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In 2020, the prevalence of gaming disorder (GD) was comparable with the prevalence of obsessive-compulsive disorder, thus demonstrating the necessity of addressing Internet gaming disorder (IGD) and GD in general. GD has been introduced as a psychiatric disorder by International Classification of Diseases and paving the way for treatment and prevention interventions. In this review, we researched available treatment interventions in children and adolescents. Τhe initial search resulted in 972 studies and we ended up with 16 by excluding inappropriate studies according to six inclusion criteria. The studies confirmed that cognitive-behavioral therapy (CBT) or CBT-based interventions are the most used, and in cases of comorbidity, such as depression or attention-deficit/hyperactivity disorder, the appropriate pharmaceutical intervention also was an effective option. Other interventions combined CBT with family therapy or CBT-based therapies that took place in specialized camps. Family as a supportive expedient or even treatment expedient seemed to play a major role. It is remarkable that only little knowledge exists regarding treatment interventions for children aged 8-12 years old. Therefore, more studies need to be carried out for this age range especially, with comparable efficacy to this of other interventions.

Objectives: The nine-item Problematic Internet Use Questionnaire (PIUQ-9) is a brief self-report screening instrument for problematic internet use. The main objective of the present study was to explore the psychometric properties of the PIUQ-9 among nine different language-based samples of European internet users (Italian, German, French, Polish, Turkish, Hungarian, English, and Greek). Methods: The total sample comprised 5,593 internet users (38.1% men), aged between 18 and 87 years (M = 25.81; SD = 8.61). Via online recruitment, participants completed the PIUQ-9, the Brief Symptom Inventory (BSI) and items about time spent online. Results: Confirmatory factor analysis demonstrated that the bifactor model with one general factor (i.e., general problem) and two-specific factors (i.e., obsession and neglect + control disorder) yielded acceptable or good fit indices in all subsamples except for one. The common variance index in the bifactor model indicated that the general problem factor explained from 57.0 to 76.5% of common variance, which supports the presence of a strong global factor. According to the multiple indicators multiple causes (MIMIC) model, psychiatric symptoms had a moderate-to-strong direct effect on the general problem factor in all subsamples, ranging from β = 0.28 to β = 0.52 supporting the construct validity of the scale. Furthermore, in a majority of the subsamples, time spent online during the weekend had considerably higher effect sizes on the general problem factor than time spent online during weekdays. Conclusion: The present study highlights the appropriate psychometric properties of the PIUQ-9 across a number of European languages and cultures., The study was supported by the Hungarian National Research, Development and Innovation Office (Grant numbers: K111938, KKP126835) and the COST Action (grant number: CA16207) funded by the Horizon 2020 Framework Programme of the European Union. This work was completed in the ELTE Institutional Excellence Program (783-3/2018/FEKUTSRAT) supported by the Hungarian Ministry of Human Capacities (OK and RU)

The purpose of this study is to evaluate the predictive value of personality factors, character defenses and psychopathology indexes in discerning between a clinical sample of Internet-addicted college students and a random sample of non-addicted college students. A discriminant analysis identified the variables which enabled discerning Internet addicts from non-addicts in 78% of all subjects. Internet-addicted students presented with higher frequency of connecting to the Internet, more time spent online, higher impulsivity, higher help-rejecting complaining and lower sublimation. Indexes of overt symptomatology did not assist in discerning clinical cases from controls. In conclusion, employing a test battery which includes not only measures of Internet addiction but also measures of inheritable personality factors and character defenses can be of assistance both in clinical work and in epidemiological research.

Cases of excessive use of the Internet have been reported for some time, with numerous claimed adverse effects to the well-being of the subject. Objective signs and subjective symptoms are similar to those of addictive behavior, leading to the classification of those cases as incidences of an addiction disorder. Research results from this new field of study have led to the recent provisional introduction of a subset of those cases, those concerning online gaming, in the fifth edition of the Diagnostic & Statistical Manual of Mental Disorders by the American Psychiatric Association (DSM-5) under the heading ‘Internet Gaming Disorder’. This review article critically examines research conducted on the personality attributes of those Internet users who demonstrate signs and symptoms of excessive use. The results lend credit to the notion of including a disorder in psychiatric taxonomies yet do not cover all possible fields of research, rather focusing on trait personality psychology. Directions are offered for future research.

