Medication for opioid use disorder among adolescents entering specialty treatment for opioid use disorder and trends in the US, 2017-2022
Professional societies recommend that adolescents with opioid use disorder (OUD) receive medication for opioid use disorder (MOUD). This cross-sectional study examined the association between adolescent specialty treatment episodes for OUD with planned MOUD use compared to adults over time.
The interacting role of fear of missing out in attentional bias dynamics during problematic social media use
Problematic social media use (PSMU) is increasingly conceptualized as a behavioral addiction involving attentional bias toward social media icons. Although fear of missing out (FoMO) contributes to PSMU maintenance, its dynamic interactive role in attentional bias dynamics remains unclear. Guided by the I-PACE model and attentional bias theory, this study examined whether and when FoMO modulates gaze-based attentional bias toward social media icons in PSMU. 912 university students completed online screening for PSMU and FoMO; 55 meeting PSMU criteria (M = 19.60) were categorized into high- or low-FoMO groups. Participants performed a visual dot-probe task with social/non-social app icons while eye-tracking recorded gaze behavior across four 500 ms time windows. Results revealed FoMO significantly interacted with attentional bias in two critical phases: During early processing (0-500 ms), the PSMU/high-FoMO group exhibited attentional orienting deceleration to social media icons, whereas PSMU/low-FoMO showed attentional maintenance. In later processing (1000-1500 ms), PSMU/high-FoMO demonstrated attentional vigilance-maintenance, while PSMU/low-FoMO displayed avoidance. These findings indicate FoMO exerts a temporally dynamic interaction effect on attentional bias in PSMU-characterized by initial orienting delays followed by sustained attentional engagement with social media icons. This supports reconceptualizing FoMO as a core psychological mechanism that reinforces PSMU through biased attentional dynamics, advancing theoretical alignment with the I-PACE framework.
Cannabis use among new mothers. A feasibility mixed-method study to investigate motives and perceptions
To assess the feasibility of recruiting new mothers (0-12 months postpartum) who use cannabis through social media and conducting a mixed-methods study to characterize their cannabis use. This pilot study aimed to gather preliminary data on use motives, behaviors, and objective toxicology to inform future large-scale research.
Relationship between Problematic Internet Use and emotional variables in childhood and adolescence: systematic review of longitudinal evidence
Problematic Internet Use (PIU) has been associated with emotional difficulties in childhood and adolescence. However, the directionality of this relationship remains unclear due to the lack of terminological consensus and wide variability in prevalence estimates. This systematic review aims to synthesize the longitudinal evidence on the directionality of the relationship between emotional variables (depression, anxiety, emotional dysregulation) and PIU in children and adolescents.
AAT-App+: A double-blind, pilot randomised controlled trial of a novel personalised smartphone intervention to reduce hazardous and harmful alcohol consumption among middle-older adults
Given increased rates of problematic alcohol use among middle-older age adults, novel, accessible alcohol interventions are needed. This pilot RCT explored the feasibility, acceptability, and preliminary effectiveness of personalised smartphone-delivered alcohol approach bias modification (ApBM) in Australians (≥55 years) drinking at hazardous/harmful levels (AUDIT ≥ 8).
From active users to passive watchers: Profiles of TikTok engagement and mental health predictors
Prior studies suggest that TikTok users vary in their engagement behaviors, including passive viewing, participatory interaction, and content creation, and exhibit varying levels of problematic-use risk. Yet it remains unclear which combinations of these engagement behaviors correspond to higher versus lower risk, and which psychological vulnerabilities contribute to high-risk patterns. In a two-wave study of 715 Chinese young adults, we applied latent profile analysis (LPA) to problematic TikTok use and the frequency of passive viewing, participatory, and contributory behaviors at Time 2. We then used multinomial logistic regression with the three-step method to prospectively examine how Time 1 measures of psychopathology and related affective/cognitive vulnerabilities, including depression, social anxiety, life satisfaction, emotion dysregulation, and boredom proneness, predicted TikTok profile membership. Four profiles emerged: Minimal Users (6.7%), Passive Watchers with High Problematic Use Tendencies (38.0%), Moderate Users with Mild Problematic Use Tendencies (42.4%), and Active Users with Low Problematic Use Tendencies (12.9%). Greater life satisfaction, lower social anxiety, and lower boredom proneness at baseline predicted membership in the Active rather than Passive, Moderate, or Minimal profiles. Greater emotion dysregulation predicted membership in the Passive rather than Moderate profile. These findings highlight substantial heterogeneity in TikTok use and suggest that higher baseline psychological wellbeing may increase the likelihood of more active and less problematic patterns of engagement. The current study extends prior LPA research by specifying how risk manifests in everyday use, identifying contributors to high-risk profiles, and extending empirical support for the I-PACE theoretical framework of Internet use disorders.
