Problematic smartphone use and two types of problematic use of the internet and self-stigma among people with substance use disorders

doi:10.1016/j.addbeh.2023.107807

. 2023 Dec:147:107807.

doi: 10.1016/j.addbeh.2023.107807. Epub 2023 Jul 22.

Problematic smartphone use and two types of problematic use of the internet and self-stigma among people with substance use disorders

Ching-Wen Chang¹, Jung-Sheng Chen², Shih-Wei Huang³, Marc N Potenza⁴, Jian-An Su⁵, Kun-Chia Chang⁶, Amir H Pakpour⁷, Chung-Ying Lin⁸

Affiliations

¹ Graduate Institute of Social Work, National Taiwan Normal University, No. 162, Sec. 1, He-Ping East Rd., Daan Dist., Taipei 106209 Taiwan. Electronic address: cwchangswk@ntnu.edu.tw.
² Department of Medical Research, E-Da Hospital, I-Shou University, No.1, Yida Rd., Yanchao Dist., Kaohsiung 824005, Taiwan. Electronic address: nicky071214@gmail.com.
³ Institute of Environmental Toxin and Emerging Contaminant, Cheng Shiu University, Kaohsiung 83347, Taiwan; Center for Environmental Toxin and Emerging-contaminant Research, Cheng Shiu University, Kaohsiung 83347, Taiwan. Electronic address: envhero@gcloud.csu.edu.tw.
⁴ Department of Psychiatry, Yale School of Medicine, 1 Church Street, Room 726, New Haven, CT 06510, USA; Connecticut Mental Health Center, 34 Park St., New Haven, CT 06519, USA; Connecticut Council on Problem Gambling, 100 Great Meadow Rd., Suite 704, Wethersfield, CT 06109, USA; Child Study Center, Yale School of Medicine, 350 George St., New Haven, CT 06511, USA; Department of Neuroscience, Yale University, New Haven, CT, USA; Wu Tsai Institute, Yale University, 200 South Frontage Rd., SHM C-303, New Haven, CT 06510, USA. Electronic address: marc.potenza@yale.eduj.
⁵ Department of Psychiatry, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan; School of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Nursing, Chang Gung Institute of Technology, Taoyuan, Taiwan. Electronic address: jian.7715@gmail.com.
⁶ Department of General Psychiatry, Jianan Psychiatric Center, Ministry of Health and Welfare, No. 539, Yuzhong Rd., Rende Dist., Tainan 717204, Taiwan; Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No. 1., University Rd., East Dist., Tainan 701401, Taiwan. Electronic address: kunchiachang0517@gmail.com.
⁷ Department of Nursing, School of Health and Welfare, Jönköping University, Sweden. Electronic address: Amir.Pakpour@ju.se.
⁸ Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, No. 1., University Rd., East Dist., Tainan 701401, Taiwan; Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No. 1., University Rd., East Dist., Tainan 701401, Taiwan; Department of Public Health, College of Medicine, National Cheng Kung University, No. 1., University Rd., East Dist., Tainan 701401, Taiwan; Department of Occupational Therapy, College of Medicine, National Cheng Kung University, No. 1., University Rd., East Dist., Tainan 701401, Taiwan. Electronic address: cylin36933@gmail.com.

PMID: 37542974
DOI: 10.1016/j.addbeh.2023.107807

Problematic smartphone use and two types of problematic use of the internet and self-stigma among people with substance use disorders

Ching-Wen Chang et al. Addict Behav. 2023 Dec.

. 2023 Dec:147:107807.

doi: 10.1016/j.addbeh.2023.107807. Epub 2023 Jul 22.

Authors

Ching-Wen Chang¹, Jung-Sheng Chen², Shih-Wei Huang³, Marc N Potenza⁴, Jian-An Su⁵, Kun-Chia Chang⁶, Amir H Pakpour⁷, Chung-Ying Lin⁸

