task) demands. We analyzed children's theta-power (3-6 Hz) in two contrasts: (1) Task vs. No Task and (2) Color-naming vs. Imitation Task. The findings revealed more frontomedial theta-power when children were engaged in a task and their frontomedial theta-power increased during their cognitive engagement. Theta-power was stronger over left fronto-temporal sites for language- compared to action-related demands. These findings support recent theoretical work highlighting theta oscillations in top-down control and extend this neurocognitive framework to preschoolers.
18Mobile phone short video use negatively impacts attention functions: an EEG study.PubMed
Tingting Yan, Conghui Su, Weichen Xue, et al.
Front Hum Neurosci. 2024 Jun 27;18:1383913. doi: 10.3389/fnhum.2024.1383913. eCollection 2024.
The pervasive nature of short-form video platforms has seamlessly integrated into daily routines, yet it is important to recognize their potential adverse effects on both physical and mental health. Prior research has identified a detrimental impact of excessive short-form video consumption on attentional behavior, but the underlying neural mechanisms remain unexplored. In the current study, we aimed to investigate the effect of short-form video use on attentional functions, measured through the attention network test (ANT). A total of 48 participants, consisting of 35 females and 13 males, with a mean age of 21.8 years, were recruited. The mobile phone short video addiction tendency questionnaire (MPSVATQ) and self-control scale (SCS) were conducted to assess the short video usage behavior and self-control ability. Electroencephalogram (EEG) data were recorded during the completion of the ANT task. The correlation analysis showed a significant negative relationship between MPSVATQ and theta power index reflecting the executive control in the prefrontal region ( = -0.395, = 0.007), this result was not observed by using theta power index of the resting-state EEG data. Furthermore, a significant negative correlation was identified between MPSVATQ and SCS outcomes ( = -0.320, = 0.026). These results suggest that an increased tendency toward mobile phone short video addiction could negatively impact self-control and diminish executive control within the realm of attentional functions. This study sheds light on the adverse consequences stemming from short video consumption and underscores the importance of developing interventions to mitigate short video addiction.
19Immediate Attention Enhancement and Restoration From Interactive and Immersive Technologies: A Scoping Review.PubMed
Adam C Barton, Jade Sheen, Linda K Byrne
Front Psychol. 2020 Aug 19;11:2050. doi: 10.3389/fpsyg.2020.02050. eCollection 2020.
Interactive and immersive technologies such as video games, exergames, and virtual reality are typically regarded as entertainment mediums. They also offer a multitude of health and well-being benefits. They have the capacity to incorporate established well-being techniques (e.g., mindfulness, exercise, and play) and expose users to beneficial environment settings with greater ease, improved access, and a broader appeal. The authors conducted a scoping review to explore whether these technologies could be used to benefit attention in healthy adults, that is, in a regulatory sense such as during periods of cognitive fatigue or attention-critical tasks. Research efforts have typically focused on long-term practice methods for attention enhancement with these technologies. Instead, this review provides the first attempt to unify a broad range of investigations concerned with their immediate impact on attention through state-change mechanisms. This applies the concept of attention state training and a growing evidence base, which suggests that meditative practices, exercise bouts, and nature exposures can provide short-term improvements in attentional performance following brief interactions. A systematic search of MEDLINE, Embase, and PsycINFO databases resulted in 11 peer-reviewed articles (13 experimental trials) each including at least one objective measure of attention directly following the use of an interactive or immersive technology. Most studies involved interactive technologies (i.e., video games and exergames), whereas there were three immersive interventions in the form of virtual reality. The comparisons between baseline and postintervention showed mostly no effect on attention, although there were five cases of improved attention. There were no instances of negative effects on attention. The results are significant considering mounting concerns that technology use could be detrimental for cognitive functioning. The positive effects reported here indicate a need to specify the type of technology in question and bring attention to positive vs. negative technology interactions. Implications for the literature concerning attention state training are discussed considering promising effects of technology exposures geared toward flow state induction. Significant gaps in the literature are identified regarding the implementation of traditional attention state training practices.
20Effects of music, video, and 360-degree video on cycle ergometer exercise at the ventilatory threshold.PubMed
Jonathan M Bird, Costas I Karageorghis, Steven J Baker, et al.
Scand J Med Sci Sports. 2019 Aug;29(8):1161-1173. doi: 10.1111/sms.13453. Epub 2019 Jun 3.
Despite the seemingly ubiquitous presence of audiovisual stimuli in modern exercise facilities, there is a dearth of research examining the effects of audiovisual stimuli in combination during exercise. Accordingly, we examined the influence of a range of audiovisual stimuli on the improvement of affective, perceptual, and enjoyment responses to cycle ergometer exercise at the ventilatory threshold (VT), an intensity that is associated with the most affect-related interindividual variability. A within-subject design was employed, and participants (N = 18) completed a 25-minute protocol that consisted of 2 minutes of seated rest, 5 minutes of warm-up, 10 minutes of exercise at VT, 5 minutes of cooldown, and 3 minutes of seated rest. Participants exercised at VT under music, video, music-video, 360-degree video, 360-degree video with music, and control conditions. The results revealed a condition × time interaction for perceived activation and a main effect of condition for state attention and perceived enjoyment. The 360-degree video with music condition elicited the most positive affective valence, greatest perceived activation, most dissociative thoughts, and highest ratings of perceived enjoyment. The present findings indicate that audiovisual stimuli can influence affective, perceptual, and enjoyment responses to cycle ergometer exercise at the VT. Given the emerging support pertaining to a positive relationship between affective responses and exercise adherence, audiovisual stimuli, such as 360-degree video with music, should be considered as a means by which to promote an enjoyable exercise experience.
21The Separation of Adult ADHD Inattention and Hyperactivity-Impulsivity Symptoms and Their Association with Problematic Short-Video Use: A Structural Equation Modeling Analysis.PubMed
Chuxian Xu, Zhaojia Gu, Jin Yan, et al.
Psychol Res Behav Manag. 2025 Mar 1;18:461-474. doi: 10.2147/PRBM.S491731. eCollection 2025.
PURPOSE: This study investigates the relationship between attention-deficit/hyperactivity disorder (ADHD) symptoms and problematic short-video use (PSVU) in adults, particularly focusing on the affective and cognitive processes that mediate this relationship. The research aims to clarify how different ADHD symptom domains, specifically inattention (IA) and hyperactivity-impulsivity (HI), contribute to PSVU. PATIENTS AND METHODS: The study recruited 563 Chinese college students (age: mean±SD = 19.85±1.56) through an online survey platform. Participants were assessed for ADHD symptoms, PSVU, cognitive reappraisal, emotional distress (including anxiety and depression), and boredom proneness. Structural equation modeling (SEM) was employed to analyze the mediation effects of these variables on the relationship between adult ADHD symptoms and PSVU. Additionally, the shared and distinct pathway from IA and HI to PSVU in adults were also explored. RESULTS: The results revealed a serial mediating effect of cognitive reappraisal, emotional distress, and boredom proneness for the association between ADHD and PSVU (Estimate = 0.005, 95% CI = [0.001, 0.014]). Both IA and HI symptoms were found to influence PSVU with increased emotional distress and boredom proneness (IA, Estimate = 0.055, 95% CI = [0.021, 0.099]; HI, Estimate = 0.088, 95% CI = [0.043, 0.150]). However, divergent pathways were found by which IA increased the PSVU indirectly by heightening susceptibility to boredom proneness (Estimate = 0.044, 95% CI = [0.016, 0.086]), whereas HI primarily influenced PSVU through cognitive reappraisal, emotional distress, and boredom proneness (Estimate = 0.009, 95% CI = [0.003, 0.020]). CONCLUSION: These findings shed light on how PSVU develops in adults with different ADHD symptoms, which provide valuable insights for developing more targeted prevention and treatment strategies for short-video addiction in ADHD adults.
22Accelerating dynamics of collective attention.PubMed
Philipp Lorenz-Spreen, Bjarke Mørch Mønsted, Philipp Hövel, et al.
Nat Commun. 2019 Apr 15;10(1):1759. doi: 10.1038/s41467-019-09311-w.
With news pushed to smart phones in real time and social media reactions spreading across the globe in seconds, the public discussion can appear accelerated and temporally fragmented. In longitudinal datasets across various domains, covering multiple decades, we find increasing gradients and shortened periods in the trajectories of how cultural items receive collective attention. Is this the inevitable conclusion of the way information is disseminated and consumed? Our findings support this hypothesis. Using a simple mathematical model of topics competing for finite collective attention, we are able to explain the empirical data remarkably well. Our modeling suggests that the accelerating ups and downs of popular content are driven by increasing production and consumption of content, resulting in a more rapid exhaustion of limited attention resources. In the interplay with competition for novelty, this causes growing turnover rates and individual topics receiving shorter intervals of collective attention.
23Adherence, frequency, and long-term follow-up of video game-based treatments in patients with attention-deficit/hyperactivity disorder: A systematic review.PubMed
Lucía Caselles-Pina, Aaron Sújar, Alejandro Quesada-López, et al.
Brain Behav. 2023 Nov;13(11):e3265. doi: 10.1002/brb3.3265. Epub 2023 Sep 24.
BACKGROUND: Attention-deficit/hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder in children and adolescents. Recent studies show that video games have great potential for the treatment and rehabilitation of ADHD patients. The aim of the present review is to systematically review the scientific literature on the relationship between video games and ADHD, focusing on adherence to treatment, frequency of the intervention, and the long-term follow-up of video games in children and adolescents with ADHD. METHODS: The preferred reporting items for systematic reviews and meta-analyses guidelines were adopted. The review protocol was registered in PROSPERO database. We searched in three databases, PubMed, Medline, and Web of Science to identify studies examining the association between video game interventions in ADHD patients. RESULTS: A total of 18 empirical studies met the established inclusion criteria. The results showed that video games-based interventions can be used to improve ADHD symptoms and display high adherence to treatment. In addition, in the studies reviewed, the most common intervention frequency is 30 min three to five times per week. However, there is little evidence from studies with video games showing long-term effects in patients with ADHD. CONCLUSION: Video games are useful and effective interventions that can complement traditional treatments in patients with ADHD.
24A Systematic Review on Serious Games in Attention Rehabilitation and Their Effects.PubMed
Leila Shahmoradi, Fatemeh Mohammadian, Meysam Rahmani Katigari
Behav Neurol. 2022 Feb 26;2022:2017975. doi: 10.1155/2022/2017975. eCollection 2022.
Attention is a basic and main mental task and can play an important role in the functioning of other brain abilities such as intelligence, memory, learning, and perception, and its deficit occurs in 80% of patients with traumatic brain injury. The use of game-based tools for rehabilitation is rapidly expanding. Cognitive rehabilitation via video games is an emerging hot topic in cognitive science. Serious games serve a specific purpose in addition to entertainment. They can be more engaging than exercises since they replace reward and motivation systems with real-world motivations as a complement for rehabilitation activities. This study was aimed at identifying and categorizing serious computer games used for attention rehabilitation and evaluating their effects. Six electronic databases (Scopus, PubMed, ISI, Embase, IEEE, and Cochrane) were searched in August 2021. The search strategy consisted of three main concepts of "serious game", "cognitive deficits", and "cognitive rehabilitation". The inclusion criteria were (1) journal articles, (2) English language, (3) being published in the last 10 years, (4) human participants, and (5) game-based intervention. In the 30 included studies, 22 unique games were utilized for attention rehabilitation. Lumosity (20%), Brain Age (Dr. Kawashima's Brain Training) (10%), and MoHRS (6.66%) were the most common games among the studies. There were (57%) casual, (23%) action, (10%) simulation, and (10%) multiple genres. Of the 47 tools used in the studies, 5 utilized cross-modal oddball attention tasks, 4 utilized game performance, 3 utilized the paced auditory serial additional test (PASAT), and the rest employed other tools. A total of 73 outcome measures were related to attention, 42 measures did not have significant results, 30 were significantly improved, 1 was significantly deteriorated, and 4 articles did not have any specific measures for attention evaluation. Thus, the results revealed the positive effect of serious games on attention. However, issues such as absence of scientific teams, the variety of the disorders that cause defects, the variety of criteria, differences in measurements, lack of long-term follow-up, insufficient RCT studies, and small sample sizes should be considered when designing, developing, and using game-based systems to prevent bias.
25Short video addiction scale for middle school students: development and initial validation.PubMed
Jianmei Ye, Weijun Wang, Dawei Huang, et al.
Sci Rep. 2025 Mar 22;15(1):9903. doi: 10.1038/s41598-025-92138-x.
The rise of short video platforms has increased concerns about addiction, especially among adolescents. This study aimed to develop a Short Video Addiction Scale for middle school students. A sample of 1492 middle school students participated in the study. Initial items were derived from qualitative interviews and refined through psychometric analyses, including Exploratory and Confirmatory Factor Analyses. The final scale, consisting of 15 items across five factors (Academic Procrastination, Interpersonal Strain, Social Communication Difficulties, Attention Concentration Difficulties, and Impaired Control over Short Video Use), demonstrated high internal consistency (Cronbach's α = 0.900), test-retest reliability, and strong validity. The Short Video Addiction Scale, a 15-item scale, demonstrates robust psychometric properties. It is reliable and valid for assessing short video addiction among middle school students and will be a valuable tool for identifying and addressing the growing concerns of short video addiction in adolescents.
26The relationship between short video usage and academic achievement among elementary school students: The mediating effect of attention and the moderating effect of parental short video usage.PubMed
Qiong Gong, Ting Tao
PLoS One. 2024 Nov 25;19(11):e0309899. doi: 10.1371/journal.pone.0309899. eCollection 2024.
Short videos have gained widespread popularity among elementary school students in China. As a form of entertainment media, their usage has steadily increased among adolescents in recent years. This phenomenon has sparked extensive discussions in society, especially against Chinese parents' high concern for their children's academic performance. Therefore, this study collected 1052 valid questionnaires from elementary school students, attempting to explore the possibility that their short video usage might negatively impact their academic performance. Besides, the mechanism of this relationship was also examined from the perspective of children's attention and environmental factors of parents' short video usage. The research findings indicate that the more elementary school students use short videos, the lower their academic performance, with attention mediating in this relationship. The longer the parental short video usage duration, the exacerbating effect it has on elementary school students' negative impact on attention caused by short video usage due to its positive moderating effect. This study provides crucial insights for parents, educators, and short video platforms, offering valuable references for formulating more scientifically and logically grounded educational strategies.
27Exploring the Relationship of Smartphone Addiction on Attention Deficit, Hyperactivity Symptoms, and Sleep Quality Among University Students: A Cross-Sectional Study.PubMed
Ibrahim Zeyrek, Muhammed Fatih Tabara, Mahmut Çakan
Brain Behav. 2024 Nov;14(11):e70137. doi: 10.1002/brb3.70137.
BACKGROUND: The prevalence of smartphone usage is steadily rising, leading to the potential development of addiction due to problematic use. This study examined the relationship between smartphone addiction, self-perceived attention deficit and hyperactivity symptoms, and sleep quality among 443 university students at Bingöl University. METHODS: Participants completed several questionnaires, including the Smartphone Addiction Scale-Short Version, the Pittsburgh Sleep Quality Index, and the Adult ADHD Self-Report Scale. RESULTS: This study examined 443 participants, with a mean age of 20.97 ± 3.29, of whom 72.7% (n = 322) were female. Results showed that the majority of participants primarily used smartphones (94.8%, n = 420) for social media browsing (49.9%, n = 221). Factors such as smoking, preference for smartphone screens, and prolonged screen exposure significantly affected sleep quality. Smartphone addiction rates were notable, with 50.4% (n = 61) of males and 47.2% (n = 152) of females being affected; this addiction was associated with poorer sleep quality. Correlations were found between age, sleep duration, and scores on smartphone addiction, sleep quality, and attention deficit scales. Linear regression analysis revealed that age, attention deficit scores, and sleep quality scores significantly influenced levels of smartphone addiction. CONCLUSIONS: These findings contribute valuable insights into the impact of smartphone addiction on attention and sleep in university students.
28Social media addiction and emotions during the disaster recovery period-The moderating role of post-COVID timing.PubMed
Dewan Muhammad Nur-A Yazdani, Tanvir Abir, Yang Qing, et al.
PLoS One. 2022 Oct 20;17(10):e0274898. doi: 10.1371/journal.pone.0274898. eCollection 2022.
BACKGROUND: Social media addiction, a recently emerged term in medical science, has attracted the attention of researchers because of its significant physical and psychological effects on its users. The issue has attracted more attention during the COVID era because negative emotions (e.g., anxiety and fear) generated from the COVID pandemic may have increased social media addiction. Therefore, the present study investigates the role of negative emotions and social media addiction (SMA) on health problems during and after the COVID lockdown. METHODS: A survey was conducted with 2926 participants aged between 25 and 45 years from all eight divisions of Bangladesh. The data collection period was between 2nd September- 13th October, 2020. Partial Least Square Structural Equation Modelling (PLS-SEM) was conducted for data analysis by controlling the respondents' working time, leisure time, gender, education, and age. RESULTS: Our study showed that social media addiction and time spent on social media impact health. Interestingly, while anxiety about COVID increased social media addition, fear about COIVD reduced social media addition. Among all considered factors, long working hours contributed most to people's health issues, and its impact on social media addiction and hours was much higher than negative emotions. Furthermore, females were less addicted to social media and faced less health challenges than males. CONCLUSION: The impacts of negative emotions generated by the COVID disaster on social media addiction and health issues should be reconsidered. Government and employers control people's working time, and stress should be a priority to solve people's social media addiction-related issues.
29Working memory capacity for continuous events: The root of temporal compression in episodic memory?PubMed
Nathan Leroy, Steve Majerus, Arnaud D'Argembeau
Cognition. 2024 Jun;247:105789. doi: 10.1016/j.cognition.2024.105789. Epub 2024 Apr 6.
