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      Effects of sleep quality on the association between problematic internet use and quality of life in people with substance use disorder

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          Abstract

          Background

          Problematic internet use, especially in people with substance use disorder, may negatively affect their quality of life (QoL). However, it is unclear whether sleep quality is a key mediator in the association between problematic internet use and QoL among people with substance use disorder.

          Aims

          This study aimed to investigate the relationship between problematic internet use and QoL and how sleep quality may mediate the association between these two variables.

          Method

          Overall, 319 people (85% male) with substance use disorder (mean age 42.2 years, s.d. 8.9) participated in a cross-sectional study in Taiwan. The Smartphone Application-Based Addiction Scale, Bergan Social Media Addiction Scale, Internet Gaming Disorder-Short Form, Pittsburgh Sleep Quality Index and World Health Organization Quality of Life Questionnaire Brief Version were used.

          Results

          The prevalence of sleep problems was 56%. There were significant and direct associations between sleep quality and two types of problematic internet use, and between sleep quality and different dimensions of QoL. All types of problematic internet use were significantly and negatively correlated with QoL. Mediated effects of sleep quality in relationships between the different types of problematic internet use and all dimensions of QoL were significant, except for problematic use of social media.

          Conclusions

          Different types of problematic internet use in people with substance use disorder may be directly associated with reduced QoL. Sleep quality as a significant mediator in this association may be an underlying mechanism to explain pathways between problematic internet use and QoL in this population.

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          Most cited references67

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          The Pittsburgh sleep quality index: A new instrument for psychiatric practice and research

          Despite the prevalence of sleep complaints among psychiatric patients, few questionnaires have been specifically designed to measure sleep quality in clinical populations. The Pittsburgh Sleep Quality Index (PSQI) is a self-rated questionnaire which assesses sleep quality and disturbances over a 1-month time interval. Nineteen individual items generate seven "component" scores: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medication, and daytime dysfunction. The sum of scores for these seven components yields one global score. Clinical and clinimetric properties of the PSQI were assessed over an 18-month period with "good" sleepers (healthy subjects, n = 52) and "poor" sleepers (depressed patients, n = 54; sleep-disorder patients, n = 62). Acceptable measures of internal homogeneity, consistency (test-retest reliability), and validity were obtained. A global PSQI score greater than 5 yielded a diagnostic sensitivity of 89.6% and specificity of 86.5% (kappa = 0.75, p less than 0.001) in distinguishing good and poor sleepers. The clinimetric and clinical properties of the PSQI suggest its utility both in psychiatric clinical practice and research activities.
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            The relationship between addictive use of social media and video games and symptoms of psychiatric disorders: A large-scale cross-sectional study.

            Over the last decade, research into "addictive technological behaviors" has substantially increased. Research has also demonstrated strong associations between addictive use of technology and comorbid psychiatric disorders. In the present study, 23,533 adults (mean age 35.8 years, ranging from 16 to 88 years) participated in an online cross-sectional survey examining whether demographic variables, symptoms of attention-deficit/hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), anxiety, and depression could explain variance in addictive use (i.e., compulsive and excessive use associated with negative outcomes) of two types of modern online technologies: social media and video games. Correlations between symptoms of addictive technology use and mental disorder symptoms were all positive and significant, including the weak interrelationship between the two addictive technological behaviors. Age appeared to be inversely related to the addictive use of these technologies. Being male was significantly associated with addictive use of video games, whereas being female was significantly associated with addictive use of social media. Being single was positively related to both addictive social networking and video gaming. Hierarchical regression analyses showed that demographic factors explained between 11 and 12% of the variance in addictive technology use. The mental health variables explained between 7 and 15% of the variance. The study significantly adds to our understanding of mental health symptoms and their role in addictive use of modern technology, and suggests that the concept of Internet use disorder (i.e., "Internet addiction") as a unified construct is not warranted.
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              The Pittsburgh sleep quality index as a screening tool for sleep dysfunction in clinical and non-clinical samples: A systematic review and meta-analysis.

