Banning loot boxes for minors: A public health framework and the case of Brazil Daniel Tornaim Spritzer, Ivelise Fortim, Thiago Henrique Roza, Felix Henrique Paim Kessler, Hyoun S Kim Journal of Behavioral Addictions, 2026 Brazil's Digital Child and Adolescent Act (2025) prohibits paid loot boxes in games accessible to minors under a public health and child-rights framework, regardless of whether they should be classified as gambling. The law focuses on psychological mechanisms underlying harm, including variable-ratio reinforcement and reward uncertainty, to which adolescents are developmentally vulnerable. It establishes administrative sanctions, including fines of up to 10% of the company's revenue and service suspension, and restricts personalized advertising and algorithmic systems targeting minors. As the first major market to adopt a preventive harm-reduction ban, Brazil creates measurable regulatory benchmarks and a natural experiment to assess whether legislative boundaries reduce harm, influence industry monetisation strategies, and inform proportionate digital governance internationally.
Experience report: Mental health interventions during the 2024 floods in Rio Grande do Sul, Brazil Joana Corrêa de Magalhães Narvaez, Sheila Gonçalves Câmara, Tonantzin Ribeiro Gonçalves, Daniela Centenaro Levandowski, Daniel Tornaim Spritzer, et al. International Journal of Social Psychiatry, 2025 Introduction: This Experience Report explores the mobilisation of mental health professionals and students who responded to the catastrophic floods in Rio Grande do Sul (RS), Brazil, in 2024. Triggered by prolonged rainfall and exacerbated by urbanisation and the influence of El Niño, this event caused unprecedented devastation, with over 615,000 individuals displaced and severe socioeconomic impacts. This paper aims to describe the experiences of mental health professionals and students involved in psychosocial care provided to victims between May and July 2024 in rescue sites and shelters at Porto Alegre. Method: Drawing from the collective reflections of a multidisciplinary team, this report highlights the challenges, adaptations, and lessons learned during psychosocial interventions conducted in rescue sites and shelters. The 18 participants included were psychologists, psychiatrists, nursing students, and faculty members from prominent academic institutions, providing a diverse range of perspectives. Data collection was conducted using a structured questionnaire distributed via Google Forms, data analysis used thematic analysis (Braun & Clarke, 2006) to interpret the open-ended questionnaire responses. Results: The report identifies significant gaps in disaster-specific planning and training, revealing how the absence of clear protocols led to disorganisation during initial responses. Despite challenges, mental health teams adapted flexibly and demonstrated resilience, implementing interventions that addressed acute emotional symptoms, grief, and long-term psychological impacts. Vulnerable populations, including low-income and racialised groups, faced compounded risks due to systemic inequities and inadequate public policies. Mental health professionals themselves experienced substantial emotional strain, navigating their dual roles as responders and affected community members. Conclusion: The findings emphasised the critical need to integrate mental health into disaster planning, prioritise training in psychosocial care, and adopt community-focused approaches to enhance collective resilience. This report contributes to disaster response discussions by providing insights into the lived experiences of mental health responders. It offers recommendations to strengthen preparedness and response frameworks, ensuring equitable and sustainable recovery for affected populations.
Early childhood screen use and symptoms of problematic media use Caroline Fitzpatrick, Marie-Andrée Binet, Daniel Tornaim Spritzer, Gabriel A. Tiraboschi, Sarah E. Domoff, et al. Journal of Behavioral Addictions, 2025 ObjectiveTo assess associations between early childhood screen time trajectories and problematic media use scores by age 5.5.MethodsThe present study is based on a prospective, community-based convenience sample of 315 parents of preschoolers, from Canada studied at the ages of 3.5 (2020), 4.5 (2021), and 5.5 (2022) during the Covid-19 pandemic. Parent-reported screen use at the ages of 3.5, 4.5, and 5.5 was used to estimate preschooler screen use trajectories. Using latent growth modeling, we identified low (mean = 0.9 h/day, 23%), average (mean = 3.0 h/day, 56%), and high (mean = 6.38 h/day, 21%) screen time trajectories. Parents reported child problematic media using the Problematic Media Use Measure – Short Form (PMUM-SF).ResultsA multiple regression, adjusted for child sex, effortful control and parent education and stress revealed that compared to children in the low screen time trajectory, children in the high screen time trajectory had higher problematic media use scores at age 5.5 (β = 0.378, p < 0.001). In addition, children in the average screen time trajectory scored higher than children in the low screen time trajectory (β = 0.229, p ≤ 0.001).ConclusionOur findings suggest that higher screen use in early childhood is associated with an increased risk for the development of dysregulated media use, which can interfere with family functioning. As such, parents should be encouraged to follow screen time recommendations of ≤1 h/day for children between the ages of 2 and 5.
