Jing Chen

Objective This study aimed to evaluate the psychometric properties of the Chinese version of the Stress Sensitivity Inventory (SSI), a self-reported instrument that assesses trait stress sensitivity in adults, and to examine the relationship between the SSI and symptoms of internet gaming disorder (IGD).Methods The Chinese SSI was administered, along with the Internet Gaming Disorder Scale (IGDS) and scales assessing perceived stress, anxiety, depression, and neuroticism. Data from 1,085 valid respondents (with 347 respondents who retested 4 weeks later) were analyzed. A mixed graphical model was utilized to estimate the network structure properties of stress sensitivity and IGDS symptoms.Results Item #5 was removed due to low coherence with other items. The scale demonstrated a unidimensional structure with strong reliability (Cronbach’s α=0.90, test-retest reliability=0.75) and validity. SSI scores were positively correlated with IGDS scores (r=0.42, p<0.001). In the SSI network, items with the highest expected influence were #8 (functional impairment), #6 (cognitive decline), and #3 (mental freeze). In the SSI–IGD network, items #8 (functional impairment) and #9 (substance use) showed the strongest bridge expected influence on the SSI side.Conclusion The Chinese SSI demonstrates good reliability and validity, making it a suitable instrument for assessing stress sensitivity in both clinical and research settings. Network analysis revealed significant interconnections between stress sensitivity and IGD symptoms, with functional impairment (item #8) emerging as a particularly influential node both within the SSI cluster and in linking SSI to IGD.

Introduction: Social media addiction (SMA) is often comorbid with anxiety and depression. This study examined the temporal stability of core SMA symptoms and the bridging symptoms with anxiety and depression. Methods: A total of 1,240 adolescents (179 males, 1,061 females; mean age = 15.46 ± 0.63 years, age range: 14 – 18) completed the Bergen Social Media Addiction Scale (BSMAS), the Patient Health Questionnaire–9 (PHQ–9), and the Generalized Anxiety Disorder–7 (GAD–7) on two separate occasions in 2023 (T1) and 2024 (T2). The four symptom networks, including the BSMAS networks, two comorbidity networks (the BSMAS–GAD and the BSMAS–PHQ), and the integrated BSMAS–GAD–PHQ network, were estimated using Gaussian graphical models. Core symptom centrality was assessed using Expected Influence (EI), whereas bridge symptoms were identified using Bridge Expected Influence (BEI). Results: 1) Although SMA, anxiety, and depression levels of respondents rose significantly over the year, all four networks showed strong temporal stability, with the edge weights ( r = .892 –.973, p < .001), the EI ( r = .806 – .961, p ≤ .002), and the BEI ( r = .699 – .804, p ≤ .008) highly correlated between T1 and T2; network comparison tests showed no significant changes in overall structures of all four networks, with most edges showing stable weights. 2) Within the BSMAS network, BSMAS2 (tolerance) and BSMAS6 (conflict) exhibited the highest EI at both time points. 3) In the comorbidity networks, BSMAS3 (mood modification), BSMAS5 (withdrawal), and BSMAS6 (conflict) consistently served as bridge symptoms on the SMA side at both T1 and T2. 4) Across both time points, PHQ1 (anhedonia) and PHQ7 (concentration problems) exhibited the highest BEI on the depression side, whereas GAD1 (nervousness) and GAD5 (restlessness) did so on the anxiety side. 5) These bridge symptoms were also confirmed in the integrated network. Discussion: These findings illuminate the temporal persistence and development of symptom relationships, offering a more dynamic understanding of SMA–depression–anxiety comorbidity in adolescents.

Objective The nine diagnostic criteria for Internet Gaming Disorder (IGD) proposed in Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) have been widely adopted, but have also faced significant criticism. This study evaluated the psychometric properties of the nine DSM-5 criteria for IGD using item response theory (IRT).Methods Four DSM-5-based scales, including the Game Addiction Scale, the Internet Gaming Disorder Scale Short-Form, the Ten- Item Internet Gaming Disorder Test, and the Internet Gaming Disorder Scale, were administered to 1,530 Chinese adolescents and young adults. IRT models were used to assess the psychometric properties of these criteria. The potential for differential item functioning (DIF) related to sex and between adolescents and adults was also evaluated.Results All nine DSM-5 criteria demonstrated very high to perfect discrimination (a >1.38), providing substantial diagnostic information (item information >0.476) for diagnosing IGD. These scales, despite variations in wording and scoring methods, exhibited strong correlations in total scores (r≥0.502, p<0.001) and high consistency (Kendall’s W ≥0.656, p<0.05) concerning the fitted IRT parameters. Among the nine criteria, escape showed the lowest cross-scale discrimination, item information, and difficulty. In contrast, withdrawal showed the highest item information and discrimination, and the second highest difficulty. Additionally, there was no evidence of DIF related to sex or age (adolescents vs. adults) across nearly all scale items.Conclusion These findings indicate that the nine DSM-5 criteria generally possess acceptable psychometric properties for diagnosing IGD. Notably, withdrawal may represent a core symptom of IGD. Conversely, escape demonstrated inferior performance compared to the other eight criteria, indicating a potential need for further revision.

