Yoga has been studied as an effective alternative therapy for substance use disorders, demonstrating its ability to reduce stress and addictive behaviors while improving self-control and self-esteem. However, not everyone may be willing or able to engage in yoga for various reasons. Furthermore, there is a lack of systematic reviews and meta-analyses of the existing research on this topic. The objective is to explore the nonparticipation rate in yoga intervention randomized controlled trials related to addictive disorders, and to explore the reasons for nonparticipation in yoga trials related to addictive disorders. We searched Google Scholar, CENTRAL, and PubMed for peer-reviewed published RCTs that incorporated yoga interventions in any format of at least one session. Data were extracted using standard procedures, and the risk of bias was evaluated. Pooled analysis and sensitivity analysis were done. About 54% of potential participants were not included. The pooled effect size was 0.544 (95% confidence interval: 0.301-0.787), with an I² = 99.797. Key barriers included failure to meet inclusion criteria, such as medical conditions, mental health issues, and specific health conditions such as posttraumatic stress disorder, depression, and heart disease. Participant refusals and lack of interest in randomization or the study itself were common reasons for nonparticipation. Scheduling conflicts were also frequently reported as a significant obstacle. Two broad categories for noninclusion were meeting exclusion criteria, and not interested/declined to participate. Understanding reasons for noninclusion can lead to more efficient and effective recruitment efforts in future trials and also possibly guide the design of future studies to minimize dropout rates and ensure a representative sample.
The rapid expansion of legalized sports betting and mobile gambling in the U.S. has transformed how gambling is accessed and experienced. Young adults are particularly vulnerable to these changes; however, limited research has examined how gambling behaviors are shifting across multiple modalities during periods of expanding gambling availability. We analyzed repeated cross-sectional data from the Rhode Island Young Adult Survey (RIYAS) collected in 2022 (n = 1,022) and 2024 (n = 1,008) among individuals aged 18-25 years. Outcomes included past-year participation in specific gambling behaviors, positive BBGS (Brief Biosocial Gambling Screen) screens, and overall gambling involvement measured as the number of gambling types endorsed. Multivariable logistic regression models estimated adjusted odds ratios for differences in individual gambling behaviors between survey waves, and Poisson/zero-inflated Poisson models estimated differences in gambling involvement. Gambling participation did not differ significantly between 2022 and 2024. However, among individuals reporting gambling, participation increased in several activities, including lottery tickets (AOR = 1.36, 95 % CI: 1.01-1.83), raffle gambling (AOR = 1.40, 95 % CI: 1.05-1.88), sports betting (AOR = 1.65, 95 % CI: 1.07-2.56), casino slot machines (AOR = 2.99, 95 % CI: 2.10-4.27), other slot machines (AOR = 2.30, 95 % CI: 1.23-4.33), and app-based gambling (AOR = 2.14, 95 % CI: 1.38-3.32). The number of gambling types endorsed increased (IRR = 1.28, 95 % CI: 1.16-1.41). Positive BBGS screens were more common in 2024 but not statistically significant after adjustment. Findings suggest while overall gambling participation remained stable, engagement across multiple and mobile-based gambling activities increased between survey waves, potentially signaling emerging risk. Increasing diversification and digitalization of gambling behaviors requires continued surveillance and public health strategies addressing emerging gambling environments.
Dating violence is a significant public health concern with detrimental effects on the mental and physical health of young adults. Understanding its prevalence and related factors is key to prevention. To assess university students' experiences, attitudes, and behaviors regarding dating violence and associated factors. A cross-sectional study was conducted with 1,008 students selected via stratified sampling. Data were collected using a questionnaire, the dating violence scale, and the cyber dating abuse scale. Dating violence prevalence was 37.1%. Alcohol and substance use, exposed to violence in the family, having friends exposed to violence and increased in age were increased exposure to dating violence. The participants generally did not support dating violence. Gender, age, use of addictive substances, and exposure to violence in the family or at school were effective on dating violence attitudes. One-third of students experienced dating violence. Preventive education addressing family and school violence is recommended.
