Abstract
BACKGROUND AND AIMS: Situational triggers such as acute stress may exert significant effects on behavioral execution in addictive behaviors potentially leading to increased cue-reactivity and the expression of implicit cognitions. We measured the effects of acute stress on cue-reactivity, attentional bias and implicit associations to stimuli related to online social networks (SN) in problematic social network use (p-SNU) among women. DESIGN, SETTING AND PARTICIPANTS: This was a mixed-method, cross-sectional, between-subjects design with 135 female participants recruited in Germany who were assigned to the group with p-SNU (n = 71) or the control group (n = 64) based on a diagnostic interview using DSM-5 criteria for gaming disorder (applied to p-SNU). Participants were randomly exposed to acute stress using the Trier Social Stress Test (TSST) or a placebo-TSST. MEASUREMENTS: Participants performed a Cue-Reactivity Paradigm, Implicit Association Test and the Dot Probe Paradigm with SN-related stimuli. FINDINGS: Acute stress led to increased subjective urge to use social networks in both groups [TSST: mean (M) = 2.26, standard deviation (SD) = 0.92, placebo-TSST: M = 2.08, SD = 0.96, F(1,131) = 6.820, P = 0.01, ηp(2) = 0.029]. In the placebo-TSST condition, the p-SNU group showed increased subjective arousal (p-SNU: M = 2.39, SD = 0.74; control group: M = 1.79, SD = 0.90, t(70) = 2.55, P = 0.013, │d│ = 0.30) and urge (p-SNU: M = 2.49, SD = 0.84; control group: M = 1.60, SD = 0.88, t(70) = 5.40, P < 0.001, │d│ = 0.58) and the control group showed increased attentional bias (p-SNU: M = -1.75, SD = 16.11; control group: M = 6.43, SD = 15.3, t(67) = 2.136, P = 0.036, │d│ = 0.52). No group difference was found regarding the effects of acute stress on implicit associations to SN-related stimuli or an interaction effect of subjective urge and stress on implicit cognitions. CONCLUSIONS: Among women in Germany, acute stress appears to lead to an increased subjective urge for the use of social networks. Women with problematic social network use report higher subjective urge independent of stress, whereas women with non-problematic use report an attentional bias.