BACKGROUND: Long screen time hours may be associated with behavioral problems in children. To better understand the relationship between children's behavioral problems and screen time, it the associated risk factors must be subdivided based on the purpose underlying screen use. This study examined the relationship between screen time based on intended usage and behavioral problems in Japan. METHODS: This study included 3,332 children aged between 7-17 years from the Hokkaido Study on Environment and Children's Health. From October 2020 to October 2021, the children and their parents answered questionnaires on the children's screen use duration (never used, <30 min, ≥30 min & <1 hour, ≥1 h & <2 h, ≥2 h) based on seven intended usage categories: watching television/video, video gaming, reading books/comics, sending/receiving e-mail/messages, browsing/posting on social networking services, studying for classes/homework, drawing/editing pictures/photos/videos, along with the Strengths and Difficulties Questionnaire (SDQ). Logistic regression was used to analyze the association between screen time, purpose of children's screen use, and behavioral problems across the 13 SDQ total scores. RESULTS: The mean ± standard deviation age of the participants was 12.4 ± 2.4-years-old, 487 (14.6%) children were determined to have behavioral problems, and the duration of screen time increased with their age. The children's primary purposes for screen use were watching television/video, video gaming, sending/receiving e-mail/messages, and browsing/posting on social networking services. Children who reported playing video games for ≥2 hours on weekdays had higher odds of problematic total difficulties scores than never user (Odds Ratio: 2.10, 95% confidence interval: 1.45-3.06). CONCLUSION Long video gaming screen time is associated with behavioral issues, hyperactivity/inattention, and prosocial behaviors in children. Conversely, watching television and videos for 30 min-1 h per day, using e-mail or messaging, and using social networking services were significantly association with reduced odds ratio for peer relationship problems as compared to children who never engaged in these activities. Longitudinal follow-up is needed to further examine screen time and problem behaviors.
Humans ; Screen Time ; Child ; Japan/epidemiology* ; Male ; Female ; Adolescent ; Problem Behavior/psychology* ; Surveys and Questionnaires ; Child Behavior ; Television/statistics & numerical data* ; Video Games/statistics & numerical data*

OBJECTIVE: To investigate the dose-related effect of trunk control training (TCT) using Trunk Stability Rehabilitation Robot Balance Trainer (TSRRBT) in chronic stroke patients with poor sitting balance. METHODS: This was a retrospective study of 38 chronic stroke patients with poor sitting balance that underwent TCT with TSRRBT. The participants were assigned either to the low-dose training (LDT) group (n=18) or to the highdose training (HDT) group (n=20). In addition to the conventional rehabilitation therapy, the LDT group received 5 sessions of TSRRBT intervention per week, whereas the HDT group received 10 sessions of TSRRBT intervention per week. The outcome measures were the scores on the Trunk Impairment Scale (TIS) and its subscales, Berg Balance Scale (BBS), Functional Ambulation Classification (FAC), and the Korean version of Modified Barthel Index (K-MBI). All outcome measures were assessed before the training and at the end of the 4-week training. RESULTS: After the 4-week intervention, TIS, BBS, FAC, and K-MBI scores showed improvement in both LDT and HDT groups. Furthermore, the improvements in TIS scores and its subscales were significantly greater in the HDT group than in the LDT group (p < 0.05). CONCLUSION: TCT using TSRRBT could be an additional treatment for the conventional rehabilitation therapy of chronic stroke patients with poor sitting balance. HDT may provide more beneficial effects on improving patients’ sitting balance than LDT.
Biofeedback, Psychology ; Classification ; Humans ; Outcome Assessment (Health Care) ; Rehabilitation ; Retrospective Studies ; Stroke* ; Video Games* ; Walking

INTRODUCTIONThe current study aimed to establish the prevalence of internet gaming disorder (IGD) and its association with demographic characteristics, game genre, game use (time spent on gaming), as well as psychological distress, social phobia and well-being among current online gamers in Singapore.