This paper presents a cross-sectional study of a large, high-school Greek student sample (N=1971) with the aim to examine adolescent motives for participating in social networking (SN) for a possible link with parenting style and cognitions related to Internet addiction disorder (IAD). Exploratory statistics demonstrate a shift from the prominence of online gaming to social networking for this age group. A regression model provides with the best linear combination of independent variables useful in predicting participation in SN. Results also include a validated model of negative correlation between optimal parenting on the one hand and motives for SN participation and IAD on the other. Examining cognitions linked to SN may assist in a better understanding of underlying adolescent wishes and problems. Future research may focus in the patterns unveiled among those adolescents turning to SN for the gratification of basic unmet psychological needs. The debate on the exact nature of IAD would benefit from the inclusion of SN as a possible online activity where addictive phenomena may occur.

Background: To investigate the phenomenon of internet addiction and concurrent social (off-line) behaviours of an adolescent population a cross-sectional survey of the entire adolescent student population (N = 1270, aged 14–18) of the island of Kos in Greece was conducted. Method: Completion by the survey participants of a demographic questionnaire, the 8-question YDQ (Diagnostic Questionnaire for Internet Addiction) and the 20-question IAT (Internet Addiction Test), followed by comparative analysis between and within usage groups. Results: Results demonstrate that 7.2% of male and 5.1% of female internet users present addictive behaviours while using the internet. Conclusions: Anti-social, aggressive behaviours were significantly correlated with an increase to the pattern of abusive internet use in both sexes. Boys and girls had distinct profiles of off-line and online preferences. Boys tended to favour interest-driven online activities as their levels of addictive behaviour increased while girls favoured communication-driven online activities.

This paper presents results from the study of gambling behaviors in a representative sample of Cypriot high-school students. The aim of the study was to ascertain epidemiology of adolescent online gambling in Cyprus and possible correlates. The sample consisted of 2,684 students (48.5% boys, 51.5% girls) from the first grades of junior (Gymnasium) and senior (Lyceum) high school. Our results indicate that gamblers presented with lower school achievement and related expectations while scoring consistently higher on measures of Internet addiction, parental bonding and psychopathology. Discriminant analysis revealed two profiles which explained the most variance in gambling behavior; the first profile that corresponded to more explained variance was the student with higher psychopathology, less prosocial behavior, higher Internet addiction score with higher frequencies of online activities and moderate levels of truancy and lower expectation of school achievement. The second profile was that of a student who reported less psychopathology, more prosocial behavior, less involvement with the Internet in general but skipped classes more and his prospects on finishing high school were even slimmer. These results will be utilized in the design of a comprehensive prevention program in an effort to combat online addictive behaviors.

In this study, we attempt to identify motives pivotal in choices made regarding online and offline game genres and assess whether they are meaningful predictors of Internet addiction. A separate goal was to determine how an assessment of Internet-related cognitions compares to criteria-based research instruments on Internet addiction, and demonstrate its clinical usefulness. We are using data from a cross-sectional study of the entire adolescent student population aged 12-18 of the island of Kos. Results indicate that specific game genres and motives for choosing a game are important predictors of Internet addiction, even after accounting for sociodemographic and Internet-use-related variables. Gender differences are not statistically important when we account for genre choices and motives for choosing them. Boys' thought content tends to revolve more around their Internet use compared to girls. Several patterns of motives to play specific genres were identified with the help of a canonical correlation analysis, demonstrating the fact that the simple observation of overt behavior is not enough to deduce the meaning of these actions for the individual. Using multiple measures of online addiction, examining genre preferences and underlying motives for choosing a game can be helpful in reaching a better understanding of the individual game player.

