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      Is the I-PACE (Interaction of Person-Affect-Cognition-Execution) model valid in South Korea? The effects of adverse childhood experiences (ACEs) on internet gaming disorder and the mediating effect of stress on adolescents

      research-article
      1 , 3 , 1 , 2 , 3 , 4 , 5 , 4 , 6 , 7 , * ,
      Journal of Behavioral Addictions
      Akadémiai Kiadó
      adverse childhood experiences, internet gaming disorder, youth, mediation, stress

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          Abstract

          Background and aims

          The purpose of the present study was to investigate the effects of adverse childhood experiences (ACEs) on internet gaming disorder (IGD) and the mediating effect of stress based on the Interaction of Person-Affect-Cognition-Execution (I-PACE) model.

          Methods

          The 2017 survey data from one community addiction management center in South Korea were analyzed. A sample of 3,593 adolescents (mean age = 13.75 years, SD = 2.22) were recruited from 23 elementary, middle and high schools and 11 local children’s centers. The mediating effect was analyzed by the three-step analysis method.

          Results

          Our study found that ACEs had a significant effect on the stress score ( B = 1.420, P < 0.001) and the stress scale score had a significant effect the IGD score ( B = 0.127, P < 0.001). After adjusting for the stress score in the model, ACEs had a significant effect on the IGD score ( B = 0.328, P < 0.001), and the stress score had partial mediating effects ( B = 0.1802, 95% C. I: 0.131–0.239).

          Discussion

          We found that ACEs directly affect IGD and that ACEs directly affect IGD through stress in support of the I-PACE model. In the sensitivity analysis, the mediating effect of stress in the low-risk IGD group was significant, but the mediating effect of stress in the high-risk IGD group was not significant. Prior ACEs should be considered when interviewing IGD clients. In addition, enhancing stress management skills would be beneficial to IGD clients with a history of ACEs, and actions reducing exposure to ACEs in childhood are necessary.

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          Most cited references65

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          Reconsidering Baron and Kenny: Myths and Truths about Mediation Analysis

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            Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study.

            The relationship of health risk behavior and disease in adulthood to the breadth of exposure to childhood emotional, physical, or sexual abuse, and household dysfunction during childhood has not previously been described. A questionnaire about adverse childhood experiences was mailed to 13,494 adults who had completed a standardized medical evaluation at a large HMO; 9,508 (70.5%) responded. Seven categories of adverse childhood experiences were studied: psychological, physical, or sexual abuse; violence against mother; or living with household members who were substance abusers, mentally ill or suicidal, or ever imprisoned. The number of categories of these adverse childhood experiences was then compared to measures of adult risk behavior, health status, and disease. Logistic regression was used to adjust for effects of demographic factors on the association between the cumulative number of categories of childhood exposures (range: 0-7) and risk factors for the leading causes of death in adult life. More than half of respondents reported at least one, and one-fourth reported > or = 2 categories of childhood exposures. We found a graded relationship between the number of categories of childhood exposure and each of the adult health risk behaviors and diseases that were studied (P or = 50 sexual intercourse partners, and sexually transmitted disease; and 1.4- to 1.6-fold increase in physical inactivity and severe obesity. The number of categories of adverse childhood exposures showed a graded relationship to the presence of adult diseases including ischemic heart disease, cancer, chronic lung disease, skeletal fractures, and liver disease. The seven categories of adverse childhood experiences were strongly interrelated and persons with multiple categories of childhood exposure were likely to have multiple health risk factors later in life. We found a strong graded relationship between the breadth of exposure to abuse or household dysfunction during childhood and multiple risk factors for several of the leading causes of death in adults.
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              The lifelong effects of early childhood adversity and toxic stress.

              Advances in fields of inquiry as diverse as neuroscience, molecular biology, genomics, developmental psychology, epidemiology, sociology, and economics are catalyzing an important paradigm shift in our understanding of health and disease across the lifespan. This converging, multidisciplinary science of human development has profound implications for our ability to enhance the life prospects of children and to strengthen the social and economic fabric of society. Drawing on these multiple streams of investigation, this report presents an ecobiodevelopmental framework that illustrates how early experiences and environmental influences can leave a lasting signature on the genetic predispositions that affect emerging brain architecture and long-term health. The report also examines extensive evidence of the disruptive impacts of toxic stress, offering intriguing insights into causal mechanisms that link early adversity to later impairments in learning, behavior, and both physical and mental well-being. The implications of this framework for the practice of medicine, in general, and pediatrics, specifically, are potentially transformational. They suggest that many adult diseases should be viewed as developmental disorders that begin early in life and that persistent health disparities associated with poverty, discrimination, or maltreatment could be reduced by the alleviation of toxic stress in childhood. An ecobiodevelopmental framework also underscores the need for new thinking about the focus and boundaries of pediatric practice. It calls for pediatricians to serve as both front-line guardians of healthy child development and strategically positioned, community leaders to inform new science-based strategies that build strong foundations for educational achievement, economic productivity, responsible citizenship, and lifelong health.
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                Author and article information

                Contributors
                Journal
                J Behav Addict
                J Behav Addict
                JBA
                Journal of Behavioral Addictions
                Akadémiai Kiadó (Budapest )
                2062-5871
                2063-5303
                16 December 2021
                December 2021
                December 2021
                : 10
                : 4
                : 967-982
                Affiliations
                [1 ] Graduate School of Social Welfare, Yonsei University , Seoul, Korea
                [2 ] T.H. Chan School of Public Health, Harvard University , Boston, USA
                [3 ] Suicide and School Mental Health Institute, Hallym University College of Medicine , Anyang, Korea
                [4 ] Center for School Mental Health, Eulji University , Seoul, Korea
                [5 ] Department of Social Welfare, Ewha Womans University , Seoul, Korea
                [6 ] Department of Psychiatry, Eulji University School of Medicine, Nowon Eulji University Hospital , Seoul, Korea
                [7 ] Nowon Community Addiction Management Center , Seoul, Korea
                Author notes
                [* ]Corresponding author. E-mail: bsy1@ 123456euji.ac.kr
                Author information
                https://orcid.org/0000-0002-9436-3392
                https://orcid.org/0000-0003-0617-3917
                https://orcid.org/0000-0003-2918-0546
                https://orcid.org/0000-0003-2621-0973
                https://orcid.org/0000-0001-5254-0314
                Article
                10.1556/2006.2021.00081
                8987428
                34935634
                86e65a72-694e-46d8-9b84-f36475b83ade
                © 2021 The Author(s)

                Open Access. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( https://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and reproduction in any medium for non-commercial purposes, provided the original author and source are credited, a link to the CC License is provided, and changes – if any – are indicated.

                History
                : 10 April 2021
                : 26 October 2021
                : 28 October 2021
                Page count
                Figures: 4, Tables: 6, Equations: 0, References: 49, Pages: 16
                Categories
                Article

                adverse childhood experiences,internet gaming disorder,youth,mediation,stress

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