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Objective: Fluorodeoxyglucose (FDG) whole body positron emission tomography (PET) scan may show clinically occult second lesions. Such lesions in the thyroid are increasingly common. There are several recent reports of a high probability of malignancy in these lesions ranging from 14% to 63%. Study Design and Setting: This is a retrospective review of 15,711 PET scans at a multi-disciplinary thyroid clinic at a tertiary care university medical center. Twenty-two patients were referred with thyroid PET "incidentalomas." The review included 18 FDG-PET scans, ultrasound guided fine needle aspiration biopsies, and thyroid surgery pathology. Aspiration cytology or pathology were the main outcome measures. Results: Three patients had malignancy of the PET-positive thyroid lesions. Papillary thyroid micro carcinomas were detected in four of the specimens that showed a benign pathology of the dominant nodule. Conclusion: Our experience shows a 14% malignancy rate for the dominant (imaged) nodule and a total malignancy rate of 32% when the incidental micro carcinomas are included. Both of these rates are significantly lower than results published previously. [ABSTRACT FROM AUTHOR]

A longstanding challenge in the behavioral addictions field has been determining the point at which gaming involvement becomes clinically significant problematic use. Gaming disorder (GD) and hazardous gaming as recent ICD-11 diagnoses have attracted polarized perspectives due in part to the global popularity of recreational gaming and gaming culture. The broad continuum of gaming can often be perceived differently by different parties, including gamers themselves; what might be seen as regular, harmless, and normative to some, may be considered risky and problematic by others. The ICD-11 guidelines provide some clarity by advising that gaming disorder should not be diagnosed based on persistent gaming alone; that gaming as part of a routine, developing skills, changing mood or relieving boredom, or facilitating social interaction is not sufficient for a diagnosis; and that cultural and peer group norms should be considered in diagnosis. In this paper, we examine gaming normality-disorder boundary issues in the areas of conceptualization, assessment, and interventions. Some examples of the complex personal, social, and cultural considerations that arise in gaming diagnoses are provided. We call for researchers in the addiction and health disciplines to grapple with conceptual controversy and conduct the empirical and clinical research needed to ensure that normal recreational gaming is always clearly distinguished from harm and disorder.

Gambling disorder is the only behavioral addiction recognized as a clinical disorder in DSM-5, and Internet gaming disorder is included as a condition requiring further research. ICD-11 categorizes gambling and gaming disorders as disorders due to addictive behaviors. Additional behavioral addictions may include compulsive sexual behavior disorder, compulsive buying-shopping disorder, and problematic use of social media. This narrative review summarizes the current state of knowledge regarding these five (potential) disorders due to addictive behaviors. All five (potential) disorders are clinically relevant and prevalent. Behavioral addictions frequently co-occur with other mental and behavioral problems, such as depression, anxiety, and attention deficit hyperactivity disorder. Validated diagnostic instruments exist, with empirical support varying across conditions. No medications have approved indications from regulatory bodies for behavioral addictions, and cognitive-behavioral therapy has the most empirical support for efficacious treatment. Given that behavioral addictions are prevalent, frequently co-occur with psychiatric disorders, may often go undiagnosed and untreated, and have been linked to poorer treatment outcomes, active screening and treatment are indicated. Public health considerations should be expanded, and impacts of modern technologies should be investigated more intensively. Treatment optimization involving pharmacotherapy, psychotherapy, neuromodulation, and their combination warrants additional investigation., Competing Interests: Drs. Brand, Demetrovics, King, Müller, and Potenza are board members of the International Society for the Study of Behavioral Addictions. Dr. Demetrovics’s university (ELTE Eötvös Loránd University) receives funding from Szerencsejáték Ltd. (the gambling operator of the Hungarian government) to maintain a telephone helpline service for problematic gambling, and his other university (University of Gibraltar) receives funding from the Gibraltar Gambling Care Foundation and donations from gambling operators through the LCCP RET process supervised by the UK Gambling Commission. Dr. Fineberg has held research or networking grants from the National Institute for Health and Care Research, COST Action, the EU, UK Research and Innovation, and Orchard; she has received travel and/or hospitality expense coverage from the British Association for Psychopharmacology, the European College of Neuropsychopharmacology, the Royal College of Psychiatrists, the International College of Neuropsychopharmacology, the International Forum of Mood and Anxiety Disorders, and the World Psychiatric Association; she has received payment from Elsevier for editorial duties and the Mental Health Academy and Children and Screens for lecturing; she leads an NHS treatment service for OCD; she is a board member for various registered charities linked to OCD; she provides expert advice on psychopharmacology to the Medicines and Healthcare Products Regulatory Agency; and she has participated in a WHO working group focusing on diagnosis and classification of obsessive-compulsive or related disorders for ICD-11. Dr. Potenza has served as a consultant for the Addiction Policy Forum, AXA, BariaTek, Game Day Data, Idorsia Pharmaceuticals, and Opiant Therapeutics and has served as a consultant and/or adviser for gambling, health care, nonprofit, and legal entities on issues related to impulse control, Internet use, and/or addictive disorders; he has been involved in a patent application with Yale University and Novartis; he has received research support from Children and Screens, the Connecticut Council on Problem Gambling, and Mohegan Sun Casino; and he has participated in surveys, mailings, or telephone consultations related to drug addiction, impulse control disorders, and other health topics. All of the authors have performed grant reviews for research funding agencies, and/or edited journals or journal sections, and/or given academic lectures in clinical or scientific venues, and/or produced book chapters for publishers of mental health texts.

