Annotated Bibliography 8 - Psychology
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Vol.:(0123456789)1 3
European Child & Adolescent Psychiatry (2020) 29:839–847
https://doi.org/10.1007/s00787-019-01398-2
O R I G I N A L CO N T R I B U T I O N
Time spent gaming and psychiatric symptoms in childhood:
cross‑sectional associations and longitudinal effects
Frode Stenseng1,2 · Beate Wold Hygen3 · Lars Wichstrøm3,4
Received: 26 March 2019 / Accepted: 30 August 2019 / Published online: 6 September 2019
© Springer-Verlag GmbH Germany, part of Springer Nature 2019
Abstract
There is sparse knowledge on how the amount of gaming overlaps with—and is longitudinally related to—psychiatric symp-
toms of ADHD and emotional problems throughout early and middle childhood. In this prospective study of 791 Norwegian
children, we investigated the amount of electronic gaming at ages 6, 8, and 10 while also measuring DSM symptoms of such
disorders. Cross-lagged longitudinal analyses showed that more ADHD symptoms at age 8 predicted more gaming at age
10, whereas gaming did not predict more psychiatric symptoms, controlled for gender and socio-economic status. Cross-
sectional overlaps between gaming and symptoms were marginal but nonetheless increased with each age level. Hence, time
spent gaming did not forecast more psychiatric problems at these ages, but children with more ADHD symptoms were more
likely to increase their amount of gaming throughout middle childhood. Results indicate that the sheer amount of gaming
is not harmful to children’s mental health, but that poorly regulated children become more attracted to games throughout
childhood. Findings are discussed in light of the coexistence of problematic gaming and psychiatric problems reported among
adolescents and adults, as well as the potential beneficial psychological outcomes from gaming.
Keywords ADHD · Internet gaming disorder · Cross-lagged analyses · Structural equation modeling · Community sample ·
Video games
Introduction
The majority of 10-year-olds spend more than 1 h per day
playing digital games, both in Europe [41] and in the United
States [13, 42]. At the same time, little is known with regards
to whether the amount of gaming may alter children’s psy-
chological development, and concerns have been raised that
gaming may negatively impact young children’s cognition
and temperament [22]. It is also important to identify factors
that make some children more vulnerable to develop a patho-
logical pattern of gaming, including excessive time used on
gaming, so that these children can be protected from gaming
addiction and the problems emerging from it [35].
The number of reports from this field is growing, for
example finding cross-sectional links between time spent
gaming and impulsivity [14] and self-harm [36], and lon-
gitudinally, that more video game exposure predicts more
attention problems and impulsivity traits [15, 43]. On the
social level, studies have found that more gaming is cross-
sectionally associated with more conduct problems [5] and
predicts more loneliness over a 6-month period [26]. It has
also been shown that boys with attention-deficit/hyperactiv-
ity disorder (ADHD) are more at risk for developing prob-
lematic video game use than their non-diagnosed peers [29].
It seems plausible that children with limited self-regulation
resources—in particular—may be attracted to such games
because of the sense of control that emerges when gaming,
as well as the reward systems implemented in such games
[28]. Playing digital games may provide pleasurable states of
flow [10] or a state of escape [3, 38], which is related to cog-
nitive narrowing, reduced self-awareness, and diminished
* Frode Stenseng
[email protected]
Beate Wold Hygen
[email protected]
Lars Wichstrøm
[email protected]
1 Department of Education and Lifelong Learning, NTNU,
Trondheim, Norway
2 Queen Maud University College, Trondheim, Norway
3 NTNU Social Research, Trondheim, Norway
4 Department of Psychology, NTNU, Trondheim, Norway
http://orcid.org/0000-0002-6581-1133
http://crossmark.crossref.org/dialog/?doi=10.1007/s00787-019-01398-2&domain=pdf
840 European Child & Adolescent Psychiatry (2020) 29:839–847
1 3
negative affect. Such a state of immersion [16] maybe par-
ticularly valued among children with higher levels of nega-
tive self-perceptions, as found frequently among children
with ADHD [4]. Moreover, the positive effects of immersion
or escapism through gaming has been stressed by several
authors as understated in the discussion around the inclusion
of internet gaming disorder in DSM-5 and ICD-11 [21, 44].
Notably, building from the technical possibilities in digital
games, studies have also tested whether video game-based
interventions can improve real-life abilities among adults
with ADHD, but results are per now mixed [40].
ADHD may lead to more gaming, but the opposite causal
direction—that excessive gaming may lead to, or elevate,
ADHD symptoms in early childhood—has also found some
support [34]. Theoretically, this latter outcome is based on
the idea that gaming offers stimuli at a fast pace, also typi-
cal of TV series and movies for children. According to the
scan-and-shift hypothesis [20], exposure to media with high
informative pace leads children to adopt a high-speed mode
of attentional focus. This alteration of cognition may hinder
children’s ability to develop sustained attention. Likewise,
it has been suggested that gaming and other types of media,
through their intense cognitive stimulation, may habituate
children to elevated levels of arousal, so that environments
with low stimulation provoke restlessness [25]. The easiest
way to uphold such arousal may be through sustained and/
or more intense gaming.
