Background: With increasing accessibility to the virtual world, behavioral addiction is an emerging global concern among children and adolescents. Understanding attitudes and perceptions regarding behavioral addictions is critical to formulate appropriately tailored and meaningful interventions. This review aims to widen the scope of understanding behavioral addictions, by synthesizing findings from qualitative studies on perspectives, experiences, and key processes across the spectrum of behavioral addictions among children and adolescents. Methods: We conducted systematic search in PubMed and Google Scholar using keywords pertinent to qualitative research in behavioral addictions, adhering to enhancing transparency in reporting the synthesis of qualitative research guidelines. Eighteen studies were included after thorough screening of studies. We followed the analytical approach described by Petticrew and Roberts for thematic comparative synthesis. Results: There were five principal themes that articulate the experiential realities of children and adolescents in the context of behavioral addictions. They are (1) high-risk environment as a vulnerability: etiopathogenetic model for gambling, (2) attitudes toward behavioral addiction across the spectrum, (3) awareness, (4) perceived impact, and (5) perspectives and attitudes toward other's engagement in addictive behaviors. Conclusion: The findings have implications for public health policies such as promoting a supportive macrosystem while curtailing accessibility to activities and platforms of high addictive potentials. Future research in this area should include multiple stakeholder perspectives, perspectives of younger children and early adolescents, integration with quantitative findings, and studying the impact of particularly high-risk situations, such as the COVID-19 pandemic, to inform recommendations and policies, for comprehensive, multilevel, and multisystemic interventions.

Screen media use by children has been a subject of constant concern by parents, teachers, pediatricians, psychiatrists, and policymakers. The potential for its misuse often shadows media use in terms of its educational and communication opportunities. Adding to the concerns is that excessive screen media use is associated with poor physical and mental health. COVID-19 lockdowns, school closure, and online classes have increased media exposure to children. The prevailing risky situation has prompted global health agencies and professional societies to issue guidelines for safe media use. Parents in their day-to-day life grapple with the problem of knowing how much media is good are media addicting and how to regulate media use in their children. Whether working from home or on-site, working parents face more complex problems wherein their media use is known to shape the kids' screen media use. This viewpoint discussed the problem statement, and the possible solutions for the already overburdened parents juggling work demands, childcare, and screen media use in their children.

Technology and tech devices have revolutionized the world, made things very simple, fast, and quick, especially teaching and learning has been made accessible to all. It has been a blessing during the pandemic definitely as it has helped millions of children learn in the safety of their homes. However, it has also brought with it, numerous problems we are struggling to grapple with now. Tech-addiction is a major problem, in many children and adolescents, and it has been affecting their physical, emotional, and social well-being. This has been a major concern globally. The current article will focus on the role of schools in addressing Tech addiction and the way forward. Addressing tech addiction in schools from a primary and secondary prevention model will be very effective. The article also highlights the simple ways in which this can be done.

Behavioral addictions in the form of gaming addictions have been the rising addiction disorders in the recent years. The prevention of video game addiction is a must to curb the problem in its budding stage. The gaming industry has a vital role to play in the management of gaming addiction. The current viewpoint elucidates the role of the gaming industry in the prevention of video game addiction.

With the increase in Internet use across the world, there has also been an increase in the prevalence of problematic Internet use. There are various challenges in addressing the same – the addictive nature of Internet, lack of standard or uniform definition making its measurement or comparability across studies difficult, lack of national epidemiological studies that can help to direct resources based on the need, lack of awareness among the general public, challenges in restricting access of Internet to children and adolescents, and the commercial interests of gaming and gambling industries. The various initiatives to address problematic Internet use can be divided into supply reduction measures, demand reduction measures, and harm reduction measures, similar to that in the case of substance use disorders. Supply reduction measures focus on reduction in the availability or accessibility of Internet for children and adolescents. Harm reduction measures focus on regulating the age appropriateness of content of gaming or other Internet-related material provided to children, as well as restriction on the information that can be obtained from children. Demand reduction measures include promoting responsible use or healthy use of Internet as part of education for schoolchildren, and establishment of treatment centers for treatment of patients with problematic Internet use. India still has a long way to go in all these three arms of public health initiatives to curb the problem of Internet addiction.