Recent European studies estimate that between 15% and 80% of adolescents have engaged in gambling, reflecting substantial heterogeneity in measurement approaches and highlighting limitations in current surveillance systems. This variability may obscure the magnitude and urgency of the problem. Evidence suggests that adolescents exposed to socioeconomic vulnerability are more likely to engage in gambling and other co-occurring risk behaviours. This study aims to analyse gambling initiation patterns and their relationship with addictive behaviours within a socioeconomic framework. This cross-sectional observational study included 2,407 adolescents and young adults aged 14-21 years from the Autonomous Community of Madrid. Schools were selected using simple random sampling from an official registry, and approximately 95% of eligible students participated. Data were collected using a self-administered questionnaire with adequate psychometric properties (KMO = 0.843; Cronbach's alpha = 0.861). Group differences were assessed using chisquare and Mann-Whitney U tests, and multivariate associations were examined using logistic regression models (odds ratios with 95% confidence intervals). Overall, 8.6% of participants reported gambling behaviour. Gamblers were significantly older (median 18 vs 16 years, p < 0.001), more likely to be employed (OR = 2.68, 95% CI: 1.49-4.84, p = 0.001), and more likely to have repeated a school year (OR = 4.66, 95% CI: 3.07-7.06, p < 0.001). Gambling was also significantly associated with alcohol, tobacco, and illicit substance use (all p <0.001), as well as indicators of socioeconomic vulnerability. Adolescent gambling appears to be part of a broader cluster of socioeconomic disadvantage and co-occurring addictive behaviours rather than an isolated activity. These findings highlight the importance of integrated prevention strategies targeting multiple risk behaviours in vulnerable youth populations.
This study examined the associations among family environment, internet addiction, and coping behaviors in adolescents. This cross-sectional study included 397 high school students in a province of Türkiye, who completed self-report scales assessing family environment, internet addiction, and coping behaviors. Data were analysed using path analysis with bias-corrected bootstrapping. A more positive family environment was associated with lower levels of internet addiction and greater use of active coping, whereas internet addiction were associated with greater reliance on avoidant and negative coping strategies (p < 0.001). The direct association between family environment and active coping remained significant when internet addiction was entered as a mediator (β = 0.259, p < 0.001), whereas the direct associations with avoidant (β = 0.074, p = 0.129) and negative coping (β = -0.072, p = 0.120) were not significant. The analysis indicated an indirect influence of avoidant (β = -0.049, 95% CI [ - 0.093, -0.017]) and negative coping (β = -0.069, 95% CI [ - 0.120, -0.024]) coping were significant, whereas the indirect effect on active coping was not (β = 0.017, 95% CI [ - 0.001, 0.048]). Internet addiction indirectly accounted for part of the association between family environment and avoidant and negative coping, but not active coping. Because family environment was directly associated with active coping while internet addiction was linked to avoidant and negative coping, nursing interventions may promote active coping through direct family support, while addressing problematic internet use alongside family functioning when the goal is to reduce maladaptive coping.
This longitudinal randomized controlled trial examined the effects of anti-vaping social media content on e-cigarette attitudes and intentions among U.S. young adults (ages 18-24; n=3,400). Targeted content was embedded directly into participants' social media feeds, with varying levels of impressions. Results indicate that increased exposure to anti-vaping messages significantly elevated perceived risk of harm (β=0.11, 95% CI: 0.03-0.20, p < .01) and social unacceptability of e-cigarette use (β=0.10, 95% CI: 0.03-0.18, p < .01), while decreasing intentions to vape (RRR = 0.59, 95% CI: 0.36-0.97, p < .05). Notably, these attitudinal shifts occurred even with relatively low ad exposure and over an extended intervention period, while controlling for the e-cigarette use status (never, former, or current) of participants. Discussion These findings support the effectiveness of digital media campaigns in influencing health-related behaviors and attitudes among young adults. Specifically, embedding anti e-cigarette content directly in the feed of young adults is shown to be effective in shifting attitudes in a space where these young adults are already engaged. Limitations include limited ad impressions and minimal change in ad awareness recall, suggesting future research should explore longer interventions and broader nicotine product messaging.
