Problematic internet use and suicidality and self-injurious behaviors in adolescents: Effects of negative affectivity and social support

Correlations between problematic internet use and suicidal behavior among Chinese adolescents: a systematic review and meta-analysis

Background

Problematic Internet Use (PIU) has been increasingly linked to suicidal behavior among adolescents, raising significant public health concerns, particularly in Chinese youth. This study aimed to systematically review and meta-analyze the correlation between PIU and suicidal behavior in Chinese adolescents to provide a clearer understanding of this association.

Methods

A comprehensive search was conducted across seven databases up to July 1, 2024. Studies investigating the relationship between PIU and suicidal behavior among Chinese adolescents were included. A random-effects meta-analysis was employed to assess pooled effect sizes, with subgroup analyses conducted to explore potential moderators, such as geographic region, age, gender, assessment tools for PIU and suicidal ideation, and the presence of depression. Data analysis was performed using STATA software (version 16).

Results

This meta-analysis, comprising 23 studies with 353,904 participants, identified significant associations between PIU and suicidal behavior among Chinese adolescents. PIU was associated with increased risks of suicidal ideation (OR = 1.72, 95% CI: 1.45, 2.03), suicidal plans (OR = 1.50, 95% CI: 1.02, 2.20), and suicidal attempts (OR = 1.48, 95% CI: 1.16, 1.89). Subgroup analyses indicated higher risks in specific groups: adolescents from Central China (OR = 1.84, 95% CI: 1.46, 2.32), college students (OR = 2.09, 95% CI: 1.66, 2.62). The risk of suicidal ideation was particularly elevated when depression was not controlled (OR = 1.86, 95% CI: 1.53, 2.25). These findings underscore the need for targeted interventions in vulnerable populations.

Conclusion

This meta-analysis demonstrated significant associations between PIU and suicidal behaviors among Chinese adolescents. The findings emphasize the need for targeted interventions, particularly for adolescents from Central and Western China, college students, and those with untreated depression. Focused strategies are required to mitigate the risks associated with PIU and to effectively address suicidal behaviors in these high-risk populations.

Systematic review registration

https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024577593, identifier CRD42024577593.

Internet use and adolescent development in rural China: A scoping review protocol of research landscape and gaps

INTRODUCTION

In the digital era, the Internet has become a necessity in adolescents' daily lives. Many studies globally are exploring the influences of Internet use on adolescent development, but they focus on the negative impacts of simplistic "screen time" on adolescents' physical and mental health, rather than both positive and negative influences of multifaceted Internet use on multidimensional adolescent development. Specifically in rural China, adolescents live in disadvantageous and marginalizing contexts, and Internet use is widespread among this population. However, knowledge on Internet use and adolescent development in rural China is fragmented. It is still unclear in what ways Internet use would bring benefits or risks for Chinese rural adolescents' healthy growth. Therefore, the objective of this scoping review is to identify the current research landscape, gaps, and future directions in rural China contexts. It aims to provide a comprehensive overview of elements, findings, and limitations in existing empirical studies on the influences of Internet use on adolescent development in rural China.

MATERIALS AND METHODS

The standard for conducting this scoping review is the five-stage model proposed by Arksey and O'Malley, and the reporting standard is the Preferred Reporting Items for Systematic Reviews and Meta-Analyses: Extension for Scoping Reviews (PRISMA-ScR). The overall research question is: What are the influences of Internet use on adolescent development in rural China? In consultation with librarians, to locate articles, subject headings (controlled vocabularies) and textwords (keywords) in article titles, abstracts, and author-assigned keywords will be searched in APA PsycInfo (psychology), China National Knowledge Infrastructure (interdisciplinary), Communication Abstracts (media and communication), Education Source (education), MEDLINE (public health), Social Services Abstracts (social work), Social Work Abstracts (social work), and Sociological Abstracts (sociology). The review process via Covidence will consist of two sequential steps based on inclusion/exclusion criteria: the title and abstract review and the full-text review. Then study characteristics and research findings will be charted, and the results will be analyzed and synthesized quantitatively and qualitatively via visualizations and narratives, guided by the typological frameworks of Internet use and adolescent development.

