Prevalence of Internet Addiction during the COVID-19 Outbreak and Its Risk Factors among Junior High School Students in Taiwan

Online dialectical behavioral therapy for adults with internet addiction: A quasi-experimental trial during the COVID-19 pandemic

The pathological use of the Internet has surged during the pandemic, even though service provisions were negatively impacted. Telepsychiatry can be used as a solution to maintain psychiatric addiction services. This study examined the efficacy of online group dialectical behavioral therapy (DBT) for Internet addiction (IA), compared to cognitive behavioral therapy (CBT). Participants were divided into two arms for 8 weeks: the experimental arm received eight sessions of online DBT skill group training (n = 20), and the control arm received four sessions of online individual CBT (n = 20). All participants were required to complete a sociodemographic and Internet use survey, the Internet Addiction Test (IAT), and the University of Rhode Island Change Assessment (URICA). All participants completed the therapy. Of the 40 participants, six (15%) perceived the need for therapy and one (2.5%) participant had a history of seeking IA therapy. In the pre-post comparison, significant improvements were noted in the IAT and URICA scores as well as Internet use duration for both arms. No significant differences were observed across the arms and in the time-by-arm interaction. Online group DBT is a viable alternative to online CBT in an acute constrained setting, although further studies are required to scrutinize its long-term efficacy. Trial Registration: ISRCTN17273762.

Effects of sleep quality on the association between problematic internet use and quality of life in people with substance use disorder

BACKGROUND

Problematic internet use, especially in people with substance use disorder, may negatively affect their quality of life (QoL). However, it is unclear whether sleep quality is a key mediator in the association between problematic internet use and QoL among people with substance use disorder.

AIMS

This study aimed to investigate the relationship between problematic internet use and QoL and how sleep quality may mediate the association between these two variables.

METHOD

Overall, 319 people (85% male) with substance use disorder (mean age 42.2 years, s.d. 8.9) participated in a cross-sectional study in Taiwan. The Smartphone Application-Based Addiction Scale, Bergan Social Media Addiction Scale, Internet Gaming Disorder-Short Form, Pittsburgh Sleep Quality Index and World Health Organization Quality of Life Questionnaire Brief Version were used.

RESULTS

The prevalence of sleep problems was 56%. There were significant and direct associations between sleep quality and two types of problematic internet use, and between sleep quality and different dimensions of QoL. All types of problematic internet use were significantly and negatively correlated with QoL. Mediated effects of sleep quality in relationships between the different types of problematic internet use and all dimensions of QoL were significant, except for problematic use of social media.

CONCLUSIONS

Different types of problematic internet use in people with substance use disorder may be directly associated with reduced QoL. Sleep quality as a significant mediator in this association may be an underlying mechanism to explain pathways between problematic internet use and QoL in this population.

Stressful life events and non-suicidal self-injury among Chinese adolescents: A moderated mediation model of depression and resilience

Stressful life events are associated with an increased risk of non-suicidal self-injury (NSSI) in adolescence, but the mechanisms explaining this association are unclear. Based on the experiential avoidance model of NSSI, and the protective factor model of resilience, the current study tested depression as a mediator and resilience as a moderator of this association. Chinese adolescents (N = 643; M_age = 15.91; 52.10 % female), anonymously completed self-report measures in classrooms. Results showed that stressful life events was linked to adolescent NSSI in part because of adolescent depression, and resilience was a protective factor that buffered this effect. These findings can inspire practitioners to pay attention to the interaction of risk factors and protective factors when providing prevention and intervention for adolescent NSSI.

Exploring the links between alexithymia and cognitive emotion regulation strategies in internet addiction: A network analysis model

Alexithymia and emotion regulation are closely related to internet addiction. However, no research has examined how the different components of alexithymia are associated with cognitive emotion regulation in the context of multi-strategy use in internet addiction. The current study aimed to investigate the relation between alexithymia and cognitive emotion regulation in individuals with internet addiction via network analysis. Participants included 560 students with Young’s Internet Addiction Test scores greater than 50 points; they were also asked to complete the Toronto Alexithymia Scale (TAS-20) and the Cognitive Emotion Regulation Questionnaire (CERQ). The results revealed two bridge nodes emerging within the combined alexithymia and cognitive emotion regulation network model: “catastrophizing” and “externally oriented thoughts.” These findings indicate a more specific relation between alexithymia and cognitive emotion regulation and provide empirical evidence for targeted prevention and targeted interventions for internet addiction.

Challenges of children and adolescents with attention-deficit/hyperactivity disorder during the COVID-19 pandemic

OBJECTIVE

We aimed to understand the challenging effect of the pandemic on children and adolescents with ADHD.

METHODS

100 children and adolescents with ADHD aged 7-18 years were included in the study. They were evaluated in terms of internet addiction diagnostic criteria. Symptom severity was assessed using the CBCL, CPRS, and SNAP-IV.

RESULTS

We found that 42% spent less time outdoors, and 26% spent more time watching TV. 57% had increased internet use and 28% were diagnosed as having internet addiction. There was a significant difference in terms of symptom severity between the groups depending on whether the children took part in sports activity before the pandemic.

CONCLUSIONS

Children and adolescents with ADHD have experienced challenges in many areas, especially internet use in the pandemic. The positive long-term effects of exercise in children with ADHD are thought to be protective in terms of symptom management during the COVID-19 pandemic.

Resilience and Academic Dropout in Ecuadorian University Students during COVID-19

The pandemic caused by COVID-19 has had a global impact that has affected all areas of people’s lives. However, people have different capacities to adapt and cope with the adversities and traumatic events that may have occurred during the pandemic with different levels of resilience. One collective affected by this global crisis was university students, who had to face an unprecedented academic situation, resulting in some abandoning their studies. This study aims to analyse whether the resilience of the students could be related to academic dropout. To carry out this research, we assessed the resilience of 1676 university students from 11 universities in Ecuador. To do so, a committee of experts from the Ecuadorian Association of Social Work Education Centres and 11 Ecuadorian universities designed a questionnaire and sent it to the entire sample. Subsequently, we compared the levels of resilience between university students who withdrew from university during the COVID-19 pandemic with those who continued their studies by using a multivariate analysis. The results showed that there were statistically significant differences in all variables analysed. The students who obtained the highest scores were those who continued their studies, and those students who dropped out obtained the lowest scores. In summary, we found that school dropout among Ecuadorian university students during the COVID-19 pandemic was due to low levels of resilience. Therefore, increasing student resilience could improve university retention rates and, in turn, academic performance and future life prospects.

Internet addiction in adolescents: Role of family, personality and comorbid psychopathology in school children in Eastern India

CONTEXT

There is an increasing prevalence of internet addiction among adolescents during the COVID-19 pandemic, but very few Indian studies have assessed and taken into account various factors that can explain internet addiction in this vulnerable population.