Remembering the unfolding of past episodes usually takes less time than their actual duration. In this study, we evaluated whether such temporal compression emerges when continuous events are too long to be fully held in working memory. To do so, we asked 90 young adults to watch and mentally replay video clips showing people performing a continuous action (e.g., turning a car jack) that lasted 3, 6, 9, 12, or 15 s. For each clip, participants had to carefully watch the event and then to mentally replay it as accurately and precisely as possible. Results showed that mental replay durations increased with event duration but in a non-linear manner: they were close to the actual event duration for short videos (3-9 s), but significantly smaller for longer videos (12 and 15 s). These results suggest that working memory is temporally limited in its capacity to represent continuous events, which could in part explain why the unfolding of events is temporally compressed in episodic memory.
30How short video addiction affects risk decision-making behavior in college students based on fNIRS technology.PubMed
Shu Zhang, Shiyi Li
Front Hum Neurosci. 2025 Apr 7;19:1542271. doi: 10.3389/fnhum.2025.1542271. eCollection 2025.
INTRODUCTION: Short video addiction is an emerging form of Internet behavioral addiction characterized by dependent, inappropriate, or excessive use of short video applications. This phenomenon significantly affects decision-making processes and warrants further investigation. Despite the growing prevalence of short video addiction, research on its impact on risky decision-making abilities remains limited. To address this gap, the present study contributes to this critical issue by incorporating neurophysiological data. METHODS: Using functional Near-Infrared Spectroscopy (fNIRS) brain imaging technology and the Balloon Analogue Risk Task (BART) experimental paradigm, this study explored the decision-making behaviors and brain activity of individuals with short video addiction (Individuals with SVA) under varying short video background cues. Adopting a mixed experimental design, the study examined decision-making ability and brain activation as dependent variables across two groups (addiction and control), two outcomes (gain and loss), and two background cue conditions (with and without cues). A total of 45 participants were included in the study: 23 in the addiction group and 22 in the control group. RESULTS: Behavioral results revealed that individuals with short video addiction demonstrated higher risk-taking tendencies, shorter reaction times, and higher rates of balloon explosions, particularly when exposed to short video cues. Neural data indicated heightened sensitivity to short video cues among individuals with addiction compared to healthy controls. Specifically, the right orbitofrontal cortex (OFC) and right frontopolar area (FPA) exhibited increased activation during risk decision-making with short video cues in the addiction group, while the control group showed no activation in these regions. Additionally, Individuals with SVA displayed greater sensitivity to loss outcomes, with significant OFC activation observed in response to losses but not gains. In risk decision-making scenarios involving short video cues, notable activation was observed in the FPA and left dorsolateral prefrontal cortex (DLPFC) among Individuals with SVA when encountering reward loss. However, no significant differences were observed between the two groups in risk decision-making under the background without short video cue conditions, regardless of gain or loss outcomes. CONCLUSION: These findings suggest that Individuals with SVA are more susceptible to the influence of short video-related cues, more sensitive to income loss, and more likely to pursue higher rewards, resulting in higher-risk decisions. The fNIRS results provide critical insights into encouraging healthy short video consumption, informing psychological clinical therapy, and advancing research on addiction-related brain mechanisms.
31Compensatory increase of functional connectivity density in adolescents with internet gaming disorder.PubMed
Xin Du, Yongxin Yang, Peihong Gao, et al.
Brain Imaging Behav. 2017 Dec;11(6):1901-1909. doi: 10.1007/s11682-016-9655-x.
Behavioral studies have demonstrated visual attention bias and working memory deficits in individuals with internet gaming disorder (IGD). Neuroimaging studies demonstrated that individuals with IGD presented abnormalities in brain structures and functions including resting-state functional connectivity (rsFC) disturbance. However, most previous studies investigated IGD-related rsFC alterations by using hypothesis-driven methods with priori selection of a region of interest, which cannot provide a full picture of the rsFC changes in IGD individuals. In this study, we recruited 27 male IGD adolescents and 35 demographically matched healthy controls (HCs) to investigate abnormal connective property of each voxel within whole brain of IGD adolescents using resting-state functional connectivity density (rsFCD) method, and further to evaluate the relationship between altered rsFCD and behavioral performances of visual attention and working memory. The results exhibited no significant intergroup difference in behavioral performance (visual working memory and attention). The IGD adolescents exhibited higher global/long-range rsFCD in the bilateral dorsal lateral prefrontal cortex (DLPFC) and the right inferior temporal cortex (ITC)/fusiform compared with the HCs. Although no significant correlation survived after Bonferroni correction, higher global/long-range rsFCD of the bilateral DLPFC was correlated with the Young's internet addiction test (IAT) score and/or behavioral performance in IGD adolescents using an uncorrected threshold of P < 0.05. In conclusion, IGD adolescents demonstrated increased rsFCD in the brain regions involved in working memory, spatial orientation and attention processing, which indicated that increased rsFCD may reflect a compensatory mechanism for maintaining the normal behavioral performance in IGD adolescents compared with the HCs.
32Changes in prefrontal hemodynamics and mood states during screen use: a functional near-infrared spectroscopy study.PubMed
Daniel Fehring, Alexandra Gaillard, Emiliano Mazzoli, et al.
Sci Rep. 2025 Aug 1;15(1):28181. doi: 10.1038/s41598-025-09360-w.
Screen use has been associated with poor cognitive and mental health, yet few studies have examined its effects on brain activity. Our aims were to describe changes in brain activity and mood states following brief exposure to screen-based content; assess the feasibility of using functional near-infrared spectroscopy (fNIRS) to measure these effects; and gather preliminary data to inform future investigations. Twenty-seven young people (age = 21.5 ± 2.8 years; range = 18-25) completed six consecutive 3-min screen conditions in a psuedorandomized cross over design. All screen exposures were presented on an iPhone 12-Max while sitting. Hemodynamic changes in the dorsolateral prefrontal cortex (dlPFC) were measured continuously using fNIRS (Portalite Mk II). Changes in mood states (energy, tension, focus, happiness) were assessed before and after each condition. Condition exposure altered the hemodynamic response in the dlPFC, where oxygenated hemoglobin (HbO) increased more compared to baseline after exposure to social media (largest increase), gaming, and TV-viewing (smallest increase), respectively. Deoxygenated hemoglobin (HbR) and total hemoglobin (HbT) increased more following exposure to gaming (largest increase), social media, and TV-viewing (smallest increase), respectively. Both TV-viewing and gaming were associated with increased focus relative to baseline, whereas social media use was associated with decreased focus. Findings indicate that even short durations of screen use have measurable effects on brain regions involved in cognitive control, emotion, and social decision making. These effects are nuanced and context dependent, rather than universally beneficial or detrimental. fNIRS is a feasible method for measuring these effects.
33Neuroanatomical and functional substrates of the short video addiction and its association with brain transcriptomic and cellular architecture.PubMed
Yuanyuan Gao, Ying Hu, Jinlian Wang, et al.
Neuroimage. 2025 Feb 15;307:121029. doi: 10.1016/j.neuroimage.2025.121029. Epub 2025 Jan 16.
Short video addiction (SVA) has emerged as a growing behavioral and social issue, driven by the widespread use of digital platforms that provide highly engaging, personalized, and brief video content. We investigated the neuroanatomical and functional substrates of SVA symptoms, alongside brain transcriptomic and cellular characteristics, using Inter-Subject Representational Similarity Analysis (IS-RSA) and transcriptomic approaches. Behaviorally, we found that dispositional envy was associated with SVA. Structurally, SVA was positively correlated with increased morphological volumes in the orbitofrontal cortex (OFC) and bilateral cerebellum. Functionally, the dorsolateral prefrontal cortex (DLPFC), posterior cingulate cortex (PCC), cerebellum, and temporal pole (TP) exhibited heightened spontaneous activity, which was positively correlated with SVA severity. Transcriptomic and cellular analyses also showed specific genes linked to gray matter volume (GMV) associated with SVA, with predominant expression in excitatory and inhibitory neurons. These genes showed distinct spatiotemporal expression patterns in the cerebellum during adolescence. This study offers a comprehensive framework integrating structural, functional, and neurochemical evidence to highlight the neural-transcriptomic underpinnings of SVA symptoms in a non-clinical population.
34Gender-related differences in cue-elicited cravings in Internet gaming disorder: The effects of deprivation.PubMed
Guangheng Dong, Hui Zheng, Xiaoyue Liu, et al.
J Behav Addict. 2018 Dec 1;7(4):953-964. doi: 10.1556/2006.7.2018.118. Epub 2018 Dec 17.
BACKGROUND: Online gaming has become a popular leisure activity, in which males more frequently develop Internet gaming disorder (IGD) compared to females. However, gender-related neurocognitive differences have largely not been systematically investigated in IGD. METHODS: Cue-elicited-craving tasks were performed before game playing and immediately after deprivation operationalized as a forced break from gaming when the Internet was disconnected. Ninety-nine subjects with IGD (27 males and 22 females) or recreational game use (RGU; 27 males and 23 females) provided functional MRI and subjective data. Analyses investigating effects of group (IGD and RGU) × gender (male and female) at different times (pre-gaming, post-gaming, and post-pre) on cue-elicited craving and brain responses were performed. Correlations between brain responses and subjective measures were calculated. RESULTS: In pre-, post-, and post-pre tests, significant gender-by-group interactions (p < .001, cluster size > 15 voxels) were observed in the left dorsolateral prefrontal cortex (DLPFC). Further analyses of the DLPFC cluster showed that in post-pre comparisons, results were related to less engagement of the DLPFC in IGD, especially in females. In addition, at post-test, significant interactions were observed in the caudate, as females with IGD showed greater activation as compared to those with RGU. DISCUSSION: The results raise the possibility that women with RGU may show better executive control than men when facing gaming cues, which may provide resiliency against developing IGD; however, once they develop IGD, their gaming may impair their executive control and enhance their cravings for gaming, which may make it more difficult to quit gaming.
35A political economy analysis of strengthening health information system in Tanzania.PubMed
August Kuwawenaruwa, Henry Mollel, John Matiko Machonchoryo, et al.
BMC Med Inform Decis Mak. 2023 Oct 30;23(1):245. doi: 10.1186/s12911-023-02319-9.
BACKGROUND: Many countries' health systems are implementing reforms to improve the functioning and performance of the Health Management Information System (HMIS) to facilitate evidence-based decisions for delivery of accessible and quality health services. However, in some countries such efforts and initiatives have led to a complex HMIS ecosystem characterized by multiple and fragmented sub-systems. We undertook an in-depth analysis of the HMIS ecosystem in Tanzania to inform the ongoing initiatives, by understanding the relationship and power differences among stakeholders, as well as drivers and barriers to HMIS investment and strengthening. METHODOLOGY: This was a qualitative research method incorporating data collection through document review and key informant interviews guided by political economy analytical framework. A total of 17 key informant interviews were conducted between April and May 2022. A thematic content analysis was used during data analysis. RESULTS: Good relationship between the government and stakeholders dealing/supporting HMIS ecosystem was noted as there are technical working groups which brings stakeholders together to discuss and harmonize HMIS activities. The 'need for the data' has been the driving force toward investment in the HMIS ecosystem. The analysis showed that the government is the main stakeholder within the HMIS ecosystem and responsible for identifying the needs for improvement and has the power to approve or reject systems which are not in line with the government priority as stipulated with the HMIS investment roadmap/strategy. Moreover, partners with long relationship are powerful in influencing HMIS investment decision-making compared to those who are recently coming to support. It was further noted shortage of staff with technical competence, inadequate financial resources, and the development of fact that some of the existing systems have not been developed to their full capacity and have hindered the whole systems' integration and interoperability exercise of ensuring integration and interoperability of the systems. CONCLUSION: A need-based assessment of staff capacity at the sub-national level is equally important to identify available capabilities and the knowledge gap to strengthen the HMIS ecosystem. Strong coordination of the ideas and resources intended to strengthen the HMIS ecosystem would help to reduce fragmentation. In addition, there is a need to mobilize resources within and outside the country to facilitate the integration and interoperability process smoothly.
36Epistemic spillovers: Learning others' political views reduces the ability to assess and use their expertise in nonpolitical domains.PubMed
Joseph Marks, Eloise Copland, Eleanor Loh, et al.
Cognition. 2019 Jul;188:74-84. doi: 10.1016/j.cognition.2018.10.003. Epub 2018 Oct 19.
On political questions, many people prefer to consult and learn from those whose political views are similar to their own, thus creating a risk of echo chambers or information cocoons. We test whether the tendency to prefer knowledge from the politically like-minded generalizes to domains that have nothing to do with politics, even when evidence indicates that politically like-minded people are less skilled in those domains than people with dissimilar political views. Participants had multiple opportunities to learn about others' (1) political opinions and (2) ability to categorize geometric shapes. They then decided to whom to turn for advice when solving an incentivized shape categorization task. We find that participants falsely concluded that politically like-minded others were better at categorizing shapes and thus chose to hear from them. Participants were also more influenced by politically like-minded others, even when they had good reason not to be. These results replicate in two independent samples. The findings demonstrate that knowing about others' political views interferes with the ability to learn about their competency in unrelated tasks, leading to suboptimal information-seeking decisions and errors in judgement. Our findings have implications for political polarization and social learning in the midst of political divisions.
37Just one more level: Identifying and addressing internet gaming disorder within primary care.PubMed
Dan Loton, Dan I Lubman
Aust Fam Physician. 2016 Jan-Feb;45(1):48-52.
BACKGROUND: For most people, playing video games is a passionate leisure pursuit: a source of relaxation, fun, socialisation and culture. Moderate play has been associated with greater wellbeing and cognitive abilities in some studies. Yet, for a small subgroup, gaming can become excessive and problematic. OBJECTIVE: This article presents an overview of the world of video games and the recently proposed internet gaming disorder (IGD), as well as advice regarding relevant treatment approaches within primary care. DISCUSSION: Similar to other addictive disorders (including problem gambling), IGD is characterised by excessive use despite negative consequences, with associated difficulties in reducing or stopping. Studies that have examined individuals with IGD have identified multiple harms, including lower psychosocial wellbeing, greater levels of psychopathology and diminished functioning. As yet, few studies have rigorously examined effective treatment options, but adapting psychological interventions used in the treatment of other addictions (eg motivational interviewing and cognitive behavioural therapy) that incorporate harm minimisation approaches, and addressing underlying issues and associated problems, are recommended.
38Neuropsychological Deficits in Disordered Screen Use Behaviours: A Systematic Review and Meta-analysis.PubMed
Michoel L Moshel, Wayne A Warburton, Jennifer Batchelor, et al.
Neuropsychol Rev. 2024 Sep;34(3):791-822. doi: 10.1007/s11065-023-09612-4. Epub 2023 Sep 11.
Over the last few decades, excessive and disordered screen use has become more prevalent, prompting investigations into its associated consequences. The extent to which disordered screen use behaviours impact neuropsychological functioning has been reportedly mixed and at times inconsistent. This review sought to synthesise the literature and estimate the magnitude of overall cognitive impairment across a wide range of disordered screen use behaviours. We also sought to determine the cognitive domains most impacted, and whether the observed impairments were moderated by the classification of screen-related behaviours (i.e., Internet or gaming) or the format of cognitive test administration (i.e., paper-and-pencil or computerised). A systematic search of databases (Embase, PsycINFO, MEDLINE) identified 43 cross-sectional articles that assessed neuropsychological performance in disordered screen use populations, 34 of which were included in the meta-analysis. A random-effects meta-analysis revealed significant small/medium (g = .38) cognitive deficits for individuals with disordered screen use behaviours relative to controls. The most affected cognitive domain with a significant medium effect size (g = .50) was attention and focus followed by a significant reduction in executive functioning (g = .31). The classification of disordered screen use behaviours into Internet or gaming categories or the format of cognitive testing did not moderate these deficits. Additionally, excluding disordered social media use in an exploratory analysis had little effect on the observed outcomes. This study highlights a number of methodological considerations that may have contributed to disparate findings and shows that disordered screen use can significantly impact cognitive performance. Recommendations for future research are also discussed. Data for this study can be found at https://osf.io/upeha/ .
39Acupuncture attenuates cognitive impairments in vascular dementia through inhibiting miR-143-3p.PubMed
Runcheng Yang, Jianhua Yang, Lanfang Huang
Acta Biochim Pol. 2022 Dec 2;69(4):805-810. doi: 10.18388/abp.2020_6132.
BACKGROUND: Acupuncture can be used to treat vascular dementia (VD), but the underlying mechanism remains unclear. This study aimed to investigate the expression and clinical significance of microRNA-143-3p (miR-143-3p) in VD patients and explore whether acupuncture ameliorates VD by regulating miR-143-3p. METHODS: Cognitive function and daily living ability in VD patients were assessed by mini-mental state examination, Hasegawa's dementia scale and activities of daily living scale, respectively. VD model of male Wistar rats was established using permanent bilateral common carotid artery occlusion. The expression level of miR-143-3p was measured by quantitative real-time PCR. Morris water maze test was used to assess the cognitive function of VD rat model. Receiver operating characteristic analysis was used to assess the diagnostic value of miR-143-3p in VD patients. Correlations between variables were analyzed by Pearson's correlation analysis. RESULTS: Increased serum miR-143-3p expression in VD patients had a high diagnostic value to screen VD patients. Serum miR-143-3p level in VD patients after acupuncture treatment was decreased. After acupuncture treatment, serum miR-143-3p was negatively correlated with cognitive function and daily living ability in VD patients. miR-143-3p level was increased in VD rats, and the suppressive effects of acupuncture on miR-143-3p levels were relieved by miR-143-3p mimic. Overexpression of miR-143-3p reversed the ameliorative effect of acupuncture on cognitive functions of VD rats. CONCLUSION: Serum miR-143-3p expression is upregulated in VD patients and downregulated in VD patients after acupuncture treatment. Additionally, acupuncture treatment may attenuate cognitive impairments in VD by suppressing miR-143-3p.