Background and Aims: The study of stigma contributes greatly to our understanding of individuals' experiences of mental disorders. Addictive disorders are often associated with public misconceptions of the disorder, which can contribute to shame, discrimination, and reticence to seek help. This review aimed to: (1) evaluate the nature, frequency, and prevalence of addiction stigma; (2) identify the correlates of addiction stigma; and (3) examine the psychometric qualities of addiction stigma measures., Methods: A search of Web of Science, PubMed, Scopus, PsycINFO, and PsycNet, had 5,515 results which were screened for eligibility using Covidence. Eligible papers were quantitative, peer-reviewed studies, which reported an outcome variable of stigma related to an addiction., Results: A total of 99 studies were included in the review, including 70 studies of substance-based addictions, 19 studies of behavioral addictions, and 10 studies which examined both. Thirteen of the 20 studies examining the impact of familiarity with addiction reported that greater familiarity was associated with lower public stigma. Studies comparing substance and behavioral addictions (n = 5) typically reported greater public stigma towards vignettes depicting substance-based addictions than for behavioral addictions. Between 22% and 40% of individuals with an addictive disorder identified stigma as a significant barrier to seeking help; however, the relative importance of stigma among other barriers was unclear., Discussion and Conclusions: Evidence for countermeasures to prevent and/or reduce stigma is currently limited. Further research on the nature and prevalence of addiction stigma is needed to inform the development of effective clinical and public health countermeasures.

Background: The gaming and gambling overlap has intensified with new evidence emerging. However, the relationship between gaming and gambling in the digital space is still inconclusive, especially in resource-limited Asian countries., Objective: This study aims to review available evidence on the possible interaction and focuses specifically on the gateway interaction between gambling and gaming. Additionally, this review delves into the state of evidence from the Southeast Asian region, providing an in-depth analysis of this underexplored area., Methods: We performed a scoping review by sifting through the publications in five databases. We focused on the gateway interaction and provided a possible pathway model, while two other convergence relationships were provided for comparison., Results: The scoping review identified a total of 289 publications, with the majority being empirical (n=181), although only 12 studies used longitudinal designs. A significant proportion of the publications (n=152) concentrated on the correlation or comorbidity between gaming and gambling. Most of the evidence has originated from Global North countries, with very limited research emerging from Southeast Asia (n=8). The most commonly studied gambling-like element in video games was loot boxes (n=105). Other elements investigated included esports betting, skin betting, token wagering, gambling advertisements, and gambling-like features. Several longitudinal studies have highlighted the risk of the gateway effect associated with gamblification involvement. However, emerging evidence suggests more nuanced underlying mechanisms that drive the transition from gaming to gambling., Conclusions: Overall, there is early evidence of linkage between gambling and gaming, through shared structural and biopsychosocial characteristics. This association possibly extends beyond disparate comorbidity, as such engagement in one activity might influence the risk of partaking in the other behavior. The field requires further longitudinal data to determine the directionality and significant precipitating factors of the gateway effect, particularly evidence from Asia., (© Kristiana Siste, Daniel L King, Enjeline Hanafi, Lee Thung Sen, Adrian Adrian, Belinda Julivia Murtani. Originally published in JMIR Serious Games (https://games.jmir.org).)