AIMS

We examine the differences in family functioning, temperament, character and psychopathology in adolescents with and without internet addiction.

SETTINGS AND DESIGN

1000 adolescents from urban middle-class families were included in this cross-sectional, two-randomized-group designed, comparative study. Clinical and control group population were selected from high schools. Those with severe internet addiction were compared to those with no addiction.

METHODS AND MATERIALS

Internet Addiction Test, Temperament and Character Inventory, Devereux Scale of Mental Disorders and McMaster Family Assessment Device were administered along with General Health and CRAFFT Questionnaire as screening tool.

STATISTICAL ANALYSIS USED

Mann-Whitney U test was done along with Spearman's rank-difference coefficient of correlation.

RESULT

Adolescents with internet addiction had high novelty seeking and low persistence. Internet addiction was also associated with conduct problems and depression. There was a significant positive association between depression and years of internet usage. Family of adolescents with internet addiction had increased difficulty in problem solving, communication, affective responsiveness, affective involvement and behavior control.

CONCLUSION

Adolescents with internet addiction have temperament difficulties, more psychopathology and belong to dysfunctional families. Since the family plays a central role in an Indian context, family-focused strategies must also be included in the management of internet addiction.

Problematic Internet Use Among School-Going Adolescents in India: A Systematic Review and Meta-Analysis

Background

Problematic internet use (PIU) among school going adolescents constitutes a major area of concern. However, no comprehensive reports are available to determine the magnitude of the problem. This study aimed to estimate the pooled prevalence of PIU among school going adolescents in India.

Methods

We conducted a systematic review and meta analysis of 15 studies conducted in various parts of India.

Results

The prevalence of moderate and severe PIU among Indian school going adolescents was 21.5% (95% CI: 17.0%-26.8%) and 2.6% (95% CI: 1.6%-4.2%) based on the Young Internet Addiction Test (Y IAT) cutoff points of 50 and 80, respectively. In subgroup analysis, it was found that the year of publication, gender, sampling method, and severity of addiction had a significant effect on the prevalence estimates.

Conclusions

Currently, the use of the internet is rampant in India and our findings reflect nationally representative data on the magnitude of PIU among school going adolescents. About one fifth of school going adolescents are at risk of PIU in this setting. There is a need for further research in the reconsideration of cut off points of the Y IAT among Indian adolescents.

Prevalence and determinants of internet addiction among adults during the COVID-19 pandemic in Bangladesh: An online cross-sectional study

Background

Globally, internet use has increased significantly during the COVID-19 pandemic, and internet addiction (IA) has become a severe public health issue. Therefore, this study aimed to assess IA prevalence among adults and identify its determinants during the COVID-19 pandemic in Bangladesh.

Methods

Using a cross-sectional design, this study recruited 608 participants through a self-administered online-based e-questionnaire. Young's internet addiction test (YIAT) of 20 items was used to assess the prevalence of IA among adults in Bangladesh. Bivariate and binary logistic regression analyses explored the factors influencing IA.

Results

The overall prevalence of IA was 29.4% among adults during the COVID-19 pandemic. However, the addiction rate was 34.7% among participants under 20 years old. Tobacco smoking (AOR = 1.88, 95% CI 1.15-3.07) and spending more time on the internet during the COVID-19 pandemic (AOR = 2.06, 95% CI 1.08-3.94) were likely the reasons for IA among Bangladeshi adults. Participants aged over 24 years (AOR = 0.39, 95% CI 0.17-0.91), living in rural areas (AOR = 0.51, 95% CI 0.32-0.81), living away from family (AOR = 0.45, 95% CI 0.26-0.79), attached to physical activity (AOR = 0.35, 95% CI 0.24-0.52), and sleeping less than or equal 6 hours (AOR = 0.63, 95% CI 0.42-0.93) had a lower chance of IA during the COVID-19 pandemic.

Conclusion

This study has shown that the prevalence of IA was comparatively higher among younger participants during the COVID-19 pandemic. Smoking, long-time use of the internet, physical activity status, and sleeping duration were the most significant determinants of IA. Thus, raising awareness among the younger generation is the most important strategy to reduce IA. The findings of this study can be used to support health and educational organizations to design their programs, which will help prevent IA in Bangladesh during the COVID-19 pandemic.

The relationship between internet addiction and aggressive behavior among adolescents during the COVID-19 pandemic: Anxiety as a mediator

The COVID-19 pandemic has brought unprecedented challenges for adolescents, who tended to experience more emotional instability, impulsivity, and aggressive behavior driven by the fear of infection and the uncertainty of network information. In the present study, we investigated the relationship between Internet addiction and aggressive behavior, and the mediating effects of depression and anxiety. There were differences in Internete addiction and aggressive behavior in gender, thus the moderating role of gender between them were explored. A total of 1148 middle school students were invited to complete the Buss Perry Aggression Questionnaire, the Internet Addition Scale, the Self-rating Depression Scale (SDS), and the Self-rating Anxiety Scale (SAS) separately. The results suggested that 1) there was a significant positive correlation between Internet addiction and aggressive behavior; 2) anxiety, but not depression, mediated the effect of Internet addiction on aggressive behavior; 3) gender did not moderate the effect of Internet addiction on aggressive behavior. The practical implication of the current findings on boosting adolescents' mental health was discussed and further suggestions were provided.

Associations between Fear of COVID-19, Depression, and Internet Addiction in South Korean Adults

This study investigates the associations between Internet addiction and psychological distress, including fear of coronavirus disease 2019 (COVID-19), and depression in South Korean adults during the COVID-19 pandemic. A population-based cross-sectional online survey was conducted from 14 to 18 May 2021. Potential adult survey respondents aged 20 years or older were randomly extracted from one of the largest online survey panels in South Korea, matching the South Korean national demographic proportions (i.e., region, gender, and age). Subsequently, 1155 participants were included in the study. Descriptive and logistic regression analyses were performed to investigate the participants’ characteristics and analyze the adjusted odds ratios (aORs). Of the South Korean adults, 11.17%, 15.15%, and 37.23% were at risk of Internet addiction, COVID-19 fear, and depression, respectively. Internet addiction was positively associated with COVID-19 fear (aOR = 3.25, 95% CI [2.10, 5.04]) and depressive symptoms (aOR = 6.40, 95% CI [4.15, 9.86]). Addictive Internet use was significantly associated with psychological distress during the COVID-19 pandemic. The development of public health strategies that mitigate addictive Internet use and increase eHealth literacy will be useful for securing the public’s psychological well-being.

