Problematic internet use and its correlates among resident doctors of a tertiary care hospital of North India: A cross-sectional study

The association between problematic internet use and burnout: A three-level meta-analysis

BACKGROUND

Burnout has received considerable attention in recent years because of the adverse consequences for people. Theoretical perspectives propose that problematic internet use is a significant potential risk for burnout. Despite a plethora of studies showing a positive association between problematic internet use and burnout, there remains a contentious debate regarding the extent and direction of this association.

METHODS

This study aims to perform a three-level meta-analysis to evaluate the strength of the relationship between problematic internet use and burnout through a quantitative synthesis of eligible studies published until April 2023.

RESULTS

A total of 42 studies with 54,121 participants and 103 effect sizes were identified. The results indicated a positive, moderate, and significant association between problematic internet use and burnout. Furthermore, the subgroup analysis found that this association was moderated by population, dimension of burnout, and the measure of burnout, however, some study features (i.e., region, type of problematic internet use, gender, and publication year) could not explain the heterogeneity across individual studies.

LIMITATIONS

Studies included in the current meta-analysis mainly used cross-sectional designs, which limited the potential to make inferences on the causal relationship between problematic internet use and burnout.

CONCLUSIONS

Individuals with problematic internet use have exhibited higher levels of burnout. Overall, these findings develop a deeper understanding of this association between problematic internet use and burnout and have implications for the direction of future research and interventions.

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.

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.

Problematic internet use and safety behavior: The moderating role of safety climate

Problematic internet use (PIU) can cause mental and physical harm to individuals and may be an emerging factor contributing to unsafe work behavior. In this study, the relationship between PIU and safety behavior was investigated. Moreover, it was hypothesized that safety climate can moderate the relationship between PIU and safety behavior. Participants were employees from a mining industry in Iran. Three validated questionnaires were distributed to gather the required data regarding PIU, safety climate, and safety behavior. Hierarchical regression analysis was used to assess the moderating effect of safety climate on the relationship between PIU and safety behavior. The size of moderation effect was assessed using f2 index. Four hundred eighty-five employees participated in this study. The results demonstrated a negative relationship between PIU and safety behavior. The moderating effect of safety climate on the relationship between PIU and safety behavior was supported. The f2 index was 0.027 which demonstrates a small moderation effect. In conclusion, PIU has a significant negative effect on the safety behavior of employees. Providing a strong safety climate can be a long-term solution for reducing the negative effect of PIU on safety behavior.

Affective symptoms as a predictor of internet addiction among young adults

OBJECTIVES

Mental health difficulties have been found to be associated with internet addiction, which makes it a multifaceted problem. The current study aimed to examine the relationship between internet addiction and affective states (depression, anxiety, and stress).

MATERIAL AND METHODS

The study sample consisted of 731 individuals (403 males and 328 females) ranging in age from 18 to 25 years. We used an observational survey design to study participants with an internet addiction test and depression, anxiety, and stress scale.

RESULTS

The mean age ± standard deviation of the sample was 22.58 ± 2.80 years. Stress and depression were found to play a major role in internet addiction in the regression analysis.

CONCLUSIONS

The study supports the association between internet use and stress and depression. The findings imply the need for early identification and intervention of affective states in the context of unhealthy internet use.

Prevalence and Risk Factors of Problematic Internet Use among Hungarian Adult Recreational Esports Players

