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

Ching-Wen Chang; Jung-Sheng Chen; Shih-Wei Huang; Marc N Potenza; Jian-An Su; Kun-Chia Chang; Amir H Pakpour; Chung-Ying Lin

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

Addict Behav. 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.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Behavior, Addictive* / psychology
Cross-Sectional Studies
Humans
Internet
Smartphone
Substance-Related Disorders*