Clinical outcomes of addictive disorders six months after ADHD Diagnosis: Insights from the START study
Attention-Deficit/Hyperactivity Disorder (ADHD) is overrepresented in patients with addictive disorders but remains underdiagnosed. This comorbidity complicates clinical presentations and worsens prognosis. We aimed to evaluate addictive disorder outcomes six months after ADHD diagnosis in patients undergoing addiction treatment and to identify factors associated with a favorable outcome. Secondary objectives explored patient characteristics and therapeutic strategies.
Exploring adverse childhood experiences (ACEs) among those seeking treatment for gambling problems: A mixed-methods study
This mixed-methods study explores the relationship between Adverse Childhood Experiences (ACEs) and gambling-related harm among individuals seeking treatment in the UK.
How daily alternative behaviors' expected value shapes problematic smartphone use? An ecological momentary assessment study
With the global rise in smartphone use, problematic smartphone use (PSU) has emerged as a critical mental health concern. While reinforcement pathology theory posits that a high expected value of alternative behaviors (EVAB; e.g., psychological rewards from social or physical activities) may mitigate addictive tendencies, no prior study has examined this hypothesis in daily life contexts. This study is the first to investigate the within-person dynamics of EVAB on PSU and its underlying mechanisms. Using ecological momentary assessment (EMA), 72 participants (M = 19.01 ± 0.93 years; 40 females) completed baseline measures of episodic future thinking (EFT) followed by 14 days of intensive longitudinal data collection (three daily reports), assessing EVAB, delay discounting, PSU, and screen time. Dynamic structural equation modeling (DSEM) revealed two key findings: First, momentary increases in EVAB predicted subsequent reductions in both PSU levels and screen time, mediated by decreased delay discounting (β = -0.032, HPD 95 % CI = [-0.051, -0.014]). Second, individual differences in EFT detail/vividness and mental imagery positively predicted daily EVAB, which in turn reduced PSU via lower delay discounting (β = -0.015, HPD 95 % CI = [-0.026, -0.006]; β = -0.012, HPD 95 % CI = [-0.022, -0.004]). These results provide the first empirical support for core hypotheses of reinforcement pathology theory in PSU research, elucidating the dynamic role of EVAB while offering novel theoretical and clinical insights. The findings emphasize that PSU interventions should target both within-person fluctuations in reinforcement valuation and between-person differences in future-oriented cognition.
Sexual diversity, adolescent mental health, and adult cannabis use: Longitudinal associations through cannabis use motives
We examined prospective pathways between adolescent mental health and early adulthood cannabis use (CU) by sexual diversity, and the potential explanatory role of CU motives, accounting for confounders (demographics, CU frequency in adolescence).
Disconnected emotions, connected behaviors: Symptom network features of problematic mobile phone use across different alexithymia profiles
Problematic mobile phone use (PMPU) has been associated with individual-level psychological traits, notably alexithymia-a personality construct characterized by difficulty identifying and describing emotions, and a tendency toward externally oriented thinking. However, the heterogeneity of alexithymia in relation to PMPU remains insufficiently explored. In this study, 2345 university students completed the Toronto Alexithymia Scale and the Mobile Phone Addiction Index. Latent profile analysis identified four distinct alexithymia subtypes: Healthy Expression, Typical Alexithymia, Mild Emotional Processing Difficulties, and High Externally Oriented Thinking. Within each subgroup, psychological network analysis was used to examine the structural interconnections of PMPU symptoms. Core PMPU symptoms varied across profiles, with distraction, inability to reduce use, and feeling lost without the phone emerging as central nodes in most networks. Bridge symptoms linking emotional and behavioral dimensions also differed by profile. Network comparison tests revealed significant differences in overall structure and connectivity between groups. These findings underscore the complexity and heterogeneity of emotional processing mechanisms in PMPU and suggest the value of personalized, profile-specific intervention strategies.