Gaming Disorder and Problematic Use of Social Media Thiago Henrique Roza, Lucas Tavares Noronha, Matheus Amaral Makrakis, Daniel Tornaim Spritzer, Ary Gadelha, et al. Digital Mental Health A Practitioner S Guide, 2023
Internet and videogame addiction: A review Cristiano Nabuco de Abreu, Rafael Gomes Karam, Dora Sampaio Góes, Daniel Tornaim Spritzer Revista Brasileira De Psiquiatria, 2008
RECENT SCHOLAR PUBLICATIONS
Banning loot boxes for minors: A public health framework and the case of Brazil DT Spritzer, I Fortim, TH Roza, FHP Kessler, HS Kim Journal of Behavioral Addictions 15 (1), 5-7 , 2026 2026
Criminal Responsibility in Individuals with Gambling Disorder in Brazil TH Roza, DT Spritzer, CS Madruga, FHP Kessler, LE de Borba Telles Journal of Gambling Studies, 1-6 , 2026 2026
A Synthesis of Treatment Practices, Facilitations, and Barriers in Treatment of Behavioural Disorders Associated with Gaming Platforms and Excessive Internet Use in Six Countries S Achab, SA Arroyave, J Long, D Spritzer, YPS Balhara, KA Tan, ... Preprints , 2026 2026
Problem gambling in Brazil: Prevalence, patterns, and emerging challenges D Spritzer, C Madruga, R Laranjeira, K Isikawa, A Goldman, R Pereira, ... JOURNAL OF BEHAVIORAL ADDICTIONS 14 , 2025 2025
Experience report: Mental health interventions during the 2024 floods in Rio Grande do Sul, Brazil JCM Narvaez, SG Câmara, TR Gonçalves, DC Levandowski, DT Spritzer, ... International Journal of Social Psychiatry 71 (7), 1305-1319 , 2025 2025 Citations: 2
Early childhood screen use and symptoms of problematic media use C Fitzpatrick, MA Binet, DT Spritzer, GA Tiraboschi, SE Domoff, ... Journal of Behavioral Addictions 14 (3), 1411-1418 , 2025 2025 Citations: 2
A Cross-cultural exploration of problematic internet use, pathological personality traits, defense mechanisms, coping strategies, and self-esteem in 14 countries S Laconi, A Kalaitzaki, DT Spritzer, S Hauck, A Gnisci, I Sergi, Z Vally, ... Annales Médico-psychologiques, revue psychiatrique 183 (4), 400-406 , 2025 2025 Citations: 13
O uso de jogos digitais no tratamento de crianças e adolescentes com transtorno do espectro autista: uma revisão crítico-narrativa MV Teles, DT Spritzer Revista Brasileira de Psicoterapia 26 (3) , 2025 2025
Associations between preschooler screen time trajectories and the development of problematic media use C Fitzpatrick, MA Binet, D Spritzer, H Tavares JOURNAL OF BEHAVIORAL ADDICTIONS 13, 127-127 , 2024 2024
The prevalence and predictors of problematic mobile phone use: A 14-country empirical survey A Kalaitzaki, S Laconi, DT Spritzer, S Hauck, A Gnisci, I Sergi, Z Vally, ... International Journal of Mental Health and Addiction 22 (1), 746-765 , 2024 2024 Citations: 47
Validation of the Ten-Item Internet Gaming Disorder Test (IGDT-10) and its association with functional impairment in Brazilian gamers DT Spritzer, WL Machado, MB Yates, O Király, Z Demetrovics, J Billieux, ... Trends in Psychiatry and Psychotherapy 46, e20230622 , 2024 2024 Citations: 1
ONTOGD-An ontology-driven conceptual model for Gaming Disorder. MDG Da Silva Teixeira, H Tavares, M RODRIGUES GONÇALVES, ... Journal of Behavioral Addictions 12 , 2023 2023