Behavior addictions, including those to internet and smartphones, stem largely from underlying vulnerabilities. This article describes a framework that takes into consideration these vulnerabilities, the environmental conditions that contribute to addictions, the actual addiction and the secondary effects of addictions. In the author's view, this framework can be used to help come up with a comprehensive and individualized formulation when assessing behavior addictions in the young population thereby helping in tailored management. Some important underlying vulnerabilities include symptoms of attention deficit hyperactivity disorders, anxiety, depression, and trait impulsivity. The modifying effects of the environment on these vulnerabilities need to be understood comprehensively, especially those relating to parenting, schooling, and secondary effects of psychiatric problems in family members. The content of the actual addiction has to be properly understood as it can include a variety of different things such as gaming, social media, shopping, and gambling. Addiction processes including impulsive-compulsive phenomena, withdrawal, and craving have to be factored in the management plan. The secondary effects of addictions including the physical, psychiatric, and those related to exploitation of these children also need to be addressed systematically. The formulation and management plan therefore can possibly include a number of psychiatric disorders, temperamental traits, environmental conditions, and various secondary health aspects of the addiction. The goals of managing behavior addictions related to internet and smartphone usage are predominantly about harm reduction as our lives have become increasingly dependent on the benefits of this smart technology.

Background: Problematic use of the Internet and psychological stress are interrelated in many ways. The psychological stress originating from Internet usage can create an unfavorable impact on adolescents. These impacts vary from academic progress to competence, career goals, and nonacademic intellectual involvement, hindering skill development. Thus, there is a need to evaluate problematic Internet usage among adolescents. Aim and Objectives: This study was set up to examine Internet usage behaviors, problematic Internet use (PIU), and its association with psychological stress among adolescents from India. Materials and Methods: Six hundred and eighty-two adolescents aged between 15 and 18 years, studying at high school and senior secondary level from institutes primarily situated in South India, participated in the study. The patterns of Internet usage and sociodemographic data were collected through online and sociodemographic forms. Along with this, the Internet Addiction Test (IAT) was employed to assess PIU, and symptoms of psychological distress were evaluated with the Kessler Psychological Distress Scale (K10). Results: Among the total sample of 682 (N), 36.6% (N = 248) of adolescents met criterion on IAT for mild Internet addiction/PIU, 31.96% (N = 218) for moderate Internet addiction/PIU, and 2.93% (N = 20) for severe Internet addiction/PIU. PIU was higher among adolescents who accessed the Internet several times a day and had experienced psychological stress. In addition, stepwise regression analysis indicated that adolescents experiencing psychological stress were at higher risk for engaging in PIU, and stress also predicted engagement in PIU. Conclusions: PIU was present among a substantial proportion of adolescents, which might hinder their academic performance and progress over some time and can impact their psychological health adversely. These adolescents are likely to benefit from the early identification of PIU, which can facilitate the timely implementation of psychotherapeutic intervention strategies for PIU in school settings.

Technology enhances social communication and connectedness, people. However, it may predispose youth with socioemotional and psychological vulnerabilities, such as mental health disorders, to further behavioral and emotional dysregulation and adverse experiences such as cyber-bullying. We assessed digital technology use among adolescents requiring psychiatric inpatient care, i.e., with moderate-severe mental health morbidity. We found that over 95% of adolescents had regular digital technology use, via mobiles or tablets. The prevalence of problematic use was ~30% while technology addiction could be detected in close to 6%. A particularly concerning issue was the near-constant use of technology throughout the day, in almost 40% of adolescents, especially those with externalizing disorders, severely compromising time remaining for other developmentally appropriate engagements. Our findings suggest the need to incorporate assessment of digital technology use in the clinical evaluation of adolescents with mental illnesses. This would have critical implications for developmentally informed, life-skills-based interventions that are contemporaneous with the rapidly evolving digital-human interface in this population.