Longitudinal bidirectional relations between perceived stress and Internet gaming disorder among adolescents: The mediating role of depressive symptoms
Perceived stress is considered a significant risk factor for Internet gaming disorder (IGD). However, the longitudinal dynamics and the underlying mechanisms of this relation remain underexplored. Drawing on the Compensatory Internet Use Theory, this study examined the mediating role of depressive symptoms in the longitudinal relation between perceived stress and IGD among adolescents. A total of 1567 Chinese adolescents (44.9 % boys; M = 15.41, SD = 0.51 at baseline) participated in a three-wave longitudinal study with a six-month interval. Cross-lagged panel modeling revealed that: (a) significant bidirectional relations were observed between perceived stress and depressive symptoms (βs ranged from 0.19 to 0.22, ps < 0.001); (b) depressive symptoms positively predicted subsequent IGD (βs ranged from 0.14 to 0.16, ps < 0.001); and (c) depressive symptoms mediated the relation between perceived stress and IGD (indirect effect = 0.032, 95 % CI [0.007, 0.062]). These findings highlight the critical role of depressive symptoms in the progression from perceived stress to IGD. Addressing depressive symptoms may be crucial for preventing and intervening with adolescent IGD.
Measuring cannabis use and cannabis-related consequences among college students who engage in simultaneous alcohol and cannabis use: Associations by type of cannabis product and mode of use on weekend days with cannabis
Patterning of cannabis use behavior is evolving as legalization of recreational use increases across the US, with rates highest among young adults. Modalities (e.g., vaping) for using cannabis are increasing in prevalence. Importantly, certain types (e.g., cannabis concentrates) and modes (e.g., bong use) of cannabis are associated with increased cannabis-related risks. Previous research in young adult samples has predominately used cross-sectional studies, limiting our understanding of within-individual differences in use behaviors and outcomes. The current study aimed to describe the type and modes of cannabis used and to examine within-individual differences in number of hits and negative consequences by type and mode of cannabis use.
Youth cannabis and alcohol use expectancies mediate associations between pre-adolescent cognitive function and subsequent use initiation
Youth substance use increases risk for developing substance use disorders. Previous work using the longitudinal ABCD Study® found distinct neurocognitive factors contribute to youth tobacco and alcohol initiation. Using data for 7776 ABCD Study® participants, this study expands prior work to examine prospective associations between early neurocognitive factors (general ability, executive function, learning and memory, and visuospatial and mental rotation) at ages 9-10 years (sample enrolled 2016-2018) and cannabis use by ages 13-14 years. We also test whether positive and negative tobacco smoking, alcohol, and cannabis expectancies mediate associations between neurocognitive factors and substance use initiation. Higher performance in general ability was associated with increased risk [OR = 1.23, 95 % CI 1.07-1.42] for cannabis use; positive cannabis expectancies mediated 72.6 % (p-value = 0.003) of the effect [Indirect effect: OR = 1.16, 95 % CI 1.12-1.20] and negative expectancies mediated -10.2 % (p-value = 0.04) of the effect [Indirect effect: OR = 0.98, 95 % CI 0.97-0.99]. Accuracy in visuospatial reasoning was protective [OR = 0.83, 95 % CI 0.73-0.95)] for cannabis use; the effect was not mediated by expectancies. Positive alcohol use expectancy mediated 36.3 % of the association between general ability and early alcohol use [OR = 1.15, 95 % CI 1.05-1.25; Indirect effect: OR = 1.05, 95 % CI 1.03-1.07]. Associations with early tobacco use were independent of tobacco expectancies. Developmentally appropriate expectancy-based interventions lowering positive expectancies and bolstering negative expectancies may be effective for preventing youth cannabis initiation. Interventions lowering positive alcohol expectancies may help prevent youth alcohol use.
Problematic social media use, boredom proneness, and psychological distress among university students in China and Japan: A cross-national network analysis
Problematic social media use (PSMU) has been associated with negative effects such as depression and anxiety across different countries and cultures. However, research on specific symptoms of PSMU and its correlates across nations remains limited. The present study aimed to compare the relationships of PSMU, boredom proneness, and psychological distress symptoms in China and Japan using network analysis. Questionnaire surveys were conducted among undergraduates in China and Japan. Participants included 822 students in China (mean age = 18.36, SD = 0.80) and 698 in Japan (mean age = 19.66, SD = 2.16). Network analysis was employed to estimate the symptom network structures, identify the most central symptoms, and compare the networks across the two countries. Results show that the core PSMU symptoms were Craving/tolerance in China and Relapse/loss of control in Japan. In the comorbidity networks, the most influential symptoms in China were agitation, panic, frequent inactivity, and downheartedness. The most central ones in Japan were not looking forward, downhearted, touchy, and a pervasive lack of motivation. The present study improves understanding of the links between symptoms of PSMU, boredom proneness, and psychological distress in both countries, which can be helpful for the development of potential nationally specific interventions.