Taken together, research indicates that children with
ADHD are more vulnerable to spend substantially more time
on gaming than their peers, and conversely, that increased
gaming may cause more ADHD symptoms. It also seems
conceivable that such a reciprocal relationship depends on a
threshold of the amount of gaming, so that a mutually rein-
forcing relationship is evident among “dedicated” gamers,
but not among “casual” gamers [18]. This was also indi-
cated in a large community study in the USA on 16-year-olds
[11], finding less negative socio-emotional outcomes among
those who gamed an average amount, compared to those
who gamed most and those who did not game at all.
Emotional problems have also been linked to excessive
gaming, although mainly among adolescents and adults.
Brunborg et al. [5] found in a community sample of ado-
lescents in Norway that gaming addiction was associated
with higher levels of self-reported depression, whereas the
amount of gaming in itself was unrelated to such problems.
Likewise, Mentzoni et al. [32] reported that problematic
gaming was related to lower life satisfaction and higher
levels of anxiety and depression in a nationwide sample in
Norway. Furthermore, Mehroof and Griffiths [31] reported
in a sample of the university student in the United King-
dom that problematic gaming was related to both trait and
state anxiety. Also relevant, in a study on users of massively
multiplayer online games, Cole and Hooley [7] found that
participants with higher gaming addiction had higher levels
of social phobia, state and trait anxiety, and neuroticism.
A recent study on Norwegian 10-year-olds [45] found that
poor emotion regulation skills were associated with Inter-
net gaming disorder, which points toward the comorbidity
seen between emotional problems and pathological gam-
ing among adolescents and adults. Another recent study by
Coyne et al. [9] found that time spent on violent video games
at age fourteen predicted less empathetic concerns for others
and less benevolence two years after, supporting the notion
that gaming may undermine the development of social skills.
There is empirical evidence that excessive gaming is cor-
related with regulation deficiencies and emotional problems.
Nevertheless, studies investigating the time relationship
between gaming and such problems are lacking. This gap of
knowledge on the long-term relationship between gaming
and mental health in early life is partly due to the fact that
studies in the field often have one or more of the following
limitations: (a) have used cross-sectional designs; (b) have
used trait-based measures as opposed to mapping psychiatric
symptoms from a diagnostic interview, and also; (c) have
predominantly been conducted on adolescents (aged 12–18)
and not prepubertal children, who presumably are more
susceptible to the potential effects from gaming. However,
at least two studies are notable exceptions. First, Gentile
et al. [15] followed more than 2000 Singaporean children
and adolescents over 3 years in three waves of data collec-
tions, while measuring self-reported time spent gaming and
ADHD symptoms (inattention and hyperactivity). Measures
of gaming and symptoms were included at Wave 2 and 3,
with mean ages of approximately 12 and 13 years, and data
were analyzed in reciprocal models. Analyses showed that
time spent gaming predicted more attention and impulsiv-
ity symptoms, and such symptoms predicted more gaming.
In other words, a bidirectional relationship was evidenced
at these ages. Also notable, Lemmens et al. [26]—using
longitudinal data from a Dutch sample of adolescents—
investigated reciprocal relationships between pathological
gaming and several psychosocial constructs. Specifically,
they found that low social competence and self-esteem, and
more loneliness, predicted pathological gaming 6 months
later. They also reported that more pathological gaming pre-
dicted more loneliness during the same time period. Time
spent gaming, however, did not predict such outcomes in
their study. Despite the fact that social competence, self-
esteem, and loneliness are moderately overlapping with
ADHD symptoms and emotional problems, these factors are
known to forestall psychiatric symptoms (e.g., [39]). Most
importantly, both the Gentile et al. study and Lemmens et al.
study conveyed that gaming and psychological development
existed in a bidirectional relationship in adolescence, beg-
ging the following question: Is such an interplay evident at
841European Child & Adolescent Psychiatry (2020) 29:839–847
1 3
earlier ages? And accordingly, does it apply to both dedi-
cated and casual gamers?
In the current prospective study including 791 Norwegian
children, we investigated cross-sectional associations and
the longitudinal interplay of the amount of time spent on
screen games and symptoms of ADHD, and emotional prob-
lems (depression and anxiety) from age 6 through age 8, and
up to age 10. More specifically, in a reciprocal model, we
tested the extent to which gaming at age 6 and 8 predicted
more symptoms at age 8 and 10, and likewise, whether more
symptoms at age 6 and 8 predicted more gaming at age 8 and
10, controlling for their respective subsequent levels of gam-
ing and symptoms, as well as gender and socio-economic
status. We also tested to what extent significant longitudi-
nal effects were evident both among casual and dedicated
gamers.
