2026/07/07 by Akiho Nishimura, Genichi Sugihara, Sufang Tang +7
Medicine · Social Sciences · Psychology · #Attention Deficit Hyperactivity Disorder #Impact of Technology on Adolescents #Eating Disorders and Behaviors
paper · doi:10.1016/j.jpsychires.2026.07.003
INTRODUCTION: Problematic usage of the internet (PUI) and attention-deficit/hyperactivity disorder (ADHD) are highly comorbid and share common structural alterations in the prefrontal cortex (PFC). However, it remains unclear whether the attentional impairments seen in PUI are a pre-existing trait or a state-dependent consequence of the disorder. This study investigated whether attention-related symptoms mediate the relationship between PFC structures and PUI severity, independent of a formal ADHD diagnosis. METHODS: Ninety-one individuals with PUI, of whom 78 (85.7%) met criteria corresponding to gaming disorder or hazardous gaming, underwent structural MRI and completed clinical assessment scales related to PUI, gaming disorder, and current attention-related symptoms. We used moderated mediation analysis to test whether inattention and hyperfocus mediated the relationship between PFC thickness and PUI severity and whether an ADHD diagnosis moderated these pathways. RESULTS: We identified two distinct mediation pathways: 1) reduced thickness in several PFC regions, associated with greater PUI severity and mediated by higher inattention, and 2) increased thickness in the left caudal anterior cingulate cortex (cACC), associated with greater PUI severity and mediated by higher hyperfocus. A formal ADHD diagnosis did not moderate these pathways. CONCLUSION: In individuals with PUI, inattention and hyperfocus may mediate the relationship between PFC thickness and PUI severity, irrespective of a formal ADHD diagnosis. Further, distinct neurobiological subtypes of PUI may support the development of personalized, symptom-targeted interventions.