40Adolescents' short-form video addiction and sleep quality: the mediating role of social anxiety.PubMed
Li Jiang, Yizoon Yoo
BMC Psychol. 2024 Jun 28;12(1):369. doi: 10.1186/s40359-024-01865-9.
BACKGROUND: Adolescence is a critical period for individual growth and development. Insufficient sleep adversely affects adolescents' physical development, blood pressure, vision, and cognitive function. This study examined the effect of short-form video addiction on adolescents' sleep quality, as well as the mediating role of social anxiety, to identify methods for improving adolescents' sleep quality in the Internet era. METHODS: A questionnaire survey was conducted in this cross-sectional study on 1629 adolescents recruited from three high schools. Their short-form video addiction, social anxiety, and sleep quality were evaluated using corresponding scales. Pearson correlation analysis was carried out to analyze the relationships among short-form video addiction, sleep quality, and social anxiety. Mediating effect analysis was constructed using AMOS 20.0 statistical software. RESULTS: Participants' sleep quality score is 6.12 ± 3.29 points. The detection rate of sleep quality among them is 31.06%. Short-form video addiction, sleep quality, and social anxiety are significantly correlated (r = 0.439, 0.404, 0.457, P < 0.001). The direct effect of short-form video addiction on sleep quality is 0.248, accounting for 62.4% of the total effect. The indirect effect exerted through social anxiety is 0.149, accounting for 37.6%. CONCLUSIONS: Sleep disorders are very common among Chinese adolescents. Short-form video addiction is positively correlated with adolescents' sleep quality and social anxiety. Social anxiety partially mediates the relationship between short-form video addiction and sleep quality. The adverse effects of short-form video addiction and social anxiety on the sleep quality of this group must be minimized. Schools are recommended to implement measures to promote sleep quality among adolescents.
41Analysis of the causes, psychological mechanisms, and coping strategies of short video addiction in China.PubMed
Mingyue Liao
Front Psychol. 2024 Aug 6;15:1391204. doi: 10.3389/fpsyg.2024.1391204. eCollection 2024.
Short video addiction refers to the uncontrollable desire of users to watch short videos, leading to significant behavioral loss of control or attention disorders, which in turn result in difficulties in social interaction, learning, and work adaptation. With the "invasion" of short videos into people's daily lives and their spread among underage groups, the issue of short video addiction has attracted widespread social attention. Firstly, based on the causes of short video addiction, this study analyzes it from four levels: algorithm design, content services, platform control, and user experience. Secondly, combining relevant scientific theories, the psychological mechanisms of short video addiction are explained from four levels: cognition, emotion, motivation, and social factors. Finally, in terms of coping strategies, on the theoretical level, further research on the occurrence mechanism of short video addiction should be deepened, and attention should be paid to the influence of recommendation algorithms on short video addiction. On the practical level, the obligations and responsibilities of relevant stakeholders such as short video producers, platforms, and regulators in preventing short video addiction should be clarified, aiming to promote prevention and management of short video addiction.
42Influencing factors of short-form video addiction among Chinese university students: a systematic review.PubMed
Xiaoling Zhan, Weijia Zhu
Front Psychol. 2025 Sep 22;16:1663670. doi: 10.3389/fpsyg.2025.1663670. eCollection 2025.
INTRODUCTION: This systematic review explores the influencing factors of short-form video addiction (SVA) among Chinese university students over the past 5 years. It offers theoretical and practical implications for understanding and preventing SVA among university students and suggests future research directions. METHODS: This review identified 28 eligible peer-reviewed articles from seven English and Chinese databases. The protocol was pre-registered in PROSPERO (CRD420251030636). RESULTS: The findings indicate that SVA among university students is prevalent and multifactorial. Influencing factors include eight domains: demographic, psychological, personality traits, behavioral, social, family, motivation for media use, and platform-induced factors. DISCUSSION: Guided by the I-PACE model, the review organized these domains into the person-affect-cognition-execution framework. Personal factors include demographic and personality traits; social and family factors represent persons' external environmental influences; affective and cognitive components comprise psychological factors and media use motivations; and execution factors include behavioral and platform-induced influences. These components interact with each other and collectively predict SVA throughout university students' development. Psychological and personality trait factors often serve as mediating or chained mediating variables for other influencing factors. Conflicting findings regarding demographic, personality, and psychological influences may result from sample homogeneity and research design limitations. Research gaps remain in policy factors and longitudinal or intervention-based studies. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD420251030636, PROSPERO: CRD420251030636.
43Assessing Short-Video Dependence for e-Mental Health: Development and Validation Study of the Short-Video Dependence Scale.PubMed
AnHang Jiang, Shuang Li, HuaBin Wang, et al.
J Med Internet Res. 2025 Mar 4;27:e66341. doi: 10.2196/66341.
BACKGROUND: Short-video dependence (SVD) has become a significant mental health issue around the world. The lack of scientific tools to assess SVD hampers further advancement in this area. OBJECTIVE: This study aims to develop and validate a scientific tool to measure SVD levels, ensuring a scientifically determined cutoff point. METHODS: We initially interviewed 115 highly engaged short-video users aged 15 to 63 years. Based on the summary of the interview and references to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria for behavioral addictions, we proposed the first version of the short-video dependence scale (SVDS). We then screened the items through item analysis (second version) and extracted common factors using exploratory factor analysis (third version) and confirmatory factor analysis (final version). Convergent validity was tested with other scales (Chinese Internet Addiction Scale [CIAS] and DSM-5). Finally, we tested the validity of the final version in 16,038 subjects and set the diagnostic cutoff point through latent profile analysis and receiver operating characteristic curve analysis. RESULTS: The final version of the SVDS contained 20 items and 4 dimensions, which showed strong structural validity (Kaiser-Meyer-Olkin value=0.94) and internal consistency (Cronbach α=.93), and good convergent validity (r=0.61 and r=0.68), sensitivity (0.77, 0.83, 0.87, and 0.62 for each of the 4 dimensions), and specificity (0.75, 0.87, 0.80, and 0.79 for each of the 4 dimensions). Additionally, an SVDS score of 58 was determined as the best cutoff score, and latent profile analysis identified a 5-class model for SVD. CONCLUSIONS: We developed a tool to measure SVD levels and established a threshold to differentiate dependent users from highly engaged nondependent users. The findings provide opportunities for further research on the impacts of short-video use.
44Relationship between level of internet addiction and time management skills among nursing students.PubMed
Merve Altiner Yas, Necmettin Isci, Burcu Alacam, et al.
Perspect Psychiatr Care. 2022 Apr;58(2):758-766. doi: 10.1111/ppc.12845. Epub 2021 May 11.
PURPOSE: This study investigated nursing students' levels of internet addiction (IA) and time management (TM) skills. DESIGN AND METHODS: This cross-sectional descriptive study was conducted with 400 nursing students of a university in Turkey. The data were collected using the Personal Information Form, IA Scale, and TM Inventory. FINDINGS: The IA scale and TM inventory mean scores were 40.83 ± 14.81 and 81.34 ± 11.91, respectively. A significantly negative relationship between students' level of IA and TM skills was found (p <0.05). PRACTICE IMPLICATIONS: The concept of effective time management should be used in interventions for promoting students' conscious internet use.
45Smartphone Addiction and Quality of Sleep among Indian Medical Students.PubMed
Surobhi Chatterjee, Sujita Kumar Kar
Psychiatry. 2021 Summer;84(2):182-191. doi: 10.1080/00332747.2021.1907870. Epub 2021 Apr 15.
: Smartphone is an indispensable miracle of artificial intelligence in the hands of global netizens. Medical students overburdened and sleep-deprived due to the curricular demands can have serious health effects due to further sleep deprivation caused by problematic smartphone use, affecting their work proficiency as practicing physicians. This study aimed to evaluate the association of smartphone addiction and quality of sleep among medical students across all semesters, along with other background variables.: This cross-sectional study was conducted on 224 medical students of a tertiary care teaching hospital in North India using a self-administered questionnaire with four parts -Socio-demographic characteristics, General health questionnaire (GHQ-12), Smartphone addiction scale-short version (SAS-SV), and Pittsburgh sleep quality index (PSQI).: The prevalence of smartphone addiction is was found out to as assessed by their PQSI scores, and . There was a positive correlation between overall PQSI scores and smartphone use duration per day, SAS-SV scores, and GHQ scores.: The high prevalence of excessive smartphone usage among medical students is a cause for concern and is detrimental to their health and sleep quality. The research addresses current lacunae in correlating smartphone addiction with smartphone usage before sleeping and right after waking up. Risky behavior adoption and pervasive mood changes associated with excessive smartphone use are addressed with equal representation across semesters. The study recommends increasing self-awareness for help-seeking to regulate smartphone usage and providing counseling services for students in their formative years.
46[Relationship Between Sleep Quality, Smartphone Addiction, and Academic GPA in Medical Students].PubMed
Cristel Iona Kennedy Cuevas, Hugo Ariel Cabrera Britez, Keyla Noemí Vázquez Ovelar
Rev Med Chil. 2025 Jul;153(7):475-484. doi: 10.4067/s0034-98872025000700475.
UNLABELLED: Sleep quality and smartphone use are factors that could influence academic performance, since sleep deprivation decreases concentration and smartphone use is related to not planning work. AIM: To evaluate the relationship between sleep quality and smartphone addiction with the grade point average (GPA) in medical students. METHODS: Analytical cross-sectional study. 181 medical students were included. Data were collected through an electronic survey. Sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI), smartphone addiction with the Smartphone Addiction Scale - Short Version (SAS-SV) and GPA based on the average of the last semester. Chi2, t-test and Wilcoxon tests were used to analyze the relationship between the variables. RESULTS: The students were 116 (64.09%) female and 65 (35.91%) male. The median age was 22 years (IQR 21-24). The ICSP results were 91 (50.28%) with poor sleep quality and 90 (49.72%) with good sleep quality. The SAS-SV results were 119 (65.75%) without smartphone addiction and 62 (34.25%) with smartphone addiction. The GPA was 3.96 (SD ±0.66). A significant difference was found between the GPA of the group of students without smartphone addiction and GPA of the group of students with smartphone addiction (p value 0.0007). A significant difference was also observed in the sleep efficiency of the group of students without smartphone addiction and the sleep efficiency of the group of students with smartphone addiction (p value 0.0425). CONCLUSION: The GPA and sleep efficiency are lower in medical students with smartphone addiction.
47Association between impulsivity and cognitive capacity decrease is mediated by smartphone addiction, academic procrastination, bedtime procrastination, sleep insufficiency and daytime fatigue among medical students: a path analysis.PubMed
Csaba Hamvai, Hedvig Kiss, Henrietta Vörös, et al.
BMC Med Educ. 2023 Jul 27;23(1):537. doi: 10.1186/s12909-023-04522-8.
BACKGROUND: Medical students are at high risk for sleep disturbance. One possible cause of their sleeping problem is impulsivity. We aim to investigate the possible mediators between medical students' impulsivity and sleep outcomes. Thus, we developed and investigated a model where the predictors were attentional, non-planning, and motor impulsivity subtraits. In the final model, subjective cognitive capacity decrease was the outcome variable. In light of previous findings, academic procrastination, smartphone addiction, and bedtime procrastination were considered important mediators as well as two variables of poor sleep, sleeping insufficiency, and daytime fatigue. METHODS: Medical students (N = 211; age = 22.15 years; age = 3.47 years; 71.6% women) were recruited to complete an online survey comprised of demographics (age, gender), self-administered scales (Abbreviated Impulsiveness Scale, Bedtime Procrastination Scale, Abbreviated Impulsiveness Scale, Academic Procrastination Scale-Short Form) and questions on tiredness, daily fatigue and subjective cognitive capacity decrease. Correlation and path analyses were implemented to examine hypothesized relationships between the variables. RESULTS: Both attentional impulsivity (β = 0.33, p < .001) and non-planning impulsivity (β = -0.19, p < .01) had a direct relationship with cognitive capacity decrease. Attentional impulsivity was also associated with decreased cognitive capacity with a serial mediation effect via smartphone addiction, academic procrastination, bedtime procrastination, sleep insufficiency and fatigue (estimate = 0.017, p < .01). The indirect link between non-planning impulsivity and cognitive capacity decrease was mediated by academic procrastination, bedtime procrastination, sleep insufficiency and fatigue (estimate = 0.011, p < .01). CONCLUSIONS: Inability to stay focused and plan tasks effectively (directly and indirectly) predicts poor sleep outcomes. This relationship is mediated by excessive smartphone use, academic procrastination, and bedtime procrastination. Our findings are relevant in light of self-regulatory learning, which is crucial in medical education. This is a recursive cycle of planning, emotion regulation, proper strategy selection and self-monitoring. Future interventions addressing attentional and non-planning impulsivity, problematic smartphone use, academic procrastination, and in turn, bedtime procrastination might make this routine more effective. In the conclusion section, practical implications of the results are discussed.
48The Influence of Parenting Style and Time Management Tendency on Internet Gaming Disorder among Adolescents.PubMed
I-Hua Chen, Zeng-Han Lee, Xiao-Yu Dong, et al.
Int J Environ Res Public Health. 2020 Dec 6;17(23):9120. doi: 10.3390/ijerph17239120.
The problem of adolescent online gaming addiction is related to individual-level characteristics and the influence of the family environment. The present study explores the potential role of adolescents' time management tendency in mediating the relationship between parenting style and adolescent internet gaming disorder (IGD). Responses from a total of 357 Chinese high school students were collected for a Pathological Video-Game Use Questionnaire, Simplified Parenting Styles Scale, and Time Management Tendency Scale. Overall, participants reported moderate use of online games (Mean = 1.41; SD = 0.41), lower than the median value of 2 on a three-point scale. In terms of the mediating role of adolescents' time management tendency, full meditation was observed for the relationship between the parenting style factor of "parents' emotional warmth" for both mothers and fathers and internet gaming disorder. The results highlight the benefits of emotional warmth in supporting self-efficacy, self-control, and autonomy through the promotion of time management, which is an important protective factor for IGD and can serve as a mediating personality variable. Although non-significant in the complete model, over-protection and rejection by parents should also be cautiously considered as potential risk factors related to addiction.
49Association of Internet Addiction with Family Functionality, Depression, Self-Efficacy and Self-Esteem among Early Adolescents.PubMed
Hsiao-Ching Chen, Jiun-Yi Wang, Ying-Lien Lin, et al.
Int J Environ Res Public Health. 2020 Nov 27;17(23):8820. doi: 10.3390/ijerph17238820.
Early adolescents usually have worse self-control and poor time management abilities. They are a higher-risk group for Internet addiction than older adolescents or adults. This study aims to explore the prevalence of Internet addiction and associated factors in early adolescents. Participants included 451 fifth and sixth-grade students in Central Taiwan. This study adopted a cross-sectional design and a structured questionnaire that consisted of demographics, Young's Internet Addiction Test, the Centre for Epidemiological Studies-Depression scale, the General Self-Efficacy Scale and the Rosenberg Self-Esteem Scale. The participants were 50.8% male, and the mean age was 11.35, with a range of 10.33-12.92 years. A total of 33.7% of all participants were prone to Internet addiction. The results showed that participants who were male and had high money allowance, poor family atmosphere, parents who did not limit Internet usage time, high depression, low self-efficacy and low self-esteem were more prone to Internet addiction. A multiple logistic regression analysis revealed that being male, having parents who did not limit Internet usage time and higher degrees of depression were the associated factors of Internet addiction in early adolescents. The phenomenon of Internet addiction among early adolescents seems to be increasing. Improving family functionality and individual mental health may be effective ways to reduce Internet addiction.
50Childhood Maltreatment, Bullying, and Internet Addiction in Relation to Suicidal Ideation Among Adolescents: Cross-Sectional Mediation and Network Analysis.PubMed
Jiayi Lu, Sihong Li, Tianqing Fan, et al.
J Med Internet Res. 2025 Oct 7;27:e79858. doi: 10.2196/79858.
BACKGROUND: Internet addiction (IA), childhood maltreatment (CM), and bullying are prevalent psychosocial stressors among adolescents and have each been associated with suicidal ideation (SI). However, existing research often treats these factors in isolation, overlooking their potential interrelationships and joint associations with SI. OBJECTIVE: This study aimed to examine how CM, IA, and bullying are jointly related to SI at both the scale and symptom levels and identify key symptoms within the CM-IA-bullying-SI network that may serve as intervention targets to disrupt maladaptive associations across the network. METHODS: A total of 6573 adolescents were recruited through cluster sampling. Mediation analyses were conducted to assess direct and indirect effects of CM on SI via IA and bullying. Network analysis was conducted to examine symptom-level associations among CM, IA, bullying, and SI and identify core and bridge symptoms within the network. Network comparison tests were conducted to assess differences in network structure by gender and history of nonsuicidal self-injury. RESULTS: Mediation analyses revealed that both IA and bullying partially mediated the association between CM and SI, with significant indirect effects via IA (c'=0.010, 95% CI 0.008-0.011; P<.001) and bullying (c'=0.004, 95% CI 0.002-0.005; P<.001). In the network, tolerance, time management, and compulsive internet use were identified as central symptoms, whereas SI, emotional abuse, and traditional bullying victimization served as bridge symptoms. Emotional abuse and cyberbullying victimization were most strongly linked to SI. Among individuals with a history of nonsuicidal self-injury, emotional abuse and emotional neglect showed stronger associations with SI. Sex subgroup analysis showed no significant difference in global strength (S=0.095; P=.69) but a significant difference in network structure (M=0.174; P=.01). CONCLUSIONS: This study revealed how CM, bullying, and IA are jointly related to SI among adolescents at both the scale and symptom levels. Key symptoms, including tolerance and time management, played central roles within the symptom network, with SI bridging multiple psychosocial domains. These findings underscore the need for multilevel, targeted interventions to disrupt maladaptive links and reduce suicide risk in adolescents.