Patterns of polysubstance use disorder among human trafficking survivors: A latent class analysis
Substance use is commonly documented among human trafficking (HT) survivors in emergency department (ED) settings. Multiple substance use disorders (poly-SUD) are associated with poor health and psychosocial outcomes. This study identified latent classes and demographic covariates of HT-related ED visits by the types of SUDs documented in survivors' medical records.
Witnessed overdose history and response among overdose survivors who use non-prescribed opioids in an overdose prevention trial
The REpeated-dose Behavioral intervention to reduce Opioid Overdose Trial (REBOOT) evaluated motivational interviewing for overdose prevention, focusing partly on witnessed overdose response. We assessed participants' witnessed overdose history and REBOOT's impact on overdose response among opioid overdose survivors using non-prescribed opioids in Boston and San Francisco.
Characterizing sociodemographic differences in substance use treatment need and receipt among pregnant women in the U.S
Sociodemographic disparities in SUD treatment need and receipt among women inform public health initiatives. While rates of SUD among pregnant women are lower than those who are not pregnant, an investigation of whether and how sociodemographic disparities of SUD treatment need and receipt among pregnant women can further accelerate SUD related risk prevention for both mothers and babies.
Meta-inner humor beliefs and problematic social media use: A six-month longitudinal test of metacognitive pathways
No previous studies have ever examined humor as a diffusion strategy in the context of technology use. The present study is the first to investigate whether meta-inner humor beliefs (MIHBs) are prospectively associated with problematic social media use (PSMU) via metacognitions about social media use. A prospective, two-wave longitudinal design with a bidirectional cross-lagged panel (CLPA) model was used to examine associations between adaptive and maladaptive MIHBs on PSMU, examining the indirect pathway of positive and negative metacognitions about social media use (meta-SMUs). The study was conducted across two waves at a six-month interval. At Wave 1, a large community sample (N = 1,253; 58.2 % females; age = 36.8 years [SD ± 14.1]) participated in the study, and at Wave 2, 78.1 % of the starting sample completed the follow-up assessment. Results from the bidirectional CLPA showed that adaptive MIHBs at Wave 1 were significantly associated with lower negative and positive meta-SMUs at Wave 2. In contrast, maladaptive MIHBs were only associated with higher negative meta-SMUs at Wave 2. Also, negative meta-SMUs predicted an increase in PSMU six months later, whereas it was non-significant for positive meta-SMUs. Analyses of bidirectional indirect pathways demonstrated that adaptive MIHBs were indirectly related to lower PSMU through reduced negative metacognitions, while maladaptive MIHBs were indirectly related to higher PSMU through elevated negative metacognitions. Multi-group analyses established full longitudinal measurement and structural invariance across gender. The findings underscore the potential role of humor-related metacognitive pathways in the maintenance of PSMU, suggesting that humor-based psychotherapeutic approaches warrant further investigation.
Motives for posting and deleting alcohol-related content on social media: Longitudinal associations with behavior among adolescents and young adults
Examining why adolescents and young adults post or delete alcohol-related content on social media has important implications for understanding and mitigating the influence of alcohol-related social media content on alcohol cognitions and use. This longitudinal study explored motives for posting and deleting alcohol content and their association with actual posting and deleting one month later. Survey data were collected from 306 adolescents and young adults recruited as part of a longitudinal experimental study examining alcohol-related content on social media and alcohol norms and use. Participants aged 15-20 (M = 18.39; SD = 1.32) indicated the top three motives for posting alcohol content: prove they were having fun, show they have an active social life, and make themselves look cool. The most endorsed motives for deleting alcohol-related social media content included: it being unflattering, feeling embarrassed, or fear of others sharing it. After controlling for relevant covariates, a negative binomial regression indicated that at baseline, alcohol-related posting motives related to making others jealous, posting about most things, and doing what friends do were significantly and positively associated with frequency of posting alcohol-related content one month later. Further, results of a linear regression indicated that the only baseline motive significantly associated with frequency of deleting alcohol-related content at 1-month follow-up was finding the content unflattering. Overall, results suggest that there are unique motives associated with both posting and deleting alcohol-related content on social media, which has implications for preventative interventions aiming to reduce alcohol-related social media behavior.
