Internet addiction: Associated with lower health-related quality of life among college students in Taiwan, and in what aspects?

The comorbidity mechanism of problematic internet use and depression among Chinese college students: A cross-lagged panel network analysis

Problematic internet use (PIU) and depression usually co-occur and are common among college students. According to network theory, it may be attributed to the interplay of symptoms that connect these two mental health problems. However, most studies have failed to examine complex and subtle connections at the symptom level and have not clarified how PIU and depression symptoms are intercorrelated, which symptoms serve as the source of comorbidity (i.e., the central symptoms), and whether such a comorbidity mechanism would change with higher grades. To explore these questions, this study examined four contemporaneous networks and three cross-lagged panel networks, visualizing the symptoms as nodes and the connections between symptoms as edges. A total of 2,420 college students (Mage = 18.35, SD = 0.84; 67.98 % girls) completed four annual surveys. Overall, the results of contemporaneous networks and cross-lagged panel networks indicated that (a) PIU and depression symptoms are intercorrelated; (b) the core symptoms responsible for comorbidity mostly belonged to PIU, and (c) the comorbidity mechanism would change with time. These findings explain the dynamic relation between PIU and depression and identify possible primary symptoms that comorbidity programs can mitigate at different stages of the college years.

Exploring the relationship between resilience and internet addiction in Chinese college students: The mediating roles of life satisfaction and loneliness

Internet addiction is of great impact on college students' academic performance, life quality and mental health. Although it's well documented the association between resilience and Internet addiction among college students, the mechanism underlying it are not well acknowledged. The study applied resilience scale, the Chinese Internet Addiction Scale, Satisfaction with Life Scale and the third edition of the UCLA Loneliness Scale to explore the mechanism of action between resilience and Internet addiction in college students by applied questionnaire investigation. A total of 813 college students (321 male, Mean age = 22.55) participated in the study. We found resilience and life satisfaction of college students were negatively correlated with Internet addiction (β = -0.85, t = -21.35, p < 0.001; β = -0.08, t = -2.23, p < 0.05), while loneliness was positively correlated with Internet addiction (β = 0.17, t = 7.42, p < 0.01). Furthermore, mediating analyses showed life satisfaction and loneliness played mediating role in the relationship between resilience and Internet addiction (β = -0.90, t = -58.76, p < 0.001). Measures such as strengthening the construction of college students' mental health courses to improve their resilience and life satisfaction, and providing rich community activities to reduce college students' loneliness have been put forward to reduce college students' Internet addiction.

Turning Lemons into Lemonade: Social Support as a Moderator of the Relationship Between Technostress and Quality of Life Among University Students

Purpose

The overuse of internet-based technologies as a means of coping with the stress they generate has resulted in an alarming level of addiction, adversely impacting the quality of life and overall health of younger individuals. This social detachment, in turn, contributes to both physical and mental health deterioration. The potential remedy for this predicament lies in the application of social support as an antidote to internet addiction. In this context, our present study employs the Stress-Strain-Outcome model to explore the indirect effects of internet addiction and the moderating role of social support in relation to the influence of technostress on the quality of life of adults.

Methods

We adopted a time-lagged design to collect data from university graduates and evaluated our study hypotheses using Mplus.

Results

Our empirical findings highlight the significant influence of technostress on internet addiction, with the latter significantly mediating the relationship between technostress and quality of life. Furthermore, our results reveal that social support effectively moderates the indirect effects of technostress on quality of life through its impact on internet addiction.

Conclusion

These findings can help researchers and educators better understand the underlying mechanisms between technostress and quality of life with social support as the silver lining. This form of social support holds the potential not only to alleviate internet addiction but also to positively enhance the quality of life and overall wellbeing of individuals facing these challenges. The implications of these findings and avenues for future research are also discussed.

Psychosocial Factors Influencing Quality of Life Among Medical Students

OBJECTIVE

This study investigated the influence of psychosocial factors on medical students' quality of life (QOL).

METHODS

A total of 408 medical students participated in this study. We collected data on participants' sociodemographic details, symptoms of depression and Internet addiction, self-esteem, social support, and QOL. QOL was assessed using the World Health Organization Quality of Life-Abbreviated form, which has four domains (physical health, psychological health, social relationships, and environment). A stepwise multiple linear regression model was constructed to identify factors' independent impact on QOL.

RESULTS

Higher levels of depression and Internet addiction were associated with lower scores in all domains of QOL, whereas higher levels of self-esteem and social support were associated with higher scores. Being in third-year versus first-year was associated with higher scores in the physical health and environment domains. Living alone or in dormitories, low or middle socioeconomic status, and insufficient or moderate pocket money were associated with lower scores in the environment domain. Additionally, female students displayed significantly lower scores for physical health, psychological health, and environment than male students, but not for social relationships. There were significant differences in certain domains of QOL due to sociodemographic factors.

CONCLUSION

This study demonstrates the psychosocial factors influencing medical students' QOL. Educational strategies focusing on strengthening self-esteem and social support as well as preventing depression and Internet addiction may contribute to improving medical students' QOL.

Latent profile analysis for health-related quality of life, sleep quality, morning and evening type, and internet addiction among medical students

Health-related quality of life, sleep quality, morning and evening types, and internet addiction are of significant importance to the development of medical students, yet they have rarely been studied. Taking this into consideration, the study aimed to confirm latent profiles in health-related quality of life, sleep quality, morning and evening types, and internet addiction in medical students and investigate the characteristics of participants in each profile to provide suggestions for students' health. This was an observational cross-sectional study including 1221 medical student subjects at China Medical University in 2019. Multiple correspondence analysis was the initial step to verify the correspondence, dispersion, and approximation of variable categories. Latent profile analysis was used to identify the multiple correspondences between the levels of variables. Three profiles were found, including: (1) The Low sleep quality profile was characterized by the lowest sleep quality among the three existing profiles. (2) The High health-related quality of life and Low internet addiction profile was characterized by the highest level of health-related quality of life but the lowest level of internet addiction. (3) The Low health-related quality of life and High internet addiction profile was characterized by the highest standardized values of internet addiction but the lowest standardized values of health-related quality of life. This study had important implications for improving student health and supported the medical universities and hospitals in implementing targeted policies based on distinctive student characteristics.

Social Media Addiction and Poor Mental Health: Examining the Mediating Roles of Internet Addiction and Phubbing

Many researchers have examined the potential detrimental role of problematic social media use (often referred as 'social media addiction') on mental health. The present study investigated how social media addiction is associated with three components of mental health: depression, anxiety, and stress. In addition, structural equation modeling was used to test the mediating roles of internet addiction and phubbing among a sample of young adults (N = 603). Results showed that social media addiction was associated with poorer mental health via internet addiction and phubbing. More specifically, associations between social media addiction and stress, and social media addiction and anxiety were explained by both internet addiction and phubbing. The association between social media addiction and depression was explained by internet addiction only. These results remained consistent after controlling for gender, age, frequency of internet use, frequency of social media use, and frequency of smartphone use. These findings extend the extant literature by providing evidence for the dual roles of internet addiction and phubbing in explaining the relationship between social media addiction and poor mental health. Social media addiction did not directly influence poorer mental health but did via internet addiction and phubbing. Therefore, greater awareness of the inter-relationships between technology-based behaviors and their impact on mental health is needed among a wide range of stakeholders, and these inter-relationships need considering in the prevention and treatment of technology-based disorders.

Internet, studying and daily rhythm: health symptoms among higher education students

OBJECTIVES

Excessive Internet use is a health concern among higher education students leading to reduced academic performance and problems in everyday life. This study aimed to explore the relationship between health and problems of studying and daily rhythm caused by time spent online among students (n=3,050).

METHODS

A cross-sectional survey was carried out. The data were analyzed using descriptive and chi-square tests and logistic regression analyses.

RESULTS

Findings indicated that one fifth of students reported having problems of studying and daily rhythm caused by time spent online. Psychological health symptoms such as anxiety (p<0.001) and physical health symptoms including lower back problems (p<0.001) were associated with these problems. According to the logistic regression analyses, problems of studying and daily rhythm caused by time spent online and higher amount of Internet use by time were associated with psychological and physical health symptoms.

