Participation
The randomly chosen, right-handed, 197 healthy participants (participated in the study by answering all the questions of the study) categorized between n = 98 female (50%) and n = 99 male (50%), were mainly undergraduate students (77%) from various departments and diversified jobholders (23%) from different areas of Bangladesh. The age range for male and female participants was 18–31 years (male = mean 23.57 ± 3.32 years SD, female = 25.43 ± 3.37 years SD). The participants were mainly frequent computer and other digital device users and had been using these devices for about 5–10 years (44%), > 10 years (31%), 2–4 years (21%), and < 2 years (4%). The inclusion criteria of the participants were:
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a)
Having a digital device.
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b)
Anyone over the age of 18.
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c)
Both sexes.
The exclusion of the participants was based on different factors like:
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a)
Arthritis.
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b)
Previous injuries.
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c)
Color blindness [17].
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d)
Not having a computer or laptop and internet connection.
Materials and procedures
The data was collected from September 2020 to October 2020 by following the cross-sectional and stratified random sampling methods. In the sampling process, data variables were arranged based on gender, occupation and age-wise. The data collection method followed the structure without missing respondents; all the participants had to respond to the entire incorporated questionnaire. The questionnaire was collected from the World Health Organization Adult ADHD Self-Report Scale (ASRS) constructed in conjunction with the revision of the WHO Composite International Diagnostic Interview (CIDI) for the ADHD symptoms prevalence data compilation [18]. In terms of questionnaires` standardization, it has consistency on sensitivity (68.7%), specificity (99.5%), total classification accuracy (97.9%), and Cohen kappa value (0.76) regarding the adult's symptom acceptability [19]. In our included questions, (1–4) sequence questions represent the severity of the inattention; (5–6) specify the impulsivity and the 7th question represents hyperactivity according to the standard ASRS-v1.1 manual [20]. The ADHD scoring method was followed by the established procedure of ASRS-v1.1, where the process was to mark each question based on the selected option from "Sometimes" to "Very often" [19].
In the scoring method, ADHD scores less than 4 indicate the little disposition of ADHD symptoms, whereas a score 4 or higher than 4 indicates the high prevalence of ADHD in the participants and needs to go for the further diagnostic procedure ASRS-V1.1 symptoms checklist tool [20]. For CVS, the self-administered research-based questions were drawn up, where the questions included demographic information of age, gender, duration of computer use, use of glasses, or contact lenses. At last, ADHD scoring was correlated with the Stroop test effect [21]. The Stroop effect represents the cognitive inhibition of the participants, and then the relationship with the digital media use was correlated. The open-source website PsyToolkit was used to engage the Stroop test, which only runs on the real keyboard. Here, the RT (Reaction Time) was measured comparing incongruent and congruent stimuli along with " + " and "right/wrong" appearing on the screen. In the color word strop task, the following colors, for example: red, yellow, blue, and green, were presented on a black background. The presentation of stimuli within each block was randomized and repeated 15 times per color for 70 trials. The whole Stroop task process lasted approximately 3.5 min. The survey taker solved any confusion regarding the instruction given on the Stroop task or in the questionnaire. Most importantly, their confidentiality and anonymity were maintained. The participants' full consent was taken in the form before participating in the game-task survey analysis.
Statistical analysis
Data were analyzed using the Statistical Package for Social Sciences software version 20.0 and the Microsoft Excel 2016 for professionals. The correlation between ADHD and CVS is performed by bivariate correlation and linear regression procedure. The bivariate correlation is done by Spearman—Pearson correlation coefficient at the 2-tail significance test. Correlation is significant at the 0.01 level (2-tailed). For CVS, the correlation and significance of data with gender have been estimated by the logistic regression analysis procedure with 95% confidence interval and p-value less than 0.05 have been considered statistically significant.