Background: Sports betting is becoming increasingly common among young people in the UK and Australia. There is a need to understand how the marketing of sports betting may influence risky and pathological gambling to inform policies aimed at reducing harm. This study examines whether sports betting advertising may predict problem gambling scores among young people, while accounting for non-marketing variables., Methods: We recruited 567 participants (53.1% male) aged 18-24 years from an online research panel. Participants were eligible if they had an active betting account and regularly bet on sports. We conducted a hierarchical regression analysis to examine whether four marketing-related measures (exposure to advertising, ad-driven betting decisions, use of betting inducements, and perceived susceptibility to betting inducements) could predict PGSI scores. We controlled for several demographic, psychological, and behavioural variables, including gender, gambling participation, spend per session, participation in in-play betting, normative beliefs about sports betting, and impulsivity., Results: The study revealed that sports betting marketing was positively associated with PGSI scores after controlling for non-marketing variables. Significant marketing predictors included ad-driven betting decisions and perceived influence from betting inducements. Other significant predictors included participation in non-sports betting gambling activities, spend per session, involvement in in-play betting, and the impulsivity trait of negative urgency., Conclusion: Sports betting marketing appears to be implicated in young people's gambling problems. Specifically, young people who have gambling problems may be more likely to bet in response to advertising, and betting incentives may contribute to an intensification of their gambling behaviour. This study supports the implementation of regulations and restrictions on advertising as a measure to protect young problem gamblers., Competing Interests: Declarations Conflict of interest The authors declare no competing interests. The authors alone are responsible for the content and writing of the paper. Informed consent All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 (5). Informed consent was obtained from all patients for being included in the study., (© 2024. The Author(s).)

The Australian university sector had almost one million international students in 2024. This population faces significant mental health challenges that affect their wellbeing and academic success, but these issues have received minimal empirical attention. Past research reports that international students experience acculturative stress due to language barriers, lack of social support, and discrimination, which contribute to poor mental health. Current evidence lacks insight into the progression of acculturative stress over time. To address this gap, this study conducted a longitudinal investigation of the mental health profiles of 140 Chinese international tertiary students in Australia and 84 Chinese tertiary students in China (M age  = 22.4, SD = 2.7). Participants in Australia were assessed in 2023 after their arrival (T1) and then five months later (T2). Contrary to expectations, the groups did not differ on standardised measures of distress, loneliness, wellbeing, social support, and resilience. However, Chinese students reported greater acculturative stress, as measured by the Acculturative Stress Scale for International Students (ASSIS), at T2 than at T1. Participants reported that the most significant challenge in adapting to life in Australia were language barriers and communication difficulties (84.3 %), which were rated more frequently than the academic demands of university (55.0 %). Potential methodological limitations aside, the results suggest that Chinese students may benefit from resources, supports, and interventions that target specific areas of acculturative stress, particularly in relation to language proficiency, to optimise their health and study., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2025 The Authors. Published by Elsevier B.V. All rights reserved.)