Behavioral addiction has been defined as a repeated behavior which is perceived as pleasurable and which persists over a significant period, is not reduced by the person, and leads to significant functional impairment. In the Diagnostic and Statistical Manual of Mental Disorders, 5^th Edition, the only condition that is currently included in the category for behavioral addiction is gambling disorder, while internet gaming disorder included in Appendix III as a potential addition to the category. However, recent research in the field of behavioral addiction has reported several other maladaptive behaviors, a significant one of them being maladaptive daydreaming (MD). Maladaptive daydreaming (MD) has been described as engagement in fanciful daydreaming for hours, leading to neglect of real-life relationships and responsibilities, resulting in clinical distress and functional impairment. This case series describes two cases of “MD” referred to the behavioral addiction clinic of the psychiatry outpatient department of a tertiary hospital in North India from a phenomenological perspective.

Aim: The study aims to identify significant personality predictors of selfie-taking behavior among college and school-going students. Methods: The sample size consists of 50 boys and 50 girls (n = 100) between the age range of 16–23 years from various schools and colleges of Delhi NCR. The tools used in the study were Cattell's 16 Personality Factors and Selfitis Behavior Scale. Results: The results of the study depicted a positive correlation of selfitis behavior with perfectionism and sensitivity. However, self-reliance, reasoning, and emotional stability showed a negative correlation with selfitis behavior. Furthermore, the results of the study showed that girls have more selfitis behavior as compared to boys and the college group have more selfitis behavior than that of the school group. ANOVA and linear regression were used to analyze data. Conclusion: Social media is the strongest tool of communication nowadays. “Selfies” are a growing social networking technique for self-disclosure. Use of social media is focusing on the physical aspect and allowing posting and amending pictures that are creating concerns about body image, poor self-esteem, loneliness, and depression among students. The overall results suggest that while selfies provide individuals with the potential of enhancing self-disclosure, they also demonstrate some risky and unhealthy behaviors. Therefore, predicting personality traits could be considered an effective variable to sensitize them before the deterioration of their mental health.

Background: Internet addiction (IA) has emerged as a potential problem in young people, which refers to excessive Internet use that interferes with their daily life as well as having significant health impacts. Objectives: The objective of this study was to ascertain the prevalence and the predictors of IA among general degree college students of Bankura municipal area. Materials and Methods: This analytical cross-sectional study was conducted from July 2019 to December 2019 at Bankura town among 216 undergraduate general degree college students who were regular Internet users (at least once in a week for the last 3 months). The study population was selected through simple random sampling method, and data were collected by a self-administered semi-structured questionnaire comprising Young's IA Test Scale, Patient Health Questionnaire-9 Depression Scale, Insomnia Severity Index, and Rosenberg's Self-Esteem Scale. To ascertain the predictor (s), variables which were found statistically significant in bivariate analysis, were considered for multivariate logistic regression. Results: The overall prevalence of IA among college students was 65%. Screen-related health impacts such as eyestrain, musculoskeletal problem, and insomnia were found significantly higher among Internet-addicted students. Multivariate logistic regression revealed that moderately and severely depressed college students are 6 times more prone to develop the IA, whereas it is 4 times higher in those who are in relationship. Conclusions: Although Internet technology is considered the most effective tool and one is compelled to use it for various purposes, every individual should be able to recognize the point where the Internet starts to overrule one's life and further hinders other activities of daily living.

Introduction: Nomophobia, i.e., No mobile phone phobia, is the irrational fear of being out of mobile phone contact. Mostly youth get very anxious on not being able to use their smartphone. Thus, identification of the extent of the problem in this population might be helpful. Aims: The aims of this study were to find the presence of nomophobia and its severity among the medical students, postgraduate residents, and faculty and to assess the association with certain demographic factors, mobile phone use-related factors, and nomophobia among them. Settings and Design: This observational, cross-sectional study was conducted in a medical college and tertiary care hospital. Materials and Methods: An online survey was conducted by using Google Forms and utilizing validated No Mo Nomophobia- Questionnaires. A self-reported questionnaire inclusive of demographic data, information regarding smartphone use, and factors of nomophobia was administered. A total of 446 people participated in this survey. SPSS version 20 of the institute was used. Levene's test for equality of variances, independent t-test for equality of means, and analysis of variance were used for statistical analysis. P < 0.05 was considered statistically significant. Results: The mean NMP-Q score was found to be 79.08. The mean age of the study participants was 22.83 years (±4.68). Majority (62%) of the participants reported moderate level of nomophobia. Factors such as female gender, MBBS students, single relationship status, and age <25 years were found to be significantly associated with higher levels of nomophobia. Participants with >50 applications in smartphone showed higher scores of nomophobia. Living arrangements, number of phones and SIM cards, and duration of cell phone use had no significant impact on nomophobia scores. Conclusion: A significant prevalence of nomophobia was noted among medical graduates, which highlights the need for early identification and intervention.