CONCLUSIONS

The findings suggest that problems of studying and daily rhythm and spending more time online are related to health symptoms among the students. The study's findings can be used from a prevention standpoint for early identification and further to identify the need for seeking professional treatment.

The Moderator Effect of Subthreshold Autistic Traits on the Relationship between Quality of Life and Internet Addiction

People with sub-threshold autistic traits (SATs) are more prone to develop addictive behaviors such the ones linked to Internet abuse. The restrictions for anti-COVID-19 distancing measures encourage social isolation and, consequently, increase screen time, which may lead to Internet addiction (IA). However, a better quality of life (QoL) may have function as a protective factor against the development of IA. This study wanted to investigate the relation between SATs, QoL, and the overuse of the Internet in a group of 141 university students in the North of Italy. Participants completed a battery of tests. Results suggest that QoL is a predictive factor of IA and that the relationship between QoL and IA is significantly moderated by SATs. This could mean that SATs might represent a risk factor for IA, even when people have a better quality of life. Differences between female and male students are discussed, as well as possible implications for practice.

Associations between 24-h Movement Behavior and Internet Addiction in Adolescents: A Cross-Sectional Study

OBJECTIVE

This study aimed to explore the relationship between 24-h activity behavior and Chinese adolescents' Internet addiction.

METHODS

A survey of 2045 adolescents (56.5% boys) was conducted, and adolescents' 24-h movement behavior and Internet addiction were measured via a questionnaire. Descriptive statistics were used to analyze the basic situation of the respondents; chi-square analysis was used to compare gender differences, and logistic regression was used to analyze the relationship between 24-h exercise guide entries and Internet addiction.

RESULTS

From the number of 24-h movement behavior guides, 25.3% of the children did not meet the recommended amount of any kind of activity behavior guide, while 50.4% and 21.7% of the children reached the recommended amount of one and two activity behavior guidelines, respectively; only 3.2% of the children met the recommended amount of all three activity behavior guidelines. Adolescents who did not meet the recommended 24-h activity behavior guidelines were more likely to have Internet addiction (OR = 8.46, 95 CI = 3.06-23.36), and were more likely to have one item (OR = 4.50, 95 CI = 1.64-12.39) or two items (OR = 3.12, 95 CI = 1.11-8.74).

CONCLUSIONS

Physical activity, static behavior, and sleep may all have a greater impact on adolescents' Internet addiction, among which physical activity has a greater impact on adolescents' Internet addiction. Different combinations of 24-h movement behavior have different effects on adolescents' Internet addiction.

Relationship between adverse childhood experiences and problematic internet use among young adults: The role of the feeling of loneliness trajectory

BACKGROUNDS AND AIMS

Given problematic Internet usage's (PIU) negative impact on individual health, this study evaluates how adverse childhood experiences (ACEs) affect young adults' PIU and the possible underlying mechanism of the "feeling of loneliness" (FOL) trajectory.

METHODS

Analyzing a retrospective cohort sample from the Taiwan Youth Project, 2,393 adolescents were interviewed from the average ages of 14-28. We constructed ACE in 2000 using six categories (e.g., abuse and low family socioeconomic status) and 5-item PIU in 2017 from Chen's Internet Addiction Scale. FOL trajectories measured eight times, at average ages 14, 16, 17, 18, 20, 22, 25, 28 years-old.

RESULTS

Overall, 12.65% of the participants did not have ACEs, and 12.78% exhibited PIU. FOL trajectory analyses yielded three groups: "constant low" (reference group: 53.25%); "moderate decline" (36.81%); and "increasing" (9.94%). Regression models showed a dose-response association between ACE and young adults' PIU (adjusted odds ratio = 1.12; 95% confidence interval [CI] = 1.02-1.23) and the two risky loneliness groups (moderate decline: relative risk ratio [RRR] = 1.42, 95% CI = 1.32-1.54; increasing: RRR = 1.52, 95% CI = 1.37-1.71). Structural equation modeling further found that ACEs increase young adults' risk of being in the increasing group, and consequently, the risk of PIU.