Individuals who struggle to regulate their gaming involvement, particularly those with gaming disorder, often report strong subjective urges to play games. Desire thinking has been proposed to be an active driver of urge, and therefore disrupting desire thinking processes may reduce urges to play. Detached mindfulness, a meta-cognitive therapy technique, is a candidate option for reducing desire thinking, but the available research in relation to gaming is limited. To address this gap, this pre-registered study employed a 3 (Group: mindfulness, relaxation, control) x 3 (Time: baseline, pre-task, post-task) mixed experimental design to evaluate the effectiveness of different techniques to reduce gaming urges. Gamers (N = 337) were recruited via the crowd-sourcing platform Prolific. Participants were administered interactive video-based tasks that induced gaming-related desire thinking and were then randomly delivered one of three techniques. Results showed that the desire thinking exercise significantly increased gaming urge. However, the detached mindfulness technique had no significant effect on urge to play, whereas relaxation significantly reduced urge compared to control. The effect of relaxation on urge was stronger for those with moderate to high impulsivity. These results support the proposed link between desire thinking and gaming urge. Gaming urges may be reliably induced using a brief self-guided protocol, which has applications for interventions involving exposure exercises without the use of physical gaming stimuli. Relaxation techniques may have short-term utility in reducing gaming-related urges. Further research should examine other meta-cognitive therapy-based techniques to support a broader research program on CBT for gaming disorder., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2025 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Background: In the Compensatory-Dissociative Online Gaming (C-DOG; Giardina et al., 2024) model, we proposed a continuum from compensatory to dissociative gaming involvement. This continuum represents different degrees of integration between physical and virtual environments with three core processes - Active Escapism, Escape, and Dissociation - and two peripheral processes - Gaming-Related Relaxation and Body-Mind Detachment. Here, we developed and tested a multidimensional measure based on this model., Method: We capitalized on existing items for measuring escapism and dissociation and we generated new items consistent with the hypothesized model dimensions. A total of 54 items were administered to 1,176 online gamers playing different game genres, together with measures of problematic gaming, passion for gaming, and other psychological distress indicators., Results: Exploratory and confirmatory factor analyses yielded a six-factor, 36-item structure, with multiple hierarchical regression analyses highlighting unique associations with other psychological constructs assessed., Discussion: The following factors were identified: (1) Emotional Displacement - redirection of negative emotion into the game with associated relaxation; (2) Absorption - detachment of the player from time and space while gaming; (3) Active Escapism - simulative use of the game to compensate for lack of self-confidence in reaching physical life objectives; (4) Virtual Withdrawal - maladaptive gaming to balance impaired social functioning, predicted by traumatic experiences and pervasive depression; (5) Dissociative Regulation - dysfunctional level of engagement associated with excessive anxiety; (6) Failure Escape - problematic avoidance via gaming related to fear of future failures., Conclusions: The C-DOG factors identify critical psychological processes associated with problematic gaming, with relevant research and clinical implications.

In their study, Stavropoulos et al. (2023) capitalized on supervised machine learning and a longitudinal design and reported that the User-Avatar Bond could be accurately employed to detect Gaming Disorder (GD) risk in a community sample of gamers. The authors suggested that the User-Avatar Bond is a "digital phenotype" that could be used as a diagnostic indicator for GD risk. In this commentary, our objectives are twofold: (1) to underscore the conceptual challenges of employing User-Avatar Bond for conceptualizing and diagnosing GD risk, and (2) to expound upon what we perceive as a misguided application of supervised machine learning techniques by the authors from a methodological standpoint.

Background and Aims: Mobile phone bans in secondary schools are claimed to reduce student distraction and promote learning and face-to-face socializing. Currently, the evidence on phone bans is limited. The aim of this preregistered study was to evaluate the South Australian mobile phone ban's effects on students' problematic phone use, academic engagement, school belonging, and bullying. The study also sought to identify student variables that predict phone ban compliance., Methods: As the ban was phased in over 2023, a 2 (phone ban: yes/no) × 2 (time: baseline, 1-month follow-up) repeated-measures design was employed. Students (n = 1,282 at baseline; n = 1,256 at follow-up) in Grades 7 to 12 were recruited from five public secondary schools. Surveys included measures drawn from the Longitudinal Study of Australian Children (LSAC) and the Programme for International Student Assessment (PISA)., Results: Problematic phone use was reported by 2.6% of the sample. Being older and a more frequent user of social media predicted lower phone ban compliance. Linear mixed models indicated that ban and no ban school groups did not differ significantly in terms of problematic phone use, academic engagement, and school belonging. There was slightly higher bullying in the ban group but bullying decreased significantly in both groups., Discussion: Imposing access restrictions may not affect the underlying psychological mechanisms that drive problematic phone use. Although these results indicate limited to no short-term benefits of the ban, further evaluation with more sensitive methodologies is recommended., Conclusions: Student-technology interactions in learning institutions should be continually monitored to determine the optimal balance to support student etiquette, learning, and wellbeing.