Background: As substances of abuse, inhalants are chemicals whose vapors can be intentionally inhaled to produce psychoactive effects. Serious mental health and substance use problems commonly co-occur with inhalant-use disorders (IUDs). Methods: It was a cross-sectional study. All patients attending the outpatient service and inpatient department of the de-addiction center of the institute-seeking treatment for inhalant use were approached for the study. Diagnosis of IUD was made as per the Diagnostic and Statistical Manual-5 criteria by the consultant psychiatrist. A semi-structured questionnaire was used to record the sociodemographic status. A phenomenology checklist was used to assess the phenomenology. Results: A total of 92 patients were included in our study. Nearly 98.9% of participants were males and 70.5% were of urban background. About 59.8% of participants were educated up to middle classes. The mean age of the study group was 18.38 years. Two-third of our study group were in the age group of 10–19 years. Adhesives were the most predominant inhalant used by 100% of cases. Bagging was the predominant mode of intake of inhalants (83.7%), followed by sniffing (16.3%). Feeling of relaxation (100%) followed by euphoria (73.9%) was the common hedonic experiences, whereas nausea was the most common aversive experience reported by 73.9% of cases. All patients reported high levels of craving. Conclusion: Our results showed that inhalant users were mostly urban male students who were using adhesives as the predominant inhalant. Bagging was the most common mode of intake of inhalants. Policymakers need to develop strategies regarding inhalant-use problem, especially in schools.

Background: The available research on alcohol-induced sexual dysfunction has mainly deliberated on erectile dysfunction and premature ejaculation. Other major domains of sexual dysfunctions (viz., sexual pleasure, sexual desire, arousal, orgasmic function, and intercourse satisfaction) were rarely taken into consideration. This study was undertaken with the aim to boost an interest and understanding in this area and to reduce the morbidity associated with alcohol-induced sexual dysfunction. Materials and Methodology: The study utilized a cross-sectional descriptive design and recruited 78 male patients admitted for de-addiction. The assessment was conducted using a specially designed intake pro forma and psychometrically strong and validated tools such as Changes in Sexual Functioning Questionnaire-Male Clinical version (CSFQ-MC), International Index of Erectile Function scale, Diagnostic and Statistical Manual of Mental Disorders -5, and International Classification of Disease, 10^th revision, diagnostic criteria for research. Results: The various domains of sexual dysfunction as per CSFQ revealed decreased sexual pleasure (71.8%) as the most common sexual dysfunction followed by low sexual desire (in terms of frequency) in 61.5%. Sexual desire (in terms of interest) was low in 55.1%. Sexual arousal/excitement was low in 59%. Sexual orgasm/completion scores were low in 48.7% alcohol-dependent male patients. Erectile dysfunction was found in 43.6% of alcohol-dependent male patients. Conclusion: The most common sexual dysfunction reported in the current study was decreased sexual pleasure (71.8%) followed by low sexual desire 61.5% (in terms of frequency). These findings emphasize the fact, that alcohol significantly compromises almost all domains of sexual functioning in addition to erectile dysfunction. Further, this information can be used in motivational counseling of heavy drinkers (especially adolescents and young adults) to provide motivation for change.

Context: Alcohol use disorder (AUD) in men has a profound impact on the mental health of wives of persons with alcohol use disorder (WoPA). Quality of their marital life is an overlooked aspect which affects both the mental health of the partners and their children. Resilience in WoPA acts as a protective element in maintaining their marital quality and, in turn, their mental health. Aims: The aim of this study was to assess the resilience in the WoPA and to find its association with marital quality. Subjects and Methods: Data was collected through an interview using a sociodemographic questionnaire and standardized tools and from current case records. The resilience of WoPA was assessed using the Connor-Davidson Resilience Scale. The Marital Quality Scale was used to assess their marital quality. The severity of alcohol consumption of patients with AUD was evaluated using the Severity of Alcohol Dependence Questionnaire. The differences between the scores were analyzed using ANOVA or Student t-test, whichever was applicable. Results: The mean score of resilience was 50.98 (26–77), and 52% of the wives reported their marital quality as severely affected. Low resilience was found to be associated with poor marital quality. Resilience was found to be poor in wives who experienced physical abuse from their husbands. Conclusions: The resilience of WoPA has a significant association with their marital quality. Hence, improving the resilience of WoPA would improve their marital quality, which, in turn, would positively impact the treatment of their husbands' alcohol use and their children's mental health.