DISCUSSION AND CONCLUSIONS

We demonstrated that ACE may be associated with 1) adults' PIU, 2) FOL from adolescence to emerging adulthood, and 3) young adults' PIU through its association with FOL trajectories.

Is Problematic Internet and Smartphone Use Related to Poorer Quality of Life? A Systematic Review of Available Evidence and Assessment Strategies

Purpose of Review

Previous studies have explored the links between problematic Internet use (PIU) or problematic smartphone use (PSU) and quality of life (QOL). In this systematic review, we (i) describe the instruments used to assess QOL or health-related quality of life (HRQOL) in these studies, (ii) critically examine the content validity of the instruments used, and (iii) examine the relationships between PIU, PSU, QOL, and HRQOL.

Recent Findings

We identified 17 PIU and 11 PSU studies in a systematic search. Evidence suggests that PIU and PSU negatively correlate with either QOL or HQOL and most of their domains (especially mental and physical health). Multiple instruments were used to assess QOL or HRQOL in these studies. Our analysis showed an important heterogeneity in the domains covered by these instruments.

Summary

Because of the widespread prevalence of PIU and PSU, which tend to be linked with lower QOL or HRQOL, in particular poor mental and physical health, a more systematic public health campaign is required to target the healthy use of these communication devices. Prevention programs should also target vulnerable individuals, focusing on the most affected domains of QOL and HRQOL (i.e., physical and psychological health). Among the existing instruments, the World Health Organization Quality of Life for adults and the Pediatric Quality of Life Inventory for adolescents (aged 13-18 years) proved to be the most relevant, although new measurement instruments are needed to target domains that are specifically relevant in the context of PIU and PSU (e.g., physical and psychological health domains such as sleep, loneliness, and quality of familial relations).

Is there a gradient in the association between internet addiction and health?

Background

Internet Addiction (IA) is often shown to be associated with health issues, but no study explicitly examined a possible gradient in the association between different levels of IA and health. This study aimed to examine if the levels of IA had a graded relationship with poor sleep quality, psychological distress, and self-rated health among university students in Bangladesh.

Methods

In this cross-sectional study, a sample of 625 students from six universities/colleges responded to an online survey that contained measures of internet addiction test (IAT), general health questionnaire (GHQ-12), sleep quality, and self-rated health. Modified Poisson regression models were fitted to estimate the adjusted risk ratios (RR) and confidence intervals (CI) of the associations between IA and health outcomes.

Results

The IA levels were associated with each of the three health outcomes in a linear fashion. Compared to the lowest IA quintile, the highest quintile remained associated with an increased risk of poor-quality sleeping (RR: 1.77; 95% CI: 1.26, 2.48), psychological distress (RR: 2.09; 95% CI: 1.55, 2.82), and worse self-rated health (RR: 1.46; 95% CI: 1.09, 1.96) after adjusting for socio-demographic covariates. There were also dose-response associations between IAT z-scores and health outcomes. The association between IAT z-scores and psychological distress was significantly stronger in males compared to females (p-value for interaction<0.05).

Conclusions

The study found strong gradients between levels of addiction to internet and health outcomes, suggesting that increased health risks may exist even at lower levels of internet addiction. The findings highlight the need for departure of current research from a focus on the classic dichotomy of problematic versus not problematic internet use and a move toward recognizing the potential hierarchical effects of IA on health.

Association of problematic Internet use and oral health-related quality of life among medical and dental students

BACKGROUND

The Internet as a communication tool is an essential component of daily life. Nowadays, problematic Internet use (PIU) has led to various psychosocial problems that can indirectly lead to oral diseases due to neglect of healthy behaviors. Also, college students are a large proportion of Internet users. The present study aimed to determine the association between problematic Internet use and oral health-related quality of life (OHRQoL) among medical and dental students.