University students may be particularly vulnerable to experiencing gambling-related problems. This study investigated the rate of screening positive for gambling problems in a UK university and associated factors, including demographic, mental health, and trans-diagnostic variables. We analysed cross-sectional data from the Nurture-U student mental health and wellbeing survey (2022-2024 data; N = 2302). The 3 item NORC DSM-IV Screen (NODS-CLiP) was used to identify positive screen for gambling problems. Variables of interest were anxiety, depression, eating symptoms, self-reported ADHD, problematic use of the internet (PUI), hazardous alcohol use, drug use, compulsivity and suicide attempts. Logistic regression was conducted to examine associations between gambling problems and these measures. Overall, 8.1% of students screened positive for potential gambling problems. When considering associations with comorbid mental disorders and problematic behaviours, positive associations of moderate strength were observed between a positive screen for gambling problems and any drug use (OR 3.00 [95% Confidence Interval 2.09, 4.33]), restrictive eating (OR 2.74 [1.89, 3.99]), PUI (OR 1.04 [1.02, 1.07]) and hazardous drinking (OR 1.5 [1.03, 2.26]), but not for anxiety, depression, binge eating or ADHD. When considering transdiagnostic factors, suicide attempts (OR 2.61 [1.69, 4.04]) and standardised reward drive (OR 1.41 [1.16, 1.72]) were associated with screening positive for gambling problems, while standardised perfectionism had a protective effect (OR 0.59 [0.49, 0.71]). The findings of this study suggest that gambling problems may be common in university students and linked to impairments in reward-driven compulsive behavioural patterns that can extend beyond gambling.
Short drama addiction has emerged as a novel form of behavioral addiction in the digital age. Chinese Gen X women (born 1965-1980), the core user and high-risk group for this addiction, have had the underlying mechanisms of their addictive behavior not yet elucidated. Existing research has critical gaps in exploring the subconscious drivers of short drama addiction in this specific generational-gender population, alongside methodological limitations of traditional quantitative approaches. This qualitative study used the Zaltman Metaphor Elicitation Technique (ZMET) combined with semi-structured in-depth interviews. 36 participants with typical short drama addiction behaviors were recruited via snowball sampling and screened using the Revised Personal Involvement Inventory (RPII) scale. Following the 10 steps of ZMET, we performed data analysis through hierarchical construct extraction, personal mental mapping, and group consensus map construction. 71 constructs regarding short drama addiction were extracted, a group consensus map of addiction in this cohort was built, and four core consensus themes were identified, which reconstructed the dynamic evolution of their addictive behaviors. This study concludes that short drama addiction among Chinese Gen X women is primarily driven by emotional stress and psychological compensation needs, reinforced by poor time and attention management, leading to significant physical and mental health impacts, while also prompting growing awareness and efforts toward more rational and controlled media consumption.
Glucagon-like peptide-1 receptor agonists (GLP1RAs) have demonstrated substantial efficacy for obesity and metabolic disease treatment, with emerging evidence suggesting effects on reward-processing pathways and motivated behaviors. Although reductions in food craving and addictive behaviors may be beneficial, some patients anecdotally report diminished motivation and anhedonia-like symptoms during high-dose therapy. This case series highlights a potentially underrecognized neurobehavioral effect associated with high-dose tirzepatide and explores clinical management strategies. Three female patients with obesity treated with high-dose tirzepatide (15 mg·week-1) reported reduced motivation, emotional "flatness," or loss of interest in exercise and previously enjoyable activities despite successful weight loss. Two patients had no prior history of mood disorders, while one patient had a history of depression and anxiety. Symptoms were described as distinct from depressive episodes and emerged after prolonged treatment at or near maximal dosing. One patient independently noted symptom improvement after temporary discontinuation and dose reduction surrounding a medical procedure. All patients underwent tirzepatide dose reduction to 10 mg·week-1 or lower. Two patients experienced marked improvement in motivation and enjoyment of daily activities after dose reduction alone. One patient required adjunctive bupropion therapy, which produced additional symptomatic improvement. Re-escalation of the tirzepatide dose in one patient resulted in recurrence of symptoms without additional weight loss benefit, whereas subsequent dose reduction restored motivation while maintaining weight-loss outcomes. Across all cases, symptom improvement occurred alongside continued weight maintenance or further weight reduction. This case series suggests that anhedonia-like symptoms may occur in a subset of patients receiving high-dose tirzepatide, potentially related to GLP1RA-mediated modulation of mesolimbic dopaminergic pathways. Clinicians should consider monitoring for changes in motivation and reward perception during treatment, particularly at higher doses. Dose reduction, with or without adjunctive dopaminergic therapy such as bupropion, may alleviate symptoms while preserving therapeutic benefits.
