Eye movement verification and evaluation of initial sandplay picture system for internet addiction symptoms in Chinese adolescents

BACKGROUND: Sandplay therapy is a psychotherapeutic technique, based on the psychoanalytic theory of the unconscious. Nearly a century after it was developed, sandplay can now be applied for the initial diagnosis tools for sand players. The goal of the current research is to demonstrate the role of sandplay in identifying internet-addicted adolescents in China. The study aims to evaluate the reliability and validity for sandplay as a diagnosis and evaluation tool for internet addiction symptoms, and to verify the consistency that exists between results based on sandplay pictures and those based on the Pathological Internet Usage Scale for Adolescents (APIUS). METHODS: The research was conducted with a 2 × 2 mixed factorial design – two types of participants (addicts and non-addicts) and two types of sandplay pictures (pictures for addicts and pictures for non-addicts). An absolute recognition-judgment paradigm was used along with eye movement evaluations to evaluate the existing initial sandplay picture system for internet addiction symptoms (22 sandplay pictures, 11 related to addicts and 11 related to non-addicts, respectively). Sixty Chinese adolescents were selected as the participants (30 as addicts and 30 as non-addicts) according to the APIUS. RESULTS: (1) The initial sandplay pictures for internet addicts are clearly preferred by Chinese internet-addicted adolescents, which are more familiar and easier to process; (2) Such pictures have a higher level of emotional arousal and cognitive resonance for the addicts; (3) Track and heat maps indicate that young internet addicts mainly fixate on the initial sandplay pictures for internet addicts. CONCLUSION: This initial sandplay picture system can be used to screen and identify young Chinese internet addicts based on symptoms, and the evaluation results are consistent with those based on the APIUS. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13052-023-01487-8.