The predictive role of tendency toward mobile learning and emotional intelligence in Internet addiction in healthcare professional students

INTRODUCTION

Internet addiction is a psychological disorder that can lead to serious damages to university students as a group at risk. This study aimed to determine the predictive role of tendency toward mobile learning (purposeful use of mobile technologies for educational purposes) and emotional intelligence in Internet addiction in healthcare professional students.

METHODS

A cross-sectional descriptive study was carried out on 403 healthcare professional students at Saveh University of Medical Sciences-Iran in 2021 using convenience sampling method. For data gathering, three questionnaires were used: willingness to use mobile learning, Young's Internet Addiction Test, and the Emotional Intelligence Appraisal. Data analyses were done using Pearson Correlation Coefficient and Hierarchical Regression in SPSS 16 (Inc SPSS USA, IL, Chicago).

RESULTS

The mean age of the participants was 21.09±1.47 years; 125 subjects (31.01%) were boys and 278 (68.99%) girls. As the findings showed, 16.87% of the students had Internet addiction and 33% were on the edge of developing Internet addiction. Internet addiction was significantly negatively correlated with willingness to m-learning (r=-0.45, P=0.001) and emotional intelligence (r=-0.32, P=0.01). In addition, regression analysis results showed that the variables willingness to use learning and emotional intelligence explained 23% of the Internet addiction variance (P<0.001).

CONCLUSION

In the present study, a considerable number of the healthcare professional students had excessive and unnecessary use of the Internet. Emotional intelligence and willingness to use mobile learning had an inverse relationship with Internet addiction. There is a need to screen Internet-addicted students using proper screening tools and take primary preventive measures in this regard. In addition, proper measures are needed to be taken to improve emotional intelligence and mobile learning skills and control Internet addiction to some extent.

Effects of Screen Viewing Time on Sleep Duration and Bedtime in Children Aged 1 and 3 Years: Japan Environment and Children's Study

This study aimed to clarify the effects of television/digital versatile disc (TV/DVD) viewing time and portable electronic device (PED) usage time on sleep duration and bedtime and the difference between the effects of TV/DVD and PED on sleep. The effect of TV/DVD viewing time or PED usage time on sleep duration and bedtime was analyzed using a multiple logistic regression analysis adjusted for covariates. A total of 74,525 participants were included in the analysis, using data from Japan Environment and Children’s Study. TV/DVD viewing was not associated with short sleep duration, but PED usage was associated with short sleep duration. In addition, the risk of short sleep duration increased as PED usage time increased. We also investigated the effects of sleep habits at age 1 year on sleep at age 3 years. This study showed that late bedtime at age 1 year posed a significant risk of late bedtime at age 3 years. In summary, particular caution should be paid to PED use from a child’s health perspective, and sleep habits should be focused on bedtime from the age of 1 year.

Determining the relationship between loneliness and internet addiction among adolescents during the covid-19 pandemic in Turkey

PURPOSE

This study was conducted to determine the relationship between the levels of loneliness adolescents feel during the pandemic, and their respective levels of internet addiction.

DESIGN AND METHODS

The sample of the study consists of 482 adolescents who volunteered to participate in the study. All participants had the cognitive competence to express themselves, and had access to the Internet. Participants filled out a Google Docs form including the "Descriptive Information Form", "ULS-SF" and "IASA", which were used to collect data.

RESULTS

As a result of the multiple regression analysis, it was found that family income, mothers' education status, fathers' education status, the duration of Internet use before and during the pandemic, and the total score of ULS-SF had statistically significant effects on the total score of IASA (p < 0.05).

CONCLUSIONS

It was concluded that adolescents' internet addiction increases with the increasing level of loneliness. Adolescents who reported feeling moderately lonely had a low level of Internet addiction. There were certain variables that were also found to be influential on adolescents' average levels of loneliness and Internet addiction during the Covid-19 pandemic.

PRACTICE IMPLICATIONS

Protecting adolescents' mental health during the pandemic is dependent on taking measures to reduce the risks, while strengthening the protective factors. These protective factors include providing adolescents the access to the appropriate information resources and encouraging the rational use of the Internet, which will support the individual and the individual's social development.

A grounded theory study to explore the digital gameplay experiences of adolescents at risk of addiction in Turkey

PURPOSE

This study aimed to explore the experiences of adolescents at risk of digital game addiction in Turkey.

DESIGN AND METHODS

Guided by a grounded theory design, data were collected from 14 adolescents through one-on-one in-depth interviews between January and April 2021. Simultaneous data collection and analysis involved theoretical sampling, constant comparison, and memo writing. Open, axial, and selective coding were used in data analysis, while analytic coding identified the core category and subcategories and provided the foundation for the substantive theory.

RESULTS

The core category, "I want to limit my time playing digital games, but I need the support of my family to do so," demonstrated the adolescents' awareness of their situation. The analysis yielded an interpretive theory comprising three inter-related categories: causal factors, effects on life, and solution pathways.

CONCLUSIONS

The participants' reasons for playing digital games included meeting their need for socialization and passing the time. However, digital gaming affects adolescents physically, psychosocially, and culturally. Solutions include early childhood education and family support, which can significantly reduce the risk of digital game addiction.

PRACTICE IMPLICATIONS

Preventing digital game addiction is an important goal, and identifying risks contributing to digital game addiction is fundamental to establishing preventive measures. This study's findings may increase awareness of the subject for teachers, school nurses, and parents. Among the potential remedial measures are future studies focused on preventing digital game addiction and adding instruction to school curricula regarding necessary and beneficial uses of digital technologies.

An Investigation of Changing Attitudes and Behaviors and Problematic Internet Use in Children Aged 8 to 17 Years During the COVID-19 Pandemic

PURPOSE

To examine the effects of the COVID-19 pandemic on the lifestyle, habits, and behavioral differences in children, and their changing internet use habits.

METHODS

The research was planned as a cross-sectional study involving 4892 children aged 8 to 17 years attending schools in the city center of Trabzon, Turkey. Children's daily living activities, social habits, mood and temperament changes, and internet use were investigated before and during the pandemic. In terms of problematic internet use, internet addiction rates were evaluated using the validated Turkish-language version of the Parent-Child Internet Addiction Scale (PCIAT-20).

RESULTS

The children's mean age was 13 ± 2.45 years, and 17.1% (n = 837) exhibited problematic internet use features on the PCIAT-20. Problematic internet use was higher in boys and in children older than 13 years. The presence of COVID-19 infection among members of the household, quarantine measures, attending private schools, the mother's occupation, the time spent by the mother and father on their mobile phones, and high parental education levels were associated with a high level of internet addiction. Families also described significant changes in their children's temperament and character compared with the pre-pandemic period.

CONCLUSION

The prevalence of problematic internet use increased during the COVID-19 pandemic compared with previous studies from Turkey. Children were also more introverted, irritable, and pessimistic during the pandemic.

COVID-19-Related Social Isolation Predispose to Problematic Internet and Online Video Gaming Use in Italy

COVID-19 pandemic and its related containment measures have been associated with increased levels of stress, anxiety and depression in the general population. While the use of digital media has been greatly promoted by national governments and international authorities to maintain social contacts and healthy lifestyle behaviors, its increased access may also bear the risk of inappropriate or excessive use of internet-related resources. The present study, part of the COVID Mental hEalth Trial (COMET) study, aims at investigating the possible relationship between social isolation, the use of digital resources and the development of their problematic use. A cross sectional survey was carried out to explore the prevalence of internet addiction, excessive use of social media, problematic video gaming and binge watching, during Italian phase II (May-June 2020) and III (June-September 2020) of the pandemic in 1385 individuals (62.5% female, mean age 32.5 ± 12.9) mainly living in Central Italy (52.4%). Data were stratified according to phase II/III and three groups of Italian regions (northern, central and southern). Compared to the larger COMET study, most participants exhibited significant higher levels of severe-to-extremely-severe depressive symptoms (46.3% vs. 12.4%; p < 0.01) and extremely severe anxiety symptoms (77.8% vs. 7.5%; p < 0.01). We also observed a rise in problematic internet use and excessive gaming over time. Mediation analyses revealed that COVID-19-related general psychopathology, stress, anxiety, depression and social isolation play a significant role in the emergence of problematic internet use, social media addiction and problematic video gaming. Professional gamers and younger subjects emerged as sub-populations particularly at risk of developing digital addictions. If confirmed in larger and more homogenous samples, our findings may help in shedding light on possible preventive and treatment strategies for digital addictions.

Is There a Relationship Between Youth Bullying and Internet Addiction? An Integrative Review

Youth bullying is a global public health problem; Internet addiction is on the rise globally among youths. Because the linkage between these behaviors has not been clearly explicated, this integrative review evaluated the relevant empirical evidence. A search of five electronic databases identified 2,761 original citations published between January 2000 and May 2019. After further abstract screening and detailed evaluation of 262 full-text articles, the final sample consisted of 14 prospective descriptive studies representing 10 countries. Review results clearly established that the relationship between bullying and Internet addiction is firmly supported; less is known as to the contribution of gender, age, and other demographic variables, their impact on health outcomes, problematic behaviors, and the role of parental mediation. Inconsistent definitions and instrumentation and lack of sophisticated study designs limited the synthesis of findings. Future research is needed to explicate these relationships, so data-driven interventions can be developed.

Internet addiction in young adults: The role of impulsivity and codependency

Excessive Internet use has demonstrated comorbidity with other psychological symptoms and psychiatric disorders, as well as impairments in the management of daily life, relationships and emotional stability. Recent findings in the literature have consistently supported the relationship between impulsivity and Internet addiction. The present study hypothesized that, in addition to impulsivity, a further predictor of Internet addiction might be relational co-dependency, which is also associated in the literature with addiction phenomena, but mainly substance addiction. This paper investigates the role and predictive weight of impulsivity and codependency on Internet addiction on a sample of young adult university students (n = 481) by using a hierarchical regression analysis. The participants were administered the UADI-2, the BIS-11 and the SFCDS. In terms of percentage distribution, 38 % of the participants were in the dependency range, while 37.7 % demonstrated Internet abuse behavior. The results confirmed the role of impulsiveness (β = 0.312) and added to the literature by showing the significant role of relational codependency (β = 0.275), gender (β = 0.174) and age (β = 0.196). Thus, male participants were more dependent, more impulsive and more co-dependent, with increasing age in the given range (18-30). The present study shed light to the presence of this issue among young adults and that, as a preventive and restraining measure, there is a need not only for targeted awareness-raising programmes but also for interventions to promote greater emotional control and a more balanced management of personal relationships.

A multidimensional construct of helicopter parenting and college students' game and social media addictive behaviors: A cross-cultural study in South Korea and China

Introduction

We explored latent classes of helicopter parenting among Korean and Chinese college students. In addition, we examined whether these latent classes of helicopter parenting are related to Korean and Chinese students' game and social media addictive behaviors.

Methods

A three-step latent class analysis was conducted using 452 students from six universities in South Korea and 372 students from four universities in China.

Results and discussion

We identified four distinct helicopter parenting latent classes among the parents of Korean and Chinese students: weak, strong, academic management, and academic and schedule management. We also found that Korean students in the strong class reported significantly higher levels of game and social media addictive behaviors than those in the other three classes, but this did not hold for Chinese students. This finding indicates that the association between helicopter parenting and college students' game and social media addictive behaviors can be differentiated within Asian cultural contexts.

Factors influencing the addiction characteristics of non-suicidal self-injurious behaviors in adolescents: A case-control study

BACKGROUND

Many studies have shown that in the context of public health emergencies, the incidence rate of adolescent non-suicidal self-injury (NSSI) patients increased dramatically. This paper aims to characterize the behavioral characteristics of adolescent NSSI and analyze the influencing factors of NSSI behavior addiction characteristics.

METHODS

Our research was a case-control study which included 84 adolescents with NSSI (female vs. male: 59 vs. 25) and 84 healthy controls (female vs. male: 53 vs. 31). All the participants enrolled were aged 12-18 years. The differences in the scores of the following five scales were compared between the case and control groups: Egna Minnen Barndoms Uppfostran (EMBU), Perceived Social Support Scale (PSSS), Perceived Stress Scale (PSS); Bergen Social Media Addiction Scale (BSMAS) and Video Game Dependence Scale (VDG-S). The characteristics of NSSI behavior of the study group were evaluated using the Ottawa Self Inventory Chinese Revised Edition (OSIC). And a binary logistic regression model was developed to analyze the factors that influence adolescent NSSI behavioral addiction characteristics.

RESULTS

In the study group, the emotional warmth scores in the father's and mother's rearing style scores in the EMBU were significantly lower than the controls. The BSMAS and VDG-S scores were significantly higher than those in the control group. 38 cases of NSSI with addiction characteristics accounted for 45.24% in the study group. The risk factors for NSSI addiction traits were as follows: female, single-child, high level of VDG-S scores, high scores of excessive interferences in father's rearing style, and high scores of punishments and excessive interferences in mother's rearing style score.

CONCLUSION

Female, only child, internet addiction, and negative parenting styles were predictors of NSSI behavioral addiction characteristics in adolescents. Targeted coping strategies should be developed to reduce the occurrence and development of self-injurious behavior, especially for female adolescents with Internet dependence in one-child families with negative parenting styles.