Short-video addiction has emerged as a growing behavioral concern in the context of the widespread use of platforms such as Douyin and TikTok, posing potential risks to young adults' psychological well-being. Psychological resilience and rejection sensitivity are considered important psychological characteristics that may function as protective and risk factors, respectively, in the development of addictive media use. However, the longitudinal interplay among these variables remains insufficiently understood. This study examined the longitudinal relationships among psychological resilience, rejection sensitivity, and short-video addiction over time among university students. A two-wave longitudinal design with a six-month interval was conducted among 1394 Chinese university students. Participants completed validated measures assessing short-video addiction, psychological resilience (CD-RISC-10), and rejection sensitivity (RSQ). Cross-lagged panel modeling (CLPM) was employed to investigate the bidirectional predictive associations among these variables while controlling for autoregressive effects. All three constructs demonstrated substantial temporal stability across the two measurement waves. Cross-lagged analyses indicated that higher psychological resilience at Time 1 predicted lower rejection sensitivity and lower short-video addiction at Time 2, whereas higher rejection sensitivity at Time 1 predicted lower psychological resilience and higher short-video addiction over time. Although these longitudinal associations were statistically significant, their effect sizes were modest. These findings suggest that psychological resilience and rejection sensitivity may represent protective and vulnerability-related psychological characteristics associated with short-video addiction over time. The findings support the I-PACE model by highlighting the dynamic and longitudinal associations among psychological resources, interpersonal vulnerability, and addictive digital behaviors. Interventions aimed at strengthening psychological resilience and reducing rejection sensitivity may contribute to preventing short-video addiction and promoting healthier digital engagement among university students.
Problematic smartphone use (PSU), characterized by addictive behaviors such as neglecting other activities and persisting despite harm, has become increasingly prevalent. Ritualized smartphone use, a habitual, unguided, and purposeless interaction with smartphones, reflects dependence on the device itself rather than on specific content, such as social media or games. Despite its significance, the concept of ritualized PSU lacks a rigorous, quantifiable operational definition, hindering empirical progress. This study proposes to operationalize ritualized PSU based upon the frequency of mind-wandering during smartphone use, a cognitive state reflecting low cognitive demand and drifting attention. We conducted a three-month ecological momentary assessment (EMA), collecting real-time self-reports on participant mind-wandering states in conjunction with smartphone screen on/off logs. Our analysis revealed a U-shaped relationship between PSU severity and the tendency to engage in mind-wandering during smartphone use. This finding provides empirical evidence of the inherent heterogeneity of PSU, and the existence of two distinct states: ritualized and non-ritualized PSU. Additionally, we discuss observed correlations between mind-wandering and social anxiety, providing further insight into psychological mechanisms underlying ritualized smartphone behaviors. These findings help to characterize ritualized PSU and highlight cognitive dimensions of this emerging phenomenon.
The co-occurrence use of e-cigarettes and hallucinogens has become increasingly common, particularly among youth and young adults. However, evidence regarding the association between these behaviors remains limited and fragmented. This systematic review and meta-analysis aimed to synthesize current evidence, examining the correlation between hallucinogen use and the likelihood of being an e-cigarette user. A comprehensive search was conducted in PubMed, Scopus, Web of Science, EMBASE, and Cochrane CENTRAL up to June 2025. Eligible studies measured both hallucinogen and e-cigarette use and reported quantitative associations between these behaviors. Data extraction and risk-of-bias assessments were performed independently by three reviewers using the Newcastle-Ottawa Scale. Pooled effect sizes were calculated using a random-effects model (REML). Certainty of evidence was evaluated with the GRADE approach. Eleven studies met the inclusion criteria (n = 247,904), and seven were included in the meta-analysis (n = 217,478). The pooled analysis demonstrated that hallucinogen users had 4.47 times higher odds of being e-cigarette users (OR: 4.47, 95% CI 2.72 to 7.34; p < 0.001; I2 = 95.7%, n = 7). The certainty of evidence was rated as low. Hallucinogen use is directionally and strongly associated with e-cigarette use across diverse populations. Although the direction of association was consistent across studies, the magnitude of effect was heterogeneous. These behaviors likely share psychosocial and environmental determinants, although alternative explanations, including shared genetic liability, recall bias, and residual confounding, cannot be excluded. Further longitudinal studies are needed to clarify the underlying mechanisms of this association and establish temporality. The findings also support integrating hallucinogen-use screening into e-cigarette prevention and harm-reduction programs targeting youth and young adults.