51The epidemiology and effects of video game addiction: A systematic review and meta-analysis.PubMed
Pierpaolo Limone, Benedetta Ragni, Giusi Antonia Toto
Acta Psychol (Amst). 2023 Nov;241:104047. doi: 10.1016/j.actpsy.2023.104047. Epub 2023 Oct 26.
With the increasing popularity and accessibility of video games, the public concern about their effects - positive and negative - has also increased. In this regard, this systematic review sought to identify and thematically analyze recent studies (in the last five years) and report on video games' epidemiological characteristics and outcomes. A systematic database search was done on ScienceDirect, APA PsycINFO, Emerald, and Scopus databases for articles published from January 1, 2017, to April 1, 2022. The Meta XL software - an add-in for Microsoft Excel - was used to calculate the pooled prevalence level of video game addiction. The database search yielded a total of 693 non-duplicate articles. After applying the inclusion and exclusion criteria, 27 articles were selected to be included in the systematic review. Along with this, 12 articles were considered for the final meta-analysis. The pooled prevalence level of gaming addiction was 5.0 % (95 % CI, 2.1-8.8 %). The I value was 99.297 with a p-value of 0.000. The factors that accompanied addictive video gaming were psychological, social, and personal. An addictive gaming behavior was characterized by spending an above-average time on gaming, doing most of the gaming online, and gaming activities interfering with sleep patterns. Some predictors of addictive gaming were emotional dependence, social detachment, increased gaming time, preference for playing online than offline, and increased emotional and psychological stress. Engaging in addictive gaming led to adverse outcomes such as lower academic scores, depression, and anxiety, as well as decreased self-esteem, life satisfaction, and social support. From the collected findings it could be concluded that extreme playing of video games can be classified as addictive. Following the identification of risk factors, appropriate corrective or interventional measures should be developed and applied coherently to newer statistical data.
52Factors associated with sleep deprivation and their impact on academic performance of hostelites of twin cities of Pakistan.PubMed
Rimsha Luqman, Misbah Ghous, Javeria Nawaz, et al.
J Pak Med Assoc. 2020 May;70(5):851-855. doi: 10.5455/JPMA.16468.
OBJECTIVE: To determine the factors associated with sleep deprivation and their impact on academic performance of students living in a hostel setting. METHODS: It was a correlational study conducted from January to June, 2018 in Rawalpindi and Islamabad, Pakistan, and comprised university students of either sex aged 18-25 years who were studying at different universities of the twin cities. A semi-structured questionnaire was used along with Pittsburgh Sleep Quality Index to collect data which was analysed using SPSS 21. RESULTS: Of the 850 students, 450(50%) each were males and females. The overall mean age was 21.10±1.84 years. There was academic stress in 672(79%) students which disturbed the normal sleep cycle. Other factors affecting students; sleep were financial issues 632(74%), uncomfortable bed mattresses 671(79%), environmental noise 468 (53%), poor ventilation 666 (78%), hostel near commercial places 233(27%), and the habit of playing mobile games 545(65%). Female students had more sleep problems than males (p<0.05). Bivariate correlation showed no association of these factors and cumulative grade point average (p>0.05). CONCLUSION: The most common factors found to be influencing hostelites' sleep were stress, financial issues, uncomfortable mattresses, environmental noise and playing games on mobile before sleep. Disturbed sleep did not affect academic performance.
53Smartphone addiction, depression, distress, eustress, loneliness, and sleep deprivation in adolescents: a latent profile and network analysis approach.PubMed
Fedai Kabadayi
BMC Psychol. 2024 Oct 31;12(1):608. doi: 10.1186/s40359-024-02117-6.
BACKGROUND: Previous research on adolescent smartphone addiction has tended to focus on general populations that are assumed to be homogeneous, overlooking latent profiles. Furthermore, previous research has not focused on potentially important differences in the latent profiles of adolescent smartphone addiction in networks. The present study aimed to reveal the latent profiles of smartphone addiction, depression, stress, eustress, loneliness, and sleep deprivation in adolescents, and general and latent profiles were examined in the network. METHODS: The study group consisted of 436 (222 boys and 214 girls) adolescents, aged between 13 and 18 years. The findings of the present study were provided using Pearson correlation, ANOVA, latent profile analysis and network analysis. The data were analyzed using SPSS, JASP, and Mplus. RESULTS: The results of the study showed solutions with three latent profiles. The non-addicted group constituted 20.87%, the addicted group covered 29.82% and the risky group included 49.31% of the study group. Although the general profile and the addicted latent group had similar characteristics, the differences in the risky and non-addicted groups contributed to the current literature by providing a further and remarkable perspective on smartphone addiction, depression, distress, eustress, loneliness, and sleep deprivation in adolescents. CONCLUSIONS: The theoretical and practical implications of the present results will provide contributions to researchers and practitioners in understanding smartphone addiction.
54Internet and Video Game Addictions: Diagnosis, Epidemiology, and Neurobiology.PubMed
Clifford J Sussman, James M Harper, Jessica L Stahl, et al.
Child Adolesc Psychiatr Clin N Am. 2018 Apr;27(2):307-326. doi: 10.1016/j.chc.2017.11.015. Epub 2018 Feb 1.
In the past 2 decades, there has been substantial increase in availability and use of digital technologies, including the Internet, computer games, smart phones, and social media. Behavioral addiction to use of technologies spawned a body of related research. The recent inclusion of Internet gaming disorder as a condition for further study in the DSM-V invigorated a new wave of researchers, thereby expanding our understanding of these conditions. This article reviews current research, theory, and practice regarding the diagnosis, epidemiology, and neurobiology of Internet and video game addictions.
55Treatment Considerations in Internet and Video Game Addiction: A Qualitative Discussion.PubMed
David N Greenfield
Child Adolesc Psychiatr Clin N Am. 2018 Apr;27(2):327-344. doi: 10.1016/j.chc.2017.11.007. Epub 2018 Jan 9.
Internet and video game addiction has been a steadily developing consequence of modern living. Behavioral and process addictions and particularly Internet and video game addiction require specialized treatment protocols and techniques. Recent advances in addiction medicine have improved our understanding of the neurobiology of substance and behavioral addictions. Novel research has expanded the ways we understand and apply well-established addiction treatments as well as newer therapies specific to Internet and video game addiction. This article reviews the etiology, psychology, and neurobiology of Internet and video game addiction and presents treatment strategies and protocols for addressing this growing problem.
56Neurobiological findings related to Internet use disorders.PubMed
Byeongsu Park, Doug Hyun Han, Sungwon Roh
Psychiatry Clin Neurosci. 2017 Jul;71(7):467-478. doi: 10.1111/pcn.12422. Epub 2016 Sep 13.
In the last 10 years, numerous neurobiological studies have been conducted on Internet addiction or Internet use disorder. Various neurobiological research methods - such as magnetic resonance imaging; nuclear imaging modalities, including positron emission tomography and single photon emission computed tomography; molecular genetics; and neurophysiologic methods - have made it possible to discover structural or functional impairments in the brains of individuals with Internet use disorder. Specifically, Internet use disorder is associated with structural or functional impairment in the orbitofrontal cortex, dorsolateral prefrontal cortex, anterior cingulate cortex, and posterior cingulate cortex. These regions are associated with the processing of reward, motivation, memory, and cognitive control. Early neurobiological research results in this area indicated that Internet use disorder shares many similarities with substance use disorders, including, to a certain extent, a shared pathophysiology. However, recent studies suggest that differences in biological and psychological markers exist between Internet use disorder and substance use disorders. Further research is required for a better understanding of the pathophysiology of Internet use disorder.
57Behavioral addictions in addiction medicine: from mechanisms to practical considerations.PubMed
Barbara C Banz, Sarah W Yip, Yvonne H C Yau, et al.
Prog Brain Res. 2016;223:311-28. doi: 10.1016/bs.pbr.2015.08.003. Epub 2015 Nov 23.
Recent progress has been made in our understanding of nonsubstance or "behavioral" addictions, although these conditions and their most appropriate classification remain debated and the knowledge basis for understanding the pathophysiology of and treatments for these conditions includes important gaps. Recent developments include the classification of gambling disorder as a "Substance-Related and Addictive Disorder" in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and proposed diagnostic criteria for Internet Gaming Disorder in Section 3 of DSM-5. This chapter reviews current neuroscientific understandings of behavioral addictions and the potential of neurobiological data to assist in the development of improved policy, prevention, and treatment efforts.
58Internet gaming disorder: deficits in functional and structural connectivity in the ventral tegmental area-Accumbens pathway.PubMed
Ruonan Wang, Min Li, Meng Zhao, et al.
Brain Imaging Behav. 2019 Aug;13(4):1172-1181. doi: 10.1007/s11682-018-9929-6.
Dopamine projections from the ventral tegmental area (VTA) to the nucleus accumbens (NAc) and from the substantia nigra (SN) to the dorsal striatum are involved in addiction. However, relatively little is known about the implication of these circuits in Internet gaming disorder (IGD). This study examined the alteration of resting-state functional connectivity (RSFC) and diffusion tensor imaging (DTI) -based structural connectivity of VTA/SN circuits in 61 young male participants (33 IGD and 28 healthy controls). Correlation analysis was carried out to investigate the relationship between the neuroimaging findings and the behavioral Internet Addiction Test (IAT). Both the NAc and medial orbitofrontal cortex (mOFC) showed lower RSFC with VTA in IGD subjects compared with controls. Moreover, the RSFC strength of VTA-right NAc and VTA-left mOFC correlated negatively with IAT in IGD subjects. The IGD subjects also showed lower structural connectivity in bilateral VTA-NAc tracts compared with controls, but the connectivity did not correlate with IAT in IGD. We provide evidence that functional and structural connectivity of the VTA-NAc pathway, and functional connectivity of the VTA-mOFC pathway are implicated in IGD. Since these pathways are important for dopamine reward signals and salience attribution, the findings suggest involvement of the brain DA reward system in the neurobiology of IGD. The association of functional but not structural connectivity of VTA circuits with IAT suggests that while lower structural connectivity might underlie vulnerability for IGD, lower functional connectivity may modulate severity. These results strengthen the evidence that IGD shares similar neuropathology with other addictions.
59The flexible approach hypothesis: unification of effort and cue-responding hypotheses for the role of nucleus accumbens dopamine in the activation of reward-seeking behavior.PubMed
Saleem M Nicola
J Neurosci. 2010 Dec 8;30(49):16585-600. doi: 10.1523/JNEUROSCI.3958-10.2010.
Dopamine released in the nucleus accumbens is thought to contribute to the decision to exert effort to seek reward. This hypothesis is supported by findings that performance of tasks requiring higher levels of effort is more susceptible to disruption by manipulations that reduce accumbens dopamine function than tasks that require less effort. However, performance of some low-effort cue-responding tasks is highly dependent on accumbens dopamine. To reconcile these disparate results, we made detailed behavioral observations of rats performing various operant tasks and determined how injection of dopamine receptor antagonists into the accumbens influenced specific aspects of the animals' behavior. Strikingly, once animals began a chain of operant responses, the antagonists did not affect the ability to continue the chain until reward delivery. Instead, when rats left the operandum, the antagonists severely impaired the ability to return. We show that this impairment is specific to situations in which the animal must determine a new set of approach actions on each approach occasion; this behavior is called "flexible approach." Both high-effort operant tasks and some low-effort cue-responding tasks require dopamine receptor activation in the accumbens because animals pause their responding and explore the chamber, and accumbens dopamine is required to terminate these pauses with flexible approach to the operandum. The flexible approach hypothesis provides a unified framework for understanding the contribution of the accumbens and its dopamine projection to reward-seeking behavior.
60Decreased functional connectivity between ventral tegmental area and nucleus accumbens in Internet gaming disorder: evidence from resting state functional magnetic resonance imaging.PubMed
Jin-Tao Zhang, Shan-Shan Ma, Sarah W Yip, et al.
Behav Brain Funct. 2015 Nov 18;11(1):37. doi: 10.1186/s12993-015-0082-8.
BACKGROUND: Internet gaming disorder (IGD) has become an increasing mental health problem worldwide. Decreased resting-state functional connectivity (rsFC) between the ventral tegmental area (VTA) and the nucleus accumbens (NAcc) has been found in substance use and is thought to play an important role in the development of substance addiction. However, rsFC between the VTA and NAcc in a non-substance addiction, such as IGD, has not been assessed previously. The current study aimed to investigate: (1) if individuals with IGD exhibit alterations in VTA-NAcc functional connectivity; and (2) whether VTA-NAcc functional connectivity is associated with subjective Internet craving. METHODS: Thirty-five male participants with IGD and 24 healthy control (HC) individuals participated in resting-state functional magnetic resonance imaging. Regions of interest (left NAcc, right NAcc and VTA) were selected based on the literature and were defined by placing spheres centered on Talairach Daemon coordinates. RESULTS: In comparison with HCs, individuals with IGD had significantly decreased rsFC between the VTA and right NAcc. Resting-state functional connectivity strength between the VTA and right NAcc was negatively correlated with self-reported subjective craving for the Internet. CONCLUSIONS: These results suggest possible neural functional similarities between individuals with IGD and individuals with substance addictions.
61Stimulant-induced dopamine increases are markedly blunted in active cocaine abusers.PubMed
N D Volkow, D Tomasi, G-J Wang, et al.
Mol Psychiatry. 2014 Sep;19(9):1037-43. doi: 10.1038/mp.2014.58. Epub 2014 Jun 10.
Dopamine signaling in nucleus accumbens is essential for cocaine reward. Interestingly, imaging studies have reported blunted dopamine increases in striatum (assessed as reduced binding of [(11)C]raclopride to D2/D3 receptors) in detoxified cocaine abusers. Here, we evaluate whether the blunted dopamine response reflected the effects of detoxification and the lack of cocaine-cues during stimulant exposure. For this purpose we studied 62 participants (43 non-detoxified cocaine abusers and 19 controls) using positron emission tomography and [(11)C]raclopride (radioligand sensitive to endogenous dopamine) to measure dopamine increases induced by intravenous methylphenidate and in 24 of the cocaine abusers, we also compared dopamine increases when methylphenidate was administered concomitantly with a cocaine cue-video versus a neutral-video. In controls, methylphenidate increased dopamine in dorsal (effect size 1.4; P<0.001) and ventral striatum (location of accumbens) (effect size 0.89; P<0.001), but in cocaine abusers methylphenidate's effects did not differ from placebo and were similar whether cocaine-cues were present or not. In cocaine abusers despite the markedly attenuated dopaminergic effects, the methylphenidate-induced changes in ventral striatum were associated with intense drug craving. Our findings are consistent with markedly reduced signaling through D2 receptors during intoxication in active cocaine abusers regardless of cues exposure, which might contribute to compulsive drug use.
62Altered Functional Connectivity of the Insula and Nucleus Accumbens in Internet Gaming Disorder: A Resting State fMRI Study.PubMed
Chiao-Yun Chen, Ju-Yu Yen, Peng-Wei Wang, et al.
Eur Addict Res. 2016;22(4):192-200. doi: 10.1159/000440716. Epub 2016 Feb 11.
AIMS: A possible addiction mechanism has been represented by altered functional connectivity (FC) in the resting state. The aim of this study was to evaluate the FCs of the insula and nucleus accumbens among subjects with Internet gaming disorder (IGD). METHODS: We recruited 30 males with IGD and 30 controls and evaluated their FC using functional magnetic imaging scanning under resting, a state with relaxation, closed eyes, with inducement to think of nothing systematically, become motionless, and instructed not to fall asleep. RESULTS: Subjects with IGD had a lower FC with the left insula over the left dorsolateral prefrontal cortex (DLPFC) and orbital frontal lobe and a higher FC with the insula with the contralateral insula than controls. The inter-hemispheric insula connectivity positively correlated with impulsivity. Further, they had lower FC with the left nucleus accumbens over the left DLPFC and with the right nucleus accumbens over the left DLPFC, and insula and a higher FC with that over the right precuneus. CONCLUSION: The elevated inter-hemispheric insula FC is found to be associated with impulsivity and might explain why it is involved in IGD. The attenuated frontostriatal suggests that the emotion-driven gaming urge through nucleus accumbens could not be well regulated by the frontal lobe of subjects with IGD.
63Sex differences in neural substrates of risk taking: Implications for sex-specific vulnerabilities to internet gaming disorder.PubMed
Lingxiao Wang, Hui Zheng, Min Wang, et al.
J Behav Addict. 2022 Sep 2;11(3):778-795. doi: 10.1556/2006.2022.00057. Print 2022 Sep 26.
BACKGROUND AND AIMS: Sex differences in internet gaming disorder (IGD) remain unknown. Investigating sex-specific neural features that underlie the core risk factor (i.e., risk-taking) of IGD would help in understanding sex-specific vulnerabilities to IGD and advance sex-specific treatments and prevention for IGD. METHODS: 111 participants (28 IGD males, 27 IGD females, 26 recreational game user (RGU) males, 30 RGU females) completed a probability discounting task during fMRI scanning. RESULTS: First, among RGUs, males showed a higher risk-taking tendency and greater neural activation associated with risk/value evaluation for reward (the ventromedial prefrontal cortex (vmPFC), anterior cingulate cortex (ACC), left putamen) and smaller activation associated with cognitive control (the inferior frontal gyrus) than females during the contrast of risky-safe choices. Moreover, males showed a greater modulatory effect of risky choices on the connection from the vmPFC/ACC to the left putamen than females. Second, IGD males showed decreased activation in the vmPFC/ACC and left putamen compared to RGU males, whereas this decrease did not exist in IGD females. DISCUSSION: Males show a higher risk-taking tendency than females. Altered neural substrates associated with risky decision-making exist in IGD males but not in IGD females. CONCLUSIONS: The present findings fill the gap in information on the behavioral and neural substrates underlying IGD among females and demonstrate that a high risk-taking tendency is a risk factor and core symptom only in IGD males but not in IGD females. It is necessary to design and adopt distinct treatments and prevention strategies for IGD in males and females.
64The impact of anger on intertemporal decision-making in individuals with internet addiction: an fNIRS study.PubMed
Ziyi Li, Wei Zhang, Yunjing Du, et al.
Eur Arch Psychiatry Clin Neurosci. 2025 Oct;275(7):2099-2110. doi: 10.1007/s00406-024-01882-0. Epub 2024 Sep 3.
Intertemporal decision-making is the choice between an immediate smaller reward (SS) and a delayed larger reward (LL). Intertemporal decision-making depends on the interaction of the cognitive and emotional systems, and the latter is particularly vital. According to the Appraisal Tendency Frame (ATF) theory, anger influences intertemporal decision-making by increasing an individual's sense of certainty and control. This study examined whether anger affects intertemporal decision-making in individuals with internet addiction (IA) in this manner and investigated its neural mechanisms. Nineteen individuals with IA and 20 healthy controls were recruited. All subjects performed the Monetary choice task under anger and neutral emotions while functional near-infrared spectroscopy (fNIRS) equipment simultaneously recorded the hemodynamics in the prefrontal cortex (PFC). Individuals with IA showed a more considerable delay discount and lower brain activations in the orbitofrontal cortex (OFC) and left dorsolateral prefrontal cortex (L-dlPFC) compared to HC. Moreover, individuals with IA made more LL choices in the angry condition than in the neutral emotion, yet there was no difference in HC. The brain activation in L-dlPFC of individuals with IA tends to increase in the angry condition compared to the neutral condition. These findings revealed that impairment of intertemporal decision-making in individuals with individuals with IA might be related to the dysfunction of OFC and L-dlPFC. Our work also provided initial footing for the applicability of the appraisal tendency frame theory to individuals with IA, and L-dlPFC might play a role in the effects of anger on intertemporal decision-making.
65Concurrent behavioral modeling and multimodal neuroimaging reveals how feedback affects the performance of decision making in internet gaming disorder.PubMed
Xinglin Zeng, Ying Hao Sun, Fei Gao, et al.
Neuroimage. 2024 Aug 15;297:120726. doi: 10.1016/j.neuroimage.2024.120726. Epub 2024 Jul 8.
Internet gaming disorder (IGD) prompts inquiry into how feedback from prior gaming rounds influences subsequent risk-taking behavior and potential neural mechanisms. Forty-two participants, including 15 with IGD and 27 health controls (HCs), underwent a sequential risk-taking task. Hierarchy Bayesian modeling was adopted to measure risky propensity, behavioral consistence, and affection by emotion ratings from last trial. Concurrent electroencephalogram and functional near-infrared spectroscopy (EEG-fNIRS) recordings were performed to demonstrate when, where and how the previous-round feedback affects the decision making to the next round. We discovered that the IGD illustrated heightened risk-taking propensity as compared to the HCs, indicating by the computational modeling (p = 0.028). EEG results also showed significant time window differences in univariate and multivariate pattern analysis between the IGD and HCs after the loss of the game. Further, reduced brain activation in the prefrontal cortex during the task was detected in IGD as compared to that of the control group. The findings underscore the importance of understanding the aberrant decision-making processes in IGD and suggest potential implications for future interventions and treatments aimed at addressing this behavioral addiction.
66The impacts of stress and loneliness on gambling and gaming problems: A nationwide longitudinal study.PubMed
Ilkka Vuorinen, Iina Savolainen, Anu Sirola, et al.
Int J Soc Psychiatry. 2024 Nov;70(7):1325-1332. doi: 10.1177/00207640241264661. Epub 2024 Jul 25.
BACKGROUND: Problems related to gambling and digital gaming have been a topic of concern for years. Less attention has been paid to the probable psychosocial factors behind these problems. While previous studies have established links between stress, loneliness, and addiction, there is a lack of longitudinal research investigating how stress and loneliness affect addictive behaviors, including problem gambling and gaming. AIMS: This study uses multilevel mixed-effects generalized linear models to analyze the between- and within-person effects of stress and loneliness on gambling and gaming problems. The interaction between stress and loneliness was also investigated. METHODS: A representative sample of Finns ( = 1,530) answered a survey in 6-month intervals between spring 2021 and autumn 2023; 49.22% of the sample took part at all six time points. The Problem Gambling Severity Index and the Internet Gaming Disorder Test were used to measure gambling and gaming problems. The three-item UCLA Loneliness Scale was used to assess loneliness, and the Perceived Stress Scale was used to evaluate stress. RESULTS: After controlling for gender and age, loneliness was found to increase only gaming problems at both the between- and within-person levels, but not gambling. In contrast, stress enhanced both gambling and gaming problems at the between- and within-person levels. Additionally, loneliness and stress were found to have negative interaction suggesting that their combined effect was lower than their separate effects. CONCLUSION: The findings provide longitudinal insight into the psychosocial vulnerabilities behind problem gambling and gaming, which can be helpful in designing targeted interventions.
67Rates and psychological stress predictors of problematic internet use (PIU) during the COVID-19 pandemic in a racially diverse sample of young adults.PubMed
G Alice Woolverton, Courtney Stevens, Hyeouk Chris Hahm, et al.
Anxiety Stress Coping. 2024 Nov;37(6):775-793. doi: 10.1080/10615806.2024.2383766. Epub 2024 Jul 31.
BACKGROUND: Problematic internet use (PIU), which includes social media misuse (SMM) and gaming misuse (GM), is uncontrollable and associated with significant psychological impairment. PIU is a coping behavior for COVID-19-related stress. We explored distress-related predictors of PIU in a young adult racially diverse sample during the pandemic. METHODS: Analyses used cross-sectional survey data ( = 1956). Psychological diagnoses, financial distress, COVID-19-related emotions, psychological distress, distress tolerance, social support, loneliness, SMM and GM were measured. Hierarchical multiple regressions identified predictors of PIU. Race-stratified exploratory analyses sought to understand if predictors held true across racial groups. RESULTS: Low distress tolerance was associated with SMM and GM, as were depression symptoms, with racial differences observed. SMM was associated with younger age, and GM was associated with male gender. PTSD symptoms predicted more GM. SMM and GM rates varied between racial groups. COVID-19-related adjustment challenges and stress predicted SMM and GM respectively, with racial differences observed. CONCLUSION: Individual psychological distress and low distress tolerance markedly increased PIU risk. Clinicians should screen for stress-related PIU risk factors and bolster distress tolerance in vulnerable patients. Comparing PIU to different forms of coping in a larger sample would further clarify groups differences in stress coping behaviors.
68Perceived Stress, Loneliness, and Resilience in Relation to Game Addiction Among Adolescents in Bangkok During the COVID-19 Pandemic Transition Period.PubMed
Prangwalai Attasara, Tusana Thaweekoon, Wilai Napa
J Child Adolesc Psychiatr Nurs. 2025 Nov;38(4):e70044. doi: 10.1111/jcap.70044.
BACKGROUND: The COVID-19 pandemic has led to an increase in adolescent gaming due to lockdowns and the shift to online learning. Although factors linked to game addiction in adolescents before and during the pandemic have been explored, research on patterns following the easing of restrictions is limited. PURPOSE: This study examined the relationship between perceived stress, loneliness, resilience, and game addiction among adolescents in Bangkok during the COVID-19 pandemic transition period. METHODOLOGY: This correlational study included 346 high school students from two schools in Bangkok, Thailand, selected using a proportional stratified random sampling method. Data were collected from November to December 2022 during Thailand's reclassification of COVID-19 as a communicable disease under a surveillance system. Descriptive statistics and Spearman's correlation were used for the analysis. RESULTS: The findings showed that 15.0% of adolescents were at risk of game addiction, with 4.4% being addicted. Most (87.3%) engaged in gaming, and 38.7% played games daily. Perceived stress (r = 0.14, p = 0.01) and loneliness (r = 0.25, p < 0.001) were positively correlated with game addiction, while resilience was negatively correlated (r= -0.26, p < 0.001). All resilience components-"I have" (external support) (r = -0.21), "I am" (inner strength) (r = -0.28), and "I can" (interpersonal and problem-solving skills) (r= -0.24)-were negatively correlated with game addiction (p < 0.001). CONCLUSIONS: This study identified perceived stress and loneliness as risk factors for game addiction, and resilience as a protective factor. These findings offer valuable insights for professionals, including nurses, to develop targeted prevention programs for adolescents during the pandemic transition period and in the event of future crises.
69Virtual Social Interaction in a Multiplayer-Online Video Game Increases Implicit Learning: An EEG Study.PubMed
Elena Del Fante, Francesca Piovesan, Pietro Sarasso, et al.
Cyberpsychol Behav Soc Netw. 2024 Aug;27(8):599-605. doi: 10.1089/cyber.2023.0336. Epub 2024 Jun 21.
It is well known that social interaction enhances learning processes, improving abilities such as attention and memorization. However, it is not clear whether similar advantages may be obtained even in virtual environments. Here, we investigate whether virtual interactions in a video game, similarly to real-life social interactions, may improve individuals' performance in a subsequent implicit learning task. Twenty-one healthy participants were asked to play a cooperative video game for 20 minutes in three different gaming modalities: alone (); together with someone without verbal interactions (); and with someone with verbal interactions (). After each gaming session, participants were presented with an EEG paradigm directed to measure mismatch negativity (MMN) responses, a well-validated index of implicit learning. MMN responses were significantly larger following , as compared with conditions. No significant difference was found between and conditions. These results indicate that implicit learning processes are enhanced following communicative virtual interactions. Verbal interaction in a virtual environment seems necessary to elicit social copresence and its positive effects on learning performances. This finding may have important implications for the design of virtual rehabilitation protocols and distance learning programs.
70Intensive online videogame involvement: A new global idiom of wellness and distress.PubMed
Jeffrey G Snodgrass, H J François Dengah, Evan Polzer, et al.
Transcult Psychiatry. 2019 Aug;56(4):748-774. doi: 10.1177/1363461519844356. Epub 2019 May 13.
Extending classic anthropological "idioms of distress" research, we argue that intensive online videogame involvement is better conceptualized as a new global idiom, not only of distress but also of wellness, especially for emerging adults (late teens through the 20s). Drawing on cognitive anthropological cultural domain interviews conducted with a small sample of U.S. gamers ( = 26 free-list and 34 pile-sort respondents) (Study 1) and a large sample of survey data on gaming experience ( = 3629) (Study 2), we discuss the cultural meaning and social context of this new cultural idiom of wellness and distress. Our analysis suggests that the "addiction" frame provides a means for gamers to communicate their passion and commitment to online play, even furthering their enthusiasm for the hobby and community in the process, but also a way for players to express and even resolve life distress such as depression and loneliness. The American Psychiatric Association (APA) has recently included "Internet gaming disorder" (IGD) as a possible behavioral addiction, akin to gambling, warranting further consideration for eventual formal inclusion in the next iteration of the (DSM-5). Our study leads us to suggest that clinicians only sparingly use IGD as a clinical category, given that medical and gamer understandings of "addictive" play differ so markedly. This includes better distinguishing positive online gaming involvement-also sometimes framed by gamers as "addictive"-from other play patterns more clearly entailing distress and dysfunction.
71Research on the mechanism of short video information interaction behavior of college students with psychological disorders based on grounded theory.PubMed
Wang Linlin, Huang Wanyu, Li Yuting, et al.
BMC Public Health. 2023 Nov 16;23(1):2256. doi: 10.1186/s12889-023-17211-4.
BACKGROUND: The utilization of short videos by individuals often leads to the emergence of information exchange behavior. Previous studies have shown that certain students with psychological disorders exhibit addictive tendencies towards short video-related software. Therefore, it is essential to address the psychology and behavior of college students with psychological disorders while engaging with short videos. This study aims to explore the mechanism of short video information interaction behavior among college students with psychological disorders. METHODS: We conducted semi-structured interviews with 30 college students afflicted by psychological disorders in a prefecture-level city in Henan Province, China from September to December 2022. Based on the Grounded theory, we encoded 30 text materials across three levels to explore the mechanism of short video information interaction behavior among college students with psychological disorders, and subsequently build a model framework. RESULTS: The findings of this study suggest that college students with psychological disorders exhibit negative cognition tendencies that can lead to strongly negative emotions, excacerbated by a lack of social support. These adverse factors collectively drive the consumption of short video content in this demographic, providing a virtual environment where they can fulfill their unmet social needs. Therefore, the mechanism governing short video messages interaction among college students with psychological disorders encompasses negative cognitive tendencies, negative emotions, lack of social support, post-video-watching behaviors, and the gratification of social needs within the confines of a virtual environment. CONCLUSIONS: This study comprehensively analyzes the motivation and complexity of college students with psychological disorders in short video interaction. Although short videos provide this group with some ways of self-expression and emotional support, they still have a negative impact on their physical and mental health. The short video interaction of college students with psychological disorders is affected by many factors, including their negative cognitive tendencies, negative emotions, lack of social support, post-video-watching behaviors, and the gratification of social needs within the confines of a virtual environment. These findings deepened our understanding to the mechanism of short video information interaction behavior among college students with psychological disorders, also provided us with guidance on facilitating the proper use of short video and maintaining the mental health. In future researches, researchers can discuss more about intervention measures to help this demographic cope with the challenges from short video interaction.
72Health impact of screen addiction: A cross-sectional comparative study.PubMed
Shirish Ravichandra Rao, Pauras Pritam Mhatre, Amey Abhijit Ambike, et al.
Natl Med J India. 2024 Jan-Feb;37(1):18-21. doi: 10.25259/NMJI_344_2022.
Background Prevalence-based, non-comparative studies have been done to assess psychological and physical consequences of social media and gaming addiction. However, similar studies are lacking for binge-watching, especially in India. We compared the physical and psychological health impact between screen addicted and healthy screen users, by minimizing bias due to confounding factors. Methods We did this cross-sectional comparative study among 120 participants (60 cases and 60 matched controls) consisting of gamers, social media users and binge-watchers, who were recruited from schools and colleges of Mumbai based on their scores on the Digital Addiction Scale (DAS). Levels of depression, anxiety and stress; sleep quality; and dry eye disease were assessed using pre-validated scales such as DASS-21, Pittsburgh Sleep Quality Index (PSQI), and Ocular Surface Disease Index (OSDI), respectively, while the other variables were assessed using a self-designed questionnaire with a content validity ratio (CVR) >0.65. Results The mean (SD) age of the participants was 19.3 (3.2) years, one-third were women; 68% were from medical colleges and 16% each from engineering colleges and high schools. The prevalence and scores of depression, anxiety and stress; poor sleep quality; and dry eye disease; and prevalence of loneliness, aggression and musculoskeletal pain in the wrist, thumb, neck and back were significantly higher in the screen addicted group (p<0.05). Conclusions There was a significant difference in the prevalence and levels of physical and psychological health impact between screen addicted and healthy screen users.
73Bidirectional relationship between gaming disorder, internalizing psychopathology, psychological distress, and well-being: A systematic review with meta-analysis of longitudinal studies.PubMed
Simone Amendola, Jael Bernath, Fabio Presaghi, et al.
J Affect Disord. 2025 Aug 15;383:480-493. doi: 10.1016/j.jad.2025.04.108. Epub 2025 Apr 25.
There is a lack of a synthesis of longitudinal studies that clarify the relationship between gaming disorder (GD) symptoms and mental health. To address this gap, we undertook a systematic review with meta-analysis of longitudinal studies. The study protocol was preregistered online on PROSPERO (CRD42023407665). We included studies analyzing the association between GD or problematic/pathological videogame use, and internalizing psychopathology (depression and anxiety), psychological distress (loneliness and stress), and well-being (life satisfaction, quality of life, and well-being). Research articles were searched in PsycInfo, PsycArticles, PubMed, and Web of Science up until December 29, 2022.30 articles were considered for meta-analysis (N = 28,782). Effect sizes (partial correlation) were pooled using random-effects models. Sensitivity analyses excluded studies rated as "poor" - using the National Institutes of Health quality assessment tool for observational cohort studies - and Chinese studies. The associations between GD and subsequent depression, emotional mixed symptoms (i.e., a combination of internalizing symptoms) and life satisfaction were statistically significant. GD was not associated with subsequent anxiety. On the other hand, depression, anxiety, emotional mixed symptoms, life satisfaction and loneliness were significantly associated with subsequent GD. Overall, sensitivity analyses supported the robustness of the main results. In conclusion, this study found reciprocal longitudinal associations between GD and depression, life satisfaction, and emotional mixed symptoms, an effect of anxiety on GD (but not the inverse), and of loneliness on GD. However, the causal nature and practical relevance remain uncertain because effect sizes were small - or medium, depending on effect size guidelines - and based on observational studies.
74Early Childhood Screen Use Contexts and Cognitive and Psychosocial Outcomes: A Systematic Review and Meta-analysis.PubMed
Sumudu Mallawaarachchi, Jade Burley, Myrto Mavilidi, et al.
JAMA Pediatr. 2024 Oct 1;178(10):1017-1026. doi: 10.1001/jamapediatrics.2024.2620.