METHODS

A cross-sectional descriptive-analytical study was conducted on medical and dental students in the first and second years of education (basic sciences courses) at the Golestan University of Medical Sciences, Iran, between January and July 2020. The data collection process was carried out in the following sequence: questionnaire on demographic characteristics (age, gender, marital status, academic field, and year); Problematic Internet Use Questionnaire (PIUQ); and Oral Health Impact Profile (OHIP-14) questionnaire.

RESULTS

Among 268 medical and dental students, 171 students (63.81%) [95% confidence interval: 58.02%- 69.60%] had problematic Internet use. The mean PIU score in the first-year was significantly higher than the second-year students. In addition, 65% of single students and 25% of married subjects were dealing with PIU. The statistical difference between mean OHIP scores among PIU students (12.5 ± 2.9), with average Internet usage (7.39 ± 6.6), was significant. The Spearman correlation coefficient between PIU and OHIP was 0.309 and significant (P-value < 0.000001). It indicates that students with higher PIU showed higher OHIP scores.

CONCLUSION

The present study showed that problematic Internet use was significantly associated with oral health-related quality of life (OHRQoL) among first and second-year medical and dental students. Thus, the students with problematic Internet use experienced a poorer oral health-related quality of life than average Internet users. Furthermore, appropriate preventive and interventional strategies need to be developed to encourage rational use of the Internet to protect the users' oral health, especially among medical and dental students.

Internet use and health in higher education students: a scoping review

The amount of time spent online has increased over the last decade among higher education students. Students engage in online activities related to studies, work, leisure, entertainment and electronic services (e-services) use. The Internet is also used for health-related matters. The increase in the use of the Internet has influenced students' health, especially mental and physical health and well-being. This scoping review scrutinizes the literature between 2015 and 2020 (N = 55) on the association between Internet use and health in higher education students. A methodological framework, outlined by Arksey and O'Malley, was applied to conduct this review. Systematic searches were carried out in the CINAHL, PubMed and Scopus databases and in the available grey literature. For the data, a thematic analysis by Braun and Clarke was utilized. Two major themes of 'Health-promoting Internet use' and 'Health-threatening Internet use' emerged and are described in this review.

Internet Addiction Effect on Quality of Life: A Systematic Review and Meta-Analysis

PURPOSE

Due to the use of different methodologies, tools, and measurements, the positive or negative impact of Internet use on human life quality is accompanied by a series of ambiguities and uncertainties. Therefore, in this study, a systematic review and meta-analysis are conducted regarding the effect of Internet addiction on the quality of life.

METHODS

A systematic search of resources was conducted to investigate the effect of Internet addiction on the quality of life. The databases of PubMed, Cochrane Library, Scopus, Web of Science, Embase, and Science Direct were searched from January 1980 to July 2020. The articles were screened by two researchers in multiple levels in terms of the title, abstract, and full-text; then, final studies that met the inclusion criteria were retrieved and included in the study.

RESULTS

After searching the previously mentioned international databases, 3863 papers were found, 18 of which we included in the final analysis. Surveys indicated that people who had a high Internet addiction received lower scores of quality of life than those who were normal Internet users (OR = 2.45, 95% CI; 2.31-2.61, p < 0.001; I 2 = 85.23%, p < 0.001). Furthermore, There was a negative significant relationship between Internet addiction and quality of life in the psychological (OR = 0.56, 95% CI: 0.32-0.99, p=0.04, I 2 = 97.47%, p < 0.001), physical (OR = 0.58, 95% CI: 0.39-0.86, p=0.007, I 2 = 95.29%, p=0.001), and overall quality of life score (OR = 0.39, 95% CI: 0.27-0.55, p < 0.001, I 2 = 0.0%, p=0.746).

CONCLUSION

These findings illustrate that Internet addiction should be regarded as a major health concern and incorporated into health education and intervention initiatives.

Problematic Internet Use, Emotional Problems and Quality of Life Among Adolescents

Abstract This study aimed to evaluate the prevalence of Problematic Internet Use (PIU) among adolescents (N = 466) and its possible association with emotional problems and quality of life. Students (Mage = 12.8 years; SD = 1.9) from five public schools in a city in the State of São Paulo participated in this study and completed four instruments: a sociodemographic questionnaire; Internet Addiction Test (IAT); Depression Anxiety Stress Scale (DASS-21) and Pediatric Quality of Life Inventory (PedsQL). No significant differences were detected about the frequency and intensity of symptoms of depression, anxiety, and stress compared to those who did not have problems with the use of the Internet. No differences were observed between the groups in respect of quality of life either. However, those individuals who felt that their internet use impaired their daily activities presented higher average IAT scores and higher levels of stress. These findings indicated that the perception of internet use was the main variable associated with emotional symptoms.

The association between internet addiction, sleep quality, and health-related quality of life among Iranian medical students

Due to the increasing use of the internet in Iranian society, especially among students, and the importance of sleep quality (SQ) and quality of life (QOL), the present study examined the relationship between QOL, SQ, and internet addiction (IA) among medical science students. In the present descriptive-analytical study, the sample comprised Saveh University of Medical Sciences students who were studying in 2019. The survey included demographic information (i.e., age, gender, place of residence, field of study, semester, marital status, smoking status, daily exercise) and the 20-item Internet Addiction Test. From 285 distributed questionnaires, 279 individuals with a mean age of 21.01 years (SD ± 3.17) completed the survey. Findings indicated that students with IA had higher mean scores on (i) all physical dimensions concerning QOL (except for the physical pain) and (ii) all psychological dimensions of QOL. The findings will help national health authorities and planners in Iran design appropriate and effective interventions to improve student health and prevent IA.

When adolescents face both Internet addiction and mood symptoms: A cross-sectional study of comorbidity and its predictors

This study aimed to determine the prevalence of comorbid Internet addiction (IA) and mood symptoms and to identify common and unique risk profiles for individual and comorbid mental health problems among adolescents. A total of 2272 high school students in Changchun, China, were included in a cross-sectional study. Participants were asked to complete paper-based questionnaires on sociodemographic characteristics, lifestyle factors, Internet use, parent-child relationships, IA, and mood symptoms. Multivariate logistic regressions were used to compare the risk profiles for IA, mood symptoms, and their comorbidity. The Bonferroni correction was used for multiple tests. Students who were girls, were current smokers, had more than 1.5 h sleep deprivation per day on weekdays, used the Internet for more than 30 and 240 min per day on weekdays and weekends, respectively, used social networking sites more than 6 times per day, were Internet gamers, and/or reported poor parent-child relationships reported higher rates of comorbid IA and mood symptoms. Adolescents exposed to more of these correlates would have a higher risk of IA, mood symptoms, and their comorbidity. Public strategies for the prevention of mental illnesses should expand their capacity to identify and limit the co-occurrence of IA and mood symptoms.

Internet addiction disorder detection of Chinese college students using several personality questionnaire data and support vector machine

With the unprecedented development of the Internet, it also brings the challenge of Internet Addiction (IA), which is hard to diagnose and cure according to the state-of-art research. In this study, we explored the feasibility of machine learning methods to detect IA. We acquired a dataset consisting of 2397 Chinese college students from the University (Age: 19.17 ± 0.70, Male: 64.17%) who completed Brief Self Control Scale (BSCS), the 11th version of Barratt Impulsiveness Scale (BIS-11), Chinese Big Five Personality Inventory (CBF-PI) and Chen Internet Addiction Scale (CIAS), where CBF-PI includes five sub-features (Openness, Extraversion, Conscientiousness, Agreeableness, and Neuroticism) and BSCS includes three sub-features (Attention, Motor and Non-planning). We applied Student's t-test on the dataset for feature selection and Support Vector Machines (SVMs) including C-SVM and ν-SVM with grid search for the classification and parameters optimization. This work illustrates that SVM is a reliable method for the assessment of IA and questionnaire data analysis. The best detection performance of IA is 96.32% which was obtained by C-SVM in the 6-feature dataset without normalization. Finally, the BIS-11, BSCS, Motor, Neuroticism, Non-planning, and Conscientiousness are shown to be promising features for the detection of IA.