Chih Hung Ko

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

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

The association between Internet addiction and problematic alcohol use in adolescents: the problem behavior model.

Abstract This study aimed to a) evaluate the association between Internet addiction and problematic alcohol use; b) based on problem behavior theory, explore whether Internet addiction, as well as problematic alcohol use, correlated with the psychosocial proneness of problem behaviors among adolescents. A total of 2,114 high school students (1,204 male and 910 female) were recruited to complete the questionnaire assessing Internet addiction, problematic alcohol use, and associated psychosocial variables. The result revealed that Internet addiction was associated with problematic alcohol use. Besides, the psychosocial proneness of problem behaviors is associated with Internet addiction as well as problematic alcohol use in adolescents. These results suggest Internet addiction might be included in the organization of problem behavior theory, and it is suggested that prevention and intervention can best be carried out when grouped with other problem behaviors.

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

Aims:  The aim of the present study was to examine the discriminative effects of sociodemographic, individual, family, peers, and school life factors on Internet addiction in Taiwanese adolescents.

The relationships between body mass index and television viewing, Internet use and cellular phone use: the moderating effects of socio-demographic characteristics and exercise.

OBJECTIVE This study aimed to examine the relationships between body mass index (BMI) and television viewing, Internet use and cellular phone use and the moderators for these relationships in adolescents. METHOD The relationship between BMI and the time spent on three kinds of sedentary activities and the moderators for these relationships were analyzed among 9,278 Taiwanese adolescents. The different relationships between BMI and various Internet and cellular phone-related activities were analyzed. RESULTS High television viewing and high Internet use were associated with increased BMI in adolescents. Exercising had a moderating effect on the relationship between BMI and television viewing. Several Internet and cellular phone-related activities were associated with increased BMI. DISCUSSION The results support the relationships between adolescent BMI and television viewing and Internet use. The moderating effect of exercise and various Internet and cellular phone-related activities should be considered when developing intervention strategies for overweight adolescents.

Factor structure of the center for epidemiologic studies depression scale in Taiwanese adolescents

BACKGROUND The original study of Radloff (Appl Psychol Meas. 1977. 1:385-401) on the Center for Epidemiologic Studies Depression Scale (CES-D) indicated a 4-factor model in the adult population. However, the factor structure of the CES-D in Asian adolescents has not been extensively validated. The aim of this study was to examine the factor structure of the Chinese version of the CES-D in a large representative Taiwanese adolescent population. METHOD A total of 10 116 adolescents completed the Chinese version of the CES-D. We used confirmatory factor analysis to examine the adequacy of 5 models of the factor structure in adolescents who were divided into 4 groups by sex and age. We also enrolled the variables of suicide tendency, insomnia, and peer relationships into the confirmatory factor analysis to examine the factor structure of the CES-D and examined the correlations between the CES-D factors and these variables. RESULTS The results of this study indicated that the four-factor model (depressed affect, somatic symptoms, interpersonal problems, and positive affect) had the highest validity in Taiwanese adolescents. We also found that although the 4 factors of the CES-D were correlated with each other, their correlations with suicide tendency, insomnia, and peer relationships were different. CONCLUSIONS This study supported the usefulness of the Chinese version of the CES-D as a tool to understand the concept of depression in Taiwanese adolescents.

Relationship between psychosocial adjustment and executive function in patients with bipolar disorder and schizophrenia in remission: The mediating and moderating effects of insight

OBJECTIVES The aims of this study were to examine the relationships between executive function and psychosocial adjustment, and the mediating and moderating effects of insight on the association between executive function and psychosocial adjustment in patients with bipolar disorder and schizophrenia in clinical remission. METHODS The level of psychosocial adjustment was assessed in 96 subjects with bipolar disorder and 96 subjects with schizophrenia who were in remitted state. The association between executive function and psychosocial adjustment and the mediating and moderating effects of insight were examined by multiple regression analysis models and the Goodman test. RESULTS The results indicated that executive function had direct effect on psychosocial adjustment in both subjects with bipolar disorder and schizophrenia. However, the mediating effect of insight on the association between executive function and psychosocial adjustment was only found in subjects with schizophrenia, but not in subjects with bipolar disorder. No moderating effect of insight on the association between executive function and psychosocial adjustment was found in subjects with schizophrenia or bipolar disorder. CONCLUSIONS The results of this study indicated that executive function has an important role in psychosocial adjustment in both patients with bipolar disorder and schizophrenia. Meanwhile, insight has a different role in the association between executive function and psychosocial adjustment between patients with bipolar disorder and schizophrenia.

