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      The association between Internet addiction and personality disorders in a general population-based sample

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          Background and aims

          Data on Internet addiction (IA) and its association with personality disorder are rare. Previous studies are largely restricted to clinical samples and insufficient measurement of IA.


          Cross-sectional analysis data are based on a German sub-sample ( n = 168; 86 males; 71 meeting criteria for IA) with increased levels of excessive Internet use derived from a general population sample ( n = 15,023). IA was assessed with a comprehensive standardized interview using the structure of the Composite International Diagnostic Interview and the criteria of Internet Gaming Disorder as suggested in DSM-5. Impulsivity, attention deficit hyperactivity disorder, and self-esteem were assessed with the widely used questionnaires.


          Participants with IA showed higher frequencies of personality disorders (29.6%) compared to those without IA (9.3%; p < .001). In males with IA, Cluster C personality disorders were more prevalent than among non-addicted males. Compared to participants who had IA only, lower rates of remission of IA were found among participants with IA and additional cluster B personality disorder. Personality disorders were significantly associated with IA in multivariate analysis. Discussion and conclusion: Comorbidity of IA and personality disorders must be considered in prevention and treatment.

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          Most cited references 30

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          Society and the adolescent self-image

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            Reliability and validity studies of the WHO--Composite International Diagnostic Interview (CIDI): a critical review.

            This paper reviews reliability and validity studies of the WHO - Composite International Diagnostic Interview (CIDI). The CIDI is a comprehensive and fully standardized diagnostic interview designed for assessing mental disorders according to the definitions of the Diagnostic Criteria for Research of ICD-10 and DSM-III-R. The instrument contains 276 symptom questions many of which are coupled with probe questions to evaluate symptom severity, as well as questions for assessing help-seeking behavior, psychosocial impairments, and other episode-related questions. Although primarily intended for use in epidemiological studies of mental disorders, it is also being used extensively for clinical and other research purposes. The review documents the wide spread use of the instrument and discusses several test-retest and interrater reliability studies of the CIDI. Both types of studies have confirmed good to excellent Kappa coefficients for most diagnostic sections. In international multicenter studies as well as several smaller center studies the CIDI was judged to be acceptable for most subjects and was found to be appropriate for use in different kinds of settings and countries. There is however still a need for reliability studies in general population samples, the area the CIDI was primary intended for. Only a few selected aspects of validity have been examined so far, mostly in smaller selected clinical samples. The need for further procedural validity studies of the CIDI with clinical instruments such as the SCAN as well as cognitive validation studies is emphasized. The latter should focus on specific aspects, such as the use of standardized questions in the elderly, cognitive probes to improve recall of episodes and their timing, as well as the role of order effects in the presentation of diagnostic sections.
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              Inter-rater reliability of the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID I) and Axis II Disorders (SCID II).

              This study simultaneously assessed the inter-rater reliability of the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders Axis I (SCID I) and Axis II disorders (SCID II) in a mixed sample of n = 151 inpatients and outpatients, and non-patient controls. Audiotaped interviews were assessed by independent second raters blind for the first raters' scores and diagnoses. Categorical inter-rater reliability was assessed for 12 Axis I disorders of SCID I, while both categorical and dimensional inter-rater reliability was tested for all Axis II disorders. Results revealed moderate to excellent inter-rater agreement of the Axis I disorders, while most categorically and dimensionally measured personality disorders showed excellent inter-rater agreement. Copyright © 2010 John Wiley & Sons, Ltd.

                Author and article information

                Journal of Behavioral Addictions
                J Behav Addict
                Akadémiai Kiadó (Budapest )
                21 December 2016
                : 5
                : 4
                : 691-699
                [ 1 ]Department of Psychiatry and Psychotherapy, University of Lübeck , Lübeck, Germany
                [ 2 ]Institute of Social Medicine and Prevention, University Medicine Greifswald , Greifswald, Germany
                Author notes
                [* ]Corresponding author: Sina Zadra; Department of Psychiatry and Psychotherapy, University of Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany; Phone: +49 451 500 2871; Fax: +49 451 500 3480; E-mail: sina.zadra@
                © 2016 The Author(s)

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium for non-commercial purposes, provided the original author and source are credited.

                Page count
                Figures: 1, Tables: 7, Equations: 0, References: 29, Pages: 9
                Funding sources: This work was supported by German Federal States and German Federal Ministry of Health.
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