How to Know if You Are a Diathesis or Differential Suseptability

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Diathesis stress or differential susceptibility? testing the relationship between stressful life events, neuroticism, and internet gaming disorder among Chinese adolescents

• Hao Li,
• Xiong Gan,
• Xin Li,
• Ting Zhou,
• Xin Jin,
• Congshu Zhu

10

• Published: January 27, 2022
• https://doi.org/10.1371/journal.pone.0263079

Figures

Abstract

A previous study has documented that stressful life events is positively related to Net gaming disorder (IGD) among adolescents. However, the mechanism underlying this human relationship remains unclear. The electric current study examined whether the link between stressful life events and boyish IGD was moderated past neuroticism and whether the interaction of stressful life events and neuroticism supported the diathesis stress model or differential susceptibility model. To this end, self-written report questionnaires were distributed. Participants were 927 Chinese adolescents (mean_age = 14.53 years, 51.02% male). After controlling for adolescent gender, age, family economic situation, and family socioeconomic condition, the results revealed that stressful life events could be positively associated with adolescent IGD and that this link is chastened past neuroticism. Moreover, the results of interaction effects supported the "diathesis stress" model. The in a higher place findings contributed to a improve understanding of how and when stressful life events increase the risk of IGD and provided new evidence for the diathesis stress hypothesis.

Citation: Li H, Gan 10, Li 10, Zhou T, Jin X, Zhu C (2022) Diathesis stress or differential susceptibility? testing the relationship between stressful life events, neuroticism, and internet gaming disorder amid Chinese adolescents. PLoS ONE 17(ane): e0263079. https://doi.org/x.1371/journal.pone.0263079

Editor: Sarah Whittle, The University of Melbourne, AUSTRALIA

Received: August 12, 2021; Accepted: January 11, 2022; Published: January 27, 2022

Copyright: © 2022 Li et al. This is an open admission article distributed nether the terms of the Creative Eatables Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: The data underlying this paper's findings can be found at (https://github.com/leoha0/data.git).

Funding: Youth project of Natural Science Foundation of Hubei Province in 2020 (2020CFB365). XG Achievements of central projects of educational activity science plan of Hubei Province in 2019 (2019GA017). XG.

Competing interests: The authors have declared that no competing interests exist.

one. Introduction

As of June 2021, the number of Internet users in China has reached 1 billion, while the number of online game users has reached 510 million, including more than than 100 1000000 young users [1]. Cyberspace gaming disorder (IGD) is divers as a persistent and recurrent engagement in Cyberspace gaming which results in distress [2]. As IGD has go a global public health issue, information technology has been included in the updated version of the Diagnostic and Statistical Manual Disorders (DSM-v) and the International Nomenclature of Diseases (ICD-11) and is thus alluring enormous attention from researchers [3, four]. Due to the differences in measurement tools, the rates of possible IGD among adolescents in China ranged betwixt 2% and 17% [five, 6]. IGD has serious adverse furnishings on youth and adolescents because it non but leads to a variety of externalizing issues (east.g., academic dysfunction, poor sleep quality, substance use) but too causes internalizing problems (e.one thousand., feet, depression) among adolescents [7, 8]. Therefore, it is urgent to examine adventure factors and mechanisms that contribute to the development of IGD to provide a scientific basis for its intervention practice.

Among the many factors associated with IGD, stressful life events have attracted much attending of researchers [nine, 10]. Based on the general strain theory, a diverseness of strain or stress experienced by adolescents might crusade negative emotions, which afterward cause problem behaviors such every bit Internet habit [xi]. Theorists have also proposed that IGD is a behavioral response to pre-existing stressful life events such every bit family conflict, academic underachievement, and peer rejection [11, 12]. Specifically, stressful life events can cause a variety of psychological strains and negative emotions in an individual, and Internet gaming can go a psychological escape that distracts a user from a real-life problem or allows them to vent negative emotions [11]. Previous studies have demonstrated that excessive online gaming may be a coping strategy for life issues [13]. And some other report besides discovered a positive human relationship betwixt stressful life events and problematic Internet use [14]. Consequently, the present study investigates the relationship between stressful life events and adolescent IGD and puts forward the hypothesis that stressful life events can positively correlate with adolescent IGD.

one.1. The moderation effect of neuroticism: "Diathesis stress model" or "differential susceptibility"

Neuroticism is an emotion-related personality trait that reflects differences in individual emotional stability [fifteen]. The results of several studies indicate that the response of the depression neurotic population to stress is mild and dull, while the loftier neurotic population has the characteristics of being emotional, impulsive, dependent, and poor self-feeling [xvi, 17]. The theory of addictions highlights personality vulnerabilities that interact with stress in the development of addiction [eighteen], and neuroticism can moderate perception of stress and its consequences [19]. Previous studies likewise investigated that high neuroticism was positively associated with high boyish problematic gaming behavior [20] and neuroticism is a potential predictor of Internet gaming disorder [21, 22]. Thus, the interaction between neuroticism and stressful life events could be crucial in the evolution of IGD among adolescents.