Methods
Participants and procedure
The present study is based on data from the second, third,
and fourth wave of the Trondheim Early Secure Study (for a
comprehensive description, please see [37]. The first wave
of this study was conducted in 2007 and 2008 (T1) and
included participants from two birth cohorts of children in
Trondheim, Norway (born in 2003 or 2004). The project
has been approved—for each wave of data collection—by
the Regional Committee for Research Ethics, Mid-Norway
(www.etikk om.no, REK 4.2008.2632).
There were 1250 Norwegian-speaking children in the
birth register for 2003 and 2004 in Trondheim, and all were
recruited to participate in the study. Of these nine-hundred
and five children were tested at the time of study enroll-
ment (mean age = 4.55 years; 50.6\% boys). At T1, 81\% of
the children were accompanied by their biological mother in
the clinic, and more than 99\% of the children were of West-
ern ethnic origin, and 86\% of their parents lived together.
Socio-economic status was assessed through the maternal
educational level at T1 (5 categories: lower secondary, upper
secondary, vocational school, college, and university).
Approximately 2 years later, a total of 752 children par-
ticipated in the follow-up assessment (T2), resulting in a lon-
gitudinal participation rate of 75.6\% (mean age = 6.72 years;
50.5\% boys). At the second follow-up (T3), 661 children
participated (mean age = 8.8 years; 48.7\% boys), which cor-
responded to a participation rate of 87.9\%, and at the third
follow-up, 699 children participated (T1–T3 participants
were recruited to T4). The retention rate in the data used in
the present study, from the first wave (T2) to the last wave
(T4), was 86.7\% (including subjects participating at T2,
missing at T3, but returning at T4).
Measures
Digital gaming
At age 6 and 8, parents estimated the amount of time
their child spent on digital games on different platforms,
such as computers and tablets. They were asked to report
how many days per week their child spent gaming and
the average amount of hours and minutes per day when
gaming, resulting in a measure of hours of gaming per
day. At age 10, the children reported their gaming the last
30 days at a very specific level by means of an interview
(typical amount of gaming i.e., before school, after school
but before dinner, after dinner, and after bedtime, with
adapted classifications for weekends, i.e. excluding before/
after school). The average amount of hours of gaming per
day was then computed.
ADHD symptoms
The Preschool Age Psychiatric Assessment/Child and Ado-
lescent Psychiatric Assessment (PAPA/CAPA; [1, 12]) is a
semi-structured diagnostic interview developed for assessing
DSM-IV diagnoses [2]. The interview follows a structured
protocol using parents as informants. According to the DSM-
IV and DSM-5, we computed one Hyperactivity-Impulsivity
score and one Inattention score consisting of their respec-
tive symptoms. Interviewers (n = 7) had at least a bachelor’s
degree in a relevant field and had been trained by the team
that developed the PAPA/CAPA. To calculate the interrater
reliability, the audio of 9\% of the interviews was recorded
by pairs of blinded raters. The reliability (intraclass correla-
tions) for ADHD among multiple pairs of blinded raters was
0.96 for the PAPA and 0.90 for the CAPA.
Emotional problems
As with ADHD, the PAPA/CAPA [1, 12] was used to meas-
ure emotional problems. Because the core aspects of emo-
tional problems, depression and anxiety, are highly over-
lapping in childhood [8], we created a latent construct of
symptoms of depression and generalized anxiety from the
PAPA/CAPA interview. We also tested the factorial validity
of a second order latent factor intended to measure emo-
tional problems, including for example social anxiety, but
this model did not converge due to low occurrence of such
symptoms in our sample. However, a latent factor consist-
ing of the sum of depression symptoms and the sum of
http://www.etikkom.no
842 European Child & Adolescent Psychiatry (2020) 29:839–847
1 3
generalized anxiety symptoms yielded sufficient factorial
validity (see Fig. 1).
Results
Preliminary analyses, including mean-level differences
between times of measurement and bivariate correlations,
are presented first. Analyses of the structural equation model
follows, first to test whether cross-lagged effects of gaming
and symptoms from age 6 to age 10 were identified in the
total sample, and then to determine whether children who
gamed more/less than average displayed different paths in
the model.
Descriptives
The amount of gaming increased substantially from age 6
(M = 35.7 min) to age 8 (M = 67.5 min; t = 11.42, p < 0.001),
and from age 8 to age 10 (M = 100.1 min; t = 6.96, p < 0.001).
Hyperactivity-impulsivity symptoms decreased from age 6
(M = 0.84) to age 8 (M = 0.61; t = 2.98, p < 0.01), but not sig-
nificantly from age 8 to age 10 (M = 0.49; t = 1.63, p = 0.10).