IMPORTANCE: The multifaceted nature of screen use has been largely overlooked in favor of a simplistic unidimensional measure of overall screen time when evaluating the benefits and risks of screen use to early childhood development. OBJECTIVE: To conduct a systematic review and meta-analysis to examine associations of screen use contexts in early childhood with cognitive and psychosocial outcomes. DATA SOURCES: PsycINFO, Embase, MEDLINE Ovid, ProQuest, CINAHL, Web of Science, and Scopus were searched from inception to December 31, 2023. STUDY SELECTION: A total of 7441 studies were initially identified. Studies were included if they examined associations between a contextual factor of screen use among children aged 0 to 5.99 years and cognitive or psychosocial development. Observational, experimental, and randomized clinical trial study designs were included. DATA EXTRACTION AND SYNTHESIS: All studies were independently screened in duplicate following PRISMA guidelines. Effect sizes of associations (r) from observational studies were pooled using random-effects 3-level meta-analyses. The remaining study designs were narratively synthesized. MAIN OUTCOMES AND MEASURES: Screen use contexts included content (child directed and age inappropriate), type (program viewing and game or app use), co-use (or solo use), background television, caregiver screen use during child routines, and purpose. Outcomes were cognitive (executive functioning, language, and academic skills) or psychosocial (internalizing and externalizing behavior problems and socioemotional competence). RESULTS: Overall, 100 studies (176 742 participants) were included, and of these, 64 observational studies (pooled sample sizes ranging from 711 to 69 232) were included in meta-analyses. Program viewing (n = 14; k = 48; r, -0.16; 95% CI, -0.24 to -0.08) and background television (n = 8; k = 18; r, -0.10; 95% CI, -0.18 to -0.02) were negatively associated with cognitive outcomes, while program viewing (n = 6; k = 31; r, -0.04; 95% CI, -0.07 to -0.01), age-inappropriate content (n = 9; k = 36; r, -0.11; 95% CI, -0.17 to -0.04), and caregiver screen use during routines (n = 6; k = 14; r, -0.11; 95% CI, -0.20 to -0.03) were negatively associated with psychosocial outcomes. Co-use was positively associated with cognitive outcomes (n = 8; k = 28; r, 0.14; 95% CI, 0.03 to 0.25). CONCLUSIONS AND RELEVANCE: Findings show small to moderate effect sizes that highlight the need to consider screen use contexts when making recommendations for families, clinicians, and educators beyond screen time limits; including encouraging intentional and productive screen use, age-appropriate content, and co-use with caregivers.
75Impacts of digital technologies on child and adolescent health: recommendations for safer screen use in educational settings.PubMed
Julie Cullen, Alex Muntz, Samantha Marsh, et al.
N Z Med J. 2024 Jul 5;137(1598):9-13. doi: 10.26635/6965.6565.
The use of screen-based digital technologies (such as computers and digital devices) is increasing for children and adolescents, worldwide. Digital technologies offer benefits, including educational opportunities, social connection and access to health information. Digital fluency has been recognised as an essential skill for future prosperity. However, along with these opportunities, digital technologies also present a risk of harm to young people. This issue may be particularly important for young New Zealanders, who have among the highest rates of screen use in the world. Our recently published review examined the impacts of digital technologies on the health and wellbeing of children and adolescents. Key findings revealed some positive impacts from moderate use of digital technologies; however, frequent and extended use of screen-based digital tools were associated with negative impacts on child and adolescent health in some areas, such as eye health, noise-induced hearing loss and pain syndromes. Conversely, in areas such as mental health, wellbeing and cognition, quality of screen media content and additional factors such as age may be more important than duration of use. These challenges gave us the impetus to develop pragmatic recommendations for the use of digital technologies in schools, kura kaupapa and early childhood education. Recommendations include interventions to lower risk across different ages and stages of development. Supporting young people to mitigate risk and develop safer screen behaviours will allow them to gain essential digital skills and access opportunities that will enable them to thrive.
76Digital gratification: short video consumption and mental health in rural China.PubMed
Chen Zhang, Bochen Zhu
Front Public Health. 2025 Apr 22;13:1536191. doi: 10.3389/fpubh.2025.1536191. eCollection 2025.
BACKGROUND: In recent years, short videos have become increasingly popular in rural China, yet their impact on mental health remains underexplored. While prior studies have debated the psychological effects of social media, little is known about how short-form video consumption affects rural populations. OBJECTIVE: This study investigates the causal relationship between short video consumption and mental health among rural residents in China. METHODS: We use longitudinal data from the China Family Panel Studies and apply a Difference-in-Differences strategy to estimate the impact of frequent short video usage on mental health. To address self-selection and staggered treatment timing, we employ Propensity Score Matching and heterogeneity-robust difference-in-differences estimators. Robustness checks include placebo tests and an event study analysis. RESULTS: We find that short video consumption appears to improve mental health among rural residents. The effect is immediate and significant only in the first year of exposure, but fades in subsequent periods. Mechanism analysis suggests that the improvements are driven by enhanced entertainment and information access rather than increased social interaction. The effects are more pronounced in economically underdeveloped and less pandemic-affected regions, but not evident among urban residents. CONCLUSION: Short videos provide short-term mental health benefits for rural Chinese residents by enriching their leisure and information access, especially in less developed areas. However, their positive effect is transient and cannot offset pandemic-related stress. Policy efforts should aim to balance the benefits of digital entertainment with potential risks such as addiction and information overload.
77Dual-Task Upper Extremity Motor Performance Measured by Video Processing as Cognitive-Motor Markers for Older Adults.PubMed
Changhong Wang, Mohsen Zahiri, Ashkan Vaziri, et al.
Gerontology. 2023;69(5):650-656. doi: 10.1159/000528853. Epub 2023 Jan 13.
INTRODUCTION: The use of dual-task model such as dual-task gait has been extensively studied to assess cognitive-motor performance among older adults. However, space restriction and safety factor limit its applications in remote assessment. To address the gap, we propose a video processing-based approach to remotely quantify cognitive-motor performance using a 20-s repetitive elbow flexion-extension test with dual-task condition, called video-based motoric-cognitive meter (MCM). METHODS: Eighteen older participants (age: 78.6 ± 6.5 years) who were clinically diagnosed as having either mild cognitive impairment or dementia were included in this study. Participants were asked to perform 20-s repetitive elbow flexion-extension exercise with a memory exercise by counting backward from a two-digit number. During the test, all movements of the forearm were recorded by a video camera. As a comparator, a validated wrist-worn sensor was used, which allowed quantifying upper extremity kinematics. RESULTS: The results showed a good agreement (r ≥ 0.530 and ICC2,1 ≥ 0.681) between the derived dual-task upper extremity motor performance from the proposed video-based MCM and a clinically validated sensor-based MCM. We also observed moderate correlations (r ≥ 0.496) between some measures of video-based MCM (flexion time, extension time, and flexion-extension time) and clinical cognitive scale (Mini-Mental State Examination [MMSE]). Additionally, some measures of dual-task upper extremity motor performance (speed, flexion time, extension time, and flexion-extension time) were associated with dual-task gait speed (r ≥ 0.557), which has been found to be correlated with cognitive impairment. Lastly, the selected dual-task motor performance metric (flexion time) was sensitive to predict MMSE scores in linear regression analyses with statistical significance (adjusted R2 = 0.306, p = 0.025). CONCLUSION: This study proposes a video processing-based approach to analyze dual-task upper extremity motor performance from a simple and convenient upper extremity function test. The results indicate concurrent validity of the proposed video-based MCM compared with the sensor-based MCM, and associations between dual-task upper extremity motor performance and clinically validated cognitive markers (MMSE scores and dual-task gait). Future studies are warranted to explore sensitivity of this solution to promote remote assessment of cognitive-motor performance among older adults in telehealth applications.
78Treating Children With Physical Disabilities: A Video-Based Educational Resource Using Simulated Participants.PubMed
Alexandra Kimmel, Erin Nozetz, Mary Salisbury, et al.
J Med Educ Curric Dev. 2023 Apr 11;10:23821205231162579. doi: 10.1177/23821205231162579. eCollection 2023 Jan-Dec.
OBJECTIVES: Children with physical disabilities (CWPD) have historically experienced inadequate and insensitive care across medical settings. A lack of comfort and knowledge about CWPD is prevalent among healthcare provider trainees. We developed a new, readily distributable educational resource about CWPD for healthcare students and conducted a study to determine its efficacy in improving their attitudes toward CWPD. METHODS: We collaborated with a working group of stakeholders in the disability community to develop an educational resource for healthcare students. We developed nine short video clips (with a cumulative duration of 27 min) of a primary care visit using simulated participants and embedded them into a 50-min workshop. We conducted a study of the workshop's utility for volunteer healthcare students using synchronous videoconferencing. Participating students completed assessments at baseline and after the workshop. Our primary outcome measure was a change in the Attitudes to Disabled Persons-Original (ATDP-O) scale. RESULTS: Forty-nine healthcare students participated in the training session: 29 (59%) from medicine, and 21 (41%) from physician assistant or nursing programs. The materials were easy to deliver virtually. The workshop resulted in measurable change in attitudes regarding physical disabilities, with improvement in ATDP-O scores between baseline ( = 31.2, = 8.9) and endpoint ( = 34.8, = 10.1) scores ( = 3.28, = .002, Cohen's = 0.38). CONCLUSION: This video-based educational resource on CWPD is readily distributable and can be delivered virtually as a workshop. The video-enhanced workshop improved healthcare students' perceptions and attitudes toward CWPDs. All materials are available to view, download, or adapt by end-use instructors.
79Systematic review of sedentary behavior and cognitive development in early childhood.PubMed
Valerie Carson, Nicholas Kuzik, Stephen Hunter, et al.
Prev Med. 2015 Sep;78:115-22. doi: 10.1016/j.ypmed.2015.07.016. Epub 2015 Jul 26.
OBJECTIVE: To comprehensively review observational and experimental studies examining the relationship between sedentary behavior and cognitive development during early childhood (birth to 5years). METHOD: Electronic databases were searched in July, 2014 and no limits were imposed on the search. Included studies had to be peer-reviewed, published, and meet the a priori determined population (apparently healthy children aged birth to 5years), intervention (duration, types, and patterns of sedentary behavior), comparator (various durations, types, or patterns of sedentary behavior), and outcome (cognitive development) study criteria. Data extraction occurred in October and November 2014 and study quality and risk of bias were assessed in December 2014. RESULTS: A total of 37 studies, representing 14,487 participants from nine different countries were included. Thirty-one studies used observational study designs and six studies used experimental study designs. Across study designs, increased or higher screen time (most commonly assessed as television viewing (TV)), reading, child-specific TV content, and adult-specific TV content had detrimental (negative) associations with cognitive development outcomes for 38%, 0%, 8%, and 25% of associations reported, respectively, and beneficial (positive) associations with cognitive development outcomes for 6%, 60%, 13%, and 3% of associations reported, respectively. Ten studies were moderate quality and 27 studies were weak quality. CONCLUSIONS: The type of sedentary behavior, such as TV versus reading, may have different impacts on cognitive development in early childhood. Future research with reliable and valid tools and adequate sample sizes that examine multiple cognitive domains (e.g., language, spatial cognition, executive function, memory) are needed. Registration no. CRD42014010004.
80Evaluating the impact of short educational videos on the cortical networks for mathematics.PubMed
Marie Amalric, Pauline Roveyaz, Stanislas Dehaene
Proc Natl Acad Sci U S A. 2023 Feb 7;120(6):e2213430120. doi: 10.1073/pnas.2213430120. Epub 2023 Feb 2.
Many teaching websites, such as the Khan Academy, propose vivid videos illustrating a mathematical concept. Using functional magnetic resonance imaging, we asked whether watching such a video suffices to rapidly change the brain networks for mathematical knowledge. We capitalized on the finding that, when judging the truth of short spoken statements, distinct semantic regions activate depending on whether the statements bear on mathematical knowledge or on other domains of semantic knowledge. Here, participants answered such questions before and after watching a lively 5-min video, which taught them the rudiments of a new domain. During the video, a distinct math-responsive network, comprising anterior intraparietal and inferior temporal nodes, showed intersubject synchrony when viewing mathematics course rather than control courses in biology or law. However, this experience led to minimal subsequent changes in the activity of those domain-specific areas when answering questions on the same topics a few minutes later. All taught facts, whether mathematical or not, led to domain-general repetition enhancement, particularly prominent in the cuneus, posterior cingulate, and posterior parietal cortices. We conclude that short videos do not suffice to induce a meaningful lasting change in the brain's math-responsive network, but merely engage domain-general regions possibly involved in episodic short-term memory.
81Comparing the effectiveness of video and written material for improving knowledge among sleep disorders clinic patients with limited literacy skills.PubMed
P W Murphy, A L Chesson, L Walker, et al.
South Med J. 2000 Mar;93(3):297-304.
BACKGROUND: Health care professionals often use written material or video recordings to teach their patients without knowing which is more effective for comprehension of the information. METHODS: Patients watched either an instructional videotape about sleep apnea or read a newly designed brochure, then responded to a structured questionnaire containing 11 knowledge-based questions and 1 open-ended question (requesting suggestions for improvement of the brochure or videotape). RESULTS: Mean reported educational level was grade 12, and mean reading level was between grade 7 and 8. Using video significantly improved only two areas of knowledge for low-level (below grade 8) readers: defining sleep apnea (66% vs 43%) and identifying what continuous positive airway pressure (CPAP) does for the patient (94% vs 78%). Patients requested material with more diverse cultural representation, more information on treatment and outcomes, and fewer polysyllabic words. CONCLUSIONS: Emphasis on diagnosis and treatment, explained using simple words, should be reflected in the content of patient education brochures or videos. Providing information by video alone may have limited benefits.
82Audiovisual information of oral epithelial dysplasia: Quality, understandability and actionability.PubMed
Waleed Alamoudi, Richeal Ni Riordain, Stefano Fedele, et al.
Oral Dis. 2024 May;30(4):1945-1955. doi: 10.1111/odi.14701. Epub 2023 Jul 30.
OBJECTIVES: Online information on oral epithelial dysplasia (OED) is insufficient and of low quality. While only written information has been previously assessed, this study aims to evaluate the content and quality of audiovisual (AV) online information about OED. METHODS: One hundred and twenty-seven materials were initially considered using six key words across two search engines (YouTube and Google). Ultimately, 29 materials remained for the final assessment. These materials were then analysed for content, quality (DISCERN instrument, JAMA benchmarks), understandability and actionability. RESULTS: Most contents were scientific (n = 25), while three videos were educational, and one video was a personal experience with OED. On a scale of 1-5, the overall DISCERN score was (mean ± SD = 2.26 ± 0.79), suggesting poor quality of information. Regarding JAMA benchmarks, there was no single material that fulfilled or lacked all four benchmarks. The overall mean understandability score was 82% and the actionability mean score was significantly low at 29%. CONCLUSION: Although the vast majority of AV materials on OED were primarily produced for scientific purposes, these materials could be helpful as resources for patient education. Keeping in mind, however, that the desired quality and essential patient information about OED available online remains largely poor and missing.
83YouTube as a source of patient information for stroke: A content-quality and an audience engagement analysis.PubMed
Tomasz Szmuda, Ahmed Alkhater, Mohammed Albrahim, et al.
J Stroke Cerebrovasc Dis. 2020 Sep;29(9):105065. doi: 10.1016/j.jstrokecerebrovasdis.2020.105065. Epub 2020 Jun 30.
BACKGROUND: Stroke is the second leading cause of death worldwide following ischemic heart disease, and the fifth in the United States. The video-sharing database, YouTube, is the second most popular visited website with more than 2 billion users, thus it's increasingly being used as a medium for delivering health information. AIM: We aimed to evaluate the quality, reliability and audience engagement of stroke-related YouTube videos. METHODS: In October 2019 we conducted a search on YouTube using 5 keywords: stroke, brain attack, hemorrhagic stroke, ischemic stroke and transient ischemic attack. We selected the first 30 videos from each search query for further analysis. The validated DISCERN instrument was used (a score of 0-5 per question) to assess the videos by four independent raters. We then recorded qualitative data and quantitative data for each video. RESULTS: After sorting through 150 stroke videos, a total of 101 unique YouTube videos met our inclusion criteria. We found that the mean overall quality of YouTube videos according to DISCERN is of fair quality. Most videos (65.3%) were uploaded by hospitals, mentioned the symptoms of stroke (66.3%), had a doctor speaking (60.4%) and contained diagrams (20.8%). CONCLUSION: YouTube is a useful source of gathering information about treatment choices for patients and their families as the quality of YouTube videos is fair. The audience engagement suggestions in our paper may help content creators improve the appeal of YouTube videos.
85Quality Assessment of Videos About Dengue Fever on Douyin: Cross-Sectional Study.PubMed
Youlian Zhou, Liang Yang, Li Luo, et al.
JMIR Infodemiology. 2025 Sep 26;5:e76474. doi: 10.2196/76474.
BACKGROUND: Dengue fever has evolved into a significant public health concern. In recent years, short-video platforms such as Douyin have emerged as prominent media for the dissemination of health education content. Nevertheless, there is a paucity of research investigating the quality of health education content on Douyin. OBJECTIVE: This study aimed to evaluate the quality of dengue videos on Douyin. METHODS: A comprehensive collection of short videos pertaining to dengue fever was retrieved from the popular social media platform, Douyin, at a designated point in time. A systematic analysis was then performed to extract the characteristics of these videos. To ensure a comprehensive evaluation, three distinct scoring tools were used: the DISCERN scoring tool, the JAMA benchmarking criteria, and the GQS method. Subsequently, an in-depth investigation was undertaken into the relationship between video features and quality. RESULTS: A total of 156 videos were included in the analysis, 81 of which (51.9%) were posted by physicians, constituting the most active category of contributor. The selected videos pertaining to dengue fever received a total of 718,228 likes and 126,400 comments. The video sources were categorized into four distinct classifications: news agencies, organizations, physicians, and individuals. Individuals obtained the highest number of video likes, comments, and saves. However, the findings of the study demonstrated that physicians, organizations, and news agencies posted videos are of higher quality when compared with individuals. The integrity of the video content was analyzed, and the results showed a higher percentage of videos received a score of zero points for outcomes, management, and assessment, with 69 (45%), 57 (37%), and 41 (26%), respectively. The median Total DISCERN scores, JAMA, and GQS of the 156 dengue-related videos under consideration were 26 (out of a total of 80 points), 2 (out of a total of 4 points), and 3 (out of a total of 5 points), respectively. Spearman correlation analysis was conducted, revealing a positive correlation between video duration and video quality. Conversely, a negative correlation was observed between the following variables: video comments and video quality, and the number of days since posting and video quality. CONCLUSIONS: This study demonstrates that the quality of short dengue-related health information videos on Douyin is substandard. Videos uploaded by medical professionals were among the highest in terms of quality, yet their videos were not as popular. It is recommended that in future, physicians employ more accessible language incorporating visual elements to enhance the appeal and dissemination of their videos. Future research could explore how to achieve a balance between professionalism and entertainment to promote user acceptance of high-quality content. Moreover, platforms may consider employing algorithmic optimization or content recommendation mechanisms to encourage users to access and engage with more high-quality health science videos.