Internet addiction and psychosocial problems among adolescents during the COVID-19 pandemic: A cross-sectional study

PURPOSE

This research was conducted to investigate the prevalence of internet addiction and psychosocial problems and associated factors among adolescents during the COVID-19 pandemic.

DESIGN AND METHODS

A cross-sectional study was conducted in Turkey. The population was composed of 9th and 10th grade students. The sample consisted of 1572 participants. Data were collected from parents of the students through a questionnaire, the Pediatric Symptom Checklist, and the Parent-Child Internet Addiction Test.

RESULTS

The prevalence of psychosocial problems was 20.7%. A few (4.8%) of adolescents had limited internet addiction symptoms. The psychosocial problems risk was significantly higher in adolescents whose fathers did not work, whose family income was less than expense, and whose daily internet use time was more than 3 h and more (p < 0.05). The risk of problematic internet use was significantly higher in males, whose mother's education level was high school and lower, whose family income was less than expense, and whose duration of internet use was 5 years and more (p < 0.05). There was a positive correlation between internet addiction and psychosocial problem mean scores (p < 0.05).

CONCLUSION

Most of the adolescents were internet users and one in five adolescents was at risk of psychosocial problems. Internet addiction and psychosocial problems were associated with several sociodemographic factors.

PRACTICE IMPLICATIONS

This study emphasizes the need for the prevention of excessive internet use and psychosocial problems during COVID-19 pandemic among adolescents. Nurses should organize online trainings for internet addiction and psychosocial problems for adolescents and their parents during the quarantine process.

Impact of the COVID-19 Pandemic on the Mental Health of Adolescent Students in Daegu, Korea

BACKGROUND

In February 2020, as coronavirus disease 2019 (COVID-19) spread rapidly in Daegu, South Korea, students in that region experienced many emotional difficulties. In this study, we analyzed the stress and emotional crisis experienced by students during the COVID-19 pandemic, its causative factors, and the factors that affect negative emotions.

METHODS

We identified the demographic information related to the experiences of unbearable stress and emotional crisis and their causal factors at three points in time: before the pandemic, during its peak, and at the time of the survey (2-3 months after the peak). In addition, we analyzed the factors related to depression and anxiety experienced by students during the COVID-19 pandemic. The Korean version of the Patient Health Questionnaire 9 and the Korean version of the Generalized Anxiety Disorder 7 was used to assess for depressive and anxiety symptoms in the subject students, respectively.

RESULTS

A total of 8,177 students participated in the analysis, with 4,072 boys (49.8%), 4,105 girls (50.2%), and 4,463 middle school students (54.6%) and 3,177 high school students (45.4%). The percentage of students who experienced unbearable stress was 9% before the COVID-19 pandemic, increased to 16% at the peak of the COVID-19 pandemic, then decreased to 12.7% at the time of the survey. Stress was experienced more by girls (18.1% versus 13.8% in boys; χ² = 28.159, P < 0.001) and high school students (19.0% versus 13.5% in middle school students; χ² = 45.437, P < 0.001). Overall, 7.6% experienced emotional crises during the COVID-19 pandemic, which was more prevalent in girls (10.1% versus 5.2% in boys; χ² = 71.025, P < 0.001) and in high school students (8.8% versus 6.7% in middle school students; χ² = 12.996, P < 0.001). Depression and anxiety was seen in 19.8% and 12.3% of students during the COVID-19 pandemic, respectively. The risk factors for depression and anxiety included unbearable stress before the COVID-19 pandemic (P < 0.001), mental health (P = 0.044), and age (P = 0.040), whereas resilience was identified as a protective factor for depression and anxiety (P = 0.001).

CONCLUSION

Students in Daegu experienced lots of mental difficulties since the COVID-19 pandemic. It will be necessary to improve stress management and resilience to improve students' mental health in disasters such as the COVID-19 pandemic.

COVID-19-Related Variables and Its Association with Anxiety and Suicidal Ideation: Differences Between International and Local University Students in Taiwan

Purpose

The present study examined the differences between international and local university students in Taiwan regarding COVID-19-related variables, anxiety, and suicidal ideation.

Participants and Methods

An online cross-sectional survey (sent via an online link in an email) was carried out comprising university students (n=529). The students were assessed on measures (including validated psychometric instruments) of perceived susceptibility to COVID-19, perceived sufficiency of resources, sources of COVID-19 information, perceived satisfaction with support, anxiety and suicidal ideation.

Results

Local students had higher susceptibility to COVID-19 (p<0.001) but decreased sufficiency with resources (p<0.001) and anxiety (p<0.001) compared with international students. Staying with family members, satisfaction with support, and information seeking were the factors that predicted anxiety among international students (all p-values<0.05), while information seeking predicted local students’ anxiety (p<0.001). Furthermore, staying with family members, susceptibility to COVID-19, and sufficiency with resources were the factors that predicted suicidal ideation among international students (all p-values<0.05), while being a male and satisfaction with support predicted suicidal ideation among local students (all p-values<0.05).

Conclusion

International students displayed different COVID-19-related challenges compared with local students. More specifically, international students as compared with local students had lower susceptibility to COVID-19 and higher anxiety. Therefore, healthcare providers should pay more attention to international students’ psychological health and awareness regarding impacts of COVID-19 on health.

The Relationship between Internet Addiction, Internet Gaming and Anxiety among Medical Students in a Malaysian Public University during COVID-19 Pandemic

The internet has become an important medium for learning and communication during the COVID-19 pandemic, particularly for university students. Nevertheless, an increase in internet usage could predispose people to internet addiction (IA) and internet gaming (IG). Equally, there is concern that anxiety levels have increased during the pandemic. The aim of this study is to determine the prevalence of IA and IG, and their associations with anxiety among medical students during the pandemic. Data were collected during the second wave of the “Conditional Movement Control Order” (CMCO) in Malaysia between 12 November and 10 December 2020. A total of 237 students participated through proportionate stratified random sampling in this cross-sectional study. They completed a set of online questionnaires which consisted of a sociodemographic profile, the Malay version of the internet addiction test (MVIAT), the Malay version of the internet gaming disorder-short form (IGDS9-SF) and the Malay version of the depression, anxiety and stress scale (DASS-21). The prevalence of IA and internet gaming disorder (IGD) were 83.5% and 2.5%, respectively. A multiple logistic regression showed that those in pre-clinical years had a greater risk of anxiety than those in clinical years [(AOR) = 2.49, p-value 0.01, 95% CI = 1.22–5.07]. In contrast, those who scored high on IA were protected against anxiety [AOR = 0.100, p-value 0.03, 95% CI = 0.01–0.76)]. In conclusion, IA was highly prevalent during the COVID-19 pandemic and its high usage might serve as a protective factor against anxiety among the medical students in this study sample.