Context: The Fagerstrom test for nicotine dependence (FTND) is a self-administered ordinal measure of nicotine dependence containing six items that evaluate the quantity of tobacco smoking, the compulsion to use, and dependence. Aims: To date, no Bengali version of the questionnaire is available. We aimed to develop its Bengali version and examine its cross-cultural adaptability considering linguistic equivalence. Settings and Design: A cross-sectional study was conducted through consecutive sampling at the outpatients of the National Institute of Homoeopathy, Kolkata. Subjects and Methods: The FTND-Bengali version (FTND-B) was produced by standardized forward-backward translations. The psychometric analysis was run to examine its factor structure, validity, and reliability. Reliability was examined using internal consistency (n = 263). Construct validity was examined by exploratory factor analysis (n = 132) using principal component analysis (varimax rotation). Subsequently, confirmatory factor analysis (CFA; n = 131) was performed to verify the model fit. Results: The internal consistency was acceptable (Cronbach's α = 0.701; 95% confidence interval [CI] 0.641–0.753). The Kaiser–Meyer-Olkin (=0.712) and Bartlett's test of sphericity (Chi-square 109.593, P < 0.001) both suggested adequacy of the sample. In factor analysis using varimax, all the items loaded above the pre-specified value of 0.3 and identified two components – “restraint” (question no. 1, 2, and 6) and “compulsion” (question no. 3, 4, and 5); explaining 56.1% of the variation. The goodness-of-fit in the CFA model was mediocre, but acceptable (Comparative Fit Index = 0.871, Tucker Lewis Index = 0.759, Root Mean Square Error of Approximation = 0.142, Standardized Root Mean Square Residual = 0.026). Conclusions: FTND-B, consisting of 6 items and framed within two components, appeared to be a valid and reliable questionnaire.

Background: Despite the magnitude and impact of co-occurring physical and substance use disorders (SUDs) and evidence of effectiveness of integrated care, the training for management of comorbidities has been neglected. Our objective was to examine the effectiveness of 1-day continuing medical education (CME) in this area on participants' perceived and objective knowledge and skills. Materials and Methods: It was a cross-sectional study of CMEs conducted in a tertiary care center with a pre-post assessment design. Assessment included rating perceived knowledge and skill on a five-point scale and objective multiple-choice questions. Subjective feedback on qualitative aspects of the CME was taken. Out of total 154 participants, 69 completed pre-post assignments that included interactive lectures through multimodal presentations and problem-based learning. Pre-post comparisons were done by paired t-test and Wilcoxon signed-rank test. Results: Pre-CME assessment showed low mean scores (4.04 [1.75]) in objective (assessment to be added) and limited perceived knowledge and ability. However, objective knowledge assessment showed a significant improvement (P < 0.001) after the CME. Perceived knowledge and skills showed a significant positive (P < 0.001, all comparisons) change in all the four (CME-1) and seven (CME-2) domains assessed. CME was perceived to be excellent in terms of the practical value of material (60.3%), able to meet its stated objectives (60.3%), quality of instructions (58.8%), and organization of material (60.3%). Conclusion: CME is a viable option for training of psychiatrists to address the unmet need for treating co-occurring physical and SUDs. Future studies with experimental designs should determine the effectiveness of the components of CMEs.

There has been increased interest in media and the World Health Organization advisory regarding digital gaming. We did a Google Trend study using relative search volumes (RSVs) for the keywords identifying with different themes related to digital gaming. It was seen that there was a significant increase in RSVs in the Indian population for the keywords identifying with online gaming, reward-seeking, and genres or types of games. Although online gaming is an easy way to engage during the lockdown, the risks due to excessive engagement cannot be ignored. We recommend balanced and effective approaches for gaming during lockdown for physical and psychological well-being.