Background: Esports are highly prevalent in modern culture, particularly among young people, and are a healthy hobby for the majority of users. However, there is a possible link between video gaming (including esports) and problematic internet use (so-called internet addiction, IA), mostly involving adolescents. Methods: Here we present an online survey focusing on the prevalence and risk factors of internet addiction among adult esports players. Demographics included age, gender, family type, type of work, working years and daily internet use. Medical conditions associated with IA such as smoking, alcohol and drug intake, hypertension, diabetes, ischemic heart disease, musculoskeletal pain and history of depression were also recorded. Results: Overall, 2313 players including 176 females (7.6%) and 2137 males (92.4%) participated in our online survey. Age distribution was the following: 18−25 years 90.3% (2088/2313), 26−35 years 7.95% (184/2313), 36−45 years 0.86% (20/2313), 46−55 years 0.82% (19/2313), 56−62 years 0.04% (1/2313) and 62 years or older 0.04% (1/2313). Internet addiction was detected in 19.9% of players (461/2313) based on the Problematic Internet Use Questionnaire. In a multivariate analysis internet addiction was significantly associated with age between 18 and 25 (OR: 1.675, p = 0.002), being single (OR = 1.505, p = 0.014), internet use > 6 h daily (OR = 4.338, p < 0.001), having < 3 children (OR: 2.037, p = 0.023) and having secondary employment (OR = 1.789, p = 0.037). Regular alcohol intake (OR = 18.357, p < 0.001) and history of depression (OR= 5.361, p = 0.032) were also strongly correlated with IA. Conclusion: This is the first study from Hungary investigating the prevalence and risk factors of internet addiction among adult esports players. One out of five adult gamers suffered from IA. Our study also draws attention to increased risk within this group and risk factors such as younger age, family status and type of employment.

Internet Addiction and Depression Among Postgraduate Residents: A cross-sectional survey

Objectives

This study aimed to estimate the prevalence of social media usage and Internet addiction among Oman Medical Specialty Board (OMSB) residents and to determine associations between Internet addiction, sociodemographic characteristics and symptoms of depression.

Methods

This cross-sectional study took place between January and March 2017. All 499 residents enrolled in OMSB training programmes during the 2016–2017 academic year were targeted. A self-administered questionnaire was distributed to collect information concerning sociodemographic characteristics. In addition, the Patient Health Questionnaire-9 and Internet Addiction Test were used to screen for depression and Internet addiction, respectively.

Results

A total of 399 residents participated in the study (response rate: 80%). Overall, 115 residents (28.8%) had varying degrees of depression and 149 (37.3%) were addicted to the Internet; moreover, among those addicted, 54 (36.2%) had depression. While no significant associations were observed between Internet addiction and sociodemographic characteristics, the association between Internet addiction and depression was statistically significant (P = 0.012).

Conclusion

Internet addiction was clearly detected among many OMSB residents, with a significant association observed between Internet addiction and depression. Although a causal link between these two variables cannot be established as depression is multifactorial in origin, the disadvantages and harmful effects of excessive Internet and social media usage need to be addressed. Further research on the consequences of Internet addiction and its effect on quality of life and academic achievement is recommended.

Compulsive Internet Use Scale: Psychometric Properties and Associations With Sleeping Patterns, Mental Health, and Well-Being in Lithuanian Medical Students During the Coronavirus Disease 2019 Pandemic

Background: The increase in problematic Internet use (PIU) among medical students and resident doctors during the coronavirus disease 2019 (COVID-19) pandemic may be leading to significant impairments in everyday functioning, including sleeping patterns, anxiety, depressive symptoms, and overall well-being. The Compulsive Internet Use Scale (CIUS) has been developed to assess the severity of PIU, however, it has not been elucidated whether this scale is also applicable to medical students and resident doctors. The first aim of this study was to explore the psychometric properties of the Lithuanian version of the CIUS. The second aim was to examine associations between subjectively reported mental health symptoms and PIU during the COVID-19 pandemic. Methods: A total of 524 medical students and resident doctors (78.60% women, mean age 24 [SD 3] years old) participated in an online survey between December 2020 and February 2021. Participants completed the CIUS, the Pittsburgh Sleep Quality Index (PSQI) questionnaire, the Patient Health Questionnaire-9 (PHQ-9), the Generalized Anxiety Disorder Assessment-7 (GAD-7), and the WHO-Five Well-Being Index questionnaire (WHO-5). Results: The confirmatory factor analysis (CFA) suggested brief versions (CIUS-5, CIUS-7, and CIUS-9) rather than the original (CIUS-14) version of the CIUS questionnaire as reliable and structurally stable instruments that can be used to measure compulsive Internet use severity in the sample of medical students and resident doctors. The most prevalent online behaviors were social media use (90.1%), online shopping (15.6%), and online gaming/gambling (11.3%). Students with higher CIUS scores reported significantly lower academic achievements during the 6 months (r = 0.12-0.13; p < 0.006), as well as more severe depressive and anxiety symptoms, worsened sleep quality, and lower sense of well-being (r = 0.21-0.41; p's < 0.001). Both, during workdays (d = 0.87) and weekend (d = 0.33), students spent more time online than resident doctors (p's < 0.001). Conclusion: The brief, 5-, 7-, and 9-item versions of the Lithuanian CIUS are reliable and valid self-report screening instruments for evaluating the severity of PIU symptoms among the medical student population. Symptoms of PIU during the COVID-19 period were associated with worsened self-reported mental health and everyday functioning.

Prevalence and Risk Factors of Internet Addiction among Hungarian High School Teachers

The extensive availability of internet has led to the the recognition of problematic internet use (so called internet addiction, IA) mostly involving adolescents. There is limited data about the prevalence of IA in adults. Here we present a study focusing on the prevalence and risk factors of internet addiction among high school teachers. Overall 2500 paper-based questionnaires were successfully delivered and 1817 responses received (response rate of 72.7%). In our study 1194 females (65.7%) and 623 males (34.3%) participated. In a multivariate analysis including of all factors (demographic data, internet habits, comorbidity etc.) age <35 years (OR: 6.098, CI: 5.09-7.08, p < 0.001), male gender (OR = 5.413, CI: 4.39-6.18, p = 0.002), surfing on the internet > 5 h daily (OR 2.568, CI: 2.03-3.39, p < 0.001), having no children (OR: 1.353, CI: 1.13-1.99, p = 0.0248), and having secondary employment (OR = 11.377, CI: 8.67-13.07, p = 0.001) were significantly associated with internet addiction. This is the first study from Hungary showing the prevalence and risk factors of internet addiction among high school teachers. A small, but significant proportion suffered from IA. Our study also draws attention to the risk factors of IA such as younger age, family status and working type.

Internet Addiction and Burnout in A Single Hospital: Is There Any Association?

The extensive availability of the internet has led to the recognition of problematic internet use, the so-called Internet Addiction (IA), mostly involving adolescents. Burnout can lead to substance abuse or addictive behaviour (such as internet addiction) as a coping method. There are insufficient data about internet addiction and its possible association with burnout in adults, especially among healthcare workers. The aim of our present study was to focus on prevalence and the risk factors of internet addiction and its possible association with burnout among healthcare workers in a single hospital applying a questionnaire-based survey. In total, 49 doctors (10.1%), 198 nurses (40.9%), 123 medical assistant (25.4%), 73 other healthcare workers (15.1%), and 42 (1.7%) healthcare associated workers (cleaning, laundry, etc.) have completed our survey. In a multivariate analysis, IA was associated with age between 18 and 25 (OR: 2.6, p = 0.024), surfing on the internet >5 h daily (OR 25.583, p < 0.001), being single (OR: 4.275, p = 0.006), being childless (OR: 3.81, p = 0.011), working less than five years (OR 2.135, p = 0.048) and job type (being healthcare associated worker, OR: 2.907, p = 0.009). Illicit drug intake (OR 52.494, p < 0.001), and diabetes (OR: 4.122, p = 0.043) were also significantly associated with internet addiction. No association of burnout and IA could be found. A small but significant proportion of our healthcare workers suffered from IA, which was associated with substance abuse and diabetes in multivariate analysis. Our study also draws attention to the risk factors of IA such as younger age, family status, working type and working hours internet use. The possible association of burnout and IA merits further investigation.

Burden of internet addiction, social anxiety and social phobia among University students, India

Background:

Social anxiety disorder (SAD) is a common mental health disorder affecting adolescents often associated with comorbidities like depression, suicide ideation and substance abuse. The objective of this study was to estimate the prevalence of social anxiety in adolescents and to explore its correlation with internet usage.

Methods:

An exploratory cross-sectional study was conducted among 307 undergraduate students to screen for social anxiety and social phobia using a validated instrument, social interaction anxiety scale (SIAS). Young's internet addiction scale was used for measuring internet addiction. Respondents were categorised according to the scores obtained and later compared with their internet addiction behaviours.

Results:

Internet addiction was seen in 93.8% of respondents. The prevalence of SAD was estimated to be 15.3%. Internet addiction was positively correlated with social anxiety score (Pearson correlation = 0.994, P < 0.001).

Conclusion:

More than 90% of participants had internet addiction, the majority had mild-moderate internet addiction. Social anxiety was present in more than one-third of the participants. SAD was found to be associated with internet addiction.

Emotional dysregulation features and problem gambling in university students: a pilot study

Undergraduate students typically cope with various changes in their lives and experience many stressors associated with academic issues. Distress can make them more vulnerable to particular behavioral patterns in order to cope with negative affect. The association of problematic gambling with particular emotion regulation characteristics-some of which are developmentally dependent-becomes a recent focus of research with clinical and preventive implications. We carried out a pilot study enrolling voluntarily young adults of a public university in the Lisbon area, and 117 Portuguese-speaking individuals were interviewed. Participants, mainly female (M = 20.6; SD = 3.9), were investigated taking into consideration their gambling practices, characteristics of impulsivity and alexithymia, along with the symptoms of depression and anxiety. Portuguese versions of the South Oaks Gambling Scale (SOGS) and Short-Version of Impulsive Behavior Scale (S-UPPSP) were prepared (i.e., translation and back-translation of the original versions were performed). The prevalence of gambling problems in this sample is modest, although they were associated with negative urgency and sensation-seeking, as well as with depression symptoms. Multiple correspondence analysis, a particular multivariate model associating gambling problems with socio-demographic and psychological variables, allowed identifying different profiles of individuals. Trace and state emotional dysregulation features are selectively associated with distinctive gambling patterns, according to some previous findings in studies with other groups. Results may address new findings in terms of morbidity, risk factors and the design of future preventive strategies among such individuals.

Problematic Internet Use, Psychopathology, Defense Mechanisms, and Coping Strategies: a Cross-Sectional Study from the United Arab Emirates

A number of studies point to a demonstrated relationship between problematic Internet use (PIU) and psychopathological variables. However, explorations of PIU in relation to defense mechanisms and coping strategies remain rare. The present study sought to determine the extent of PIU among a sample of college-aged young adults resident in the United Arab Emirates. The relationship of PIU to two psychopathological variables (depression and low self-esteem) and two psychological variables (defense mechanisms and coping strategies) were examined. A sample of 697 Emirati participants aged between 18 and 33 years of age completed assessments of PIU, socio-demographic, psychopathological, and psychological variables. A total of 67.3% exhibited PIU. Problematic users produced higher scores for maladaptive coping strategies and for the use of immature, neurotic, and autistic fantasy defenses. Regression analyses revealed that PIU was predicted by the mature, immature, and autistic fantasy defenses as well as, negatively by adaptive coping, and positively by maladaptive coping. These differed when the analyses were repeated on gender-stratified samples. Given that this initial prevalence estimation suggests that PIU may be a substantial issue in this region of the world, future research should examine the mental health risk factors related to PIU, particularly their causal relationships.

Patologías asociadas al uso problemático de internet. Una revisión sistemática y metaanálisis en WOS y Scopus

El uso problemático de internet (UPI) ha empezado a vincularse con la predisposición a padecer ciertas patologías que afectan la salud del ser humano. Este trabajo se propuso determinar las patologías asociadas al uso problemático de internet a partir de una revisión sistemática en Web of Science y Scopus, y analizar la incidencia del UPI en cada una de las patologías a través del metaanálisis. Así pues, se empleó una metodología de revisión sistemática con metaanálisis y se estableció una muestra final de 62 documentos. Entre los resultados destacan, como principales patologías asociadas al uso problemático de internet, el trastorno obsesivo-compulsivo, el abuso del alcohol, la depresión, el estrés, los trastornos del sueño, el déficit de atención y la hiperactividad y los trastornos alimenticios. Además, en la mayoría de estas patologías se estableció una significación estadística entre los grupos de control y los grupos con UPI. Finalmente, se muestra una panorámica general sobre los riesgos que conlleva el abuso de internet y la incidencia que presentan en la salud tanto física como mental.