MATERIALS AND METHODSA total of 1251 participants aged 13 to 40 years completed the study which was administered as a web survey. The online questionnaire was designed using QuestionPro, and consisted of 8 sections and 105 questions. The 9-item Internet Gaming Disorder Questionnaire was used to establish the prevalence of IGD in the study. A series of logistic regression models were used to examine the associations between IGD, demographic characteristics and game genre, as well as IGD and psychological distress, social phobia and well-being.

RESULTSThe prevalence of IGD established using a cutoff of 5 among those who were current online gamers was 17.7%. Multiple logistic regressions revealed that those meeting criteria of IGD were more likely to be older, reported an earlier age of onset of playing online games, had primary and secondary education versus tertiary education, were currently students versus being currently employed and played massively multiplayer online role-playing games. Distress and social anxiety were higher while satisfaction with life was significantly lower among those who met criteria for IGD than those who did not meet the criteria.

CONCLUSIONThe prevalence of IGD and its negative consequences in our sample of current online gamers was significant and point towards the need for further clinical studies and innovative interventions to address the problem.

Adolescent ; Adult ; Age Factors ; Behavior, Addictive ; epidemiology ; psychology ; Educational Status ; Employment ; statistics & numerical data ; Female ; Humans ; Internet ; Logistic Models ; Male ; Multivariate Analysis ; Personal Satisfaction ; Phobia, Social ; epidemiology ; psychology ; Prevalence ; Singapore ; epidemiology ; Stress, Psychological ; epidemiology ; psychology ; Students ; statistics & numerical data ; Surveys and Questionnaires ; Video Games ; Young Adult

The purposes of this study were to: 1) describe the patterns of screen-based sedentary behaviors, and 2) examine the association between screen-based sedentary behavior and cardiovascular disease (CVD) risk factors in representative Korean children and adolescents, aged 12 to 18 yr, in the Korean National Health and Nutrition Examination Survey. Screen-based sedentary behavior was measured using self-report questionnaires that included items for time spent watching TV and playing PC/video games. Physical activity was measured using items for frequency and duration of moderate-to-vigorous physical activity (MVPA). CVD risk factors such as body mass index (BMI), waist circumference, LDL cholesterol, HDL cholesterol, total cholesterol, triglycerides, glucose, systolic blood pressure, and diastolic blood pressure were measured. Boys spent more time playing PC/video games, and girls spent more time watching TV. After adjusting for age, gender, annual household income, and MVPA, an additional hour of watching TV was significantly associated with the risk of overweight (OR 1.17 [95% CI 1.03-1.33]), high abdominal adiposity (OR 1.27 [1.06-1.51]), and low HDL cholesterol (OR 1.27 [1.10-1.47]). An additional hour spent playing PC/video games also increased the risk of high abdominal adiposity (OR 1.20 [1.03-1.40]). Prospective observations and interventions are needed to determine causal relationships between screen-based sedentary behavior and CVD risk profiles in Korean youth.
Abdominal Fat ; Adolescent ; Cardiovascular Diseases/*etiology ; Child ; Cholesterol, HDL/blood ; Cross-Sectional Studies ; Exercise ; Female ; Health Behavior ; Humans ; Male ; Nutrition Surveys ; Odds Ratio ; Overweight ; Questionnaires ; Republic of Korea ; Risk Factors ; *Sedentary Lifestyle ; Socioeconomic Factors ; Video Games/psychology

OBJECTIVE: To explore the functional locations of brain regions related to internet addiction (IA)with task-functional magnetic resonance imaging (fMRI). METHODS: Nineteen college students who had internet game addition and 19 controls accepted the stimuli of videos via computer. The 3.0 Tesla MRI was used to record the Results of echo plannar imaging. The block design method was used. Intragroup and intergroup analysis Results in the 2 groups were obtained. The differences between the 2 groups were analyzed. RESULTS: The internet game videos markedly activated the brain regions of the college students who had or had no internet game addiction. Compared with the control group, the IA group showed increased activation in the right superior parietal lobule, right insular lobe, right precuneus, right cingulated gyrus, and right superior temporal gyrus. CONCLUSION Internet game tasks can activate the vision, space, attention and execution center which are composed of temporal occipital gyrus and frontal parietal gyrus. Abnormal brain function and lateral activation of the right brain may exist in IA.
Adolescent ; Adult ; Behavior, Addictive ; physiopathology ; Brain ; physiology ; Case-Control Studies ; Female ; Humans ; Internet ; Magnetic Resonance Imaging ; Male ; Students ; psychology ; Universities ; Video Games ; psychology ; Young Adult