The Self-perception of Text message Dependence Scale (STDS): A Brazilian-Portuguese validation and expansion of its psychometric properties DT Spritzer, ALM Andrade, AZ Xavier, GT da Silva, HS Kim, ... Current Psychology 42 (21), 17670-17681 , 2023 2023 Citations: 23
Depression in mothers at childhood: Direct and indirect association with problematic gaming in late adolescence/young adulthood TH Roza, FD Rabelo-da-Ponte, DT Spritzer, MS Hoffmann, R Massuda, ... Journal of psychiatric research 159, 14-21 , 2023 2023 Citations: 13
Crianças bem conectadas: como o uso consciente da tecnologia pode se tornar um aliado da família e da escola A Restano, B Bueno, D Spritzer, J Potter, L Moreira Maquinaria Editorial , 2023 2023 Citations: 3
ONTOGD-An ontology-driven conceptual model for Gaming Disorder MDGDS TEIXEIRA, H TAVARES, MR GONCALVES, DT SPRITZER, ... AKADEMIAI KIADO ZRT , 2023 2023
Gaming disorder and problematic use of social media TH Roza, LT Noronha, MA Makrakis, DT Spritzer, A Gadelha, FHP Kessler, ... Digital Mental Health: A Practitioner's Guide, 237-253 , 2023 2023 Citations: 12
Psychometric properties of the smartphone addiction inventory-short form (SPAI-SF) in Brazilian adolescents ALM Andrade, DT Spritzer, A Scatena, B de Oliveira Pinheiro, GT da Silva, ... Psychiatry Research 319, 115001 , 2023 2023 Citations: 26
Mental health help-seeking among Brazilian medical students: Who suffers unassisted? TM Bastos, DB Bumaguin, VR Astolfi, AZ Xavier, MS Hoffmann, F Ornell, ... International Journal of Social Psychiatry 68 (6), 1203-1212 , 2022 2022 Citations: 11
Exploration interculturelle de l'utilisation problématique d'Internet, des traits pathologiques de personnalité, des défenses, du coping et de l'estime de soi dans 14 pays S Laconi, A Kalaitzaki, DT Spritzer, S Hauck, A Gnisci, I Sergi, Z Vally, ... Annales Medico-Psychologiques , 2022 2022
MOST CITED SCHOLAR PUBLICATIONS
Gaming disorder: Its delineation as an important condition for diagnosis, management, and prevention JB Saunders, W Hao, J Long, DL King, K Mann, M Fauth-Bühler, ... Journal of behavioral addictions 6 (3), 271-279 , 2017 2017 Citations: 605
Including gaming disorder in the ICD-11: The need to do so from a clinical and public health perspective: Commentary on: A weak scientific basis for gaming disorder: Let us err … HJ Rumpf, S Achab, J Billieux, H Bowden-Jones, N Carragher, ... Journal of behavioral addictions 7 (3), 556-561 , 2018 2018 Citations: 417
Dependência de Internet e de jogos eletrônicos: uma revisão CN Abreu, RG Karam, DS Góes, DT Spritzer Brazilian Journal of Psychiatry 30, 156-167 , 2008 2008 Citations: 349
Expert appraisal of criteria for assessing gaming disorder: An international Delphi study J Castro‐Calvo, DL King, DJ Stein, M Brand, L Carmi, SR Chamberlain, ... Addiction 116 (9), 2463-2475 , 2021 2021 Citations: 284
Precisamos falar sobre tecnologia: caracterizando clinicamente os subtipos de dependência de tecnologia F Picon, R Karam, V Breda, A Restano, A Silveira, D Spritzer Rev. Bras. Psicoter.(Online), 44-60 , 2015 2015 Citations: 71
Exposure to electronic devices and sleep quality in adolescents: A matter of type, duration, and timing GH Caumo, D Spritzer, A Carissimi, AC Tonon Sleep health 6 (2), 172-178 , 2020 2020 Citations: 69