We present results from a cross-sectional study of the entire adolescent student population aged 14 to 18 years of the island of Kos, on the correlates between personality, illicit chemical substance use, and Internet abuse. Results demonstrate that adolescents who have used illicit substances and are abusing the Internet as well appear to share some common personality characteristics, namely those that are classified under the label of "psychoticism" in the Eysenck's personality model. An increase in the severity of pathological Internet use has been linked to increased chances of having used an illicit substance. Taking into account any common personality attributes, Internet addiction can still be useful as a predictor variable for substance use experiences. Future research should attempt to verify any biological common factors between chemical substances use and Internet abuse. Targeting the adolescent population that engages in increased Internet use may be of benefit for drug abuse prevention programs.

We present results from a cross-sectional study of the entire adolescent student population aged 12–18 of the island of Kos and their parents, on Internet abuse, parental bonding and parental online security practices. We also compared the level of over involvement with personal computers of the adolescents to the respective estimates of their parents. Our results indicate that Internet addiction is increased in this population where no preventive attempts were made to combat the phenomenon from the initial survey, 2 years ago. This increase is parallel to an increase in Internet availability. The best predictor variables for Internet and computer addiction were parental bonding variables and not parental security practices. Parents tend to underestimate the level of computer involvement when compared to their own children estimates. Parental safety measures on Internet browsing have only a small preventive role and cannot protect adolescents from Internet addiction. The three online activities most associated with Internet addiction were watching online pornography, online gambling and online gaming.

This research aimed to assess the prevalence of Internet addiction among Greek adolescent students, ages 12 to 18. The sample of 2,200 students was recruited from 120 classes among 85 schools in Thessaly, Greece. The sample included 10% of all classes in schools of Thessaly. The method of randomized stratified selection in every school was used for its constitution. Participants were asked to complete the Diagnostic Questionnaire for Internet Addiction (YDQ), based on eight criteria, as well as an inventory that included sociodemographic factors and questions about the use of Internet, their social life, and their habits. In Greece, 70.8% of adolescents had access to the Internet. The consistency of the YDQ was tested with Cronbach's alpha (0.719), with standardized item alpha (0.728). Proportions are also calculated only on the frequent Internet users, which results in 11% fulfilling five YDQ criteria. The most frequent type of Internet use is online games, representing 50.9% of Internet users, and information services, representing 46.8%. The prevalence of Internet addiction among Internet users of Central Greece is 8.2%, and it concerns mainly the male students who play online games and visit Internet cafés.

Introduction Internet addiction is a multi-faceted construct which is currently under review for inclusion in the forthcoming fifth edition of the Diagnostic and Statistical Manual of the American Psychiatric Association. In Greece, a specialized outpatient counseling service has been setup by our Psychiatric department in order to provide counseling for any students with related problems. Objectives This survey has been setup in order to facilitate comparisons with those seeking help and validate the research measures used for their assessment. Furthermore, it sheds some light into Internet use from the future health professionals, an area of research that has been neglected. Aims To gather data on student Internet use, social media use, online gaming and gambling, use of online sexual content and any addictive phenomena related to those behaviors. Methods We employed an extensive battery of questionnaires identical to that employed by our counseling service. The battery includes detailed measures of all online behaviors, the SCL-90 psychopathology index, the Defense Styles Questionnaire (DSQ) and the Zuckerman-Kuhlman Personality Questionnaire (ZKPQ). Results The presentation includes detailed results from the battery of questionnaires including comparisons with the validation samples and previous related research work carried out. Our sample demonstrated an unexpectedly high incidence of psychiatric symptoms and several cases of online addictive behaviors. Conclusions Our results are demonstrating the need for a broader reach out to the target populations since a large number of students may be hesitant to seek help for their online addictions or simply prefer to ignore them.