INTRODUCTIONIncrease in internet use and video-gaming contributes to public concern on pathological or obsessive play of video games among children and adolescents worldwide. Nevertheless, little is known about the prevalence of pathological symptoms in video-gaming among Singaporean youth and the psychometric properties of instruments measuring pathological symptoms in video-gaming.

MATERIALS AND METHODSA total of 2998 children and adolescents from 6 primary and 6 secondary schools in Singapore responded to a comprehensive survey questionnaire on sociodemographic characteristics, video-gaming habits, school performance, somatic symptoms, various psychological traits, social functioning and pathological symptoms of video-gaming. After weighting, the survey data were analysed to determine the prevalence of pathological video-gaming among Singaporean youth and gender differences in the prevalence. The construct validity of instrument used to measure pathological symptoms of video-gaming was tested.

RESULTSOf all the study participants, 8.7% were classified as pathological players with more boys reporting more pathological symptoms than girls. All variables, including impulse control problem, social competence, hostility, academic performance, and damages to social functioning, tested for construct validity, were significantly associated with pathological status, providing good evidence for the construct validity of the instrument used.

CONCLUSIONThe prevalence rate of pathological video-gaming among Singaporean youth is comparable with that from other countries studied thus far, and gender differences are also consistent with the findings of prior research. The positive evidence of construct validity supports the potential use of the instrument for future research and clinical screening on Singapore children and adolescents' pathological video-gaming.

Adolescent ; Behavior, Addictive ; epidemiology ; pathology ; psychology ; Child ; Diagnostic and Statistical Manual of Mental Disorders ; Female ; Health Surveys ; Humans ; Male ; Prevalence ; Psychopathology ; Sex Factors ; Singapore ; epidemiology ; Socioeconomic Factors ; Statistics as Topic ; Surveys and Questionnaires ; Video Games ; adverse effects ; psychology

PURPOSE: The purpose of this study was to determine effects of an empowerment education program (EEP) on internet games addiction, empowerment, and stress in middle school students. METHODS: The EEP used in this study was based on the Freire's Empowerment Education Model. The research design of this study was a non-equivalent control group pretest-posttest design for 48 middle school students, who were conveniently assigned to an experimental group or a control group. The data were collected from May 29 to June 19, 2005. Data were analyzed using SPSS/PC program with frequencies, chi-square-test, Fisher exact test, t-test, mean, standard deviation and ANCOVA. RESULTS: 1) The first hypothesis that, "the experimental group would have higher empowerment scores than the control group." was supported. 2) The second hypothesis that, "the experimental group would have lower internet games addiction scores than the control group." was supported. 3) The third hypothesis that, "the experimental group would have lower stress scores than the control group." was supported. CONCLUSION: We suggest, therefore, that the EEP should be used with adolescent to help them control their stress, internet games addiction and to increase their empowerment.
Adolescent ; Adolescent Behavior ; Behavior, Addictive/*prevention &control ; Female ; Humans ; *Internet ; Male ; Patient Education as Topic ; Power (Psychology) ; Program Evaluation ; Stress, Psychological ; Students/*psychology ; *Video Games

OBJECTIVENon-pharmacological approaches to pain management have been used by therapists for decades to reduce the anxiety and pain experienced by children during burn care procedures. With a greater understanding of pain and the principles behind what causes a child to be distracted, combined with access to state of the art technology, we have developed an easy to use, hand held multimodal distraction device (MMD). MMD is an interactive device that prepares the child for a procedure and uses developmentally appropriate distraction stories and games during the procedures to alleviate anxiety and pain. This paper summarizes the results of three randomized control trials. The trials aimed to understand the effectiveness of MMD as a distraction and preparation tool in reducing anxiety and pain in children undergoing burns and non-burns medical procedures compared to pure pharmacological approaches Standard Distraction (SD) and off the shelf video games (VG).

METHODSThree separate prospective randomized control trials involving 182 children having 354 dressing changes were conducted in the burns and orthopedic departments at Royal Children's Hospital, Brisbane, Australia, to address the above aims. Pain and anxiety scores were completed for the child, caregiver and nursing staff according to the Modified Faces, Legs, Activity, Cry and Consolability Scale, Faces Pain Scale-Revised, Visual Analogue Scale and Wong-Baker Faces Pain Rating Scale. Procedural length was recorded.

RESULTSMMD as a preparation and distraction tool were shown to have a significant impact on child, parent and nursing staff reported anxiety and pain during procedures compared to standard care and video games (P < 0.01). The MMD had a positive effect on clinical time and was shown to sustain its impact on pain and time with further dressing changes.

CONCLUSIONSMMD is more effective in reducing the pain and anxiety experienced by children in acute medical procedures as compared with SD and VG. MMD is continuing to be trialed and is continuing to show positive clinical outcomes.

Adolescent ; Analgesia ; instrumentation ; methods ; Burns ; therapy ; Child ; Child, Preschool ; Female ; Humans ; Male ; Pain ; psychology ; Pain Management ; Prospective Studies ; Randomized Controlled Trials as Topic ; User-Computer Interface ; Video Games

PURPOSE: The purpose of this study was to explore factors related to internet game addiction for adolescents. METHOD: This study was a cross-sectional survey, and data was collected through self-report questionnaires. Data was analyzed using the SPSS program. RESULTS: In logistic regression analysis, the risk of being addicted to internet games was2.22 times higher in males than females. Adolescents with low and middle academic performance also had a higher risk(2.08 times and2.54 times) to become addicted to internet games. For the location of the computer, the risk of becoming addicted to internet games were .01 times lower in the living room or brother or sisters' room than in their own room. The risk of becoming addicted to internet games was 1.18 times higher in the higher usage time of internet games. The risk of becoming addicted to internet games was .49 times lower in the more accepting and autonomic parents' rearing attitude and .02 times lower in the high self-efficacy group than the low group. CONCLUSION: The result of this study suggests that there are noticeable relationships between internet game addiction and gender, academic performance, location of computer, usage time of internet games, parents' rearing attitude, and self efficacy.
Adolescent ; Attitude to Computers ; Behavior, Addictive/*epidemiology/psychology ; Cross-Sectional Studies ; Female ; Humans ; Internal-External Control ; *Internet ; Interpersonal Relations ; Male ; Questionnaires ; Regression Analysis ; Risk Factors ; *Video Games

BACKGROUND & SIGNIFICANCE: Photosensitive epilepsy may occur by the diverse new implements. We experienced three patients suffered from the first seizure while using photosonic devices. The device is composed of light stimulating goggles and sound producing headphones. CASE: All the patients were teen-aged school girls and the types of seizure were generalized tonic-clonic seizure, focal motor seizure with secondary generalization, and complex partial seizure. They lost their consciousness while using the devices with the red colored light. Events began without aura in two but one patient felt continuous red flash light until after taking off the device. EEG revealed right frontal dominant spike-wave complexes in one but other patients showed no epileptiform discharges. During a year follow-up the patient who showed EEG abnormalities experienced another seizure that was focal motor seizure with secondary generalization but remained two did not. COMMENTS: Though the video game epilepsy is regarded as a kind of photosensitive epilepsy, the emotional excitement may contribute to the occurrence of seizure. But, this photosonic device is used for relaxation and our three patients showed normal EEG while photic stimulation during the tracing. We suggest that seizure induced by the photosonic lev genuine type of photosensitive epilepsy.
Consciousness ; Electroencephalography ; Epilepsy ; Epilepsy, Reflex ; Eye Protective Devices ; Female ; Follow-Up Studies ; Generalization (Psychology) ; Humans ; Photic Stimulation ; Relaxation ; Seizures* ; Video Games