Young people are known to be highly engaged in sports betting and therefore may be particularly susceptible to the effects of gambling-related advertising. The purpose of the present study was to examine young people's recall of sports betting advertising during the 2022 FIFA World Cup. The sample consisted of 190 UK residents aged 18-24 who had watched at least one 2022 World Cup match. A cross-sectional survey was conducted to collect data on participants' recall of sports betting advertisements across several media types and for different bets and betting offers, as well as their problem gambling scores. The findings indicated that young people were able to recall a high amount of advertising for various types of bets (95.6%) and betting inducements (89.5%). A high proportion of young people recalled advertising for risky bet types and promotions, such as 64.2% for in-play betting and 68.1% for sign-up offers. Overall, higher-risk gamblers recalled encountering more advertising than lower-risk gamblers. Participants recalled encountering sports betting advertisements on social media the most (10-14 ads per week), then on internet banners and television (5-9 ads per week, respectively). Less than half (46.3%) of respondents were aware of advertising for responsible gambling tools. This study underscores the need for policy measures that limit young people's exposure to gambling advertising, particularly for products that may contribute to gambling-related harm, and that increase the promotion of responsible gambling tools., (© 2024. The Author(s).)

Objective: The purpose of this study is to describe both the common and uncommon symptoms associated with Eagle syndrome and share our experience treating a large group of patients with surgical intervention, primarily intraoral excision of the calcified stylohyoid ligament., Methods: This retrospective case series included 56 patients at least 18 years of age or older with a diagnosis of Eagle syndrome. All operations were conducted by a single surgeon at a tertiary medical center from 2015 to 2022. Charts were reviewed for demographics, prior medical/surgical history, symptoms, imaging results, operative details, and follow-up history. A phone survey inquired about presenting symptoms and symptom resolution following surgery., Results: The most common areas of pain were the ear (64.3%), underneath the angle of the mandible (50%), throat (46.4%), and neck (30.4%). Over 70% of patients reported tinnitus, dysphagia, and pain that were exacerbated by head rotation. Fifty-one of the 56 patients underwent surgical treatment, 92.2% via intraoral and 7.8% via cervical approaches. All patients (100%) reached in a phone survey stated that their symptoms resolved or improved after surgery., Conclusion: Eagle syndrome typically presents with common symptoms. However, healthcare providers must also be vigilant for less common manifestations, such as seizures or episodes of dizziness/fainting. These may be caused by calcification of the stylohyoid ligament. Intraoral surgical resection of the calcified ligament is a safe and effective treatment for most patients., Level of Evidence: Level 4., (© 2024 The Author(s). Laryngoscope Investigative Otolaryngology published by Wiley Periodicals LLC on behalf of The Triological Society.)

Background and Objectives: As the gaming industry experiences exponential growth, concerns about gaming disorder (GD) also grow. It is crucial to understand the structural features of games that can interact with individual characteristics of gamers to promote GD. This research consolidates the views of an international body of panelists to create an assessment tool for gauging the addictive potential of distinct games., Methods: Utilizing the iterative and structured Delphi method, an international panel of researchers, clinicians, and people with lived experience were recruited to offer a multifaceted viewpoint on the addictive risk associated with specific structural elements in games. Two rounds of surveys facilitated consensus., Results: The panel initially included 40 members-ten from research, eight from clinical settings, and 22 with lived experiences. The second round included 27 panelists-seven from research, eight from clinical settings, and 11 with lived experiences. The study identified 25 structural features that contribute to potentially addictive gaming patterns., Discussion and Conclusions: Consensus was found for 25 features, which were distilled into a 23-item evaluation tool. The Saini-Hodgins Addiction Risk Potential of Games Scale (SHARP-G) consists of five overarching categories: 'Social,' 'Gambling-Like Features,' 'Personal Investment,' 'Accessibility,' and 'World Design.' SHARP-G yields a total score indicating level of addiction risk. A case study applying the scale to three games of differing perceived risk levels demonstrated that that score corresponded to game risk as expected. While the SHARP-G scale requires further validation, it provides significant promise for evaluating gaming experiences and products.