Two theories that accept attracted much attention can be used to explicate the interaction between personality (neuroticism) and the environment (stressful life events). The Diathesis-Stress Model assumes that there is an interaction between stressors and personality traits, such that personality vulnerability increases the likelihood of psychopathology only when combined with the experience of significant stressors [23]. In other words, due to their own "vulnerability" factors (such every bit temperament, physiology, or genes), certain individuals are more vulnerable to the adverse affect of stressful life events and show negative development results (eastward.thou., Cyberspace gaming disorder) (see Fig ane). But on the other hand, the diathesis-stress framework implies that there is no difference in the performance of different individuals who are vulnerable or resilient in a positive environment [24]. The Differential Susceptibility Model believes that personal development is plastic rather than fragile. An private'southward "vulnerability gene" should be regarded equally a "plasticity factor" of evolution, which makes some individuals more malleable or susceptible than others to both negative and positive environmental influences [25]. That is to say, the surround affects the development of highly plastic individuals in a better or worse manner (see Fig 2).

Which model does the interaction between neuroticism and stressful life events nigh consistently friction match with? The results of previous studies are not consistent. Wang and his colleagues found that in a negative environment, individuals with loftier neuroticism are more than probable to show anxiety symptoms when they encounter stressful life events [17]. The results support the diathesis-stress model. However, in subsequent research, Rioux revealed that individuals with certain genetic traits are not just susceptible to positive situations and can adapt well to the environment, just also more vulnerable to negative situations and suffer from maladaptive behaviors. The results improve support the differential susceptibility model [26]. It is withal debatable whether adolescent neuroticism should exist regarded equally "vulnerability" or "plasticity".

ane.2. The present written report

In summary, the current study aimed to examine how stressful life events was associated with boyish IGD, tested the moderator role of neuroticism, and provided valuable information for early prevention and intervention of boyish IGD, all within the framework of general strain theory and addiction theory [11, eighteen]. And so, we investigated whether the interaction of stressful life events and neuroticism supported the diathesis-stress model or the differential susceptibility model, based on the discrepancy of prior written report results [17, 26]. Different moderation models take different practical implications, so information technology is very disquisitional to verify which moderation model the in a higher place relationship belongs to.

two. Methods

2.1. Participants and procedures

The present report was approved by the Institutional Review Board of Yangtze University. The data was collected from three public middle schools in Jingzhou (a city in central China) by the user-friendly sampling method. Afterwards obtaining informed consent from the participants and their parents or legal guardians involved, the research was conducted in participants' classrooms past trained senior students majoring in psychology during class time. All participants were told that their answers would be protected and that they were free to withdraw from the study at any time. In this study, a total of 1400 questionnaires were distributed, and 1249 were recovered, of which 927 were valid, and the effective recovery charge per unit was 66.21%. There were 473 boys and 454 girls, with an average age of 14.53 ± 1.86 years (range = 11–20).

2.ii. Measures

2.2.1. Net gaming disorder.

IGD was assessed by the Chinese version [27] of Pathological Video-Game Use Questionnaire [28]. Participants answered xi items on a 3-point calibration (0 = never, ane = sometimes, 2 = aye). Example items included ''Have you lot tried to play online games less often or for shorter periods, but are unsuccessful?" Then the answers were recoded (0 = never, 0.5 = sometimes, 1 = frequently), and the total score was calculated for each participant. A higher mean score indicated a stronger tendency of IGD, and the cut-off score for identifying adolescents with IGD was five or more [29]. This measure had demonstrated good reliability and validity in Chinese adolescents [30, 31]. Cronbach'southward alpha for this scale in the present study was 0.75.