ObjectivesThe objective of this presentation is to present the experience from the first year of operation of the Specialized Outpatient Unit for Internet and PC Addiction created in the Department of Child and Adolescent Psychiatry of the Hippokration General Hospital of Thessaloniki, Greece.MethodsWe present data from the first 40 adolescents who attended our service. Demographics and PC / Internet usage statistics are presented along with final diagnosis and treatment where it was deemed appropriate, both for Internet addiction disorder but also any co-morbid psychiatric disorder. We describe the diagnostic tests that are employed and their appropriateness for this goal and the therapeutic methods including psychotherapy (a sixteen session CBT protocol) and pharmacotherapy. Recommendations for effectively setting up similar services are given.ResultsAll cases involved teenage boys (mean age 15 yrs) who abused the Internet primarily to play on-line games. In all cases it was the parents who initiated contact with our Unit. In 75% of the cases the primary concern was addiction to the Internet per se while in 25% of the cases it was the drop in school achievement that prompted the parents to seek a possible explanation in excessive Internet use.ConclusionsDuring the first year of operations the Unit has treated with success a variety of cases of Internet addiction disorder and made an effort to alert the public to the new phenomenon. A need for similar services is becoming evident throughout Europe as they have already proliferated in Asia.

ObjectivesThe purpose of this presentation is to describe two cases of teenage addiction to on-line gaming where the subjects required medical attention due to unintentional, self-inflicted injuries to the tongue and upper lip during the course of the game.MethodsCase study of two teenage boys, both aged 15, who attended the Specialized Outpatient Unit for Internet and PC Addiction in our Clinic, due to incessant on-line video-gaming that had a number of detrimental effects to their well-being.ResultsThe first teenager had repeatedly bitten his tongue due to stress experienced during gaming while the second had bitten his upper lip. In both cases their injuries required emergency medical assistance and thorough examinations for other possible causes (e.g spasms) for their injuries were negative. The first teenager was diagnosed with Internet Addiction Disorder and separation anxiety - pathological attachment to mother, he scored 78 on WISC-III. A behavioral intervention for separation anxiety and a CBT program for IAD was successful; his on-line gaming was limited to 2 hours/day on follow-up. The second teenager was diagnosed with IAD and co-morbid depressive disorder. Fluoxetine (30mg/day) was initiated and his mood improved while his computer usage time fell from 16 to 4 hours/day. A CBT program was initiated and he's under treatment with good progress.ConclusionsTeenagers addicted to on-line gaming can experience severe stress which they may instinctively attempt to alleviate with self-inflicted wounds. Co-morbidity with other psychiatric disorders should be carefully assessed. Treatment can be pharmaceutical or psychotherapeutic.

ObjectivesTo determine the differential impact of gender and age on pathological internet use (PIU) in the island of Kos, birthplace of Hippokrates and cradle of Medicine.MethodsWe surveyed the entire teen population (aged 14-19) of the island of Kos for symptoms of Internet addiction using Young's brief diagnostic questionnaire (YDQ) and an expanded demographics questionnaire. The sample consisted of 1221 adolescents, 587 male and 634 females, with a similar age distribution among the sexes.ResultsOne-hundred fourteen teens (11,3% of Internet users) were classified as possibly addicted to the Internet. Results indicate that gender plays a more significant role than age in Internet abuse; there is a distinct pattern among the sexes with the girls scoring lower scores in the YDQ in all ages (chi square=22.758, p< .001) with a marked difference in the 17-19 age range. Although the symptoms of PIU in girls subside in that age range, boys’ symptoms increase dramatically. Furthermore boys in that age range with higher YDQ scores report a subjective feeling of happiness, showing that PIU can be ego-syntonic. Usage patterns of those Internet users reporting heavier use are analyzed and presented graphically.ConclusionsThe discontents of modern civilization have spread to the furthermost corner of Europe, an island isolated from the continent during winter time. Results indicate that gender tends to heavily mitigate the effect of age on Internet abuse, with females being only transiently affected as their scores tend to fall dramatically with the onset of adult life.

Materials and methods The sample consists of 339 adolescents (mean age: 15.41 years, SD:1.59, min/max:13/18 ), habitants of the city of Karditsa, Greece. The sample was selected using the method of randomized stratified selection by schools. The Diagnostic Questionnaire for Internet Addiction (YDQ1), based on 8 criteria, was used as a tool to categorize the internet users. Four groups were formatted: no-users, minimal users, moderate users, excessive users. The Symptoms Checklist questionnaire (SCL-90-R2) was used to investigate the psychiatric symptoms. The sample completed also an inventory concerning socio-demographic factors.