Abstract: Stahl, CA, Regni, G, Tanguay, J, McElfresh, M, Trihy, E, Diggin, D, and King, DL. A biomechanical comparison of the back squat and hexagonal barbell deadlift. J Strength Cond Res 38(5): 815-824, 2024-Coaches often use different exercises to encourage similar strength adaptations and limit monotony. Anecdotally, the hexagonal barbell deadlift (HBD) exhibits similarities to the back squat (BS). To date, research has not examined the empirical differences between these exercises. This study examined kinematic and kinetic differences between the BS and the HBD across different loads. Sixteen resistance-trained individuals (6 men and 10 women) volunteered to participate. Subjects performed 1-repetition maximum (1RM) testing under BS and HBD conditions. Kinematic and kinetic data were collected during performance of both exercises at submaximal (warm-up sets) and maximal (1RM) loads using a 3D motion capture and force-plate system. Results showed that subjects lifted greater 1RM loads in the HBD relative to the BS (p < 0.05; d = -1.75). Kinematic data indicated that subjects exhibited greater maximum forward lean of the trunk and decreased maximum knee flexion while performing the HBD compared with the BS. The BS resulted in higher maximum extension moments at the hip joint than the HBD. Maximum extension moments at the knee joint showed no difference between the exercises. Data suggest that bar design and position facilitate balanced moment arm length at hip and knee joints during performance of the HBD. By contrast, bar position during performance of the BS increases moment arm length at the hip joint, making it a hip-dominant exercise. The present data have implications for the programming of both exercises. Future research should examine differences in muscle-activation strategies between the 2 exercises., (Copyright © 2024 National Strength and Conditioning Association.)

The concept of impaired control (IC) over gaming is an important element of assessment and interventions for problem gaming and gaming-related harm. Past studies have reported that gaming disorder (GD) is associated with various negative consequences, but there is limited research on the relationship between IC over gaming and negative outcomes. To address this gap, the study investigated the relationship between impaired control and gaming-related harm among individuals with self-identified gaming disorder. It was hypothesized that IC would be positively associated with gaming-related harm and harm severity. In addition, it was predicted that IC would be a significant predictor of harm when controlling for age, gender, psychological distress, and gaming urges. The current study recruited 513 participants through an online survey platform. The Impaired Control Over Gaming Scale (ICOGS) was used to measure IC, and modified items from Browne et al.'s taxonomy of gambling harms were used to assess gaming harm severity. The logistic regression results showed that IC was positively related to all forms of harm, after controlling for other variables. The predictive value of IC was similar across financial, psychological, relationship, social and work/school domains. These results supported the importance of IC as a mechanism that contributes to the experience of gaming-related harm, and the need to target IC in interventions for GD., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Crown Copyright © 2023. Published by Elsevier Ltd. All rights reserved.)

Objective: The vascular anatomy of the proximal subscapular artery has been previously classified into 2 major types depending on the presence of a common subscapular trunk. The purpose of this study was to determine the utility, reliability, and cost of routine chest imaging to identify these anatomical variations., Methods: Data were collected retrospectively at a tertiary medical center for patients who were undergoing CT chest for various indications between October 2019 and October 2020. Two independent and blinded readers interpreted CT chest with contrast of 52 patients for a total 104 sides., Results: The proximal branching pattern of the subscapular system was identified to have a common trunk in 99 (95%) sides. The remaining five sides (5%) demonstrated two arterial pedicles; with one patient exhibiting the variant anatomy bilaterally., Conclusion: Preoperative CT chest with contrast can accurately identify anatomic variation of the subscapular vascular system. For complex reconstruction requiring a single anastomosis in the vessel depleted neck, preoperative imaging can assure selection of a type I vascular anatomy of the proximal subscapular system. Preoperative imaging with contrasted CT has value in assessing this anatomy when planning for chimeric flaps involving circumflex scapular and thoracodorsal arteries., Level of Evidence: 3 Laryngoscope, 134:684-687, 2024., (© 2023 The American Laryngological, Rhinological and Otological Society, Inc.)

Background and Aims: Internet addiction has been linked to ADHD-related symptoms. However, the direction of the relationship and its potential for reciprocal relations is not well understood. This study examined the potential reciprocal relations between the three components of ADHD and Internet addiction, as well as the moderating effects of gender on these relations., Methods: Using a longitudinal design, we collected data of 865 Chinese adolescents across three waves (Mage = 13.78, SD = 1.56 in wave 1), with a time interval of 6 months., Results: Cross-lagged analyses revealed bidirectional associations between hyperactivity, inattention, impulsivity, and Internet addiction over time. Multi-group analyses did not yield any significant gender differences in these relationships., Discussion and Conclusions: These findings enhance our understanding of the complex link between ADHD components and Internet addiction and have implications for interventions aimed at reducing the prevalence of Internet addiction and ADHD.

Behavior frequency measures in behavioral addictions research fail to account for how engagement in the activity relates to each respondent's personal circumstances. We propose a "Red Box, Green Box" method, an alternative to conventional self-report behavior questions. Participants report two distinct time-based values: (1) Green box: time spent engaged in the activity during 'free' time, and (2) Red box: engagement in the activity at times when the respondent should be doing something else (e.g., studying, working, sleeping, exercising, etc.). Some practical examples of the 'red box, green box' method are provided. This method may help to calibrate behavioral frequency for each respondent and yield clearer insights into displacement effects and risks associated with frequency of use. We suggest some future research directions to test the feasibility and utility of this approach in different implementations.

Objective: Despite growing recognition of gaming disorder as a mental disorder, there is still debate about how best to screen for it. This is especially relevant in countries where prevalence studies that could support evidence-based policymaking have not yet been conducted. This study aims to evaluate the psychometric properties of the Brazilian Portuguese version of the Ten-Item Internet Gaming Disorder Test (IGDT-10) and to explore its association with functional impairment., Methods: An online convenience sample of 805 Brazilian adults who reported playing games completed the adapted version of the IGDT-10 and the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0), as well as the Problematic Internet Use Questionnaire (PIUQ), the Center for Epidemiologic Studies-Depression Scale (CES-D), the Rosenberg Self-Esteem Scale (RSES), and a socio-demographic questionnaire., Results: The Brazilian Portuguese version of the IGDT-10 demonstrated a unidimensional structure in both confirmatory and exploratory factor analyses with satisfactory internal consistency and adequate temporal stability. Participants who scored five or more on the IGDT-10 presented higher levels of functional impairment compared to those who scored positive for four symptoms or fewer. The difference between the two groups was statistically significant with a moderate effect size. Network analysis showed a direct connection between IGDT-10 scores and functional impairment and identified "negative consequences" as the most relevant item connecting these variables., Conclusion: The IGDT-10 is a brief, easy-to-understand, valid, and reliable instrument, proving to be a suitable candidate for screening gaming disorder in future epidemiological studies., Competing Interests: No conflicts of interest declared concerning the publication of this article.

Gaming disorder (GD) screening often involves self-report survey measures to detect the presence of symptoms. Studies have shown that gamers' responses vary greatly across survey items. Some symptoms, such as preoccupation and tolerance, are frequently reported by highly engaged but non-problematic gamers, and therefore these symptoms are thought to lack specificity and are suggested to be less important in classification decisions. We argue that the influence of response categories (e.g., dichotomous responses, such as 'yes' or 'no'; or frequency categories, such as 'rarely' and 'often') on item responses has been relatively underexplored despite potentially contributing significantly to the psychometric performance of items and scales. In short, the type of item response may be just as important to symptom reporting as the content of survey questions. We propose some practical alternatives to currently used item categories across GD tools. Research should examine the performance of different response categories, including whether certain response categories aid respondents' comprehension and insight, and better capture pathological behaviours and harms.

Social chatbots powered by artificial intelligence (AI) may be particularly appealing to individuals with social deficits or conditions that affect their social functioning. In this letter, we discuss some of the noteworthy characteristics of social chatbots and how they may influence adaptive and maladaptive behaviors, including the potential for 'dependency' on chatbots. We call for more independent studies to evaluate the potential developmental and therapeutic effects of this increasingly popular technology.