Internet addiction and sleep quality among medical students during the COVID-19 pandemic: A multinational cross-sectional survey

BACKGROUND

The emergence of the COVID-19 pandemic has affected the lives of many people, including medical students. The present study explored internet addiction and changes in sleep patterns among medical students during the pandemic and assessed the relationship between them.

METHODS

A cross-sectional study was carried out in seven countries, the Dominican Republic, Egypt, Guyana, India, Mexico, Pakistan, and Sudan, using a convenience sampling technique, an online survey comprising demographic details, information regarding COVID-19, the Pittsburgh Sleep Quality Index (PSQI), and the Internet Addiction Test (IAT).

RESULTS

In total, 2749 participants completed the questionnaire. Of the total, 67.6% scored above 30 in the IAT, suggesting the presence of an Internet addiction, and 73.5% scored equal and above 5 in the PSQI, suggesting poor sleep quality. Internet addiction was found to be significant predictors of poor sleep quality, causing 13.2% of the variance in poor sleep quality. Participants who reported COVID-19 related symptoms had disturbed sleep and higher internet addiction levels when compared with those who did not. Participants who reported a diagnosis of COVID-19 reported poor sleep quality. Those living with a COVID-19 diagnosed patient reported higher internet addiction and worse sleep quality compared with those who did not have any COVID-19 patients in their surroundings.

CONCLUSION

The results of this study suggest that internet addiction and poor sleep quality are two issues that require addressing amongst medical students. Medical training institutions should do their best to minimize their negative impact, particularly during the current COVID-19 pandemic.

How Does Psychological Distress Due to the COVID-19 Pandemic Impact on Internet Addiction and Instagram Addiction in Emerging Adults?

International research has underlined a worrying increase in Internet and Instagram addiction among emerging adults during the COVID-19 pandemic. Although the role played by alexithymia and psychological distress due to COVID-19 has been evidenced, no study has explored their complex relationship in predicting emerging adults' Internet and Instagram addiction. The present study aimed to verify whether peritraumatic distress due to the COVID-19 pandemic mediated the relationship between emerging adults' alexithymia and their Internet/Instagram addiction, in a sample composed of n = 400 Italian emerging adults. Results showed that females had higher peritraumatic distress due to COVID-19 than males, whereas males had higher externally oriented thinking and higher levels of Internet addiction than females. Emerging adults' psychological distress due to COVID-19 significantly mediated the effect of alexithymia on Internet and Instagram addiction. Our findings supported the presence of a dynamic relationship between individual vulnerabilities and the co-occurrence of other psychological difficulties in predicting emerging adults' Internet and Instagram addiction during the pandemic, with important clinical implications.

Internet use during COVID-19 lockdown among young people in low- and middle-income countries: Role of psychological wellbeing

Problematic internet use in adolescents has been shown to significantly increase over the past few years, with COVID-19 pandemic lockdowns reinforcing this phenomena globally. We sought to explore whether problematic internet use in specific countries was related to emotional well-being and importantly whether this is predicted by psychological distress. There is a growing number of studies showing that problematic internet use is increasingly prevalent in countries with emerging economies, however we have yet to find out to what extent other factors are influencing this behaviour in adolescents and young people. This study invited young people from countries such India, Mexico, Philippines and Turkey to complete a set of self-reports on their daily internet habits, social media use, alongside questions on psychological distress, self-esteem, loneliness and escapism. A total of 1182 young people aged between 16 and 25 years old completed these questionnaires online. The results showed that there were significant difference in problematic internet use scores among adolescents in the Philippines and Turkey. More specifically, social media use was significantly higher amongst young people from the Philippines whereas gaming addiction was significantly high in the Turkish sample. These findings also revealed that psychological distress, loneliness, and low self-esteem consistently predicted problematic internet use. Taken together these results emphasise that there are several factors underlying growing figures of problematic internet use in young people, these factors include emotional distress, need for escapism, loneliness, and social media use, however, going forward more nuanced cultural differences should also be considered.

The Impact of the COVID-19 Pandemic and Societal Infection Control Measures on Children and Adolescents' Mental Health: A Scoping Review

Background: The COVID-19 pandemic is primarily a crisis that affects people's physical health. However, it is well-known from previous epidemics and pandemics that there are other indirect negative impacts on mental health, among others. The purpose of this scoping review was to explore and summarise primary empirical research evidence on how the COVID-19 pandemic and societal infection control measures have impacted children and adolescents' mental health. Methods: A literature search was conducted in five scientific databases: PubMed, APA PsycINFO, Web of Science, CINHAL, and Social Science Premium Collection. The search string was designed using the Population (0-18 years), Exposure (COVID-19), Outcomes (mental health) framework. Mental health was defined broadly, covering mental well-being to mental disorders and psychiatric conditions. Results: Fifty-nine studies were included in the scoping review. Of these, 44 were cross-sectional and 15 were longitudinal studies. Most studies reported negative impact of the COVID-19 pandemic on child and adolescent mental health outcomes, yet the evidence was mixed. This was also the case for studies investigating societal control measures. Strong resilience, positive emotion regulation, physical activity, parental self-efficacy, family functioning and emotional regulation, and social support were reported as protective factors. On the contrary, emotional reactivity and experiential avoidance, exposure to excessive information, COVID-19 school concerns, presence of COVID-19 cases in the community, parental mental health problems, and high internet, social media and video game use were all identified as potentially harmful factors. Conclusions: Due to the methodological heterogeneity of the studies and geographical variation, it is challenging to draw definitive conclusions about the real impact of the COVID-19 pandemic on the mental health of children and adolescents. However, the existing body of research gives some insight to how parents, clinicians and policy makers can take action to mitigate the effects of COVID-19 and control measures. Interventions to promote physical activity and reduce screen time among children and adolescents are recommended, as well as parenting support programs.

School-Based Prevention of Screen-Related Risk Behaviors during the Long-Term Distant Schooling Caused by COVID-19 Outbreak

The COVID-19 outbreak and related restrictions meant a higher incidence of screen-related risk behaviors in both children and adolescents. Our goal was to assess the perceived importance and extent of school-based preventions related to these risks during the long-term, nation-wide distant schooling period in the Czech Republic. The online survey was responded to by the school-based prevention specialists (N = 1698). For the analysis, within-subject analysis of variance (ANOVA) and binominal logistic regression were used. At-risk internet use and cyber-bullying were perceived as pressing, but other risks, for example, excessive internet use or the use of cyberpornography, received substantially less priority. The differences in all grades were significant and moderate to large (η²G between 0.156 and 0.288). The proportion of schools which conducted prevention interventions of screen-related risks was low (between 0.7% and 27.8%, depending on the grade and the type of the risk). The probability of delivering prevention intervention was in all grades significantly predicted by the presence of screen-related problems in pupils (OR 3.76–4.88) and the perceived importance of the screen-related risks (OR 1.55–1.97). The limited capacity of schools to deliver prevention interventions during distant schooling as well as the low awareness and impaired ability to recognize the importance of some screen-related risks should be addressed.