Inattentiveness symptoms did not increase significantly from
age 6 (M = 0.80) to age 8 (M = 0.91; t = 1.35, p = 0.18) and
remained stable from age 8 to age 10 (M = 0.92). Depression
symptoms did decrease significantly from age 6 to age 10
(age 6: M = 0.58; age 8: M = 0.29; age 10: M = 0.36; t = 5.35,
p < 0.001), whereas anxiety symptoms increased signifi-
cantly (age 6: M = 0.45; age 8: M = 0.62; age 10: M = 0.81;
t = 7.19, p < 0.001). Socio-economic status was uncorrelated
to gaming at all three-time points (r’s ranging from − 0.08
to 0.07, p > 0.01), but significantly related to some of the
DSM-measures (r’s ranging up to 0.12, p < 0.01). Correla-
tion analyses of study variables are shown in Table 1.
Longitudinal cross‑lagged analyses
In order to control for repeated-measures invariance of
symptoms, corresponding sums of symptoms were allowed
to correlate between time points. All structural analyses were
performed using the maximum likelihood estimator (MLR).
Missing values were treated according to the full informa-
tion maximum likelihood procedure. Judgment of model
fit was made according to the recommendations of Hu and
Bentler [19], see also [27]. Regarded as reasonable indica-
tors of good fit of a model are values of the comparative fit
index (CFI) and the Tucker-Lewis index (TLI) close to 0.95,
and values of the root mean squared error of approximation
(RMSEA) and the standardized root mean squared residual
(SRMR) less than 0.06 and 0.08, respectively. Analyses of
the autoregressive cross-lagged model were performed in
Mplus 7.1. (Muthén & Muthén, 2012). In addition, gaming,
ADHD symptoms, and emotional problems at age 8 were
auto-regressed on the identical measures at age 6.
Fig. 1 Structural equation model illustrating stability and reciprocal effects of gaming, ADHD symptoms, and emotional problems at ages 6, 8,
and 10 in the total sample. Cross-sectional correlations are not shown. *p < .0.05. **p < .0.01
843European Child & Adolescent Psychiatry (2020) 29:839–847
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844 European Child & Adolescent Psychiatry (2020) 29:839–847
1 3
The cross-lagged model was first tested on the total
sample (see Fig. 1). The model had good fit with the data:
χ2(54, N = 791) = 84.80, p < 0.001, CFI = 0.98, TLI = 0.97,
RMSEA = 0.027, SRMR = 0.027. The stability of ADHD
symptoms was high (betas were 0.84 and 0.78, both p < 0.01,
at age 8 and 10, respectively). The stability of emotional
problems was moderate for emotional problems (betas were
0.25, p < 0.05, and 0.39, p < 0.01), as well as for gaming
(betas were 0.13, p < 0.01, and 0.35, p < 0.01). The latent
measure of ADHD symptoms was significantly correlated
with the measure of emotional problems at all three-time
points (age 6: r = 0.60; age 8: r = 0.55; age 10: r = 0.34, all
p’s < 0.01). The amount of gaming was significantly corre-
lated with emotional problems at age 6 (r = 0.13 p < 0.05),
but not significantly cross-sectionally correlated to the other
measures of ADHD symptoms and emotional problems in
the model.
Because there have been mixed results regarding the
effect of gaming on mental health, and longitudinal studies
in early childhood are lacking, we examined the effects of
gaming on ADHD symptoms and emotional problems in the
model. No such negative effects were found in the present
study.
More ADHD symptoms and emotional problems
at age 6 did not predict more gaming at age 8, but more
ADHD symptoms at age 8 predicted more gaming at age
10 (β = 0.16 p < 0.01). There was no such effect involving
symptoms of emotional disorders. Then, because gender was
correlated with gaming as well as ADHD and emotional
problems, we reran the analyses with gender as a covari-
ate. This did not impose any substantial changes in model
fit or in the paths, and the effect of ADHD symptoms at
age 8 effect on age 10 gaming remained (β = 0.12 p < 0.05).
Mediation was also tested, based on the idea that the effect
of gender on gaming may have been mediated by ADHD
symptoms, and vice versa, but there was no evidence for this
(gender → gaming at age 6 → ADHD at age 8, z = − 0.07,
p = 0.44; gender → ADHD at age 6 → gaming at age 8, z =
− 0.013, p = 0.59). Notably, we also run a model controlling
for socio-economic status at T1, which slightly attenuated
the effect of ADHD-symptoms at age 8 on more gaming at
age 10, but the main finding remained (β = 0.14 p < 0.05).
Finally, we tested the idea that the interplay of variables
in the model may be different for those children who game
substantially more than their peers. To test this potential
non-linear distribution, we added new variables computed
from the mean-centered square sums of gaming at age 6 and
at age 8, separately, which then were included in the model
as predictors of the relevant outcomes (predicting the effect
of the residuals of the linear regression effect). If these vari-
ables contributed significantly in predicting the outcomes,
this would indicate the existence of a non-linear effect in
the amount of gaming (see e.g. [33]). First, when we added
the squared interaction variable for gaming at age 6 on age
8 variables; this did not have a significant effect (Gaming
T12 → ADHD symptoms at age 8: β = − 0.07 p = 0.20; Gam-
ing T12 at age 6 → emotional symptoms at age 8: β = 0.02
p = 0.69). Second, when we included the corresponding ×2
variable for gaming at age 8 as a predictor; it did not have a
significant effect on ADHD symptoms at age 10 (β = 0.04,
p = 0.30) or emotional problems at age 10 (β = − 0.02,
p = 0.63).