Does emotional distress tolerance negatively predict problematic smartphone use or vice versa? Evidence from a longitudinal study and a daily diary study
Low emotional distress tolerance (EDT) is a risk factor for problematic smartphone use (PSU). While theoretical and preliminary empirical considerations suggest that PSU may impair EDT, no studies have directly examined their bidirectional relationship. To address this gap, in this research, the bidirectional relationship between PSU and EDT is investigated through two studies among young adults. Study 1 employed a two-wave longitudinal design. A total of 901 young adults (61.7 % women) completed questionnaires three months apart. A cross-lagged regression analysis revealed a significant bidirectional predictive relationship between EDT and PSU. Study 2 used a daily diary design (N = 77; 39.0 % women) to examine the day-to-day directional relationship between EDT and PSU. Participants completed daily assessments over 14 consecutive days. Multilevel linear models with time lag analyses indicated that PSU predicted next-day EDT, whereas EDT did not predict next-day PSU. Study 1 revealed a reciprocal negative association between EDT and PSU, offering empirical support for Compensatory Internet Use Theory (CIUT) and the reinforcing cycle of the Interaction of Person-Affect-Cognition-Execution (I-PACE) model. Moreover, on a daily timescale, only PSU was found to predict next-day EDT. These findings have implications for interventions aiming to break the cycle between PSU and low EDT.
Restricting choice of e-cigarette flavor and device type increases choices to use combusted cigarettes among adults who dual use both products: Results from a within-subjects randomized trial
Data from real-world e-cigarette (EC) flavor bans suggest that such bans may increase combusted cigarette (CC) use. However, experimental data are needed to better understand how EC characteristics affect EC appeal and CC use.
Perceptual distortions of social support in multi-age cohort as a function of internet addiction and attention control
Internet addiction and attention control increasingly influence how individuals across age groups perceive social support. This study explored the psychological impact of excessive internet use and attentional regulation within a diverse Indian population.
Working memory capacity predicts cannabis-induced effects on alcohol urge
Cannabis has shown mixed results in its association with alcohol urge, which may be explained by individual differences. One such factor, working memory capacity (WMC) is associated with drug-related cue reactivity and implicated in alcohol use and problems. In the current study, we examined whether WMC moderates the acute effect of cannabis on alcohol urge in a randomized placebo-controlled crossover trial.
Application of the differential susceptibility to media effects model to comprehend emerging adults' problematic smartphone use: A one-year longitudinal study
Considering the pervasive integration of smartphones into the daily lives and high prevalence of problematic smartphone phone use (PSU) among emerging adults, there is an urgency for an integrated perspective to understand their PSU for better intervention insights. This study aims to apply a multi-level theoretical framework, the Differential Susceptibility to Media Effects Model (DSMM), to PSU and evaluate not only the direct effects of dispositional (i.e., neuroticism), social (i.e., family adaptability), and developmental factors (i.e., inclusion of smartphone in the self [ISS]) on PSU but also the potential indirect effect of ISS. We obtained a sample of 801 Chinese emerging adults (559 females; M = 19.02 and SD = 0.88) through a one-year longitudinal study with two surveys (at wave 1 [W1] and wave 2 [W2]). Hierarchical regression analysis indicated that all baseline susceptibility factors (neuroticism [W1], family adaptability [W1], and ISS [W1]) significantly predicted PSU (W2) after controlling for both demographics and PSU (W2). The results of structural equation modeling further suggested that neuroticism (W1) and family adaptability (W1) were longitudinally associated with ISS (W2), which was in turn associated with PSU (W2). This study provided not only longitudinal evidence to support the application of DSMM to explain PSU but also insights into interventions using targeted approaches.
General executive functions, stimulus-specific inhibitory control and predisposing variables of individuals with problematic social network use
General executive functions and decreased stimulus-specific inhibitory control may be relevant factors for the development and maintenance of problematic social network use (PSNU). Related predisposing variables that are risk factors for PSNU may include self-directedness, ADHD symptoms, or impulsivity, and as a result, social networks (SN) may be habitually utilized, which can manifest over time. Theoretical models suggest that interactions between predisposing factors and PSNU may influence neurocognitive deficits during problematic behavior. Therefore, we investigate possible interaction effects of SN use type (PSNU vs. non-problematic use) and predisposing factors on the expression of cognitive control mechanisms.