Internalizing and externalizing problems in adolescent aggression perpetrators, victims, and perpetrator-victims

The aims of this study were to examine the risks of internalizing and externalizing problems in aggression perpetrators, victims, and perpetrator-victims and their sex differences, and to examine the effects of the level of aggression involvement on internalizing and externalizing problems. Eight thousand eighty-five adolescents in Taiwan completed the questionnaires. The associations of aggression involvement and the level of aggression involvement with internalizing and externalizing problems were examined. Compared with the neutrals, pure aggression perpetrators and perpetrator-victims had higher risks for internalizing and externalizing problems and pure victims had higher risks for internalizing problems and theft. Differences in the risks for internalizing and externalizing problems were found among 3 groups with aggression involvement. Levels of aggression involvement increased the risks for some internalizing and externalizing problems. Sex differences were also found. Internalizing and externalizing problems need to be detected among adolescents involved in aggression, especially among perpetrator-victims, those with high levels of aggression involvements, and females.

Comparisons of insight in schizophrenia, bipolar I disorder, and depressive disorders with and without comorbid alcohol use disorder

Aims:  To compare the level of insight among six groups of patients with psychiatric disorders, including those with schizophrenia (SZ), bipolar I disorder (BP), or depressive disorders (DD) who had or did not have comorbid alcohol use disorder (AUD).

Tattooing among high school students in southern Taiwan: The prevalence, correlates and associations with risk-taking behaviors and depression

This study aims to examine the prevalence and sociodemographics, family and peer correlates of tattooing among high school students in southern Taiwan, and to examine the associations between tattooing and a variety of adolescent risk‐taking behaviors and depression. A total of 9755 high school students (grades 7 to 12) in southern Taiwan were recruited into this study and completed the questionnaires. The prevalence of tattooing among the adolescents was calculated. The responses were analyzed using the logistic regression analysis models. It was found that 1% of high school students in southern Taiwan had 1 or more tattoos on their bodies. The older students who were perceived to have low family monitoring and who had friends who drink regularly, used illicit drugs, had a criminal record or were in a gang were more likely to have a tattoo. Tattooing was also found to be associated with violence, weekly alcohol consumption, illicit drug use, dropping out of school, unprotected sex, suicidal ideation/attempt, and depression. The results indicate that several demographics, family and peer factors are associated with adolescent tattooing. Tattooing may be an indicator of risk‐taking behaviors in high school students.

Mediating effects of bullying involvement on the relationship of body mass index with social phobia, depression, suicidality, and self-esteem and sex differences in adolescents in Taiwan

The aims of this study were to examine the mediating effect of bullying involvement on the relationships between body mass index (BMI) and mental health problems, including social phobia, depression, suicidality, and low self-esteem among adolescents in Taiwan. The moderation effect of sex on the mediating role of bullying involvement was also examined. Five thousand two hundred and fifty-two students of high schools completed the questionnaires. Victimization and perpetration of passive and active bullying were assessed using the Chinese version of the School Bullying Experience Questionnaire. BMI was calculated from self-reported weight and height measurements. The Social Phobia Inventory, the Mandarin Chinese version of the Center for Epidemiological Studies-Depression Scale, the suicidality-related questionnaire from the epidemiological version of the Kiddie-Schedule for Affective Disorders and Schizophrenia, and the Rosenberg Self-Esteem Scale were applied to assess social phobia, depression, suicidality, and low self-esteem, respectively. The mediating effect of bullying involvement on the associations between increased BMI and mental health problems was examined by the Sobel test. The moderation effect of sex on the mediating role of bullying involvement was tested by the multiple-group structural equation model. Victimization of passive and active bullying and perpetration of passive bullying, but not perpetration of active bullying, had a mediating effect on the relationships between increased BMI and all four mental health problems. Sex did not have a significant moderation effect on the mediating role of bullying involvement. Bullying involvement should be a target of prevention and intervention in developing a strategy to improve mental health among adolescents with increased BMI.