Hence, specific analyses did not identify a differentiated
effect for ADHD symptoms among dedicated versus casual
gamers [18]. The pattern was, however, clear with regards
to the direction of effects in the total sample: ADHD symp-
toms predicted more gaming, but gaming did not predict
more ADHD symptoms. Thus, there was no evidence for a
reciprocal—or mutually reinforcing—relationship between
ADHD symptoms and gaming.
Discussion
In this longitudinal study in a large community sample, we
tested the reciprocal relationships of digital gaming, symp-
toms of ADHD, and emotional problems. More ADHD
symptoms at age 8 predicted more gaming at age 10, but this
effect was not found from ages 6 to 8. Digital gaming did not
predict more ADHD symptoms at any age, and there were
no prospective bi-directional relationships between gaming
and symptoms of emotional disorders.
Previous studies have found that gaming is cross-section-
ally correlated with poor self-regulation, including attention
problems and impulsivity [15, 43], but only among older
children. The present results are partly in line with these
findings in that gaming was related to more general anxi-
ety and inattentiveness in the bivariate correlation analyses.
Moreover, this link was nonsignificant at age 6, but signifi-
cant and stronger at age 10 than age 8, indicating that this
association may increase with age. This also points to the
possibility that specific elements [23] of inattentiveness may
be affected by the amount of gaming, although the determi-
nation of such underlying elements was beyond the scope
of this study.
Empirical studies have advocated that ADHD is a risk
factor for developing pathological gaming [29], and that
gaming may lead to more ADHD symptoms in early child-
hood [34]. Both of these assertions were supported by Gen-
tile et al. [15] in their study of Singaporean adolescents,
which found a bidirectional relationship between time spent
gaming and self-reported ADHD symptoms. In the present
study, the only assertion supported was the one suggest-
ing that more ADHD symptoms are a risk factor for more
gaming. Hence, as gaming did not predict ADHD symp-
toms, a bi-directional relationship was not evidenced at this
845European Child & Adolescent Psychiatry (2020) 29:839–847
1 3
developmental stage. Accordingly, neither the scan-and-shift
hypothesis [20] nor the elevated arousal-hypothesis [25]—
two models which postulate that screen use may provoke
ADHD-related behavior—were supported.
The amount of gaming overlapped cross-sectionally with
more anxiety symptoms at ages 6 and 10, but only weakly
(both r’s 0.10). However, no cross-lagged effects between
gaming and emotional problems were documented in the
longitudinal model. Overall, in our sample of prepubertal
children, the substantial comorbidity of gaming problems
and emotional disorders typically found among adolescents
[5] and adults [32] was not evident in terms of time spent
gaming. Likewise, emotional problems did not predict more
gaming over time, nor did gaming predict more emotional
problems. Although there are indices suggesting that gaming
may indirectly forecast emotional problems in adolescence
(i.e., through more loneliness, [26], there was no direct rela-
tionship found in the present study.
Several community studies have documented that boys
tend to game more than girls [13, 14], and this was also
supported in the present study. Boys gamed more than girls
at all time points, and the discrepancy between the genders
was stable across age groups. In fact, the amount of gaming
was almost tripled from age 6 to age 10 in the total sample.
This is in accordance with expectations, as many games are
designed to capture the interest of older children. As chil-
dren get older, they are also typically more autonomous in
their time management and hence given more freedom to
choose their own activities throughout the day. At the same
time, there was great variation in the amount of gaming,
which indicates that children choose different paths in their
orientation toward gaming. Future studies may investigate
how gaming is intertwined with other spare-time activities
[17], and perhaps disentangle how and when gaming may
become a problem in some children’s lives, in the sense that
their interest becomes a source for intra- and/or …
PSY 499 Annotated Bibliography Rubric
Instructor comments:
First and foremost, please follow the organization of material outlined in the grading rubric.
Always start with the purpose of the study. This is the normal flow of a research paper. End with
limitations/critique and implications for future research.
Criterion #1
Please be sure to address the purpose of the study you are reviewing. If there is a hypothesis or
research question, please be sure to include it in your own words (summarize). For articles that
are case studies or are qualitative research, there may goals and objectives rather than a purpose and hypothesis.
Criterion #2
Please address the methods adequately. Discuss the participants and include the demographics, specific material used, and procedures for the study. There should be enough detail in the methods so that the reader could design a replication. For meta-analyses, you may list the number of studies used, the inclusion or exclusion criteria, and the total number of participants. For articles with qualitative analyses there are unique issues that need to be addressed. If there were subjects, they need to be discussed. If the authors used interviews or documents, how where they coded and analyzed? Describe the methods used as clearly as you can.