DISCUSSION

The scoping review will be a pioneering review to inform the current research landscape and gaps in the Internet use influences on adolescent development in rural China. It will advance the research agenda on this issue conceptually, theoretically, and empirically. In addition, it can provide contextual implications for designing prevention and intervention programs.

Bidirectional associations between loneliness and problematic internet use: A meta-analytic review of longitudinal studies

BACKGROUND

Loneliness and problematic Internet use (PIU) are both major public health concerns around the world. These two constructs have long been linked, but there is conflicting evidence regarding the temporal nature of the loneliness-PIU relationship.

METHOD

We searched 8 databases to identify studies examining longitudinal associations between loneliness and PIU published on or before August 2023. From the 316 articles identified, 26 studies were included with a total of 23,382 participants.

RESULTS

Moderate, positive, and significant prospective pathways were found from loneliness to PIU (r = 0.287, p < 0.001, 95 % CI [0.241, 0.331]), and from PIU to loneliness (r = 0.255, p < 0.001, 95 % CI [0.205, 0.303]). Moderator analyses suggested that the association of loneliness with PIU was stronger in samples from Eastern countries, with more males, more young adults, less time passed, and in more recent years. The association of PIU with loneliness was stronger in samples from Eastern countries, with more males, more young adults, and in more recent years.

CONCLUSIONS

This meta-analytic review provided the first estimation for the overall bidirectional longitudinal associations between loneliness and PIU. A deeper comprehension of the relations has implications for loneliness and PIU intervention programs, where interventions targeting both constructs might be fruitfully applied.

Perceived Social Support and Experiential Avoidance in Adolescents: A Moderated Mediation Model of Individual Relative Deprivation and Subjective Social Class

Based on the integration of ecological systems theory and the risk and protective factor model, the current study tested whether individual relative deprivation mediated the association between perceived social support and adolescents' experiential avoidance and whether this mediation model was moderated by subjective social class. A sample of 582 senior high school students in China participated in the current survey. The results indicated that perceived social support was negatively related to the students' experiential avoidance. Mediation analysis showed a significant indirect effect of perceived social support on experiential avoidance, via individual relative deprivation. Moreover, the mediation effect of individual relative deprivation was moderated by subjective social class. Specifically, the negative relationship between perceived social support and individual relative deprivation, and the direct relationship between perceived social support and experiential avoidance were stronger for adolescents with low subjective social class. In contrast, the positive relationship between individual relative deprivation and experiential avoidance was stronger for adolescents with high subjective social class.

Problematic internet use and suicide ideation among Chinese adolescents: The indirect effects of insomnia, nightmares, and social jetlag

BACKGROUND

Problematic Internet use (PIU) is related to suicide ideation (SI) in adolescents, but little is known about the potential mechanisms between them. This study aimed to examine the mediation roles of insomnia, nightmares, and social jetlag in the association of PIU with SI in adolescents.

METHODS

A total of 39,731 adolescents (mean age = 13.49 ± 0.76 years, 54.4 % males) from Shenzhen, China, participated in a cross-sectional survey. SI was assessed using the ninth item of the Patient Health Questionnaire-9. PIU was measured by the Revised Chinese Internet Addiction Scale. A self-administered questionnaire was used to assess insomnia symptoms, nightmare frequency, social jetlag, sleep duration, psychological distress, and social-demographical characteristics. Logistic regression and path analyses were performed to examine the associations between PIU, insomnia symptoms, nightmares, social jetlag, and SI.

RESULTS

The prevalence of PIU and SI were 14.9 % and 18.6 %, respectively. PIU, insomnia symptoms, frequent nightmares, and social jetlag were significantly associated with SI. