The association between internet addiction and disordered eating attitudes among Turkish high school students

The Bidirectional Association between Internet Use, Sleep Quality and Eating Behavior: A Cross-Sectional Study in Northwestern Thrace Region in Türkiye

OBJECTIVE

This study aimed to examine the complex associations between Internet addiction, sleep disturbances, and disordered eating behaviors.

METHODS

This cross-sectional study included 646 students from 17 high schools in Edirne, Türkiye between December 2023 and May 2024. A face-to-face questionnaire was administered to assess demographic characteristics, Internet addiction (YIAT), sleep quality (PSQI), and eating behavior (TFEQ-R21).

RESULTS

In total, 644 students completed the study. The prevalence of Internet addiction among adolescents was 16.3%, with a similar prevalence among male and female adolescents. The prevalence of poor sleep quality among adolescents was 6.4%, and this trend was more pronounced in male adolescents, with an incidence of 13.0%. A weak positive correlation was observed between Internet addiction and disordered eating behavior. Additionally, a moderate positive correlation was observed between poor sleep quality and disordered eating behavior. Gender, maternal education level, Internet addiction, and poor sleep quality were significant predictors of eating disorders in adolescents.

CONCLUSION

The findings of our study are of significant value in providing insights into the development of programs designed to prevent undesired eating behaviors.

Disordered eating attitude and associated factors among late adolescent girls in Gondar city, northwest Ethiopia: a community-based cross-sectional study

Background

Disordered eating attitudes are characterized by abnormal beliefs, thoughts, and feelings regarding food and weight control. Dieting, intentional weight loss, and weight control affect 41-62% of girls worldwide. However, there is limited information related to disordered eating attitudes and associated factors among late adolescent girls in Ethiopia, including in the study area. Thus, the study aimed to assess disordered eating attitudes and associated factors among late adolescent girls in Gondar city, northwest Ethiopia.

Methods

For this community-based cross-sectional study, which was conducted from 26 June to 26 July 2022, in Gondar city, Ethiopia, 1,188 adolescent girls were included. Multistage stratified sampling followed by a systematic random sampling technique was applied to recruit participants for the study. Data were collected using an interviewer-administered questionnaire containing the Eating Attitudes Test-26 (EAT-26). Anthropometric measurements were also taken. Bivariable and multivariable logistic regressions were employed to identify factors associated with disordered eating attitudes. In the final model, variables with a p-value of < 0.05 were considered statistically significant.

Results

A total of 1,158 late adolescent girls (a response rate of 97.5%) participated in the study. The prevalence of disordered eating attitudes among late adolescent girls was 9.7% [95% confidence interval (CI): 7.96, 11.4%]. Having a mother who was unable to read and write [adjusted odds ratio (AOR): 3.88 (95% CI: 1.07, 14.11)], having a mother who could read and write [AOR: 4.31: (95% CI: 1.14, 16.24)], having a father who only attended primary school [AOR: 3.78 (95% CI: 1.33, 10.78)], having severe anxiety [AOR: 3.26 (95% CI: 1.42, 7.49)], and severe usage of social media [AOR: 2.80 (95% CI: 1.22, 6.46)] were factors significantly associated with disordered eating attitudes among late adolescent girls.

Conclusion

This study revealed that disordered eating attitudes among late adolescent girls were relatively high. The educational status of parents, anxiety, and severe usage of social media were positively associated with disordered eating attitudes. Therefore, nutritional education for parents of adolescents who are vulnerable to unhealthy behavior is imperative. The finding also implied the importance of an inclusive strategy to mitigate the emerging problem of targeting vulnerable groups.

Examining the interplay between physical activity, problematic internet use and the negative emotional state of depression, anxiety and stress: insights from a moderated mediation path model in university students

BACKGROUND

The aim of this study was to investigate the relationship between Problematic Internet Use (PIU), emotional states of stress, anxiety and depression, and the practice of physical activity among Tunisian students.

METHODS

Cross-sectional data were collected from 976 university students aged 20.76 ± 1.63 years (46.8% female). They filled out an online survey comprised of a socio-demographic questionnaire, the depression, anxiety and stress scale- 21 items (DASS-21), the international physical activity questionnaire (IPAQ) and the compulsive internet use scale (CIUS). Students were divided, based on their economic levels, into three groups: low (n = 256, 26.23%), medium (n = 523, 53.59%) and high (n = 197, 20.18%).

RESULTS

Mediation analysis: Indirect effects of IPAQ and gender on DASS-21 were highlighted: β= -0.18 (p < 0.01) and β= -0.04, P < 0.01) respectively. In addition, a significant and negative effect of IPAQ on CIUS was demonstrated (β = -0.45, P < 0.01). In addition, the effect of CIUS on DASS-21 was significant (β = 0.39, P < 0.01). Also, the effect of gender on CIUS was significant (β=-0.10, P < 0.01) However, its effect on DASS-21 was not significant (β = 0.05, p = 0.078). The total effect of IPAQ on DASS21 was significant (β= -0.52, p < 0.01) but the effect of Gender on DASS-21 was not significant (β = 0.01, p = 0.817). Moderation analysis: the results showed a significant moderation effect of the interaction between IPAQ and Gender on CIUS (β = 0.07, p < 0.01). However, it was not significant between Gender and CIUS on DASS-21 (β = 0.09, p = 0.390) and between IPAQ and Gender on DASS21 (β = 0.01, p = 0.736) Also, the interaction between IPAQ and CIUS did not have a significant moderation effect on DASS-21 (β = 0.15, p = 0.115).

CONCLUSIONS

Findings suggest that relationships between PIU and negative emotional state of depression, anxiety and stress are mediated via physical exercise. These results underscore the importance of the physical activity factor in the studies analyzing longitudinal effects of PIU on mental health outcomes.

Prevalence of Smartphone Addiction and its Relationship with Obesity among Young Adults: A Cross-sectional Study from Delhi, India

Smartphone addiction (SA) has emerged as an important health concern worldwide. Recent studies have recognized SA as one of the factors that promote sedentarism and can contribute to obesity. However, the relationship between SA and obesity among Indian young adults remains understudied. The present study aims to estimate the prevalence of SA and explore its association with general and central obesity among young adults in Delhi, India. This cross-sectional study was conducted among 246 young adults (aged 18-30 years) of either sex (60.16% females) from Delhi. Screening for SA was done using the Smartphone Addiction Scale-Short Version. Somatometric measurements (height, weight, waist circumference, and hip circumference) were taken to determine general and central obesity. SA was prevalent among 25.2% of the participants. The prevalence of SA was higher among males and undergraduate students than among females and postgraduate/MPhil/PhD students, respectively. Further, SA was not associated with any of the obesity variables. Interestingly, smartphone addicts were found to have a 2.5-fold increased risk of being underweight. Though SA was not associated with obesity, it was found to be associated with being underweight, indicating a relationship between smartphone use and nutritional status among young adults.

Unhealthy Eating Habits and Insomnia Symptoms are Associated with Internet Addiction in Chinese Left-Behind Children: The Gender Difference

Purpose

This study aimed to evaluate the associations between unhealthy eating habits and insomnia symptoms with Internet addiction (IA) among Chinese left-behind children (LBC) based on potential gender difference.

Methods

This cross-sectional study was conducted in junior high schools from an economically disadvantaged area of China in May 2020. Participants were asked to complete the information and scales of socio-demographic characteristics, eating habits (the frequency of eating carbohydrates, fruits, vegetables, protein, and breakfast), insomnia severity and IA. A total of 3156 LBCs (43.9% males and 56.1% females, aged 14.2 years in average) were used for final analyses. Associations between eating habits and insomnia symptoms with IA were analyzed by generalized linear model with binary logistic regression.

Results

The study found that left-behind children (LBCs) had unhealthy eating habits, particularly among females. Females reported more insomnia symptoms than males. The prevalence of IA was similar across genders. Consuming fewer fruits and vegetables and skipping breakfast were linked to increased IA risk, especially in females. Insomnia was significantly associated with higher IA risk in both genders.

Conclusion

In LBCs, unhealthy eating and sleep were notably linked to IA, especially in females. Addressing these factors might reduce the prevalence of IA among LBCs.

Problematic Internet use and attitudes towards persons with disabilities - cross-sectional research among Polish students

BACKGROUND

Problematic Internet use (PIU) can have detrimental effects on physical, emotional, psychological, and social functioning. Besides well-described PIU correlations in psychological domains such as personality traits, or life satisfaction, and self-assessment, the social aspect of PIU risk also appeared to be important. This study aimed to investigate the association between PIU and attitudes towards persons with disabilities.

METHODS

A total of 595 Polish students aged 18-29 participated in this research by completing the Internet Addiction Test, Multidimensional Attitudes Scale Towards Persons With Disabilities, and personal information form.

RESULTS

The findings revealed that 30.6% of the respondents were at high risk for PIU. Moreover, heightened levels of PIU were more prevalent among male participants and students in technical fields of study than in those in medical and social fields of study. Increased PIU was also associated with more negative attitudes towards persons with disabilities in general and in the domains of emotions and behaviours. Additionally, prior personal contact with individuals with disabilities was related to both PIU rates and attitudes towards persons with disabilities in the domain of emotions and beliefs.

CONCLUSIONS

This study highlights the prevalence of PIU among Polish students and emphasizes the need for preventive measures, particularly targeting male students and those in technical fields of study. The results indicate a relationship between PIU and attitudes towards individuals with disabilities. Further research is required to determine the direction of the relationship. It is recommended that educational programs provide opportunities for interaction with individuals with disabilities to promote understanding and acceptance.

Prevalence of Eating Disorders and Their Association with Social Media Addiction among Youths

Eating disorders and excessive attachment to social media are a matter of great concern among youths. This study assessed the prevalence of eating disorders and their association with social media addiction among youths. A descriptive cross-sectional study was conducted on 350 participants aged 14-25 years. Two pre-validated tools were used, i.e., the Eating Attitude Test and the Social Networking Addiction Scale. SPSS was used to analyze the data. Out of the 350 students, 42% had probable eating disorders, and 41.7% had social media addictions. The findings revealed that the chances of having eating disorders were significantly higher among youths who lived in separate places, smoked, and had a family history of eating disorders (p ≤ 0.05). Furthermore, the dieting domain displayed notably higher scores for youths living separately (p ≤ 0.05) and smokers (p ≤ 0.01). Moreover, the scores for bulimia and food preoccupation were significantly higher among participants who were married (p = 0.038), were smokers (p = 0.027), and had a family history of eating disorders (p = 0.001). Higher scores in the oral control domain were reported by females (p ≤ 0.05) and severely obese youths (p ≤ 0.01). Moreover, social media addiction was significantly higher among students aged 18-21 (p ≤ 0.01). Spearman's correlation revealed that social media addiction has a weak positive relationship with eating disorders (r = 0.133, p ≤ 0.01), particularly bulimia and food preoccupation (r = 0.173, p ≤ 0.001). This reflects the need to address the harmful consequences of social media addiction that might raise the likelihood of developing eating disorders, particularly bulimia nervosa.

Problematic Internet Use among Polish Students: Prevalence, Relationship to Sociodemographic Data and Internet Usage Patterns

Problematic Internet Use (PIU) is a broad term that covers problems with Internet use that result in psychological, social, academic or professional difficulties. The aim of our study was to identify individuals particularly vulnerable to developing PIU among Polish students, taking into account sociodemographic characteristics and Internet use patterns. A total of 1008 students of Polish universities took part in the survey. The research tool was The Problematic Internet Use Test-the Polish version of the Internet Addiction Test. Among the respondents, 10.2% showed signs of PIU-high or very high risk of addiction. Significantly higher levels of PIU were found in males than females, science students than medical and humanities students, and Internet users using a computer, as opposed to students using only a phone/tablet. A decrease in PIU was observed as students improved their assessment of their material situation. The severity of PIU increased significantly as the importance of Internet use for entertainment increased. Our research indicates that it is worth implementing measures to prevent the development of PIU in Poland, e.g., screening educational campaigns, especially for science students. It is also necessary to offer students at lower levels of education, especially the less affluent, forms of leisure time other than computer activity with the use of the Internet.

Hierarchical Linear Model of Internet Addiction and Associated Risk Factors in Chinese Adolescents: A Longitudinal Study

The risk effects of internet addiction have been documented in the literature; however, few longitudinal studies have considered the heterogeneity of the subjects. A hierarchical linear model was used here to explore the relationship between adolescents' internet addiction and associated risk factors (depression, anxiety, gender, and obesity) from the perspective of longitudinal analysis. A total of 1033 adolescents were investigated and followed up with every three months with the Self-Rating Depression Scale (SDS), Self-Rating Anxiety Scale (SAS), and Internet Addiction Test (IAT). The hierarchical linear model of internet addiction had only two levels. The first level of the model was the time variable (three time points) and the second level of the model was the individual adolescent (1033 adolescents). The results showed that (1) depression and anxiety, as associated risk factors, were significant positive predictors of adolescents' internet addiction considering the developmental trajectory courses of adolescent internet addiction, as well as the individual differences over time; (2) there were gender differences in the adolescents' internet addictions-specifically, the initial level of internet addiction among boys was significantly higher than that of girls, but the rate of decline was significantly faster than that of girls; and (3) there was no significant difference in obesity. The results demonstrated the importance of considering depression, anxiety, and gender in any intervention efforts to reduce adolescents' internet addictions, and we should pay attention to the cultivation of positive coping strategies for Chinese adolescents. The limitations of the study were also discussed.

Impulsiveness as potential moderators of the relation between social media dependence and eating disorders risk

BACKGROUND

Social media dependence (SMD) and eating disorders (ED) risk are often thought to be inextricably linked. Because social media dependence often precedes an ED, predicts poor outcome, and persists even after recovery from an ED, it is important to examine whether certain factors have the ability to potentially attenuate or intensify SMD's effect on eating disorders.

METHODS

In the current study, we examined one possible moderating factor: impulsiveness. 767 undergraduates (mean age = 18.78 years, SD = 1.20) in Shaanxi province of China, completed anonymous questionnaires regarding social media dependence, eating disorders, impulsiveness.

RESULTS

Revealed that non-planned impulsiveness (NPI) moderated the relation between SMD and ED risk. Individuals who were low in SMD and who reported low levels of NPI reported much lower levels of ED risk than those with low SMD and high NPI. However, Individuals who were high in SMD and who reported low levels of NPI reported much higher levels of ED risk than those with high SMD and high NPI. Contrary to our hypotheses, Motor impulsiveness and cognitive impulsiveness did not emerge as moderators of the relation between SMD and ED risk.

CONCLUSIONS

Results provide growing support that factors that interact with SMD can lessen or aggravate SMD's effect on ED risk. These findings can be beneficial to our understanding of how and when social media dependence impacts undergraduates' eating disorders risk.

Executive Function and Social Media Addiction in Female College Students: The Mediating Role of Affective State and Stress

Social media addiction is the emerging occurrence in which individuals develop psychological dependencies on microblog, wechat, Tik Tok and so on. Existing research has demonstrated the possible relationship between mobile social media addiction and disordered eating attitudes/behavior. In this study, we investigated the relationship between executive function, especially food-inhibitory control, affective state/stress, and mobile social media addiction among female college students as all play predictive roles in food addiction. A structural equation model was used to examine the mediation model hypothesis, and the results confirmed the mediating role of affective state and stress between executive function, especially inhibitory control over high-calorie food, and mobile social media addiction among Chinese female college students. The results verify the correlation between social media addiction and disordered eating attitudes/behavior from the perspective of psychological mechanisms. These proposals emphasize the significance of improving inhibitory control over high-calorie food and the importance of providing psychological counseling to intervene in negative emotions and stress management in female college students.

Common Predictive Factors of Social Media Addiction and Eating Disorder Symptoms in Female College Students: State Anxiety and the Mediating Role of Cognitive Flexibility/Sustained Attention

This study aimed to investigate the common predictive factors between social media addiction (SMA) and eating disorder symptoms (EDS), in a group of Chinese female college students. A total of 216 students completed the behavioral assessments of cognitive flexibility and sustained attention, as well as the questionnaires on anxiety, social media dependence, and eating disorders. The results indicate that SMA is significantly correlated with EDS. Structural equation modeling was used to test the model in which state anxiety, cognitive flexibility, and sustained attention predicted social gain and EDS. Additionally, the results confirmed the mediating role of cognitive flexibility and sustained attention between state anxiety and SMA/EDS in the participants. The findings revealed that in the sample group, state anxiety was related to SMA and EDS through cognitive flexibility and sustained attention. These proposals reflect the significance of improving cognitive flexibility/sustained attention and reducing state anxiety to prevent EDS and SMA in female college students.

Problematic Internet Use, health behaviors, depression and eating disorders: a cross-sectional study among Polish medical school students

BACKGROUND

Problematic Internet Use is defined as a use of the Internet which leads to various difficulties. The aim of this study was to check whether Problematic Internet Use is associated with health risks, such as: anti-health behaviors, depressive symptoms, abnormal body weight or eating disorders.

METHODS

This cross-sectional study included 540 medical school students of Polish descent (83.5% females; 16.5% males), whose mean age was 22.49 years (SD = 5.20). The participants were asked to complete a questionnaire set, including the Problematic Internet Use Test, Juczyński's Health-Related Behavior Inventory, the Beck Depression Inventory, the Eating Attitudes Test and a self-designed demographic survey.

RESULTS

Increased Problematic Internet Use scores were observed in male, full-time students, persons who use the Internet on the computer (compared to those who mostly use it on the phone), and those who go online mainly for entertainment purposes (compared to those who indicated another main purpose of using the Internet). 47.6% of the sample reported poor health behaviors, while 27.1% met the criteria of a depressive episode and 6.9% of an eating disorder. High risk of Problematic Internet Use was observed in 2.8% of the sample, particularly those who reported having more free time during the day, engaged in fewer health protective behaviors, manifested more severe depressive symptoms and scored higher on the Eating Attitudes Test.

CONCLUSION

Such results indicate that students with Problematic Internet Use lead an unhealthy lifestyle and more often show symptoms of depression and eating disorders than students without Problematic Internet Use.

The Effects of Smartphone and Internet Gaming Addiction on Eating Attitudes Among University Students

OBJECTIVE

Smartphone addiction is a public health problem increasing with the technologic developments. It particularly affects the university students negatively in terms of psychological, physical, academic achievement and social relations. This study aims to investigate the relation of eating attitudes between smartphone addiction and internet gaming disorder, also the relation of smartphone addiction with obesity.

METHODS

This cross-sectional and prospective study is consisted of 358 volunteer university students. Socio-demographic data form, Short Form of Smartphone Addiction Scale (SF-SAS), Eating Attitude Test (EAT), and internet gaming disorder scale were administered to the participants.

RESULTS

Mean age of the participants was 22.27±3.10 years and 59.8% (n=214) were female. In terms of the variables "body mass index, body weight, faculty of the student, economic status of the family, and the people they live with together" were significantly different from controls. Also "monthly mobile phone invoice, EAT score, SF-SAS scores" were statistically different. A significant difference was found among "body weight groups" in terms of both EAT score and SF-SAS. According to the linear regression model variables of "gender, smartphone addiction, and school year" were determined as the predictors for EAT.

CONCLUSION

Our current study has revealed the relation between smartphone addiction and eating attitudes, and obesity. Smartphone addiction may lead to an increase in body weight, by affecting eating attitudes. Therefore, the effect of eating behavior disorders in the emergence of the smartphone addiction should be considered. Multi-disciplinary solutions are required to prevent this addiction that may increase over time.

Prevalence and Clinical Correlates of Internet Addiction Symptoms and Their Association With Quality of Life in Adolescents With Major Depressive Disorder: A Multicenter Cross-Sectional Study

BACKGROUND

Internet addiction (IA) symptoms are common among adolescents and negatively impact their academic performance and development. These symptoms are also associated with lower quality of life (QOL) and increased suicidality. This study aimed to examine the prevalence and the sociodemographic and clinical correlates of IA symptoms in adolescents with major depressive disorder (MDD) and their association with QOL.

METHODS

This cross-sectional study was conducted in three general and four psychiatric hospitals in Anhui Province, China, from January to July 2021. Sociodemographic and clinical data were collected. The Internet Addiction Test (IAT), Center for Epidemiologic Studies of Depression Symptom Scale (CES-D), and World Health Organization Quality of Life Brief version (WHOQOL-BREF) were utilized to examine IA, depressive symptoms, and QOL, respectively.

RESULTS

In a multicenter sample of 278 adolescents with MDD, the prevalence of IA symptoms in adolescents with MDD was 46.8% (95% CI: 40.9-52.7%). Logistic regression analysis showed that patients with more severe depressive symptoms (odds ratio [OR] = 1.05, 95% CI: 1.03-1.08), those living in a rural area (OR = 1.94, 95% CI: 1.15-3.27), and those with poor academic performance (OR = 2.90, 95% CI: 1.42-5.95) were more likely to have IA symptoms. After controlling for confounding factors, patients with IA symptoms had significantly poorer QOL in the physical, psychological, and environmental domains than those without IA symptoms.

CONCLUSION

IA symptoms are common in adolescents with MDD and appear to be associated with clinical symptoms. We could not infer a causal relationship between IA and depression because this was a cross-sectional study. Considering the positive association between IA symptoms and lower QOL, screening for IA symptoms should be conducted, and effective measures should be implemented for adolescents with MDD.

Examination of the relationship between smartphone addiction and cyberchondria in adolescents

In this descriptive and correlational study, it was aimed to examine the relationship between adolescents' smartphone addiction and cyberchondria. Data were obtained from 384 adolescent high school students in Istanbul between December 2020 and January 2021, using a Personal Information Form, the Smartphone Addiction Scale, and Cyberchondria Severity Scale. The data were collected through face-to-face interviews with the students. The adolescents' smartphone use duration was 3.67 ± 1.66 years. Almost all (97.9%) connected to the internet via smartphones and 39.3% spent 3-4 h per day on the internet. It was determined that 61.7% of them checked their phones as soon as they woke up in the morning and 75.3% of them before going to bed in the evening. For those whose smartphone use duration is high, their cyberchondria also increases. The authors suggest that nurses should understand smartphone addiction and cyberchondria to identify and apply nursing interventions when necessary in adolescents.

Predictors of Nutritional Status, Depression, Internet Addiction, Facebook Addiction, and Tobacco Smoking Among Women With Eating Disorders in Spain

Eating disorders (EDs) are a complex group of psychiatric conditions that involve dysfunctional eating patterns, nutritional alterations, and other comorbid psychopathologies. Some women with EDs may develop problematic internet use while they attempt to get information on dieting/weight control or get online support from people with similar problems. They may also drift toward tobacco smoking as a method to regulate their weight or to cope with their weight-related dysphoria. The occurrence of these conditions in EDs may prolong disease course and impede recovery. This study used structural equation modeling to investigate nutritional status (noted by body mass index, BMI), depression psychopathology, internet addiction (depicted by the Internet Addiction Test), Facebook addiction (depicted by the Bergen Facebook Addiction Scale), and smoking among 123 Spanish women diagnosed with EDs (mean age = 27.3 ± 10.6 years). History of hospitalization, marital status, age, and the level of education predicted BMI in certain ED groups. BMI did not predict depression, but it predicted internet addiction, Facebook addiction, and smoking in certain ED groups. Depression did not predict BMI, internet/Facebook addition, or smoking in any ED group. Some sociodemographic and clinical variables had indirect effects on depression, internet addiction, and Facebook addiction while age was the only variable expressing a direct effect on all outcome measures. Age, education, and history of prolonged treatment predicted smoking in certain ED patients. The findings signify that a considerable target for interventional strategies addressing nutritional and addictive problems in EDs would be women with high BMI, history of hospitalization, history of prolonged treatment, who are particularly young, single, and less educated. Replication studies in larger samples, which comprise various subtypes of EDs from both genders, are warranted to define the exact interaction among the addressed variables.

There Are Predictors of Eating Disorders among Internet Use Characteristics-A Cross-Sectional Study on the Relationship between Problematic Internet Use and Eating Disorders

The aims of this cross-sectional study were: (i) to establish the prevalence of problematic Internet use (PIU) and eating disorders (EDs) among Polish students; (ii) to investigate potential correlations between the two phenomena; and (iii) to identify predictors of eating disorders among socio-demographic and Internet use characteristics in this population. To this end, a total of 1008 Polish students aged 18-40, completed the Problematic Internet Use Test (TPIU22), the Eating Attitudes Test (EAT-26) and a self-designed Socio-demographic and Internet Use Survey. Men received more PIU scores (p < 0.001), while women received more EAT-26 scores (p < 0.05) with a significant correlation observed between those variables (rho = 0.212; p < 0.001). The strongest predictors of EDs were as follows: preoccupation with the Internet, neglect of sleep in favor of Internet use, alleviation of negative feelings while online, higher mean number of hours spent online on weekends for academic and work-related purposes, extracurricular activity, lower height and higher BMI. An association has been demonstrated between problematic internet use and eating disorders. Somewhat surprisingly, our results suggest that people at risk of EDs use the Internet primarily to fulfill their routine duties. Nevertheless, further research is needed to establish the causality of EDs and PIU.

Relationship between eating disorders and internet and smartphone addiction in college students

PURPOSE

This study was planned and conducted to determine the relation between eating behavior disorder and smartphones and the internet in college students.

METHODS

This research was performed on a total of 437 college students, including 116 males and 321 females. A questionnaire questioning the general characteristics (age, sex, department, socioeconomic status, skipping meal, number of main meals and snacks in a day, sleeping duration, doing physical activity, height, and body weight) of students was used. In addition, Eating Attitude Test-40 (EAT-40), Young's Internet Addiction Scale, and Smartphone Addiction Scale were used to measure eating behavior disorders, internet addiction, and smartphone addiction, respectively. Height and body weight were measured in accordance with the method.

RESULTS

12.6% of the students participating in the study were at risk for eating disorders. Female students had higher EAT-40 scores than male students. 13% of students had potential internet addiction. According to Pearson chi-square test, the prevalence of potential internet addiction (36.4%) in students with eating disorder was higher than those without eating disorder (9.7%) (p < 0.05). Pearson correlation analyses displayed that Smartphone Addiction Test score associated positively with EAT-40 score (r = 0.277) and Internet Addiction Test score (r = 0.665) and students' body mass index (BMI) (r = 0.121). In addition to these, students' duration of staying on the internet correlated with their BMI (r = 0.137). Males had a higher rate of potential internet addiction than females (22.4% in males and 9.7% in females, respectively) (p < 0.05).

CONCLUSION

The present results suggest that students' duration of using the internet affects smartphone addiction and internet addiction, both of which influence eating behavior disorder. In addition, both smartphone and internet addiction and eating behavior disorder correlated positively and significantly with overweight.

LEVEL OF EVIDENCE

Level V: cross-sectional descriptive study.

How does Internet Addiction Affect Adolescent Lifestyles? Results from a School-Based Study in the Mediterranean Region of Turkey

PURPOSE

The habits acquired during adolescence may continue into adulthood. Therefore, the identification and prevention of Internet addiction is an important goal. The aim of this study was to investigate the effects of Internet addiction on the lifestyles of adolescents in a sample in the Mediterranean region of Turkey.

DESIGN AND METHODS

The sample consisted of 367 adolescents. Data were collected using a personal information form, the Internet Addiction Scale, and the Healthy Lifestyle Behaviours Scale-II between January and June 2018. This manuscript has been prepared according to Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines.

RESULTS

The mean Internet addiction score among the included adolescents was found to be moderate. Males aged 17 years with divorced parents and adolescents who have poor relationships with family members and friends had higher average Internet addiction scores. A negative and moderate relationship between Internet addiction and healthy lifestyle behaviours was identified among adolescents.

CONCLUSIONS

Internet addiction is negatively and moderately predictive of an adolescent's lifestyle.

PRACTICE IMPLICATIONS

Strengthening relationships with family and friends can prevent adolescents from developing Internet addictions and increase healthy lifestyle behaviours. Courses should be added to the curriculum that aim to improve the understanding of the risks and benefits (e.g. e-mail, Internet tools) associated with the Internet for both school staff and students. The results of the present study can be used to guide the development of a healthy Internet use program targeted at adolescents for use by school nurses.

The effect of Internet addiction on eating attitude and body image in university students

PROBLEM

The research was carried out to determine the effect of internet addiction on eating attitude and body perception.

METHODS

This study is descriptive, conducted with undergraduate students (n = 400) in a university in eastern Turkey. The data were collected by using Descriptive Questionnaire, Young Internet Addiction Test-Short-Form (YIAT-SF), Eating Attitude Test 26 (EAT-26), and Body Cathexis Scale (BCS). In addition, students' height and weight measurements were collected.

FINDINGS

It was determined that there was positively at a very weak level a significant correlation between YIAT-SF total score and EAT-26 total score. There was a negative, weak significant correlation between the total score of YIAT-SF and the BCS total score (p < 0.05).

CONCLUSIONS

In students, internet addiction is related to eating behavior disorder and reduces satisfaction with body image. For this reason, education programs should be organized by health professionals to prevent internet addiction and psychological and physiological problems related to excessive internet use.

Problematic usage of the internet and eating disorder and related psychopathology: A multifaceted, systematic review and meta-analysis

Eating disorders are widespread illnesses with significant impact. There is growing concern about how those at risk of eating disorders overuse online resources to their detriment. We conducted a pre-registered systematic review and meta-analysis of studies examining Problematic Usage of the Internet (PUI) and eating disorder and related psychopathology. The meta-analysis comprised n = 32,295 participants, in which PUI was correlated with significant eating disorder general psychopathology Pearson r = 0.22 (s.e. = 0.04, p < 0.001), body dissatisfaction r = 0.16 (s.e. = 0.02, p < 0.001), drive-for-thinness r = 0.16 (s.e. = 0.04, p < 0.001) and dietary restraint r = 0.18 (s.e. = 0.03). Effects were not moderated by gender, PUI facet or study quality. Results are in support of PUI impacting on eating disorder symptoms; males may be equally vulnerable to these potential effects. Prospective and experimental studies in the field suggest that small but significant effects exist and may have accumulative influence over time and across all age groups. Those findings are important to expand our understanding of PUI as a multifaceted concept and its impact on multiple levels of ascertainment of eating disorder and related psychopathology.

Maladaptive Perfectionism and Internet Addiction among Chinese College Students: A Moderated Mediation Model of Depression and Gender

The association between perfectionism and addictive behaviors has been examined in previous literature; however, few pieces of research have investigated the mediating and moderating mechanisms underlying this relationship. Using a sample of 2016 Chinese college students, the present study examined the mediator of depression between maladaptive perfectionism and Internet addiction and the moderator of gender in such associations. The findings indicated that maladaptive perfectionism was directly related to students’ Internet addiction and indirectly predicted students’ Internet addiction via the mediator of depression. Gender moderated the direct effect, rather than the indirect effect, of maladaptive perfectionism on Internet addiction. Even though males reported a lower score on Internet addiction compared to females, the effect of maladaptive perfectionism on Internet addiction was stronger for males than for females. These findings revealed the psychological mechanisms from perfectionism to Internet addiction, which contributed to the theoretical development in addiction research and provided implications for interventions to reduce Internet addiction among Chinese college students.

How has Internet Addiction been Tracked Over the Last Decade? A Literature Review and 3C Paradigm for Future Research

Background:

The popularity of the internet aggravated by its excessive and uncontrolled use has resulted in psychological impairment or addiction. Internet addiction is hypothesized as an impulse-control disorder of internet use having detrimental impacts on daily life functions, family relationships, and emotional stability. The goal of this review is to provide an exhaustive overview of the empirical evidence on internet addiction and draw attention to future research themes.

Methods:

We performed a literature search on ScienceDirect and PubMed to review original research articles with empirical evidence published on peer-reviewed international journals from 2010 to 2019. Eight hundred and 26 articles were eligible for analysis. Frequency and descriptive statistics were calculated by Microsoft Excel.

Results:

A substantial contribution has been coming from researchers from China, Turkey, Korea, Germany, and Taiwan respectively. Despite controversies regarding its definition and diagnostic procedures, internet addiction has become the focal point of a myriad of studies that investigated this particular phenomenon from different exposures. Given observed literature review data regarding research design, data acquisition, and data analysis strategies, we proposed the 3C paradigm which emphasizes the necessity of research incorporating cross-disciplinary investigation conducted on cross-cultural settings with conscientious cross-validation considerations to gain a better comprehension of internet addiction.

Conclusions:

The findings of the present literature review will serve both academics and practitioners to develop new solutions for better characterize internet addiction.

Association of Internet Addiction with Adolescents' Lifestyle: A National School-Based Survey

Internet addiction (IA) among adolescents is an issue of growing concern with adverse effects on adolescents' health and social functioning. This study aims to determine the prevalence of IA among school-going adolescents in Malaysia and its associated factors-specifically, lifestyle factors. A nationwide cross-sectional school-based health survey was conducted in 2017 among 27,497 students from 212 randomly selected secondary schools. Information regarding sociodemography, lifestyle, and internet use was obtained using a self-administered questionnaire. IA was measured using the Malay Version of Internet Addiction Test (MVIAT). The prevalence of internet addiction was 29.0%. A multivariable logistic analysis revealed that inadequate fruit and vegetable intakes, consumed carbonated soft drinks at least once a day, consumed fast food at least three days/week, sedentary behavior, current E-cigarette users, and ever/current alcohol drinkers were lifestyle factors significantly associated with IA. Adolescents from urban schools, of higher school grade, and those whose parents are married but living apart were also found to have a greater risk for internet addiction. A positive association was found between IA with unhealthy dietary and lifestyle behaviors among adolescents. The modification of lifestyle factors needs to be considered while developing strategies and interventions for awareness-raising and prevention of IA among adolescents.

Internet addiction and Facebook addiction in Spanish women with eating disorders

AIM

We aim to investigate the association between the presence of eating disorders and both Internet addiction (IA) and Facebook addiction (FA) in women suffering from eating disorders.

METHODS

A total of 124 women completed three instruments: the Internet Addiction Test (IAT), the Bergen Facebook Addiction Scale (BFAS) and a sociodemographic questionnaire.

RESULTS

The proportion of FA was 37.9%. The distribution of risk of IA was 21.8%. When the risk of Internet or Facebook addiction was compared with respect to eating disorders, no significant differences were found between groups (P = 0.146 and P = 0.086, respectively). Age and Body Mass Index (BMI) were predictors of BFAS scores; the standardized beta coefficient (β) for age was -0.463 (P ≤ 0.001), while for BMI it was 3.44; (P = 0.001) being a positive predictor of BFAS scores. For IAT scores, β age (negatively) = -0.415; (P < 0.001) and β for weight (positively) 3.657; (P < 0.001) were identified.

CONCLUSIONS

The presence of an eating disorder does not seem to be a factor that characterizes the risk of Internet or Facebook addiction in our sample. As information regarding the potential association between Internet and Facebook addiction and the presence of eating disorders is limited, we encourage further studies on this topic.

Association between Internet Use Behavior and Palpitation among Adolescents: A Cross-Sectional Study of Middle School Children from Northwest Romania

PURPOSE

The use of the internet is a tool and media literacy has become an essential skill among adolescents. Related to this behavior, some adolescents evoke cardiovascular effects. The purpose of this study was to explore a possible correlation between internet use behavior and occurrence of palpitations and related symptoms among a representative cohort of adolescents from the north-west region of Romania.

METHOD

The study included students of seven middle schools from Northwest Romania. Participants completed an anonymous questionnaire consisting of 18 questions about internet use.

RESULTS

In total, 1147 students responded to the study. Mean duration of daily internet usage was 2.57 h during school time and 3.57 h during the holidays. A total of 77% of adolescents had more than one symptom related to internet use, and 11% of them reported palpitations and related symptoms. We found an independent relation between palpitation and urban background, palpitations and the internet usage time interval 20:00-24:00, and palpitations and tobacco smoking. Strong heartbeats were independently associated with the time interval 12:00-16:00, tobacco smoking, and energy drink consumption.

CONCLUSION

In our cohort, the most important factors associated with the occurrence of palpitations and related symptoms were the timeframe of internet usage and smoking.

Mediated effects of eating disturbances in the association of perceived weight stigma and emotional distress

PURPOSE

This study aimed to examine the relationships between perceived weight stigma, eating disturbances, and emotional distress across individuals with different self-perceived weight status.

METHODS

University students from Hong Kong (n = 400) and Taiwan (n = 307) participated in this study and completed several questionnaires: Perceived Weight Stigma questionnaire; Three-factor Eating Questionnaire; Hospital Anxiety and Depression Scale. Each participant self-reported their height, weight, and self-perceived weight status.

RESULTS

After controlling for demographics, perceived weight stigma was associated with eating disturbances (β = 0.223, p < 0.001), depression (β = 0.143, p < 0.001), and anxiety (β = 0.193, p < 0.001); and eating disturbances was associated with depression (β = 0.147, p < 0.001) and anxiety (β = 0.300, p < 0.001) in the whole sample. Additionally, eating disturbances mediated the association between perceived weight stigma and emotional distress. Similar findings were shown in the subsamples who perceived themselves as higher weight or normal weight and in the male and female subsamples. However, in the subsamples who perceived themselves as lower weight, only the links between eating disturbances and emotional distress were significant.

CONCLUSION

Perceived weight stigma was associated with eating disturbances and emotional distress in young adults with both higher and normal weight. Eating disturbances were associated with emotional distress regardless of participants' weight status.

LEVEL OF EVIDENCE

Level V, cross-sectional descriptive study.

Internet Use in Relation to Overweight and Obesity: A Systematic Review and Meta-Analysis of Cross-Sectional Studies

Although several studies have investigated the association between Internet use and odds of overweight and obesity, results are inconsistent. This systematic review and meta-analysis was performed to summarize evidence on the association between Internet use and odds of overweight and obesity. A systematic literature search was conducted in PubMed/Medline, Web of Science, Scopus, and Google Scholar up to February 2019 to identify relevant publications. Finally, 9 cross-sectional studies were considered in this systematic review and meta-analysis. Combining 11 effect sizes from 9 studies, we found a significant, positive association between the highest Internet use, compared to the lowest (ranged from ≥5 h/d to no use among studies), and odds of overweight and obesity (OR: 1.47; 95% CI: 1.21-1.78; I2, 69.6%; P < 0.001), such that Internet users had 47% greater odds of being overweight or obese. We also observed a significant, positive association between the highest Internet use, compared to the lowest (ranged from ≥5 h/d to no use among studies), and overweight/obesity (OR: 1.15; 95% CI: 1.06-1.25; I2, 0.0%; P = 0.426), obesity (OR: 2.58; 95% CI: 1.88-3.54; I2, 0.0%; P = 0.637), and overweight (OR: 1.38; 95% CI: 1.16-1.64; I2, 13.1%; P = 0.330). A linear dose-response meta-analysis revealed that each additional 1 h/d of Internet use was associated with 8% increased odds of overweight and obesity (OR: 1.08; 95% CI: 1.05-1.11; I2, 3.8%; P = 0.403). Findings of this systematic review and meta-analysis indicated that Internet use was positively associated with increased odds of being overweight and obese.

The Effect of Stress and Social Media Use on the Eating Behavior in University Students

Aim: It is possible to be phisicially and mentally healthy and maintain health at every stage of life with adequate and balanced nutrition. Stress, social media, family and peer influence are also factors affecting the nutrition attitude. The aim of this study is to investigate the effects of stress and social media usage on eating behaviors in university students. Methods: Retrospective-descriptive study data were collected by using the interview form consisted of four parts. Those four parts were “general informations” for demographic informations, “Eating Attitudes Test” for eating attitudes diagnosis, “Depression, Anxiety, Stress Scale” for diagnosis of psychological disorders and “Social Media Use”. Results: A total of 422 people, 329 women and 93 men participated in the survey conducted at the Faculty of Health Sciences of Trakya University. There was a statistically significant difference between stress degree and eating behavior disorder and it was determined that the increase in stress severity caused abnormal eating behavior. There was a statistically significant difference between the time allocated to social media and eating behavior disorder, and it was determined that increased time allocated to social media caused eating behavior disorder. Conclusion: In our study, it was determined that stress and social media use had significant negative effects on students' eating behaviors. Keywords: students, stress, social media, feeding behavior

Problematic Internet Use as a Predictor of Eating Disorders in Students: A Systematic Review and Meta-Analysis Study

Problematic Internet use (PIU) has begun to be linked to the development of certain eating disorders. This uncontrolled use of the Internet is mainly found in the student population. The purposes of this paper were to determine PIU-related eating disorders in students from a systematic review of the literature and to analyze the incidence of PIU in eating disorders through a meta-analysis of the literature. We used two electronic databases (Web of Science and Scopus) from inception to June 2019. The systematic literature review was based on fixed inclusion and exclusion criteria. A total of 12 studies were identified (systematic review) and 10 studies for meta-analysis, which included 16,520 students. Different eating disorders were associated with PIU: anorexia nervosa, bulimia nervosa, binge-eating disorder, food preoccupation, loss of control eating, and dieting. Furthermore, meta-analysis confirmed that PIU is a predictor of eating disorders in students. The groups of students with PIU presented a higher rate in the presence of eating disorders, these differences being significant. Finally, this study showed empirical evidence on the link between PIU and eating disorders. The need for prevention in childhood and adolescence is highlighted.

Relationship between anxiety, depression, sex, obesity, and internet addiction in Chinese adolescents: A short-term longitudinal study

Associations between anxiety, depression and adolescent Internet addiction have been well documented in the literature; however, few published studies have examined these relationships considering the developmental trajectory courses of adolescent Internet addiction as well as the individual differences over time. Using a sample of 1545 Chinese adolescents and 3 waves of data over six months, we examined the longitudinal associations between anxiety and depression and Internet addiction, considering sex and obesity. We used latent growth curve modeling (LGCM) to examine the overall conditions of Internet addiction, and latent class growth modeling (LCGM) to determine adolescent developmental membership for Internet addiction. Both unconditional and conditional models were performed. Anxiety and depression were analyzed as time-varying variables, and sex and obesity as time-invariants in our conditional models. Overall, there was a linear decline in adolescent Internet addiction over the six months. Anxiety and depression positively predicted adolescent Internet addiction. Two developmental trajectory patterns for Internet addiction were determined (i.e., low/declining, high/declining). Anxiety was associated with adolescent Internet addiction for both groups of adolescents, but depression was associated with Internet addiction only for adolescents who followed a low/declining course of Internet addiction. Boys reported a higher mean score of Internet addiction at the initial status than girls, and boys also had a faster, declining rate of change over the six months than girls. Obesity was not a predictor of Internet addiction. The results spoke to the importance of considering mental health problems and sex in any intervention efforts to reduce adolescent Internet addiction. Limitations of the study were discussed.

Determinants of Problematic Internet use and its Association with Disordered Eating Attitudes among Minia University Students

Background

To determine the association between problematic Internet use (PIU) and disordered eating attitudes (DEAs) and to detect the potential risk factors for PIU among University students in Minia, Egypt.

Methods

A cross-sectional study was carried out among a random sample (n = 2365) of Minia University students. PIU was assessed using The Problematic Internet Use Scale (PIUS), and the DEAs were assessed using eating attitudes test-26 questionnaire.

Results

Of the 2365 students, 424 (17.9%) had DEAs, and it was more in females than males (22.3% and 14.5%, respectively). The mean of the PIUS score also was significantly higher in males than females (120.3 ± 30.5, and 117.5 ± 30.6, respectively). A positive moderate correlation (r = 0.48, P < 0.05) was detected between PIU and DEAs.

Conclusions

The results of this study indicate that PIU is significantly correlated with DEAs among University students in Minia, Egypt, and further studies are needed to identify the association between DEAs and PIU.

Internet gaming disorder and online gambling disorder: Clinical and personality correlates

Background and aims The recent growth of Internet use has led to an increase of potentially problematic behaviors that can be engaged online, such as online gambling or Internet gaming. The aim of this study is to better conceptualize Internet gaming disorder (IGD) by comparing it with gambling disorder (GD) patients who only gamble online (online GD). Methods A total of 288 adult patients (261 online GD and 27 IGD) completed self-reported questionnaires for exploring psychopathological symptoms, food addiction (FA), and personality traits. Results Both clinical groups presented higher psychopathological scores and less functional personality traits when compared with a normative Spanish population. However, when comparing IGD to online GD, some singularities emerged. First, patients with IGD were younger, more likely single and unemployed, and they also presented lower age of disorder onset. In addition, they displayed lower somatization and depressive scores together with lower prevalence of tobacco use but higher FA scores and higher mean body mass index. Finally, they presented lower novelty seeking and persistence traits. Discussion GD is fully recognized as a behavioral addiction, but IGD has been included in the Appendix of DSM-5 as a behavioral addiction that needs further study. Our findings suggest that IGD and online GD patients share some emotional distress and personality traits, but patients with IGD also display some differential characteristics, namely younger age, lower novelty seeking scores and higher BMI, and FA scores. Conclusions IGD presents some characteristics that are not extensive to online GD. These specificities have potential clinical implications and they need to be further studied.

Internet addiction, sleep and health-related life quality among obese individuals: a comparison study of the growing problems in adolescent health

BACKGROUND

The rapid rise in the global prevalence of obesity suggests that environmental factors may be responsible. The increased use of technology is associated with increased rates of obesity due to declines in physical activity and significant sedentary life style. Internet addiction is also a growing health issue associated with diminished physical activity and poor sleep quality as well as various health problems. The purpose of this study was to determine associations between Internet addiction and adolescent obesity-related problems.

DESIGN AND METHODS

In this case-control study, 71 adolescents with obesity were recruited from the outpatient clinic at Tepecik Teaching Hospital and Katip Celebi University Hospital, Department of Pediatric Endocrinology in Izmir, Turkey. The control group consisted of 64 non-obese adolescents that were matched with patients in the study group by age and gender. All subjects completed socio-demographic forms, an Internet addiction scale, the Pediatric Quality of Life Inventory, the Pittsburgh Sleep Quality Index, and the Epworth Sleepiness Scale.

RESULTS

Adolescents with obesity were significantly more likely to have Internet addiction (p = 0.002), lower quality of life (p < 0.001), and higher daytime sleepiness (p = 0.008). Moreover, binary regression analysis showed that Internet addiction and less physical activity were associated with increased odds of obesity.

CONCLUSION

The results indicated a significant association between Internet addiction and obesity. Health practitioners should take possible Internet addiction, online activities, and physical activities into consideration in follow-up of obese adolescents. In addition to pharmacologic therapies and dietary interventions, providing behavioral therapy targeting healthy Internet use may be promising to reduce the effects of obesity in adolescence.

Investigation on Internet addiction disorder in adolescents in Anhui, People's Republic of China

BACKGROUND AND AIM

The purpose of this study was to describe the characteristics and prevalence of Internet addiction (IA) in adolescents so as to provide a scientific basis for the communities, schools, and families.

METHODS

We conducted a survey by randomized cluster sampling on 5,249 students, grades ranging from 7 to 12, in Anhui province, People's Republic of China. The questionnaire consisted of general information and IA test. Chi-square test was used to compare the status of IA disorder (IAD).

RESULTS

In our results, the overall detection rate of IAD and non-IAD in students was 8.7% (459/5,249) and 76.2% (4,000/5,249), respectively. The detection rate of IAD in males (12.3%) was higher than females (4.9%). The detection rate of IAD was statistically different between students from rural (8.2%) and urban (9.3%) areas, among students from different grades, between students from only-child families (9.5%) and non-only-child families (8.1%), and among students from different family types.

CONCLUSION

Prevalence of IA is high among Chinese adolescents. IAD has more effect on male students, single-child families, single-parent families, and higher grade students. We should take more care of male students, only-child students, and students living with their fathers, and related education should be strengthen for susceptible subjects of IDA.