Background and Objectives: Internet gaming disorder (IGD) is a growing public health concern, especially among adolescents. However, most IGD studies are cross-sectional, leaving its developmental course poorly understood. This study examined IGD trajectories, their predictors, and their long-term mental health outcomes among Chinese adolescents. Methods: A cohort of 16,833 adolescent gamers (mean age = 13.40, 46.56% girls) was recruited from 76 middle schools in Zigong City through cluster sampling. Assessments were conducted in November 2020 (T1), November 2021 (T2), and November 2022 (T3). IGD was measured using the Internet Gaming Disorder Scale–Short Form (IGDS9-SF). Demographic, gaming, environmental, and psychological factors (e.g., depression, anxiety, sleep problems, suicidal ideation, conduct problems, hyperactivity, resilience, mental wellbeing, prosocial behavior) were also assessed. Growth mixture modeling (GMM) identified IGD trajectories, and logistic regression evaluated predictors and mental health outcomes at T3. Results: GMM identified four IGD trajectories: High-Risk Decreasing (4.5%), Moderate-Risk Stable (19.5%), Moderate-Risk Increasing (3.0%), and Low-Risk Stable (73.0%). Age, gaming time, anxiety, sleep problems, conduct problems, hyperactivity/inattention, and low prosocial behavior predicted worsening IGD symptoms. At T3, the Moderate-Risk Increasing group had significantly higher risks for adverse mental health outcomes compared to the Low-Risk Stable group, whereas the High-Risk Decreasing group showed no significant or minimal differences in most domains from the Low-Risk Stable group after adjusting for baseline characteristics. Discussion and Conclusions: These findings underscore the heterogeneous nature of IGD development and highlight the need for long-term monitoring and tailored interventions to mitigate adverse mental health outcomes in at-risk adolescents.

Persistent auditory verbal hallucinations (pAVHs) and olfactory identification impairment are common in schizophrenia (SCZ), but the neuroimaging mechanisms underlying both pAVHs and olfactory identification impairment are unclear. This study aimed to investigate whether pAVHs and olfactory identification impairment in SCZ patients are associated with changes in cortical thickness. In this study, cortical thickness was investigated in 78 SCZ patients with pAVHs (pAVH group), 58 SCZ patients without AVHs (non-AVH group), and 83 healthy controls (HC group) using 3T magnetic resonance imaging. The severity of pAVHs was assessed by the Auditory Hallucination Rating Scale. Olfactory identification deficits were assessed using the Odor Stick Identification Test for Japanese (OSIT-J). In addition, the relationship between the severity of pAVHs and olfactory identification disorder and cortical thickness abnormalities was determined. Significant reductions in cortical thickness were observed in the right medial orbital sulcus (olfactory sulcus) and right orbital sulcus (H-shaped sulcus) in the pAVH group compared to both the non-AVH and HC groups (P < .003, Bonferroni correction). Furthermore, the severity of pAVHs was found to be negatively correlated with the reduction in cortical thickness in the olfactory sulcus and H-shaped sulcus. Additionally, a decrease in cortical thickness in the olfactory sulcus showed a positive correlation with the OSIT-J scores (P < .05, false discovery rate correction). Cortical thickness abnormalities in the olfactory sulcus may be a common neuroimaging mechanism for pAVHs and olfactory identification deficits in SCZ patients.

Background: This study of 87,302 Chinese adolescents aimed to test: (1) the association of psychotic-like experiences (PLEs) with sleep disturbance and three different subtypes of problematic technology use (PTU), including problematic social media use (PSMU), problematic smartphone use (PSU), and internet gaming disorder (IGD); and (2) whether sleep disturbance mediated the relationship between PTU and PLEs. Method: 16-item Prodromal Questionnaire, Smartphone-Application Based Addiction Scale, the Bergen Social Media Addiction Scale, the Internet Gaming Disorder Scale-Short Form, Pittsburgh Sleep Quality Index, and Strength and Difficulties Questionnaires were employed. Results: (1) The prevalence of clinically relevant PLEs, IGD, PSMU, PSU, and sleep disturbance was 18.1%, 2.4%, 1.5%, 17.2%, and 26%, respectively. (2) PSU, PSMU, and IGD displayed comparable levels of association with PLEs (r = 0.37–0.41) and sleep disturbance (r = 0.42–0.47); (3) Sleep disturbance acted as a partial mediator between PTU and PLEs, mediating 51.8% of the effect of PSU, 49.2% of the effect of PSMU, and 44.1% of the effects of the IGD on PLEs. Conclusion: PTUs are closely associated with sleep disturbance and PLEs. The results call for formal assessments for sleep disturbance and PLEs among adolescents with PTU. Furthermore, targeting sleep disturbance holds great promise for the prevention and treatment of PLEs among adolescents, particularly those with PTUs.

: The link between hemispheric asymmetry and auditory verbal hallucinations in schizophrenia is underexplored with neuroimaging evidence. This study examined white matter asymmetries in schizophrenia patients. Diffusion tensor imaging data from 52 patients with persistent auditory verbal hallucinations, 33 who never experienced auditory verbal hallucinations, and 40 healthy controls were analyzed. Asymmetry indices for fractional anisotropy, axial diffusivity, radial diffusivity, and mean diffusivity were calculated for the whole-brain white matter skeleton and 22 pairs of regions of interest. The persistent auditory verbal hallucination group showed reduced fractional anisotropy asymmetry index in the whole-brain white matter skeleton compared to healthy control and never experienced auditory verbal hallucination groups, indicating altered asymmetry. Region of interest analysis revealed decreased fractional anisotropy asymmetry index in nine pairs and increased mean diffusivity AI in two pairs in the persistent auditory verbal hallucination group. Greater rightward asymmetry in the superior longitudinal fasciculus correlated with more severe auditory verbal hallucinations in persistent auditory verbal hallucination patients. No significant asymmetry differences were found between never experienced auditory verbal hallucinations and healthy control groups. Ridge regression analysis demonstrated that including the fractional anisotropy asymmetry index of the superior longitudinal fasciculus increased the explained variance in auditory verbal hallucination severity. These findings highlight distinct white matter asymmetry patterns in persistent auditory verbal hallucination patients, suggesting that hemispheric asymmetry plays a key role in the pathology of auditory verbal hallucinations in schizophrenia. Highlights: