The relationship between dissociation symptoms, sleep disturbances, problematic internet use and online gaming in adolescents.

Some adolescents admitted to the child and adolescent psychiatry outpatient clinic experience dissociative symptoms, such as hearing strange sounds, temporary blackouts, seeing images, changes in body parts, and looking at themselves from outside themselves. Some may also have sleep disturbances and a history of spending a long time on the internet. This study investigated the relationship between dissociative symptoms and sleep disorders, problematic internet usage (PIU),aggression and digital game addiction in adolescents. Participants completed the State-Trait Anger Expression Inventory (STAXI), Problematic Internet Usage Scale (PIUS), Digital Game Addiction Scale (DGAS-7), Children's Depression Inventory (CDI), Adolescent Dissociative Experiences Scale (A-DES), Pittsburgh Sleep Quality Index (PSQI), Screen for Child Anxiety Related Emotional Disorders Child Version (SCARED), and a sociodemographic form. Regression analyses were performed to identify associations. The sample consisted of 244 adolescents between 14 and 18 years of age (M = 15.93, SD = 0.90), of which 171 (70.1%) were girls and 73 (29.9%) were boys. Fifty-two (21.3%) were classified as having problematic online gaming (POG+), whereas 192 (78.7%) were classified as not having problematic online gaming (POG-). There was a difference between the two groups in all sub-dimensions of the PIUS, STAXI, CDI, and A-DES. Adolescents who had higher scores on the A-DES had a higher risk of sleep disorders and had higher scores on the PIU, CDI, and SCARED. The POG+ group dissociation scores were considerably higher than POG- group scores. Adolescents with high A-DES scores also had higher anger scores and weaker anger control skills. Consequently, sleep disorders, PIU, and POG may increase dissociative symptoms.