Criterion #3
Describe the results. Were there significant differences between groups or treatments,
correlations between variables etc. Be sure to address in a statement what the results mean with regard to past research (does it support or refute it?). Also, please address the significance of the findings. What are the implications for the research (e.g., policy change, educational reform, future research, etc.).
NOTE: There are a few areas where students tend to have questions regarding the grading rubric.
First, criterion #3, “Results and Significance,” is in regard to the study you are reviewing, not
your thesis paper. The rubric does not cover how you are going to use the research, so it does
not need to be covered in the annotated bibliography 11
Criterion #4
This criterion addresses strengths and limitations or critique of the article. Limitations are
generally discussed in the discussion section of the article. APA guidelines for both qualitative
and quantitative articles calls for a discussion of limitations (Cooper, 2020; Levitt, 2019). Look
in the discussion section of the article for this information. Remember, no study is perfect.
Critique can also be based on theoretical differences or inconsistencies, etc. Please be sure to
critically evaluate the article objectively (based on methodology, etc.).
Think of the critique as limitations of the study in terms of rigor (threats to internal validity) and
generalizability (threats to external validity). Limitations are neither good or bad, do not be
judgmental, rather factual, dispassionate, and objective.
Some Common Limitations
• The article is supported by a for profit organization, such as the pharmaceutical industry.
The industry controls the data and what gets published and what doesn’t (potentially
biased data).
• The subject pool or participant pool was drawn from a convenience sample, is too small,
or not representative of the population (potential threat to external validity).
• Treatment not having sufficient follow up, such as a 12-week treatment, but no follow-up
after 3 or 6 months (does not reflect data on long term effects of treatment).
• Insufficient length of the treatment (treatment may have not been sufficient to show
effect).
• Lack of a control or comparison group in a within group pre-test post-test design.
• Using a questionnaire or survey without established reliability and validity. Construct and
content validity information can be found in the methods section of the article.
• A pilot study that is not based on previous research (insufficient comparison data with
other studies available).
• Theoretical critique of the study based on the fact that another theory may explain the
results.
• Subject or participant bias can occur with self-report questionnaires and interviews. Halo
effect. 12
• Single subjects experimental designs only have one participant. Without comparing
results to other studies, it’s difficult to determine if the results are due to the experimental
manipulation or chance.
You should draw from your knowledge of Research Methods I & II to address these issues.
NOTE: In the case of qualitative studies, you may see the term “transferability,” or do these
results transfer to similar situations. Also, rather than rigor, you may see terms like transparency, fidelity, and/or utility. In other words, is the study presented in such a way that you can follow it from start to finish? Are all descriptions adequate? Do they follow from one section to another? Do the results have utility in similar “real world” situations?
Potential Threats to Internal Validity (experimental rigor)
History (local history) common in cross-sectional designs by age. Some event in one group’s
history caused the results, not the treatment. Maturation can occur in longitudinal studies where something in the group’s development causes the results, not the treatment.
Testing (listed above) does the test have adequate established reliability and validity. Faulty
testing causes the results, not the treatment. Instrumentation, similar to testing has to do with the accuracy of the instruments used to collect the data. If the instruments are not accurate, neither will the results. Statistical regression can occur with test retest studies, scores will tend to cluster around the mean.
Selection (covered above) criteria and whether the sample is a convenience sample, stratified
sample, etc.
Lack of random assignment or matched subjects.
Potential Threats to External Validity (generalization)
Sample size and demographic composition can impact the results of a study’s ability to
generalize to the population.
For more on threats to internal and external validity see link below
https://web.pdx.edu/~stipakb/download/PA555/ResearchDesign.html
https://www.scribbr.com/methodology/internal-vs-external-validity/
NOTE: Your annotated bibliographies are NOT part of your thesis paper. Use the information
from the article, do not copy and paste annotated bibliographies together to make up the body of your paper. Consider the annotated bibliographies article summaries only.
Criterion #5
Make sure that your annotated bibliographies are 200 - 300 words. Less than 200 words may not cover everything on the grading rubric.
Helpful Links
The links below will be helpful with setting up your annotated bibliographies
https://owl.purdue.edu/owl/general_writing/common_writing_assignments/annotated_bibliograp
hies/annotated_bibliography_samples.html This link gives an example for formatting of a book. Please noted that it does not share the same grading criteria for your assignments, so the content is different (see Grading Rubric). http://libguides.enc.edu/writing_basics/annotatedbib/apa
This link also provides information on formatting, but does not include a complete criterion for
grading your assignment (see Grading Rubric) http://advice.writing.utoronto.ca/types-ofwriting/annotated-bibliography/ This link gives an example of the correct format and some of the criteria that you will be required to include, for a full list of criteria, see the Grading Rubric.
https://sites.umuc.edu/library/libhow/bibliography_apa.cfm
This website has two examples of an annotated bib in APA format. Note it does not follow the
same criteria as our assignment. https://www.youtube.com/watch?reload=9&v=lPhWhRlEWtI
Putting an Annotated Bibliography into APA format. This is good example using MS Word.