Habits are essential for sustaining adaptive behaviors but can also lead to maladaptive behaviors such as compulsive and addictive disorders. They emerge through a shift in decision-making from motivation-driven strategy to an automatic one. During this, the level of habit execution, such as frequency and duration, is superficially maintained despite a decline in motivational drive, raising the question of how the amount of execution is maintained even when decision-making strategies undergo substantial changes. By developing a unique paradigm capable of inducing habit formation within a defined time window in male mice, we found that shift in decision-making and amount of habit execution are controlled by plasticity in distinct cortical pathways. Erasure of each plasticity selectively altered the decision-making strategy or the execution level without affecting the other. These findings reveal a dual regulatory model for habit, providing insights into the neurocircuit mechanisms underlying both adaptive and maladaptive habits.
With the rapid growth in the number of short-form video users, short-form video addiction (SVA) has drawn increasing attention due to its significant impact on individuals' daily lives. This study examines the relationship between short-form video addiction and sleep quality, as well as the mediating mechanisms of social anxiety and self-control. Using the College Student Short-Form Video Addiction Scale, the Interaction Anxiousness Scale, the Brief Self-Control Scale, and the Pittsburgh Sleep Quality Index, we surveyed 677 Chinese college students. Correlation and mediation analyses were conducted using SPSS and the PROCESS macro. The findings revealed that SVA was negatively associated with sleep quality both directly and indirectly, with higher social anxiety and lower self-control mediating the indirect effect. By showing that addictive behavior is linked to its risk factors through affective, cognitive, and executive pathways, this study provides preliminarily elucidates how addictive behavior feeds back to reinforce its own risk factors proposed in the Interaction of Person-Affect-Cognition-Execution (I-PACE) model.
Problematic pornography use (PPU) has been increasingly recognized as a behavioral addiction involving aberrant reward processing. However, few studies have examined reward imbalance-the co-occurrence of heightened reactivity to pornographic cues and reduced responsiveness to natural rewards-as a putative mechanism underlying PPU. The present study investigated whether the differential P3 component (ΔP3; pornographic minus natural reward P3) could serve as a neural index of individual differences in PPU risk in a sample of young heterosexual men. A total of 139 participants (aged 18-25 years, M = 20.54, SD = 1.53) completed an ERP oddball task and questionnaires assessing both pornography use and PPU symptoms. Results showed that ΔP3 was positively associated with both pornography use and PPU severity and demonstrated moderate discriminative performance in distinguishing high- versus low-risk participants (AUC = 0.71). In contrast, pornographic reward P3 (PR-P3) and natural reward P3 (NR-P3) alone showed weak and non-significant associations with outcome measures. These findings suggest that reward dysregulation indexed by ΔP3 may reflect a neural signature of altered reward processing in PPU, providing preliminary support for reward imbalance models of addictive behaviors. More broadly, the results highlight the potential value of comparative neural indices over single-cue reactivity measures in characterizing individual differences in PPU.
Background: The use of cognitive enhancers (CEs) is becoming increasingly widespread among students, especially in health fields, with significant implications for both academic performance and student well-being. The aim of the study was to investigate the use of CEs among healthcare university students in relationship with stimulant intake, academic progression, and academic anxiety. Material and Methods: The cross-sectional study included 402 students enrolled in medical studies (general medicine, pharmacy, dentistry, and physiotherapy). Socio-demographic characteristics, health-related and academic data, lifestyle behaviors, and the consumption of different CEs were collected. The Academic Anxiety Scale was used to evaluate university students' perceived stressors that contribute to academic anxiety. Data processing analysis was performed using IBM Statistical Package for Social Sciences. Results: The frequency of cognitive compound intake exhibits a positive correlation with the consumption of group B vitamins (r = 0.170, p = 0.001), tea (r = 0.158, p = 0.003), and coffee (r = 0.113, p = 0.031). Lecithin and Ginkgo biloba were significant independent predictors (p < 0.05) of enhanced alertness, memory, and academic performance. The only significant independent predictor of cardiovascular events (palpitations, tachycardia) is caffeine consumption, which increases the risk by nearly three times (OR = 2.96; p = 0.001). In terms of addictive risk, drinking caffeine raises the likelihood of being addicted by 4.78 times (p = 0.014). It has been demonstrated that the probability of using synthetic nootropics (piracetam/cerebrolysin) increases by 1.86 times (OR = 1.86, p = 0.021) as university education progresses (nN= 335). Academic anxiety had a mean score of 23.27 ± 7.38. Unemployed students exhibit markedly elevated anxiety levels compared to employed students. Respondents who justify the use of stimulants by feeling stressed or overwhelmed present the highest levels of academic distress, in contrast to those who use them to combat fatigue or out of curiosity. A large majority (95.0%) do not consider use of CEs as a form of cheating on examinations, and 88.9% are against its prohibition. Conclusions: The findings of this study highlight that many university students in the healthcare field use cognitive stimulants during periods of intellectual overload, with more than 40% of participants utilizing CEs daily or weekly in periods of academic stress. Overload schedule, academic stress, the knowledge about their positive effects, and psychosocial contexts influence consumption.