2.2.2. Neuroticism.

The written report selected the Chinese version of the Big Five personality revised by Costa and McCrae [32]. A sample detail was"Sometimes I feel angry and resentful." Adolescents were asked to answer 12 items on a 5-point scale ranging from ane (strongly disagree) to 5 (strongly agree). Hateful scores for each dimension were calculated, with college scores indicating higher levels of neuroticism. This measure has demonstrated good reliability and validity among Chinese adolescents [33]. Cronbach's alpha for this calibration in the present study was 0.83.

2.ii.iii. Stressful life events.

Stressful life events were measured using the Adolescent Cocky-Rating Life Events Cheque List (ASLEC) by Liu et al. [34]. The questionnaire consisted of 27 items and measured life stress from four sources, including physical affliction (eastward.g., personal serious illness or injury), family unit (eastward.g., expiry of relatives), schoolhouse (east.thousand., examination pressure), and interpersonal relations (e.g., break-upwardly with close friends). Respondents were asked to rate whether each event had occurred in the past half yr on a calibration of 0 to 5 (0 = did non occur; 5 = occurred and was extremely stressful). The total score was calculated for each participant, with higher scores indicating more life events the subject experienced. This measure has demonstrated good reliability and validity amid Chinese adolescents [35, 36]. Cronbach'southward alpha for this scale in the present study was 0.93.

2.iii. Statistical analysis

All the statistical analyses were conducted with Mplus. First, hierarchical regression is used to test the interaction betwixt stressful life events and neuroticism on the IGD for adolescents, and so to further probe the interactions to decide whether they are more consequent with diathesis-stress or differential susceptibility models. Traditionally, researchers have detected the influence of independent variables on dependent variables at dissimilar levels of moderator variables by conducting a elementary slopes analysis. Only information technology only focuses on teenagers with plus or minus one standard difference and estimates the differences in behavior or psychological development between a loftier neurotic grouping (M+1SD) and a low neurotic group (M-1SD) of adolescents in different environments. The present study examines specific models of significant interactions using the Assay of Region of Significance [37], which examines all the values of moderator variables when independent variables are significantly associated with dependent variables.

When using the RoS method to test the diathesis-stress model and differential susceptibility model, the following iv conditions should be met [37]: (1) Determine regions of significance on the independent (X) variable (RoS on X). Specifically, to identify the value range of X for which adolescents with different levels of neuroticism (Z) and outcome variables (Y) are significantly related. If RoS on X is significant at the low and loftier ends of the distribution of the contained variable within the normative range (i.e., ±2SD), at that place is testify that the data support the differential susceptibility model. If RoS on X is significant at the low merely not the loftier stop of X, there is evidence that the information back up the diathesis-stress model. (two) The specific measurement indexes of this method are Proportion of Interaction (PoI) and Proportion Affect (PA). PoI means the proportion that meets the difference susceptibility in the area of interaction. PoI values shut to 0.l suggest strong evidence for differential susceptibility. Values closer to 0.00 suggest potent evidence for diathesis-stress. PA is the ratio corresponding to the X value greater than the intersection of the two regression lines. Typically, the PA index will range from effectually 0.50 (indicating strong evidence for differential susceptibility) to 0.00 (in the clear example of diathesis-stress), and when PA≥xvi%, the interaction is consistent with the differential susceptibility model, and when PA≤2%, the differential susceptibility model can be rejected. (3) To test the nonlinear human relationship between variables. The nonlinear relationship between X and Y may be mistaken for a differential susceptibility model, so it would be necessary to judge differential susceptibility while demonstrating the absenteeism of nonlinear terms X² and ZX². (four) When testing the effects of multiple interactions at the aforementioned time, there may be a loftier run a risk of Blazon I errors. Roisman et al. roposed giving priority to the sequential Bonferroni examination for multiple corrections to the p-value [37].

three. Results

3.ane. Preliminary analyses

Offset, the common method divergence test is carried out by Harman's single factor examination method, and the results are KMO = 0.87, Bartlett value = 27308.45, p < 0.001, indicating that the data tin can be factored assay. Unrotated principal component factor assay constitute that in that location are 25 mutual factors with a characteristic root greater than i, and the estimation rate of the beginning factor is 13.05%, so there is no common method deviation.

Ways, standard deviations, and bivariate associations are shown in Table 1. As tin be seen in the table, stressful life events were positively correlated with neuroticism and IGD (r = 0.41 and 0.36, ps < 0.01). Neuroticism was positively associated with IGD (r = 0.27, p < 0.01). Historic period was positively associated with stressful life events, neuroticism, and IGD (r = 0.13–0.17, ps < 0.01). Family economic situation was positively associated with neuroticism (r = 0.09, p < 0.01) and IGD (r = 0.07, p < 0.05).