Addictions en temps de pandémie

L’Organisation mondiale de la santé a déclaré la maladie causée par le coronavirus 2 comme pandémie en mars 2020. Via les différentes mesures prises, un phénomène stressant psychosocial induit par cette épidémie a, dès lors, émergé en raison des difficultés financières, de l’isolement social et du caractère incertain du futur. L’ensemble des études nationales et internationales a mis en évidence une augmentation des usages de tabac, d’alcool et de substances illicites. Outre les comportements de consommation excessive, voire les décompensations addictives liées aux substances, il faut également prendre en considération l’usage excessif de la pornographie, des jeux de hasard et d’argent, des jeux vidéo essentiellement via Internet et l’exercice physique. La COVID-19 peut être à l’origine d’un certain nombre de conséquences et de complications chez les personnes souffrant de troubles liés à l’usage de substances licites ou illicites, population particulièrement vulnérable. Dans cette revue de la littérature narrative, nous analyserons les données concernant les comportements de consommation excessive et les addictions aux substances psychoactives licites et illicites et à certains types de comportements de la vie quotidienne. Nous avons, pour ce faire, utilisé les combinaisons de mots-clés pour sélectionner les articles scientifiques de langue anglaise et française publiés entre 2019 et 2021 en consultant les bases de données Medline, Embase, PsycInfo, Google Scholar.

Problematic internet use and its association with sleep disturbance and life satisfaction among Palestinians during the COVID-19 pandemic

The current study was conducted to test the relationship between problematic internet use, sleep disturbance, and life satisfaction among Palestinians during the Covid-19 pandemic. The sample consisted of 366 Palestinian adults (129 males and 237 females), recruited from online advertisements, e-mail campaigns, social media, and SMS campaigns. Results of the correlational analysis showed that problematic internet use positively correlated with sleep disturbance (r = .19, p < .01), and negatively correlated with life satisfaction (r = −.17, p < .01). Moreover, life satisfaction negatively correlated to sleep disturbance (r = −.25, p < .01). The regression analysis for predicting problematic internet use found that life satisfaction contributes in a way that was statistically significant towards explaining variance in problematic Internet use (B = -.15, SE = .05, β = −.15), in addition sleep disturbance explained statistically and significantly variance in problematic internet use (B = .16, SE = .04, β = .20). Intervention programs directed at decreasing internet use may need to be updated to better address the issues of “necessary” excessive use during COVID-19 restrictions and re-entry into normalized activity patterns when shut-downs are finished. As a completely new area of investigation, this study can serve as an impetus to further examinations of these important topics.

The Relationship between Family Functioning and Pathological Internet Use among Chinese Adolescents: The Mediating Role of Hope and the Moderating Role of Social Withdrawal

This study constructed a moderated mediation model based on problem behavior theory to explore the psychological mechanism of family functioning interaction with pathological internet use. We used the Adolescent Pathological Internet Use Scale, General Functioning Scale, Trait Hope Scale, and Social Withdrawal Scale to measure internet use in 1223 middle school students. The results showed that (1) pathological internet use was negatively correlated with family functioning and hope, and positively correlated with social withdrawal; family functioning was positively correlated with hope, and negatively correlated with social withdrawal; hope was negatively correlated with social withdrawal; (2) family functioning could not only directly predict pathological internet use, but also indirectly predict pathological internet use through hope; and (3) the mediating effect of family functioning on pathological internet use was moderated by social withdrawal, which was stronger for individuals with low social withdrawal but not significant for individuals with high social withdrawal. This study revealed the internal mechanism of the relation between family functioning and adolescents’ pathological internet use, which has theoretical significance for improving adolescents’ hope and reducing their pathological internet use.

Stress and Mental Health among Children/Adolescents, Their Parents, and Young Adults during the First COVID-19 Lockdown in Switzerland

The present study aimed to assess various stressful situations and the psychological impact of the first COVID-19 pandemic lockdown among youths in Switzerland. We included samples of 1627 young adults aged 19–24 from the Swiss Youth Epidemiological Study on Mental Health and 1146 children and adolescents aged 12–17 years and their parents. We assessed symptoms of various mental health problems, internet use, and perceived stress during the first COVID-19 lockdown. In the analyses, data were weighted to be representative of the Swiss population. During the first lockdown in Switzerland, the most common sources of perceived stress were the disruption of social life and important activities, uncertainty about how long the state of affairs would last, and the pandemic itself. In addition, around one-fifth of the young adults met the criteria for at least one of the mental health problems (attention deficit hyperactivity disorder, depression, generalized anxiety disorder), while one-third of children/adolescents screened positive for at least one of the mental health problems (attention deficit hyperactivity disorder, oppositional defiant disorder, depression, anxiety). Moreover, 30.1% of children and 21.3% of young adults met the criteria for problematic internet use. The study showed considerable stress perceived by young adults and symptoms of mental health problems, especially among females, during the first COVID-19 lockdown in Switzerland.

The impact of Internet use during COVID-19 lockdown in Rwanda: a potential public health threat

This article discusses impact of the Internet on the populations of sub-Sahara during the lockdown period in Rwanda. The aim is to eradicate the spread of COVID-19 pandemic and devise strategies to minimize the expansion of this virus. The increased misuse of the Internet has challenged the education sector. Initiatives such as broadband Internet to promote free or low-cost digital access have been fully successful. Although the Internet may have discouraged loneliness, it has promoted some risks to vulnerable people. Long-term isolation on the Internet has resulted in endangering younger people by exposing them to pornography, and violent movie films. The Government of Rwanda should address use of Internet during isolation to protect most vulnerable individuals like children and adolescents. The Rwanda Education the Ministry should train "online body guards" to educate the younger population of Rwanda.