Tobacco use and the screening of nicotine dependence using the Fagerström test among adults with intellectual disabilities (ID) is an understudied public health issue. Despite lower reported prevalence relative to the general population, methodological challenges - particularly the suitability of self-reported tools - limit reliable measurement. This study assesses the convergent validity of the Fagerström test for nicotine dependence (FTND) by comparing it with exhaled carbon monoxide (CO), an objective biomarker of recent smoking, in a sample of adults with ID. Data were collected from an observational cross-sectional validation study during 2024, which investigates addictive behaviors, health indicators, and physical activity among adults with ID in northern France. Nurses administered a standardized questionnaire, including the FTND, and measured exhaled CO using a portable analyzer. Associations were examined using correlation analyses and univariable and multivariable linear regressions controlling for sociodemographic and health variables. Among 35 people who smoke, FTND scores were positively and strongly correlated with exhaled CO (r=0.540, p<0.001). In adjusted regression models, FTND remained a significantly associated factor of CO levels (0.60; 95% CI: 0.17-1.02), alongside age (0.065; 95% CI: 0.00-0.13), employment in sheltered workshops (1.86; 95% CI: -0.07-3.78), and cognitive support needs (-1.62; 95% CI: -3.51-0.26). Analyses conducted on the full sample, including 68 people who do not smoke, yielded consistent results, with FTND remaining the strongest predictor of exhaled CO. The results suggest evidence of validity of the FTND in adults with ID, suggesting that self-report instruments can reliably estimate nicotine dependence when administered with appropriate support. Nevertheless, the interpretation of CO levels in adults with ID should account for age, cognitive support needs, and contextual factors.
Mobile phones play a pivotal role in the lives of young adults and medical students, but their problematic use may negatively affect daily functioning. The ongoing armed conflict in Sudan has substantially disrupted daily routines, academic activities, psychological wellbeing, and sleep behaviors among university students. This study aimed to assess the association between problematic smartphone use and sleep quality, sleep patterns, chronotype, and life satisfaction among undergraduate medical students during the conflict period in Sudan. An analytical cross-sectional study was conducted among 387 undergraduate medical students in Sudan between September 2025 and November 2025, during an ongoing armed conflict. Data were collected using self-administered online questionnaire incorporating validated instruments: the Problematic Use of Mobile Phone (PUMP) Scale, Smartphone Addiction Scale-Short Version (SAS-SV), Pittsburgh Sleep Quality Index (PSQI), Morningness-Eveningness Questionnaire (MEQ), and Satisfaction With Life Scale (SWLS), alongside demographic variables. Descriptive statistics summarized participant characteristics and scale scores. Associations were examined using Spearman correlation analyses. Multivariable logistic regression was performed with poor sleep quality (PSQI >5) as the dependent variable. Independent variables entered simultaneously into the model included PUMP score, SAS-SV score, MEQ score, SWLS score, age, gender, and employment status. Analyses were conducted using R software, with p < 0.05 considered statistically significant. A total of 387 students participated (mean age 22.1 ± 2.3 years; 69% female). Poor sleep quality (PSQI >5) was observed in 71% of participants. Smartphone addiction showed a modest but statistically significant association with poorer sleep quality (ρ =0.22, p < 0.001). In multivariable analysis, higher smartphone addiction scores were associated with increased odds of poor sleep quality (OR = 1.04; 95% CI: 1.00-1.07) and greater morningness preference was associated with lower odds of poor sleep quality (OR = 0.94; 95% CI: 0.91-0.96; p < 0.001). Employment status (OR = 2.34; 95% CI: 1.27-4.56) was independently associated with poor sleep quality (all p < 0.05). Poor sleep quality was highly prevalent among Sudanese medical students and was independently associated with smartphone addiction, evening chronotype, and employment status. These findings highlight important associations between smartphone use behaviors, chronotype, and sleep quality in conflict-affected academic settings and support the need for further longitudinal research, particularly within conflict-affected academic settings.