Prevalence and correlates of gambling problems among a nationally representative sample of Brazilian adolescents DT Spritzer, LA Rohde, DB Benzano, RR Laranjeira, I Pinsky, M Zaleski, ... Journal of Gambling Studies 27 (4), 649-661 , 2011 2011 Citations: 50
The prevalence and predictors of problematic mobile phone use: A 14-country empirical survey A Kalaitzaki, S Laconi, DT Spritzer, S Hauck, A Gnisci, I Sergi, Z Vally, ... International Journal of Mental Health and Addiction 22 (1), 746-765 , 2024 2024 Citations: 47
Hikikomori and the COVID-19 pandemic: not leaving behind the socially withdrawn TH Roza, DT Spritzer, A Gadelha, IC Passos Brazilian Journal of Psychiatry 43 (1), 114-116 , 2020 2020 Citations: 33
Manual de teratogênese MTV Sanseverino, DT Spritzer, L Schuler-Faccini Porto Alegre: Universidade Federal do Rio Grande do Sul, 11-47 , 2001 2001 Citations: 29
Psychometric properties of the smartphone addiction inventory-short form (SPAI-SF) in Brazilian adolescents ALM Andrade, DT Spritzer, A Scatena, B de Oliveira Pinheiro, GT da Silva, ... Psychiatry Research 319, 115001 , 2023 2023 Citations: 26
Dependência de jogos eletrônicos em crianças e adolescentes VCT Breda, FA Picon, LM Moreira, DT Spritzer Revista Brasileira de Psicoterapia 16 (1), 53-67 , 2014 2014 Citations: 26
Multimodal treatment for a Brazilian case of hikikomori TH Roza, DT Spritzer, LM Lovato, IC Passos Brazilian Journal of Psychiatry 42 (4), 455-456 , 2020 2020 Citations: 24
The Self-perception of Text message Dependence Scale (STDS): A Brazilian-Portuguese validation and expansion of its psychometric properties DT Spritzer, ALM Andrade, AZ Xavier, GT da Silva, HS Kim, ... Current Psychology 42 (21), 17670-17681 , 2023 2023 Citations: 23
Dependência de jogos eletrônicos DT Spritzer, F Picon Abreu, CN, Eisenstein, E., Estefenon, SG Vivendo esse mundo digital … , 2013 2013 Citations: 16
Psychometric properties of the nine-item Problematic Internet Use Questionnaire in a Brazilian general population sample DT Spritzer, WL Machado, MB Yates, VR Astolfi, P Laskoski, C Pessi, ... Frontiers in psychiatry 12, 660186 , 2021 2021 Citations: 15
A Cross-cultural exploration of problematic internet use, pathological personality traits, defense mechanisms, coping strategies, and self-esteem in 14 countries S Laconi, A Kalaitzaki, DT Spritzer, S Hauck, A Gnisci, I Sergi, Z Vally, ... Annales Médico-psychologiques, revue psychiatrique 183 (4), 400-406 , 2025 2025 Citations: 13
Depression in mothers at childhood: Direct and indirect association with problematic gaming in late adolescence/young adulthood TH Roza, FD Rabelo-da-Ponte, DT Spritzer, MS Hoffmann, R Massuda, ... Journal of psychiatric research 159, 14-21 , 2023 2023 Citations: 13
Dependência de internet: perspectivas em terapia cognitivo-comportamental CC Pujol, S Alexandre, A Sokolovsky, RG Karam, DT Spritzer Brazilian Journal of Psychiatry 31 (2), 185-186 , 2009 2009 Citations: 13
Gaming disorder and problematic use of social media TH Roza, LT Noronha, MA Makrakis, DT Spritzer, A Gadelha, FHP Kessler, ... Digital Mental Health: A Practitioner's Guide, 237-253 , 2023 2023 Citations: 12