Medical student Internet usage: is the literature correct to call it addiction? An opinion piece

Over the past few years, there has been a sharp rise in the number of academic articles examining "Internet addiction" among medical students. This opinion piece views the Internet as a communication environment and a medical information tool within medical education. Within this context, the paper investigates the Internet Addiction Test (IAT) and criteria used in those articles, and questions their assumptions and conclusions. It then argues that what is often viewed as "addiction" may actually be dedication to work.

Correlates of Problematic Internet Use among college and university students in eight countries: An international cross-sectional study

BACKGROUND AND AIMS

Internet use has increased worldwide exponentially over the past two decades, with no up-to-date cross-country comparison of Problematic Internet Use (PIU) and its correlates available. The present study aimed to explore the pattern and correlates of PIU across different countries in the European and the Asian continent. Further, the stability of factors associated with PIU across different countries were assessed.

MATERIALS AND METHODS

An international, cross-sectional study with a total of 2749 participants recruited from universities/colleges of eight countries: Bangladesh, Croatia, India, Nepal, Turkey, Serbia, Vietnam, and United Arab Emirates (UAE). Participants completed the Generalized Problematic Internet Use Scale -2 (GPIUS2) assessing PIU, and the Patient Health Questionnaire Anxiety-Depression Scale (PHQ-ADS) assessing the depressive and anxiety symptoms.

RESULTS

A total of 2643 participants (mean age 21.3 ± 2.6; 63% females) were included in the final analysis. The overall prevalence of PIU for the entire sample was 8.4% (range 1.6% to 12.6%). The mean GPIUS2 standardized scores were significantly higher among participants from the five Asian countries when compared to the three European countries. Depressive and anxiety symptoms were the most stable and strongest factors associated with PIU across different countries and cultures.

DISCUSSION AND CONCLUSIONS

The PIU is an important emerging mental health condition among college/university going young adults, with psychological distress being the strongest and most stable correlate of PIU across different countries and cultures in this study. The present study highlighted the importance of screening university and college students for PIU.

Problematic internet use in Bangladeshi students: The role of socio-demographic factors, depression, anxiety, and stress

Problematic Internet Use (PIU) has become a concern for public mental health across the globe. However, there are few studies assessing PIU in Bangladesh. The present cross-sectional study estimated the prevalence rate of PIU and its associated risk factors among 405 university students in Bangladesh between June and July 2018. The measures included sociodemographic questions, internet and health-related variables, the Internet Addiction Test (IAT) and the Depression, Anxiety and Stress Scale (DASS-21). The prevalence of PIU was 32.6% among the respondents (cut-off score of ≥50 on the IAT). The prevalence of PIU was higher in males in comparison to females, although the difference was not statistically significant. Internet-related variables and psychiatric comorbidities were positively associated with PIU. From the unadjusted model, more frequent use of the internet and more time spent on the internet were identified as strong predictors of PIU, whereas the adjusted model showed depressive symptoms and stress only as strong predictors of PIU. It is hoped this preliminary study will facilitate further study on PIU along with other psychiatric disorders in Bangladesh.

Online course on basics of management of behavioral addictions involving use of internet: Observations from the first batch of participants

Problematic internet use has been reported to be high among school students. An online course was developed with an aim to strengthen the capacity of school teachers and counsellors on early identification, detection and intervention for behavioral addictions involving use of internet. The current report presents the observation from the first batch of participants of this course. Of the 28 teachers and counselors who expressed interest by enrollment in the course, a total of 15 participants provided both the pre and post course evaluation forms. The preliminary findings suggest that the online course is feasible, acceptable and effective in strengthening the capacity of school teachers and counsellors on behavioral addictions involving use of internet.

Psychometric properties of Young's Internet Addiction Test (IAT) in Urdu language

Internet Addiction Disorder is characterized by excessive or poorly controlled obsessions, cravings, or manners regarding Internet use that lead to real life conflicts. In this study assessed psychometric properties of Internet Addiction Scale in Urdu. Data were collected from 506 participants and were analyzed using SPSS v23. We found 4 factors which were named; salience, conflict, tolerance and mood modification. These factors showed strong correlation among them. Further the items in the factors are comparable to other studies. The IAT was found to be psychometrically sound for measuring internet addiction among Urdu speaking population.