Gambling disorder (GD) usually co-occurs with other addictive behaviors. Given shared neurobiological underpinnings, particularly involving dopaminergic pathways, and behavioral similarities such as high reward sensitivity, investigating the link between GD and tobacco use is warranted. Therefore, the present study explored how daily smoking use relates to clinical, personality, and psychopathological profiles, as well as its potential association with treatment outcomes. Our sample included 455 individuals with GD, who completed clinical, personality, psychopathology, impulsivity, and emotion regulation assessments before undergoing a 16-week group cognitive behavioral therapy. Patients were categorized as smokers (daily smokers of conventional cigarettes) or non-smokers to examine differences in clinical profiles and treatment outcomes, specifically dropouts and relapses. While no significant differences emerged in overall psychopathology, personality, or emotion regulation, daily tobacco users with GD exhibited higher levels of impulsivity. Trends toward increased treatment dropout and relapse were observed, though these did not reach statistical significance. These findings suggest that while daily tobacco use in GD is associated with heightened impulsivity, its impact on overall clinical profiles may be limited. However, the observed trend toward poorer treatment outcomes warrants further investigation, particularly focusing on interventions targeting impulsivity in populations with co-occurrent disorders.
Noninvasive brain stimulation may alleviate social media addiction, but its efficacy requires accurate individual targeting and real-time brain monitoring. The neural mechanisms underlying the effects of social media use (SMU) remain unclear, limiting the development of interventions. Understanding how different levels of SMU modulate brain activity could guide personalized neuromodulation strategies. This study investigated a cohort of young adults using a multistage design, with concurrent electroencephalography (EEG) and functional magnetic resonance imaging (fMRI) to examine the effects of SMU on brain activity. It aimed to characterize static and dynamic neural changes at baseline and after a standardized SMU task in individuals with different daily SMU durations. Participants were all male and were divided into a heavy social media users (HSMU) group and a light social media users (LSMU) group based on self-reported daily SMU duration. All participants underwent baseline fMRI scanning, followed by an EEG-fMRI session immediately after a 2-hour controlled SMU task. Analyses were performed on the static and dynamic amplitudes of low-frequency fluctuations (sALFF and dALFF), static and dynamic functional connectivity (sFC and dFC), and EEG microstates. At baseline, compared with the LSMU group, the HSMU group showed lower dALFF variability in the middle frontal gyrus. After the immediate-effect task, the LSMU group exhibited increased sALFF in the temporal lobe and decreased sALFF in the middle and superior frontal gyri. The HSMU group showed increased sALFF in the middle temporal gyrus and decreased sALFF in the inferior temporal gyrus, superior parietal gyrus, and prefrontal cortex. Regarding dALFF variability, the LSMU group showed a decrease in the superior medial frontal gyrus, whereas the HSMU group showed a decrease in the middle frontal gyrus and an increase in the calcarine cortex. sFC analysis revealed increased connectivity across nearly all networks in the LSMU group. Conversely, the HSMU group showed reduced sFC between the visual and default mode networks. The HSMU group showed significantly shorter duration of microstate A, shorter duration and lower coverage of microstate C, and longer duration and higher coverage of microstate D. This study is the first to characterize the distinct neural patterns associated with different levels of daily SMU, using both EEG and fMRI to assess sALFF and dALFF alterations, widespread functional connectivity changes, and EEG microstate reorganizations. These findings demonstrate the unique value of multimodal assessment in identifying potential neural targets for personalized neuromodulation in social media addiction. Future studies should explore whether modulating these identified neural markers can effectively alleviate addictive behaviors and improve clinical outcomes across diverse populations.