              This review appraises the process of development and the measurement properties of the Pittsburgh sleep quality index (PSQI), gauging its potential as a screening tool for sleep dysfunction in non-clinical and clinical samples; it also compares non-clinical and clinical populations in terms of PSQI scores. MEDLINE, Embase, PsycINFO, and HAPI databases were searched. Critical appraisal of studies of measurement properties was performed using COSMIN. Of 37 reviewed studies, 22 examined construct validity, 19 - known-group validity, 15 - internal consistency, and three - test-retest reliability. Study quality ranged from poor to excellent, with the majority designated fair. Internal consistency, based on Cronbach's alpha, was good. Discrepancies were observed in factor analytic studies. In non-clinical and clinical samples with known differences in sleep quality, the PSQI global scores and all subscale scores, with the exception of sleep disturbance, differed significantly. The best evidence synthesis for the PSQI showed strong reliability and validity, and moderate structural validity in a variety of samples, suggesting the tool fulfills its intended utility. A taxonometric analysis can contribute to better understanding of sleep dysfunction as either a dichotomous or continuous construct.
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                Author and article information

                Journal
                BJPsych Open
                BJPsych Open
                BJO
                BJPsych Open
                Cambridge University Press (Cambridge, UK )
                2056-4724
                September 2022
                10 August 2022
                : 8
                : 5
                : e155
                Affiliations
                [1]Health Research Center, Lifestyle Institute, Baqiyatallah University of Medical Sciences , Tehran, Iran; and Health Education Department, School of Health, Baqiyatallah University of Medical Sciences , Tehran, Iran
                [2]Division of Colon and Rectal Surgery, Department of Surgery, E-Da Hospital , Kaohsiung, Taiwan; and School of Medicine, College of Medicine, I-Shou University , Kaohsiung, Taiwan
                [3]Graduate Institute of Social Work, National Taiwan Normal University , Taipei, Taiwan
                [4]Department of Occupational Therapy, AdventHealth University , Florida, USA
                [5]Institute of Environmental Toxin and Emerging Contaminant, Cheng Shiu University , Kaohsiung, Taiwan; and Center for Environmental Toxin and Emerging-Contaminant Research, Cheng Shiu University , Kaohsiung, Taiwan
                [6]Department of Medical Research, E-Da Hospital , Kaohsiung, Taiwan
                [7]Department of General Psychiatry, Jianan Psychiatric Center, Ministry of Health and Welfare , Tainan, Taiwan; and Department of Natural Biotechnology, Nan Hua University , Chiayi, Taiwan
                [8]Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University , Tainan, Taiwan; Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University , Tainan, Taiwan; Department of Public Health, College of Medicine, National Cheng Kung University , Tainan, Taiwan; and Department of Occupational Therapy, College of Medicine, National Cheng Kung University , Tainan, Taiwan
                Author notes
                Correspondence: Chung-Ying Lin. Email: cylin36933@ 123456gmail.com
                [†]

                Joint first authors.

                [*]

                Joint last and corresponding authors with equal contributions.

                Author information
                https://orcid.org/0000-0002-2129-4242
                Article
                S2056472422005579
                10.1192/bjo.2022.557
                9380240
                35946067
                36f3d7f7-afa5-48d4-b7ef-55aa49579838
                © The Author(s) 2022

                This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.

                History
                : 08 March 2022
                : 20 May 2022
                : 13 July 2022
                Page count
                Tables: 4, References: 68, Pages: 8
                Funding
                Funded by: Ministry of Science and Technology, Taiwan, doi http://dx.doi.org/10.13039/501100004663;
                Award ID: MOST 110-2410-H-006-115
                Categories
                Addictions
                Papers

                internet addiction,substance misuse,mediating effect,quality of life,sleep

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