3.2. Main analysis: Hierarchical multiple regression assay

A hierarchical multiple regression assay was conducted to evaluate the degree to which stressful life events and neuroticism affected IGD. In this analysis, the social demographic factors such as gender (boy = 1, girl = two), age, family unit economic situation, and family SES were first entered, followed by stressful life events and neuroticism, and lastly, stressful life events and neuroticism interactive items.

According to Table two, the master effects of stressful life events (β = 0.25, p < 0.001) and neuroticism (β = 0.18, p < 0.001) in predicting adolescent IGD were significant, and the interactions of stressful life events × neuroticism (β = 0.07, p < 0.05) were statistically pregnant.

3.3. Testing for model: Assay of Region of Significance (RoS)

The regression results showed that the interaction between stressful life events and neuroticism was significant in predicting adolescent IGD, and then the RoS method was employed to further appraise which theoretical model the interaction between neuroticism and stressful life events is consistent with. The results are shown in Tabular array iii and Fig 3. (1) The lower and upper premises of values for the pregnant region of stressful life events were -xv.29 and -0.88, respectively, indicating that when the value of stressful life events exceeded -0.88, the level of IGD in high neurotic adolescents was significantly higher than that in low neurotic adolescents. However, when the value of stressful life events was lower than -fifteen.29, the level of IGD in high neurotic adolescents was significantly lower than that in low neurotic adolescents. Obviously, in this report, only the upper boundary of this meaning interval was within the value range of M±2SD for stressful life events. (2) The PoI indicator refers to the proportion consequent with the differential susceptibility model in the surface area of interaction, which is calculated as b/(b+due west). The b refers to the proportion of good results under positive environmental conditions, and Due west refers to the proportion of problematic behaviors under negative environmental conditions. In the present study, a low score of environmental variables represents a positive surroundings, while a high score represents a negative environment, which is contrary to the description of environmental variables by Roisman et al. [37]. Therefore, although the PoI' index in this study is 1, information technology indicates that the proportion of skilful interaction effects in all interaction effects is 0. Similarly, the PA' index represents the proportion of the area to the right of the intersection of the ii regression lines. The PA' value is 0.98, which in turn indicates that the percentage of subjects affected past adept interaction effects is only 1.7%, so after clarifying the concept, the index was corrected again, and PoI = 0, PA = 0.02. Therefore, according to the indicators (1) and (ii), the interaction between stressful life events and neuroticism on IGD conforms to the diathesis-stress model. The following tests in (3) and (4) are of footling significance to this report, because (3) is a test for the differential susceptibility model, and the multiple interactions mentioned in (4) do not conform to the model of this study.

4. Discussion

Based on general strain theory [xi] and addiction theory [18], the electric current study examined the interaction effects of neuroticism and stressful life events on adolescent IGD. The results indicated that stressful life events was positively correlated with adolescent IGD, and the relationship betwixt stressful life events and IGD was moderated by neuroticism. Furthermore, the interaction between stressful life events and neuroticism on IGD conformed to the diathesis-stress model. These observations expand our understanding of the circuitous relations between stressful life events and IGD amidst teenagers in Communist china, and provide reference suggestions for the prevention and intervention of IGD in adolescents.

4.i. Stressful life events and adolescent cyberspace gaming disorder

The nowadays study examined the human relationship between stressful life events and adolescent IGD. Prior studies have found that stressful life events could exist positively associated with Cyberspace addiction in adolescents [38]. The electric current study adds to this line of literature and reveals that stressful life events is also related to specific Cyberspace habit such as IGD. Our results show that stressful life events tin exist positively associated with adolescent IGD, which is in line with the previous inquiry results [nine]. According to the full general strain theory, a variety of strains or stress experienced past adolescents might cause negative emotions, which later cause problem behaviors such as IGD [11]. Specifically, stressful life events often crusade diverseness of psychological strains and negative emotions on an private while too reawakening the desire to obtain something. And the lack of reality can often be compensated in online games, resulting in online game addiction [39]. The theory of compensatory Net use as well reveals that escapism through videogames may constitute a coping strategy that is sometimes helpful [40]. Through experiments [41], researchers evidence that the escapism motive is related to a preference for the virtual environment through experiments. The escapism motive could correspond a dysfunctional coping strategy linked to an intense need to avert or fifty-fifty dissociate from painful mental states related to current or past difficulties [42]. Thus, the more stressful life events adolescents experience, the more likely they are to lead to IGD.

four.2. The moderation effect of neuroticism

The present study examines neuroticism as a potential moderator betwixt stressful life events and IGD among adolescents. The results suggest that neuroticism buffers the associations between stress life events and IGD. Specifically, adolescents with loftier neuroticism are more than probable to develop IGD nether the negative touch on of higher stress life events. However, there was no significant departure in IGD levels between high and low neuroticism adolescents during low stressful life events. These results back up the diathesis-stress model and are consistent with previous enquiry [17].