There are a few things to note. First, acceptable formats are Times New Roman, Arial, and
Courier 12 font. The other issue presenter forgot the issue number. An issue number should be in parentheses (2) between the volume number and the page numbers.
The Assignment Needs
During this module, you will submit your third annotated bibliography. This is a clear and concise summary (200 to 300 words) of a journal article, book, or other primary academic source that will be used in your thesis paper. Each submission must also include a brief critique of the source (e.g., how could the study be improved, criticism of the author(s) assertions, ideas for future studies, etc.).
CATEGORIES
Economics
Nursing
Applied Sciences
Psychology
Science
Management
Computer Science
Human Resource Management
Accounting
Information Systems
English
Anatomy
Operations Management
Sociology
Literature
Education
Business & Finance
Marketing
Engineering
Statistics
Biology
Political Science
Reading
History
Financial markets
Philosophy
Mathematics
Law
Criminal
Architecture and Design
Government
Social Science
World history
Chemistry
Humanities
Business Finance
Writing
Programming
Telecommunications Engineering
Geography
Physics
Spanish
ach
e. Embedded Entrepreneurship
f. Three Social Entrepreneurship Models
g. Social-Founder Identity
h. Micros-enterprise Development
Outcomes
Subset 2. Indigenous Entrepreneurship Approaches (Outside of Canada)
a. Indigenous Australian Entrepreneurs Exami
Calculus
(people influence of
others) processes that you perceived occurs in this specific Institution Select one of the forms of stratification highlighted (focus on inter the intersectionalities
of these three) to reflect and analyze the potential ways these (
American history
Pharmacology
Ancient history
. Also
Numerical analysis
Environmental science
Electrical Engineering
Precalculus
Physiology
Civil Engineering
Electronic Engineering
ness Horizons
Algebra
Geology
Physical chemistry
nt
When considering both O
lassrooms
Civil
Probability
ions
Identify a specific consumer product that you or your family have used for quite some time. This might be a branded smartphone (if you have used several versions over the years)
or the court to consider in its deliberations. Locard’s exchange principle argues that during the commission of a crime
Chemical Engineering
Ecology
aragraphs (meaning 25 sentences or more). Your assignment may be more than 5 paragraphs but not less.
INSTRUCTIONS:
To access the FNU Online Library for journals and articles you can go the FNU library link here:
https://www.fnu.edu/library/
In order to
n that draws upon the theoretical reading to explain and contextualize the design choices. Be sure to directly quote or paraphrase the reading
ce to the vaccine. Your campaign must educate and inform the audience on the benefits but also create for safe and open dialogue. A key metric of your campaign will be the direct increase in numbers.
Key outcomes: The approach that you take must be clear
Mechanical Engineering
Organic chemistry
Geometry
nment
Topic
You will need to pick one topic for your project (5 pts)
Literature search
You will need to perform a literature search for your topic
Geophysics
you been involved with a company doing a redesign of business processes
Communication on Customer Relations. Discuss how two-way communication on social media channels impacts businesses both positively and negatively. Provide any personal examples from your experience
od pressure and hypertension via a community-wide intervention that targets the problem across the lifespan (i.e. includes all ages).
Develop a community-wide intervention to reduce elevated blood pressure and hypertension in the State of Alabama that in
in body of the report
Conclusions
References (8 References Minimum)
*** Words count = 2000 words.
*** In-Text Citations and References using Harvard style.
*** In Task section I’ve chose (Economic issues in overseas contracting)"
Electromagnetism
w or quality improvement; it was just all part of good nursing care. The goal for quality improvement is to monitor patient outcomes using statistics for comparison to standards of care for different diseases
e a 1 to 2 slide Microsoft PowerPoint presentation on the different models of case management. Include speaker notes... .....Describe three different models of case management.
visual representations of information. They can include numbers
SSAY
ame workbook for all 3 milestones. You do not need to download a new copy for Milestones 2 or 3. When you submit Milestone 3
pages):
Provide a description of an existing intervention in Canada
making the appropriate buying decisions in an ethical and professional manner.
Topic: Purchasing and Technology
You read about blockchain ledger technology. Now do some additional research out on the Internet and share your URL with the rest of the class
be aware of which features their competitors are opting to include so the product development teams can design similar or enhanced features to attract more of the market. The more unique
low (The Top Health Industry Trends to Watch in 2015) to assist you with this discussion.
https://youtu.be/fRym_jyuBc0
Next year the $2.8 trillion U.S. healthcare industry will finally begin to look and feel more like the rest of the business wo
evidence-based primary care curriculum. Throughout your nurse practitioner program
Vignette
Understanding Gender Fluidity
Providing Inclusive Quality Care
Affirming Clinical Encounters
Conclusion
References
Nurse Practitioner Knowledge
Mechanics
and word limit is unit as a guide only.