Background: Maladaptive metacognitive beliefs concerning the uncontrollability and danger of negative thinking (MCQ‐NEG) were associated with suicidal ideation (SI) in major depressive disorder (MDD). The present study investigated whether metacognitive beliefs were different between groups and whether metacognitive beliefs explained incremental variance in suicidal ideation. Methods: One hundred sixty‐seven patients with MDD were recruited along with 170 healthy controls. Metacognitive beliefs and suicidal ideation were assessed using the Metacognition Questionnaire‐30 Items (MCQ‐30) and Beck Scale for Suicide Ideation (BSSI), separately. Group differences were assessed using t tests. The associational variable analysis was carried out to test the association between variables in MDD. Results: (1) The MDD exhibited higher levels of maladaptive metacognitive beliefs. (2) Patients who had attempted suicide showed a higher level of MCQ‐NEG compared to those with suicidal ideation alone. (3) MCQ‐NEG explained incremental variance between depression severity and suicidal ideation when covariates are controlled in MDD. Conclusions: This study suggested that maladaptive metacognitive beliefs distinguished suicidal patients from non‐suicidal patients, and the metacognitive model appeared relevant to suicidal ideation.

Introduction: Retrospective confidence ratings (CRs) after decision-making reactively lead to prolonged response times (RTs) and improved decision accuracy, a phenomenon known as the reactivity effect. This effect reflects an individual’s metacognitive control processes. Little is known if depressive pathologies modify the reactivity effect in patients with Major Depressive Disorder (MDD).Methods: This study investigated the differences in the reactivity effect between 94 patients with MDD and 97 healthy controls (HCs), using a perceptual decision-making task and the Drift Diffusion Model (DDM) analysis.Results and discussion: The results demonstrated that prompted CRs significantly prolonged RTs in both groups. However, prompted CRs improved decision accuracy in HCs, this effect was absent in the MDD group. DDM analysis revealed increased decision thresholds under CR conditions for both groups. Crucially, a significant group×condition interaction emerged for drift rate (v), with HCs demonstrating enhanced evidence accumulation speed compared to MDD patients. These findings indicate impaired metacognitive reactivity effects in MDD through confidence monitoring, highlighting deficits in metacognitive monitoring and control processes associated with depression.

Background and aims: The shift from goal-directed to habitual control is a well-documented phenomenon in addiction research and is considered a critical factor in the development and maintenance of addictive behaviors. Whether Internet Gaming Disorder (IGD) is also associated with such a shift is not yet clear. The current study investigated the imbalance between goal-directed and habitual control in individuals with IGD. Methods: Goal-directed and habitual control, as informed by model-based (MB) and model-free (MF) learning, were assessed with a two-step sequential decision-making task during functional magnetic resonance imaging (fMRI) in 33 young adults with IGD and 32 healthy controls (HCs). Self-report data regarding addictive symptoms, game craving, and impulsivity were also collected. Results: Individuals with IGD relied more heavily on habitual control to guide subsequent choices compared to HCs. According to a hybrid reinforcement learning model, individuals with IGD also exhibited a reduced MB weight related to HCs, which was correlated with more severe addictive symptoms. fMRI results revealed that individuals with IGD showed increased MF reward prediction error (RPE _MF ) signals in the right triangular part of the inferior frontal gyrus (IFG). No significant group differences were found in the contrast of RPE _MB maps. Discussion and conclusions: Our study provides both behavioral and neural evidence highlighting an imbalance between goal-directed and habitual control, favoring habitual control in individuals with IGD. This imbalance is associated with the severity of addictive symptoms, suggesting an indication of habit inclination in IGD could potentially contribute to the development or maintenance of the addiction.