It is easy to induce the problem behavior of adolescents nether the double gamble factors of environment and individual diathesis. The diathesis-stress model unremarkably divides individuals into vulnerable individuals and resilient individuals, and the results of behavioral evolution depend on the diathesis differences in susceptibility. High neurotic individuals (vulnerable individuals) are more vulnerable to the negative impact of negative environmental and psychological behavioral problems, but in a positive environment, low neurotic individuals evidence the differences in psychological behavioral problems are ignored [43]. Diathesis susceptibility factors are normally hidden in consciousness, and individuals are not affected unless they are subjected to extreme stress. But once activated, they will make people's information processing deviate from the normal processing process. Meanwhile, the increment in harmful stimulus conditions tin can atomic number 82 victims to adopt evasive coping strategies (e.g., Net gaming) and maintain negative emotional experiences [44]. Therefore, there is no departure in IGD among individuals with unlike neuroticism levels when the stressful life events are low. Merely individuals with high neuroticism may evidence more IGD when stressful life events are high. And the decision provides a ground for explaining the important function in personality traits between the surround and adolescent IGD. In view of the above, educators should salvage teenagers from the pressure level in their family, campus, and society so as to weaken the human relationship between stressful life events and boyish IGD [ix]. Especially for individuals with loftier neuroticism, nosotros demand to pay more attention to avoid problem behaviors such every bit Net gaming disorder [20].

4.3. Limitations and time to come directions

The limitations of this study and future directions should be noted. First, this study used a cross-exclusive research design. Therefore, the causal relationships cannot be inferred. Hereafter longitudinal or experimental studies can further determine the direction of the effects. Second, the data was nerveless only through self-reported measures. Self-reports may exist subject to increased biases (e.thou., socially desirable responses) and inflated associations between antecedents and upshot variables [45]. Reports from multiple informants (e.one thousand., parents, teachers, and peers) should be considered in future research. Tertiary, due to the limitations of sample pick restrictions, the IGD score reported past the individual in this study is not high. By increasing the representativeness of the samples in the time to come, we can strengthen the external validity of the written report. Fourth, in statistical methods, some studies have begun to employ the emerging reparametric regression method to examination the specific mode of Yard×E interaction from the perspective of mathematical cognition [46]. This is also a frontier topic to verify the machinery of interaction betwixt an individual and their environment. Finally, with the rise of behavioral genetics, many studies take found that polymorphisms of the serotonin transporter factor are associated with neuroticism, and children conveying short-position genes are more sensitive to the environment, which is significantly associated with anxiety, depression, neuroticism, and other neurotic symptoms [47]. Therefore, the susceptibility of highly neurotic adolescents to the environment may have a certain genetic basis. In the future, we can explore the deeper causes of susceptibility in adolescents from the perspective of "gene-personality-environment".

4.4. Implications

In this study, analysis of region of significance was used to fully and comprehensively explore the relationship betwixt stressful life events, neuroticism, and adolescent IGD. Our findings suggest that stressful life events are associated with IGD. Thus, teachers and parents may forestall adolescent IGD and intervene in this behavior by reducing the force per unit area on adolescents. Moreover, our findings propose that the positive link between loftier stress life events and IGD is stronger for adolescents with high neuroticism than for those with depression neuroticism. Therefore, it is important to pay attention and relieve pressure level on adolescents, peculiarly those with high neuroticism.

five. Conclusion

Taken together, the current study reveals that stressful life events can be positively associated with adolescent IGD, and this direct effect is moderated past neuroticism. These findings support the diathesis-stress model, that is, adolescents with high neuroticism are more than likely to develop IGD nether the negative impact of higher stress life events. Nevertheless, there was no significant divergence in IGD levels between loftier and low neuroticism adolescents during depression stressful life events.

Supporting data

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Source: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0263079

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