Does the apple fall far from the tree? when parenting styles disrupt the intergenerational pattern of substance use
This study investigates whether parenting styles can buffer the intergenerational transmission of substance use. Using a person-centered analytic strategy with 4,280 adolescent-parent dyads in Brazil, we applied Latent Class Analysis to identify substance use profiles in both generations and modeled their association using Latent Transition Analysis. Parental and adolescent profiles were strongly aligned, especially among abstainers. However, this similarity was not deterministic: authoritative parenting significantly reduced adolescents' likelihood of polysubstance use - even among high-risk parents. Authoritarian parenting also reduced this risk but increased alcohol-specific transmission. Permissive and neglectful styles showed no protective effects. These findings underscore the role of parenting style and highlight the value of family-based interventions to disrupt intergenerational substance use patterns.
Latent profiles of cannabis use patterns and associations with eating pathology outcomes
As recreational cannabis increases among United States adults, there is growing interest in understanding potential health co-morbidities. Although past work supports cannabis use and eating disorder comorbidity, and cannabis enhances appetite and reward responses to food, little is known about how specific cannabis use patterns may relate to binge eating and other eating disorder symptoms. The purpose of this study is to identify distinct subgroups of recreational cannabis users based on several use characteristics, including subjective changes to appetite and hedonic properties of food using latent profile analysis, and to examine differences across profiles in binge eating, other eating disorder symptoms, and emotion regulation. Participants (N = 435, male = 189) were adults recruited through Prolific who endorsed past-month cannabis use and completed a battery of self-report measures assessing cannabis use characteristics, eating changes while using cannabis, eating disorder symptoms, and emotion regulation. Results identified four profiles: "Infrequent Users, Moderate Eating Changes, Low Risk," "Intense Users, Low Eating Changes, Mild Risk," "High-Risk Coping Users, Strong Eating Changes," and "Frequent Users, Slight Eating Changes, Mild Risk." All profiles reported more binge eating symptoms while under the influence of cannabis; the "High Risk Coping Users, Strong Eating Changes" profile reported the most severe sober binge eating, eating disorder, and emotion regulation difficulties. Findings highlight the utility of person-centered approaches for capturing co-morbidity risk and may help guide screening and intervention tools for determining eating disorder risk among those using cannabis.
The relationship between social media use, thin-ideal internalization, and college women's use of electronic cigarettes for weight control: A mediation analysis
Some college women report using electronic cigarettes (e-cigarettes) for weight control. Social media frequently promotes e-cigarettes for weight management and reinforces unrealistic body ideals, which may foster body dissatisfaction and unhealthy weight control behaviors. Given college women's high rates of social media and e-cigarette use, this study examined the relationship between college women's social media use, thin-ideal internalization, and e-cigarette use for weight control.
Prevalence of Internet gaming disorder in young adults: a systematic review and meta-analysis
Internet Gaming Disorder (IGD) is recognized as a condition for further study in DSM-5-TR and officially classified in ICD-11. Although gaming problems seem like an adolescent concern, growing evidence indicates that young adults are also vulnerable. This systematic review and meta-analysis aimed to estimate the global prevalence of IGD among young adults and identify sociodemographic and methodological moderators associated with its variability. Ninety-six analytical samples from 93 studies published (2015-2025) were included, comprising 149,601 participants aged 18-35 (M = 23.53 years, SD = 6.28; 51.22 % female). Generalized linear mixed models were applied to compute pooled prevalence estimates. The pooled prevalence of IGD was 6.1 % (95 % CI: 5.03-7.40). Prevalence was significantly higher in gamer-only samples (8.1 %, 95 % CI: 5.91-11.01) compared to mixed samples, including gamers and non-gamers (5.47 %, 95 % CI: 4.33-6.90). Moderator analyses showed that IGD prevalence differed by diagnostic instrument (IGDS and DSM-V criteria > IGDT-10) and by sample size, and a trend also emerged suggesting lower prevalence with higher proportions of women. In gamer-only samples, prevalence increased over time and in studies with a higher risk of bias. In mixed samples, prevalence differed by instrument (IGDS > GAS) and was negatively associated with sample size. These findings indicate that IGD is more prevalent among young adults than in the general population, especially among gamers. The variability observed across studies highlights the need for methodological consistency and the use of validated diagnostic tools to improve comparability and inform prevention and intervention strategies.