Internet and Pornography Use During the COVID-19 Pandemic: Presumed Impact and What Can Be Done

The COVID-19 pandemic continues to cause an immense psychosocial strain worldwide. Excessive use of the internet during these psychologically trying times, fueled by physical isolation as a result of lockdowns, has translated into dysfunctional behaviors. A growing body of evidence suggests an unprecedented increase in internet use and consumption of online pornography during the pandemic, and possibly even directly caused by it. In this review, the authors report data from relevant sources to show the rise in pornography use during lockdowns in different countries worldwide. In addition to a brief overview of the neurobiology of internet addiction broadly and problematic online pornography use specifically, similarities with substance use disorders are explained. Further, the current status of the debate about defining diagnostic criteria is discussed. Finally, the review sheds light on the potential detrimental outcomes during the future post-pandemic "re-adaptation," while simultaneously offering preventative and management strategies for harm reduction. The authors conclude that foresightedness with utilizing existing tools and therapies and exercising appropriate amounts of caution could go a long way in addressing the challenges that lie ahead in the post-pandemic era.

Families in the Time of the Pandemic: Breakdown or Breakthrough?

The COVID-19 pandemic has taken a toll on all individuals and their families around the world. Some suffer more adversely than others depending on their unique developmental needs, resources, and resilience. However, instead of breaking down, many families and therapists have hunkered down to cope with this 'wicked' situation as it continues to evolve. This article examines the unique challenges and opportunities of COVID-19 for families at different life developmental stages, as well as the challenges and opportunities for systemic therapists as they venture into unfamiliar territory. Through a case example and by integrating recent literature related to this pandemic, we apply three key and interconnected systemic themes (unsafe uncertainty, family life cycle, and social diversity) to discuss the challenges and opportunities for families and therapists, respectively. We are optimistic that there are many possibilities as families and therapists draw on, and often reinvent, currently available resources to navigate their course in this pandemic. We also find that while the pandemic continues to present unsafe and uncertain situations, there are new ways of being and behaving, especially when families and professionals work together collaboratively. Despite formidable challenges, there are many opportunities, both within families and communities that cut through different social contexts related to family, culture, economics, and even politics. Families and therapists could endure better when they are more cognisant of how and what these contexts may impact and offer them.

Being a Gambler during the COVID-19 Pandemic: A Study with Italian Patients and the Effects of Reduced Exposition

The COVID-19 pandemic, with the consequent lockdown of about 3 months, can be viewed as an experimental model to observe the impact of the depletion of environmental factors that stimulate gambling, particularly electronic gambling machines (EGMs) that were set to zero. The effects of some structural characteristics of gambling activities that increase gambling behavior were studied among disordered gamblers in treatment in this unique scenario. In fact, studies investigating the effects of the lockdown on problem gamblers (PGs) under treatment are missing. The aims of this study were to analyze patients’ gambling behavior and craving during the lockdown and to conduct a comparison between gambling disorder (GD) symptoms at the beginning of the treatment and during lockdown. The study was conducted in Italy, the European country with the largest gambling market and the first to be affected by the virus. Data were collected through a semi-structured telephone interview conducted by healthcare professionals. Participants were 135 PGs under treatment (109 males, mean age = 50.07). Results showed that most PGs achieved a significant improvement in their quality of life, with less gambling behavior, GD symptoms, and lower craving. No shift toward online gambling and very limited shift towards other potential addictive and excessive behaviors occurred. The longer the treatment, the more monitoring is present and the better the results in terms of symptoms reduction. Individual and environmental characteristics during the lockdown favored the reduction in symptoms. Consideration for prevention and treatment are discussed.

Prevalence of Internet Addiction Disorder and Its Correlates Among Clinically Stable Adolescents With Psychiatric Disorders in China During the COVID-19 Outbreak

Background: Since the Coronavirus disease 2019 (COVID-19) pandemic emerged, Internet usage has increased among adolescents. Due to this trend, the prevalence of Internet addiction disorder (IAD) may have increased within this group. This study examined the prevalence of IAD and its correlates among clinically stable adolescents with psychiatric disorders in China during the COVID-19 outbreak. Method: A multi-center, cross-sectional study was carried out between April 29 and June 9, 2020 in three major tertiary mental health centers in China. IAD and depressive symptoms were assessed using the Internet Addiction Test (IAT) and the 9-item Patient Health Questionnaire (PHQ-9), respectively. Results: A total of 1,454 adolescent psychiatric patients were included in final analyses. The prevalence of IAD was 31.2% (95% CI: 28.8-33.6%) during the COVID-19 pandemic. A multiple logistic regression analysis revealed that poor relationships with parents (P < 0.001, OR = 2.34, 95%CI: 1.49-3.68) and elevated total PHQ-9 scores (P < 0.001, OR = 1.19, 95%CI: 1.16-1.21) were significantly associated with higher risk for IAD while longer daily physical exercise durations (P = 0.04, OR = 0.67, 95%CI: 0.46-0.98) and rural residence (P = 0.003, OR = 0.62, 95%CI: 0.46-0.85) were significant correlates of lower risk for IAD. Conclusions: IAD was common among adolescent patients with clinically stable psychiatric disorders during the COVID-19 pandemic; regular physical exercise, healthy relationships with parents and fewer symptoms of depression were associated with lower risk within this population.

Implications of COVID-19 and Lockdown on Internet Addiction Among Adolescents: Data From a Developing Country

Introduction: Physical distancing policy during coronavirus disease 2019 (COVID-19) pandemic requires adolescents to spend most of their time at home, thus increasing Internet use duration. Limited social interaction with their peers may lead to loneliness and an increased risk of mental health among adolescents. This study aimed to assess the prevalence of Internet addiction (IA) among adolescents and analyze the influence of psychosocial factors toward the heightened risk of IA during the COVID-19 pandemic. Methods: An online survey comprising sociodemographic questionnaire, Internet Addiction Diagnostic Questionnaire (KDAI), Strengths and Difficulties Questionnaire (SDQ), and Pittsburgh Sleep Quality Index (PSQI) was distributed. Overall, a total of 2,932 adolescents (mean age, 17.38 ± 2.24 years old; female, 78.7%), originating from 33 of 34 provinces in Indonesia, completed the survey. Results: The point prevalence of IA among Indonesian adolescents during the COVID-19 outbreak was 19.3%. Increased Internet use duration, internalization, externalization, low prosocial behavior, and sleep disturbances were found as risk factors of IA, either directly or as mediating variables. Physical distancing, large-scale social restriction (PSBB), and health status were not correlated to IA. Discussion: Physical distancing was not established as a risk of IA. This could be due to other psychological factors such as internalization, externalization, prosocial, and sleep problems that had correlations to IA occurrence among adolescents in the COVID-19 pandemic. Sleep impairment might have resulted from the emotional and behavioral issues and directly contributed to IA development. Conclusion: The present study found the prevalence of IA among Indonesian adolescents to be higher than the adult during the COVID-19 pandemic. Several psychological measures were indicated to increase the risk of IA, while physical distancing did not elevate the risk. Thus, remote schooling is preferable in Indonesia along with proper parental supervision to minimize Internet use for entertainment purposes.