86Videos in short video sharing platforms as a source of information on bipolar disorder: a cross-sectional content analysis study.PubMed
Xin Qi, Qi Lu, Bo Li, et al.
Front Public Health. 2025 Oct 28;13:1627885. doi: 10.3389/fpubh.2025.1627885. eCollection 2025.
BACKGROUND: Bipolar disorder is a prevalent mental health issue characterized by recurrent episodes of mania and depression, significantly impacting patients' quality of life. With the rise of short video sharing platforms, there is an urgent need to evaluate the quality and reliability of the medical information disseminated regarding this disorder. OBJECTIVE: This study aimed to assess the quality and reliability of videos related to bipolar disorder available on popular Chinese short video platforms, including TikTok, Kwai, Bilibili, WeChat, Xiaohongshu, and Baidu. METHODS: A cross-sectional content analysis was conducted in May 2025, using keywords related to bipolar disorder to retrieve relevant videos from selected platforms. The quality of the videos was evaluated using multiple standardized assessment tools, including the JAMA Benchmarking Criteria, GQS, modified DISCERN, PEMAT, and HONCODE. RESULTS: Significant differences in video quality and audience engagement metrics were observed across platforms. TikTok and Kwai had higher quality scores, while WeChat resulted in more comments. Most videos were created by medical professionals, although independent users also contributed content. Overall, video quality was inconsistent and not necessarily correlated with engagement metrics, highlighting the necessity for improved standards in disseminating health-related information on social media. CONCLUSION: On Chinese short video platforms, clinical practitioners are the main creators of bipolar disorder-related content, but their scientific nature, production quality, and information transparency still need to be improved. It is suggested to improve the platform management, creator training, and algorithm optimization, so as to promote the improvement of public mental health literacy.
87Harnessing the sensing and stimulation function of deep brain-machine interfaces: a new dawn for overcoming substance use disorders.PubMed
Danyang Chen, Zhixian Zhao, Jian Shi, et al.
Transl Psychiatry. 2024 Oct 17;14(1):440. doi: 10.1038/s41398-024-03156-8.
Substance use disorders (SUDs) imposes profound physical, psychological, and socioeconomic burdens on individuals, families, communities, and society as a whole, but the available treatment options remain limited. Deep brain-machine interfaces (DBMIs) provide an innovative approach by facilitating efficient interactions between external devices and deep brain structures, thereby enabling the meticulous monitoring and precise modulation of neural activity in these regions. This pioneering paradigm holds significant promise for revolutionizing the treatment landscape of addictive disorders. In this review, we carefully examine the potential of closed-loop DBMIs for addressing SUDs, with a specific emphasis on three fundamental aspects: addictive behaviors-related biomarkers, neuromodulation techniques, and control policies. Although direct empirical evidence is still somewhat limited, rapid advancements in cutting-edge technologies such as electrophysiological and neurochemical recordings, deep brain stimulation, optogenetics, microfluidics, and control theory offer fertile ground for exploring the transformative potential of closed-loop DBMIs for ameliorating symptoms and enhancing the overall well-being of individuals struggling with SUDs.
88A prototype closed-loop brain-machine interface for the study and treatment of pain.PubMed
Qiaosheng Zhang, Sile Hu, Robert Talay, et al.
Nat Biomed Eng. 2023 Apr;7(4):533-545. doi: 10.1038/s41551-021-00736-7. Epub 2021 Jun 21.
Chronic pain is characterized by discrete pain episodes of unpredictable frequency and duration. This hinders the study of pain mechanisms and contributes to the use of pharmacological treatments associated with side effects, addiction and drug tolerance. Here, we show that a closed-loop brain-machine interface (BMI) can modulate sensory-affective experiences in real time in freely behaving rats by coupling neural codes for nociception directly with therapeutic cortical stimulation. The BMI decodes the onset of nociception via a state-space model on the basis of the analysis of online-sorted spikes recorded from the anterior cingulate cortex (which is critical for pain processing) and couples real-time pain detection with optogenetic activation of the prelimbic prefrontal cortex (which exerts top-down nociceptive regulation). In rats, the BMI effectively inhibited sensory and affective behaviours caused by acute mechanical or thermal pain, and by chronic inflammatory or neuropathic pain. The approach provides a blueprint for demand-based neuromodulation to treat sensory-affective disorders, and could be further leveraged for nociceptive control and to study pain mechanisms.
89Treatment outcomes using CBT-IA with Internet-addicted patients.PubMed
Kimberly S Young
J Behav Addict. 2013 Dec;2(4):209-15. doi: 10.1556/JBA.2.2013.4.3. Epub 2013 Dec 13.
BACKGROUND AND AIMS: Internet Gaming Disorder, a subtype of Internet Addiction, is now classified in Section 3 of the DSM-5. Cognitive behavioral therapy (CBT) has been suggested in treating Internet addiction as this modality has been shown to be an effective treatment for similar impulse control disorders. Given the daily and necessary use of the Internet and technology in general compared to other compulsive syndromes, a specialized form of CBT has been developed called Cognitive-Behavioral Therapy for Internet Addiction (CBT-IA). CBT-IA is a comprehensive three phase approach that includes behavior modification to control compulsive Internet use, cognitive restructuring to identify, challenge, and modify cognitive distortions that lead to addictive use, and harm reduction techniques to address and treat co-morbid issues associated with the disorder. METHODS: As the first model of its kind, this study examines 128 clients to measure treatment outcomes using CBT-IA. Clients were evaluated using the Internet Addiction Test (IAT) to classify subjects and were administered twelve weekly sessions of CBT-IA. Treatment outcomes were measured at the end of the twelve weeks, one-month, three months and at six month post-treatment. RESULTS: RESULTS showed that over 95% of clients were able to manage symptoms at the end of the twelve weeks and 78% sustained recovery six months following treatment. DISCUSSION AND CONCLUSIONS: RESULTS found that CBT-IA was effective at ameliorating symptoms associated with Internet addiction after twelve weekly sessions and consistently over one-month, three months, and six months after therapy. Further research implications such as investigating long-term outcome effects of the model with larger client populations and treatment differences among the subtypes of Internet addiction or with other cultural populations using CBT-IA are discussed.
90Strategies for self-controlling social media use: Classification and role in preventing social media addiction symptoms.PubMed
Damien Brevers, Ofir Turel
J Behav Addict. 2019 Sep 1;8(3):554-563. doi: 10.1556/2006.8.2019.49. Epub 2019 Sep 23.
BACKGROUND AND AIMS: Many people present excessive patterns of social networking site (SNS) use and try to self-regulate it. However, little is known regarding the strategies employed by young adult SNS users and their role in preventing the emergence of addiction-like symptoms in relation to SNS use. METHODS: In Study 1, we employed a naturalistic-qualitative approach for finding commonly employed self-control strategies in relation to SNS use. In Study 2, we examined differences between the frequency and difficulty of the strategies identified in Study 1 and tested the process through which trait self-control exerts influence on reducing SNS addiction symptomology. RESULTS: Study 1 revealed six families of self-control strategies, some reactive and some proactive. Study 2 pinpointed the most commonly used and most difficult to enact ones. It also showed that the difficulty to enact self-control strategies in relation to SNS use partially mediates the effect of trait self-control via SNS use habit on SNS addiction symptom severity. CONCLUSIONS: Taken together, the present findings revealed that strategies for self-controlling SNS use are common and complex. Their theoretical and clinical significance stems from their ability to prevent the translation of poor trait self-control and strong SNS use habit to the emergence of excessive use as manifested in SNS addiction-like symptoms.
91"Everything kind of revolves around technology": a qualitative exploration of families' screen use experiences, and intervention suggestions.PubMed
Lauren Arundell, Laura Gould, Nicola D Ridgers, et al.
BMC Public Health. 2022 Aug 23;22(1):1606. doi: 10.1186/s12889-022-14007-w.
BACKGROUND: Managing children's screen time is challenging for most families. Interventions have had limited success in reducing screen time, potentially due to a lack of understanding of the experiences, needs and recommendations of families. This study aimed to 1) understand the screen time experiences of families, particularly during COVID-19 lockdowns; and 2) explore parent and child suggestions for the design, components, and content of a screen time management program. METHODS: Parents and children from 30 families living in Victoria, Australia completed a semi-structured interview (63 interviews) via Zoom in October-November 2021. Parents were aged 40.8 (± 8.9) years and predominantly female (90%). Children were aged 11.4 (± 2.4) years and 47% female. The interviews were audio recorded, transcribed verbatim and analysed using inductive thematic analysis combined with a summative content analysis approach. RESULTS: Three themes under Aim 1 emerged. Theme 1) 'Screen time management experiences and practices', including rules and strategies, challenges, and the impact of COVID-19 lockdowns. Theme 2) 'Impact of screens on family interaction and communication' including conflicts within the family, reduced face-to-face interactions, and negative impact on child's behaviour and wellbeing. Theme 3) 'Benefits of increased screen time due to COVID-19 lockdowns' including continuation of social interactions, extracurricular activities, improved technology skills and using screens as a 'babysitter'. Findings from Aim 2 suggest that families want a screen time management program delivered online to parents and children, which includes static and interactive content that incorporates health information, alternative activities, cyber-safety information, tips for goal setting and rewards, screen monitoring tools, links to reputable information, and parent social connections. Reminders via text message or through the online platform would help maintain engagement in the program. CONCLUSIONS: Families are experiencing challenges in managing the complex balance between the increased need for screens and the impact it has on the family. These findings provide valuable parent and child insights to assist in developing screen time management programs that are created with an understanding of the needs and challenges of families.
92Lifestyle modification for mental health and well-being.PubMed
Indira Sharma, Arun V Marwale, Roop Sidana, et al.
Indian J Psychiatry. 2024 Mar;66(3):219-234. doi: 10.4103/indianjpsychiatry.indianjpsychiatry_39_24. Epub 2024 Mar 18.
BACKGROUND: Unhealthy life-style leads to mental ill-health and poor quality of life and is the major determinant of a wide range of lifestyle disorders. The aim was to 1) review the work relating to life style modification for promoting mental health and 2) Present recommendations on life-style modification for mental health and wellbeing. MATERIAL AND METHODS: The work on life style changes for promotion of mental health was retrieved from the scientific literature and critically reviewed. CONCLUSIONS: Recommendations on 'Life-style modification for mental health and wellbeing' are presented. 20 specific components of healthy life style included are: Routine, time management, prayer, basic activities, reading newspaper, study/work, exercise, recreation/ relaxation/ talent promotion, education, cognitive activities, social networking, guidelines for behavior, peer group, social group, marriage/family, life skills, physical health, health education, mobile use, and digital media. The lifestyle modification package is comprehensive and geared to promote mental health and well-being.
93Effectiveness of Cognitive Behavioral Therapy-Based Intervention in Preventing Gaming Disorder and Unspecified Internet Use Disorder in Adolescents: A Cluster Randomized Clinical Trial.PubMed
Katajun Lindenberg, Sophie Kindt, Carolin Szász-Janocha
JAMA Netw Open. 2022 Feb 1;5(2):e2148995. doi: 10.1001/jamanetworkopen.2021.48995.
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.
94The relationship between screen time exposure and the presence of anxiety-related disorders among adolescents during the COVID-19 pandemic: A cross-sectional study.PubMed
Rasha Rashad Alsaigh, Ghadeer Essam Assas, Nashwa Hussain Yahia, et al.
Belitung Nurs J. 2022 Jun 28;8(3):251-257. doi: 10.33546/bnj.2058. eCollection 2022.
BACKGROUND: The Coronavirus Disease 2019 (COVID-19) pandemic prompted rules and laws such as lockdown, which contributed to staying at home and participating in sedentary activities such as using smartphones, tablets, televisions, gaming devices, and computers. As a result of the increased use of digital screen time, a worldwide issue has arisen among various age groups, especially adolescents, which may have affected their psychological well-being, increasing their susceptibility to anxiety-related disorders. OBJECTIVE: This study aimed to assess the relationship between screen time exposure and the presence of anxiety-related disorders among adolescents during the COVID-19 pandemic. METHODS: A quantitative descriptive cross-sectional design using convenience sampling was used in this study. The online self-administered questionnaire, including the Arabic-translated version of the Screen for Child Anxiety-related Disorders (SCARED-C), was distributed through social media using Google forms between February and April 2021. The Chi-Squared test was used for data analysis. RESULTS: Of 625 participants, majority were females ( = 527, 84.3%) than males ( = 98, 15.7%). A significant difference between screen time and the presence of an anxiety-related disorder among adolescents during the COVID-19 pandemic ( = .021) was noted. More than half of the participants ( = 410, 65.6%) scored above 25 in the SCARED-C test, indicating the presence of an anxiety-related disorder regardless of the type. Of those, more than a quarter ( = 176, 28.2%) used screens for more than 8 hours a day. CONCLUSION: The results indicated a relationship between screen time exposure and the presence of anxiety-related disorders among adolescents during the pandemic. In particular, adolescents are more susceptible to the adverse effects of increased exposure to screen time, which is constantly on the rise. Therefore, nurses and other healthcare professionals can play a significant role in providing guidance and advice to parents, caregivers, and adolescents themselves on how to limit screen time exposure. The findings can also be useful for future studies to build on and develop screen time management interventions and guidelines.
95Effectiveness of multimodal psychotherapeutic intervention for internet gaming disorder.PubMed
Manoj Kumar Sharma, Nitin Anand, Ashwini Tadpatrikar, et al.
Psychiatry Res. 2022 Aug;314:114633. doi: 10.1016/j.psychres.2022.114633. Epub 2022 May 18.
BACKGROUND: Large number of studies on Internet gaming disorder (IGD) have primarily focused on ascertaining its psychological correlates. Few studies have focused on developing and assessing effectiveness of multimodal psychotherapeutic intervention programs. This intervention focused on minimizing salience, pre-occupation, conflict related to gaming and enhancing the overall quality of life, inclusive of psychological health, physical health, and environmental problems in individuals with IGD. At present, there appear to be no such studies in the Indian context. METHODS: In this study, we developed and assessed the effectiveness of an intervention manual for IGD. The intervention program consisted of ten 60-minutes sessions with one therapist administering sessions once in each week. The interventions included motivational enhancement strategies, cognitive restructuring, behavioral strategies and relapse prevention. The outcomes from intervention were measured in terms of improvement in IGD, IAT, and overall quality of life. Our assessments, both at baseline and post-intervention consisted of Internet Addiction Test (IAT), Internet Gaming Disorder Test (IGD-20) and the Whoqol-Bref. A total sample of 40 was selected out of which 33 individuals completed the 10 sessions of multimodal psychotherapy program and post assessments. RESULTS: A total of 40 participants (age: M = 20.25, SD = 5.39) enrolled, out of which 33 completed the entire intervention program of 10 sessions and showed significant improvements. The IAT and IGD-20 showed significant difference in the scores for before treatment (M = 52.88, SD = 16.25) and after treatment (M = 42.87, SD = 11.31; t (32) = 5.10, p = 0.000) conditions; and right before treatment (M = 56.88, SD = 19.25) and after treatment (M = 47.87, SD = 15.31; t (32) = 6.94, p = 0.000) conditions respectively. The internet addiction and internet gaming disorder scores showed a similar degree of severity reductions on the IAT and IGD-20 respectively at the end of week 8. In addition, the participants showed significant improvements in the quality of life inclusive of physical and psychological health post the completion of intervention program. LIMITATIONS: The sample size of the study was small and assessments for evaluation of other psychological symptoms like depression, anxiety could have been conducted. CONCLUSION: The intervention program indicated a substantial change in the IGD scores at post- assessment. A study on a larger sample to assess the validity of the manualized multimodal psychotherapy program for IGD needs to be conducted. In addition, this manualized intervention program can be useful for administering structured intervention for IGD by mental health professionals working in the area of internet gaming disorder.
96The quality and content of gonorrhea-related short videos on TikTok: A cross-sectional study.PubMed
Kaidi Zhao, Junlan Yang, Jiashu Liu
Digit Health. 2025 Oct 27;11:20552076251391170. doi: 10.1177/20552076251391170. eCollection 2025 Jan-Dec.
BACKGROUND: Gonorrhea is a common sexually transmitted disease that remains highly prevalent worldwide. Social media platforms such as TikTok have become important sources of public health information, yet the quality and reliability of video content on these platforms remain unclear. This study aimed to evaluate the content, quality, and reliability of gonorrhea-related short videos on TikTok. METHODS: A cross-sectional analysis was conducted on 71 gonorrhea-related short videos on TikTok. Video characteristics, uploader types, and content themes were extracted. The Global Quality Score (GQS) and modified DISCERN (mDISCERN) tool were used to assess video quality and reliability. Correlation analysis was performed between video metrics and quality scores. RESULTS: The videos were generally short in duration (median: 49.00 s) but exhibited high user engagement. Common topics included clinical manifestations (64.79%), transmission routes (47.89%), and diagnosis (45.07%), while prevention, treatment and prognosis were less frequently discussed. The main uploaders were dermatologists, urologists, and individual users. Videos uploaded by healthcare professionals had significantly higher GQS scores than those from individual users, with a similar but statistically insignificant trend in mDISCERN scores. Positive correlations were found among engagement metrics (likes, favorites, comments, and shares), but no correlation was observed between engagement and video quality. CONCLUSIONS: Gonorrhea-related TikTok videos are highly interactive but generally lack in quality, reliability, and content coverage. Increasing professional involvement and improving platform-level content regulation are essential to enhance the educational value of health information delivered via TikTok platforms.