The assessment may be re-attempted on two further occasions (maximum three attempts in total). All assessments must be resubmitted 3 days within receiving your unsatisfactory grade. You must clearly indicate “Re-su
Trigonometry
Article writing
Other
5. June 29
After the components sending to the manufacturing house
1. In 1972 the Furman v. Georgia case resulted in a decision that would put action into motion. Furman was originally sentenced to death because of a murder he committed in Georgia but the court debated whether or not this was a violation of his 8th amend
One of the first conflicts that would need to be investigated would be whether the human service professional followed the responsibility to client ethical standard. While developing a relationship with client it is important to clarify that if danger or
Ethical behavior is a critical topic in the workplace because the impact of it can make or break a business
No matter which type of health care organization
With a direct sale
During the pandemic
Computers are being used to monitor the spread of outbreaks in different areas of the world and with this record
3. Furman v. Georgia is a U.S Supreme Court case that resolves around the Eighth Amendments ban on cruel and unsual punishment in death penalty cases. The Furman v. Georgia case was based on Furman being convicted of murder in Georgia. Furman was caught i
One major ethical conflict that may arise in my investigation is the Responsibility to Client in both Standard 3 and Standard 4 of the Ethical Standards for Human Service Professionals (2015). Making sure we do not disclose information without consent ev
4. Identify two examples of real world problems that you have observed in your personal
Summary & Evaluation: Reference & 188. Academic Search Ultimate
Ethics
We can mention at least one example of how the violation of ethical standards can be prevented. Many organizations promote ethical self-regulation by creating moral codes to help direct their business activities
*DDB is used for the first three years
For example
The inbound logistics for William Instrument refer to purchase components from various electronic firms. During the purchase process William need to consider the quality and price of the components. In this case
4. A U.S. Supreme Court case known as Furman v. Georgia (1972) is a landmark case that involved Eighth Amendment’s ban of unusual and cruel punishment in death penalty cases (Furman v. Georgia (1972)
With covid coming into place
In my opinion
with
Not necessarily all home buyers are the same! When you choose to work with we buy ugly houses Baltimore & nationwide USA
The ability to view ourselves from an unbiased perspective allows us to critically assess our personal strengths and weaknesses. This is an important step in the process of finding the right resources for our personal learning style. Ego and pride can be
· By Day 1 of this week
While you must form your answers to the questions below from our assigned reading material
CliftonLarsonAllen LLP (2013)
5 The family dynamic is awkward at first since the most outgoing and straight forward person in the family in Linda
Urien
The most important benefit of my statistical analysis would be the accuracy with which I interpret the data. The greatest obstacle
From a similar but larger point of view
4 In order to get the entire family to come back for another session I would suggest coming in on a day the restaurant is not open
When seeking to identify a patient’s health condition
After viewing the you tube videos on prayer
Your paper must be at least two pages in length (not counting the title and reference pages)
The word assimilate is negative to me. I believe everyone should learn about a country that they are going to live in. It doesnt mean that they have to believe that everything in America is better than where they came from. It means that they care enough
Data collection
Single Subject Chris is a social worker in a geriatric case management program located in a midsize Northeastern town. She has an MSW and is part of a team of case managers that likes to continuously improve on its practice. The team is currently using an
I would start off with Linda on repeating her options for the child and going over what she is feeling with each option. I would want to find out what she is afraid of. I would avoid asking her any “why” questions because I want her to be in the here an
Summarize the advantages and disadvantages of using an Internet site as means of collecting data for psychological research (Comp 2.1) 25.0\% Summarization of the advantages and disadvantages of using an Internet site as means of collecting data for psych
Identify the type of research used in a chosen study
Compose a 1
Optics
effect relationship becomes more difficult—as the researcher cannot enact total control of another person even in an experimental environment. Social workers serve clients in highly complex real-world environments. Clients often implement recommended inte
I think knowing more about you will allow you to be able to choose the right resources
Be 4 pages in length
soft MB-920 dumps review and documentation and high-quality listing pdf MB-920 braindumps also recommended and approved by Microsoft experts. The practical test
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One thing you will need to do in college is learn how to find and use references. References support your ideas. College-level work must be supported by research. You are expected to do that for this paper. You will research
Elaborate on any potential confounds or ethical concerns while participating in the psychological study 20.0\% Elaboration on any potential confounds or ethical concerns while participating in the psychological study is missing. Elaboration on any potenti
3 The first thing I would do in the family’s first session is develop a genogram of the family to get an idea of all the individuals who play a major role in Linda’s life. After establishing where each member is in relation to the family
A Health in All Policies approach
Note: The requirements outlined below correspond to the grading criteria in the scoring guide. At a minimum
Chen
Read Connecting Communities and Complexity: A Case Study in Creating the Conditions for Transformational Change
Read Reflections on Cultural Humility
Read A Basic Guide to ABCD Community Organizing
Use the bolded black section and sub-section titles below to organize your paper. For each section
Losinski forwarded the article on a priority basis to Mary Scott
Losinksi wanted details on use of the ED at CGH. He asked the administrative resident