Affiliations

¹ Graduate Institute of Social Work, National Taiwan Normal University, No. 162, Sec. 1, He-Ping East Rd., Daan Dist., Taipei 106209 Taiwan. Electronic address: cwchangswk@ntnu.edu.tw.
² Department of Medical Research, E-Da Hospital, I-Shou University, No.1, Yida Rd., Yanchao Dist., Kaohsiung 824005, Taiwan. Electronic address: nicky071214@gmail.com.
³ Institute of Environmental Toxin and Emerging Contaminant, Cheng Shiu University, Kaohsiung 83347, Taiwan; Center for Environmental Toxin and Emerging-contaminant Research, Cheng Shiu University, Kaohsiung 83347, Taiwan. Electronic address: envhero@gcloud.csu.edu.tw.
⁴ Department of Psychiatry, Yale School of Medicine, 1 Church Street, Room 726, New Haven, CT 06510, USA; Connecticut Mental Health Center, 34 Park St., New Haven, CT 06519, USA; Connecticut Council on Problem Gambling, 100 Great Meadow Rd., Suite 704, Wethersfield, CT 06109, USA; Child Study Center, Yale School of Medicine, 350 George St., New Haven, CT 06511, USA; Department of Neuroscience, Yale University, New Haven, CT, USA; Wu Tsai Institute, Yale University, 200 South Frontage Rd., SHM C-303, New Haven, CT 06510, USA. Electronic address: marc.potenza@yale.eduj.
⁵ Department of Psychiatry, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan; School of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Nursing, Chang Gung Institute of Technology, Taoyuan, Taiwan. Electronic address: jian.7715@gmail.com.
⁶ Department of General Psychiatry, Jianan Psychiatric Center, Ministry of Health and Welfare, No. 539, Yuzhong Rd., Rende Dist., Tainan 717204, Taiwan; Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No. 1., University Rd., East Dist., Tainan 701401, Taiwan. Electronic address: kunchiachang0517@gmail.com.
⁷ Department of Nursing, School of Health and Welfare, Jönköping University, Sweden. Electronic address: Amir.Pakpour@ju.se.
⁸ Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, No. 1., University Rd., East Dist., Tainan 701401, Taiwan; Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No. 1., University Rd., East Dist., Tainan 701401, Taiwan; Department of Public Health, College of Medicine, National Cheng Kung University, No. 1., University Rd., East Dist., Tainan 701401, Taiwan; Department of Occupational Therapy, College of Medicine, National Cheng Kung University, No. 1., University Rd., East Dist., Tainan 701401, Taiwan. Electronic address: cylin36933@gmail.com.

PMID: 37542974
DOI: 10.1016/j.addbeh.2023.107807

Abstract

Background and aims: Guided by the Interaction of Person-Affect-Cognition-Execution (I-PACE) model and a self-stigma framework, this study aimed to investigate relationships between cognitive and affective self-stigma and behavioral self-stigma, problematic use of internet (PUI), and problematic smartphone use (PSU) among people with substance use disorders (SUDs). It also examined mediating roles for affective self-stigma in the relationships between cognitive self-stigma and behavioral self-stigma/PUI/PSU.

Methods: Using a cross-sectional design, 530 participants diagnosed with SUDs in Taiwan were recruited from a psychiatric center in Taiwan. Mediation models were investigated using the Hayes' Process Macro Model 4.

Results: Mediation analyses indicated that cognitive self-stigma was directly associated with behavioral self-stigma (p < 0.001), but not with either types of PUI or PSU (p-values ranging from 0.41 to 0.76). Affective self-stigma was directly related to behavioral self-stigma (p < 0.001), two types of PUI, and PSU (β = 0.24-0.30; all p < 0.001); cognitive self-stigma was indirectly associated with behavioral self-stigma (β = 0.53; 95 % bootstrapping CI = 0.46, 0.60), two types of PUI, and PSU (β = 0.20-0.25; 95 % bootstrapping CI = 0.08-0.14, 0.31-0.37) via a mediating effect of affective self-stigma.

Discussion and conclusion: Findings support the I-PACE model in a self-stigma context. The findings also suggest that addressing affective self-stigma may help prevent or reduce behavioral self-stigma, PUI, and PSU among people with SUDs. Longitudinal studies are warranted to investigate over time relationships between self-stigma and PUI/PSU in people with SUDs.

Keywords: Addictive behaviors; Internet addiction; Smartphone; Social media; Stigma; Substance use; Videogaming.

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Conflict of interest statement

Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: We declare that we have no known competing financial interests or personal relationships relating to the publication of this manuscript. Dr. Potenza has consulted for and advised Opiant Pharmaceuticals, Idorsia Pharmaceuticals, AXA, Game Day Data and the Addiction Policy Forum; has been involved in a patent application with Yale University and Novartis; has received research support from the Mohegan Sun Casino, Connecticut Council on Problem Gambling and National Center for Responsible Gaming; has participated in surveys, mailings or telephone consultations related to drug addiction, impulse control disorders or other health topics; has contributed to a patent application for gambling and gaming disorder treatment; and has consulted for law offices and gambling entities on issues related to impulse control or addictive disorders.

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Problematic smartphone use and two types of problematic use of the internet and self-stigma among people with substance use disorders

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Problematic smartphone use and two types of problematic use of the internet and self-stigma among people with substance use disorders

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