97Search engines and short video apps as sources of information on acute pancreatitis in China: quality assessment and content assessment.PubMed
Shishuang Jiang, Youlian Zhou, Jun Qiu, et al.
Front Public Health. 2025 Jun 4;13:1578076. doi: 10.3389/fpubh.2025.1578076. eCollection 2025.
BACKGROUND: Acute pancreatitis is a prevalent condition in China. A plethora of information pertaining to acute pancreatitis is readily available on the Internet, including on major search engines and various short video applications. The objective of this study was to evaluate and compare the quality, content completeness, and accuracy of information related to acute pancreatitis on web pages of the four major search engines and short videos on the two major short video platforms. MATERIALS AND METHODS: A search was conducted on four major search engines (Bing, Baidu, Haosou, and Sougou) and two short video apps (TikTok and BiliBili) using the Chinese keyword "acute pancreatitis." The sources can be divided into four categories: scientific resources, news/media reports, industrial/commercial profit organizations, and healthcare providers. The quality of the web pages and short videos was evaluated using the DISCERN instrument, the Global Quality Score (GQS), and the Journal of the American Medical Association (JAMA). In accordance with established guidelines and reviews of acute pancreatitis, two lists and scoring systems were devised for the evaluation of content comprehensiveness and accuracy. RESULTS: A total of 120 unique web pages and 120 unique videos were identified using four search engines and two short video applications, respectively. The most prevalent identity among those producing short videos was that of healthcare providers. With regard to the source of the web pages, the most prevalent category was that of industrial/commercial profit organizations. The median DISCERN total score, median GQS score, and median JAMA score were 26, 3, and 2, respectively. Web pages exhibited significantly higher ratings than short videos ( < 0.001, = 0.003, and < 0.001). The median overall content score for the web page was 8 (interquartile range [IQR] 4-13), and the median guideline-related score was 2 (IQR 0-4), indicating that the web page's content was deficient in terms of completeness and accuracy. In comparison, the performance of the short video was found to be even more deficient. CONCLUSION: In China, most web pages pertaining to acute pancreatitis were produced by industrial/commercial profit organizations, but the quality of the information provided by these entities was found to be the lowest. The majority of short videos were created by healthcare providers, but the overall quality of these videos was found to be inadequate. In general, the quality of both web pages and short videos is suboptimal. Nevertheless, the quality of web pages was found to be superior to that of short videos. In terms of completeness and accuracy, both the web page and the video exhibit significant deficiencies that are cause for concern.
98Investigating Topical Steroid Withdrawal Videos on TikTok: Cross-Sectional Analysis of the Top 100 Videos.PubMed
Firas Haddad, William Abou Shahla, Dana Saade
JMIR Form Res. 2024 Aug 29;8:e48389. doi: 10.2196/48389.
BACKGROUND: Social media platforms like TikTok are a very popular source of information, especially for skin diseases. Topical steroid withdrawal (TSW) is a condition that is yet to be fully defined and understood. This did not stop the hashtag #topicalsteroidwithdrawal from amassing more than 600 million views on TikTok. It is of utmost importance to assess the quality and content of TikTok videos on TSW to prevent the spread of misinformation. OBJECTIVE: This study aims to assess the quality and content of the top 100 videos dedicated to the topic of TSW on TikTok. METHODS: This observational study assesses the content and quality of the top 100 videos about TSW on TikTok. A total of 3 independent scoring systems: DISCERN, Journal of the American Medical Association, and Global Quality Scale were used to assess the video quality. The content of the videos was coded by 2 reviewers and analyzed for recurrent themes and topics. RESULTS: This study found that only 10.0% (n=10) of the videos clearly defined what TSW is. Videos were predominantly posted by White, middle-aged, and female creators. Neither cause nor mechanism of the disease were described in the videos. The symptoms suggested itching, peeling, and dryness which resembled the symptoms of atopic dermatitis. The videos fail to mention important information regarding the use of steroids such as the reason it was initially prescribed, the name of the drug, concentration, mechanism of usage, and method of discontinuation. Management techniques varied from hydration methods approved for treatment of atopic dermatitis to treatment options without scientific evidence. Overall, the videos had immense reach with over 200 million views, 45 million likes, 90,000 comments, and 100,000 shares. Video quality was poor with an average DISCERN score of 1.63 (SD 0.56)/5. Video length, total view count, and views/day were all associated with increased quality, indicating that patients were interacting more with higher quality videos. However, videos were created exclusively by personal accounts, highlighting the absence of dermatologists on the platform to discuss this topic. CONCLUSIONS: The videos posted on TikTok are of low quality and lack pertinent information. The content is varied and not consistent. Health care professionals, including dermatologists and residents in the field, need to be more active on the topic, to spread proper information and prevent an increase in steroid phobia. Health care professionals are encouraged to ride the wave and produce high-quality videos discussing what is known about TSW to avoid the spread of misinformation.
99Screen time and mental health: a prospective analysis of the Adolescent Brain Cognitive Development (ABCD) Study.PubMed
Jason M Nagata, Abubakr A A Al-Shoaibi, Alicia W Leong, et al.
BMC Public Health. 2024 Oct 7;24(1):2686. doi: 10.1186/s12889-024-20102-x.
BACKGROUND: Despite the ubiquity of adolescent screen use, there are limited longitudinal studies that examine the prospective relationships between screen time and child behavioral problems in a large, diverse nationwide sample of adolescents in the United States, which was the objective of the current study. METHODS: We analyzed cohort data of 9,538 adolescents (9-10 years at baseline in 2016-2018) with two years of follow-up from the Adolescent Brain Cognitive Development (ABCD) Study. We used mixed-effects models to analyze associations between baseline self-reported screen time and parent-reported mental health symptoms using the Child Behavior Checklist, with random effects adjusted for age, sex, race/ethnicity, household income, parent education, and study site. We tested for effect modification by sex and race/ethnicity. RESULTS: The sample was 48.8% female and racially/ethnically diverse (47.6% racial/ethnic minority). Higher total screen time was associated with all mental health symptoms in adjusted models, and the association was strongest for depressive (B = 0.10, 95% CI 0.06, 0.13, p < 0.001), conduct (B = 0.07, 95% CI 0.03, 0.10, p < 0.001), somatic (B = 0.06, 95% CI 0.01, 0.11, p = 0.026), and attention-deficit/hyperactivity symptoms (B = 0.06, 95% CI 0.01, 0.10, p = 0.013). The specific screen types with the greatest associations with depressive symptoms included video chat, texting, videos, and video games. The association between screen time and depressive, attention-deficit/hyperactivity, and oppositional defiant symptoms was stronger among White compared to Black adolescents. The association between screen time and depressive symptoms was stronger among White compared to Asian adolescents. CONCLUSIONS: Screen time is prospectively associated with a range of mental health symptoms, especially depressive symptoms, though effect sizes are small. Video chat, texting, videos, and video games were the screen types with the greatest associations with depressive symptoms. Future research should examine potential mechanisms linking screen use with child behavior problems.
100Screen Time and Health Indicators Among Children and Youth: Current Evidence, Limitations and Future Directions.PubMed
Travis J Saunders, Jeff K Vallance
Appl Health Econ Health Policy. 2017 Jun;15(3):323-331. doi: 10.1007/s40258-016-0289-3.
Despite accumulating evidence linking screen-based sedentary behaviours (i.e. screen time) with poorer health outcomes among children and youth <18 years of age, the prevalence of these behaviours continues to increase, with roughly half of children and youth exceeding the public health screen time recommendation of 2 h per day or less. The purpose of this article is to provide an overview of key research initiatives aimed at understanding the associations between screen time and health indicators including physical health, quality of life and psychosocial health. Available evidence suggests that screen time is deleteriously associated with numerous health indicators in child and youth populations, including adiposity, aerobic fitness, quality of life, self-esteem, pro-social behaviour, academic achievement, depression and anxiety. However, few longitudinal or intervention studies have been conducted, with most of these studies focusing on physical health indicators. While most studies have used self-reported assessments of screen time, the availability of more objective assessment methods presents important opportunities (e.g. more accurate and precise assessment of sedentary time and screen time) and challenges (e.g. privacy and participant burden). Novel statistical approaches such as isotemporal substitution modelling and compositional analysis, as well as studies using longitudinal and experimental methodologies, are needed to better understand the health impact of excessive screen time, and to develop strategies to minimise or reverse the negative impacts of these behaviours. The evidence to date suggests a clear need for policy aimed at minimising the hazardous health consequences associated with screen time among children and youth.
101Screen Use and Mental Health Symptoms in Canadian Children and Youth During the COVID-19 Pandemic.PubMed
Xuedi Li, Leigh M Vanderloo, Charles D G Keown-Stoneman, et al.
JAMA Netw Open. 2021 Dec 1;4(12):e2140875. doi: 10.1001/jamanetworkopen.2021.40875.
IMPORTANCE: Longitudinal research on specific forms of electronic screen use and mental health symptoms in children and youth during COVID-19 is minimal. Understanding the association may help develop policies and interventions targeting specific screen activities to promote healthful screen use and mental health in children and youth. OBJECTIVE: To determine whether specific forms of screen use (television [TV] or digital media, video games, electronic learning, and video-chatting time) were associated with symptoms of depression, anxiety, conduct problems, irritability, hyperactivity, and inattention in children and youth during COVID-19. DESIGN, SETTING, AND PARTICIPANTS: A longitudinal cohort study with repeated measures of exposures and outcomes was conducted in children and youth aged 2 to 18 years in Ontario, Canada, between May 2020 and April 2021 across 4 cohorts of children or youth: 2 community cohorts and 2 clinically referred cohorts. Parents were asked to complete repeated questionnaires about their children's health behaviors and mental health symptoms during COVID-19. MAIN OUTCOMES AND MEASURES: The exposure variables were children's daily TV or digital media time, video game time, electronic-learning time, and video-chatting time. The mental health outcomes were parent-reported symptoms of child depression, anxiety, conduct problems and irritability, and hyperactivity/inattention using validated standardized tools. RESULTS: This study included 2026 children with 6648 observations. In younger children (mean [SD] age, 5.9 [2.5] years; 275 male participants [51.7%]), higher TV or digital media time was associated with higher levels of conduct problems (age 2-4 years: β, 0.22 [95% CI, 0.10-0.35]; P < .001; age ≥4 years: β, 0.07 [95% CI, 0.02-0.11]; P = .007) and hyperactivity/inattention (β, 0.07 [95% CI, 0.006-0.14]; P = .04). In older children and youth (mean [SD] age, 11.3 [3.3] years; 844 male participants [56.5%]), higher levels of TV or digital media time were associated with higher levels of depression, anxiety, and inattention; higher levels of video game time were associated with higher levels of depression, irritability, inattention, and hyperactivity. Higher levels of electronic learning time were associated with higher levels of depression and anxiety. CONCLUSIONS AND RELEVANCE: In this cohort study, higher levels of screen use were associated poor mental health of children and youth during the COVID-19 pandemic. These findings suggest that policy intervention as well as evidence-informed social supports are needed to promote healthful screen use and mental health in children and youth during the pandemic and beyond.
102The impact of short video usage on the mental health of elderly people.PubMed
Rui Zhang, Yiming Su, Zheyu Lin, et al.
BMC Psychol. 2024 Oct 31;12(1):612. doi: 10.1186/s40359-024-02125-6.
BACKGROUND: In the context of a gradual increase in aging, improving the mental health of the elderly is particularly vital for coping with aging. Leveraging data from the 2020 China Family Panel Studies, this study rigorously examines the influence of short video on the mental health of the elderly. METHODS: We use a multiple linear regression model to investigate the influence of short video usage on the mental health of the elderly. To address endogeneity concerns, this study employs two-stage least squares and propensity score matching to estimate the impact of short video usage on the mental health of the elderly. RESULTS: The empirical analysis reveals a substantive and statistically significant enhancement in the mental health of elderly people attributable to the use of short videos. To ensure the reliability and robustness of our estimations, a comprehensive battery of robustness tests is conducted, all of which consistently support the conclusion of a positive association between short video usage and improved mental health among the elderly. Furthermore, the results of the heterogeneity analysis suggest that short videos have less of an impact on elderly males and individuals with higher levels of education. The results of the mechanism analysis indicate that the use of short videos can enhance the mental health of elderly individuals by positively impacting the intergenerational relationships between them and their children, as well as their leisure consumption habits. CONCLUSIONS: This study can provide policy inspiration for the government to improve the mental health of the elderly and achieve active aging.
103The Effect of Young People-Assisted, Individualized, Motion-Based Video Games on Physical, Cognitive, and Social Frailty Among Community-Dwelling Older Adults With Frailty: Randomized Controlled Trial.PubMed
Arkers Kwan Ching Wong, Melissa Qian Zhang, Jonathan Bayuo, et al.
JMIR Serious Games. 2024 Nov 20;12:e57352. doi: 10.2196/57352.
BACKGROUND: The aging population highlights the need to maintain both physical and psychological well-being. Frailty, a multidimensional syndrome, increases vulnerability to adverse outcomes. Although physical exercise is effective, adherence among older adults with frailty is often low due to barriers. Motion-based video games (MBVGs) may enhance motivation and engagement. OBJECTIVE: This study aims to evaluate the effect of individualized exercise programs that combine MBVGs, intergenerational support, and therapeutic frameworks on physical, cognitive, and social frailty outcomes in community-dwelling older adults. METHODS: This randomized controlled trial was conducted from March 2022 to October 2023 across 6 community centers in Hong Kong. Participants aged 60 years and above with mild neurocognitive disorder were recruited, screened, and randomly assigned to either an intervention (n=101) or control group (n=101). The intervention included an 18-week program with 12 supervised exercise sessions utilizing motion-based technology, led by occupational therapists and assisted by youth volunteers. Data were collected at baseline (T1) and postintervention (T2), focusing on physical, cognitive, and social frailty outcomes, as well as client-related metrics. Statistical analyses were performed using SPSS, with significance set at P<.05. RESULTS: A total of 202 participants were recruited, with a mean age of 78.8 years (SD 7.8). Both groups showed improvements in balance from T1 to T2, with a significant time effect (β=-0.63, P=.03). The intervention group demonstrated enhancements in hand strength and BMI, but no statistically significant between-group differences were observed. The intervention group also exhibited significant improvements in cognitive function (β=2.43, P<.001), while the control group's scores declined. Short-term memory improved for both groups, with no significant differences noted. Both groups experienced a reduction in depression levels, with a significant within-group effect at T2 (β=-1.16, P=.001). Improvements in social connectedness and eHealth literacy were observed in both groups, with the latter showing a significant within-group effect at T2 (β=3.56, P=.002). No significant effects were found for social isolation, physical activities, or quality of life. CONCLUSIONS: The growing aging population necessitates innovative strategies to support aging in place. Results indicated statistically significant improvements only in BMI and cognition, while other outcomes such as loneliness, balance, and eHealth literacy showed positive trends but lacked significance. Despite the limitations observed, particularly regarding the role of volunteer support and the diverse needs of community-dwelling older adults, the findings contribute to the foundation for future research aimed at enhancing biopsychosocial outcomes. Future studies should explore tailored interventions that consider individual preferences and abilities, as well as evaluate specific components of motion-based video games to optimize their effectiveness.
104Digital cognitive training for functionality in mild cognitive impairment: a randomized controlled clinical trial.PubMed
Cíntia Monteiro Carvalho, Bruno Costa Poltronieri, Karin Reuwsaat, et al.
Geroscience. 2025 Jun;47(3):5111-5121. doi: 10.1007/s11357-024-01464-x. Epub 2025 Jan 6.
Digital cognitive training may improve cognition in people with mild cognitive impairment (MCI); however, the effect on functionality remains poorly defined. The Canadian Occupational Performance Measure (COPM) is a valid and consistent instrument for evaluating the performance of activities of daily living in this population. This study used the COPM to investigate the effects of digital cognitive training on functionality in individuals with MCI. We recruited participants aged 60 or older with MCI to a double-blinded, randomized, stepped wedge clinical trial of digital cognitive training compared to an active control group of commercial computer games. Participants were evaluated for functionality and cognition before and after 10 h of intervention. Ten hours of digital cognitive training improved functionality, measured by COPM performance, compared to the active control group. Learning over trials also improved significantly after 10 h of digital cognitive training, as compared to the active control group. Ten hours of digital cognitive training improved functionality in MCI. More sensitive tools, such as COPM, should be used to evaluate the effect of therapeutic interventions for functionality in MCI.
105Long-term impact of digital media on brain development in children.PubMed
Samson Nivins, Bruno Sauce, Magnus Liebherr, et al.
Sci Rep. 2024 Jun 6;14(1):13030. doi: 10.1038/s41598-024-63566-y.
Digital media (DM) takes an increasingly large part of children's time, yet the long-term effect on brain development remains unclear. We investigated how individual effects of DM use (i.e., using social media, playing video games, or watching television/videos) on the development of the cortex (i.e., global cortical surface area), striatum, and cerebellum in children over 4 years, accounting for both socioeconomic status and genetic predisposition. We used a prospective, multicentre, longitudinal cohort of children from the Adolescent Brain and Cognitive Development Study, aged 9.9 years when entering the study, and who were followed for 4 years. Annually, children reported their DM usage through the Youth Screen Time Survey and underwent brain magnetic resonance imaging scans every 2 years. Quadratic-mixed effect modelling was used to investigate the relationship between individual DM usage and brain development. We found that individual DM usage did not alter the development of cortex or striatum volumes. However, high social media usage was associated with a statistically significant change in the developmental trajectory of cerebellum volumes, and the accumulated effect of high-vs-low social media users on cerebellum volumes over 4 years was only β = - 0.03, which was considered insignificant. Nevertheless, the developmental trend for heavy social media users was accelerated at later time points. This calls for further studies and longer follow-ups on the impact of social media on brain development.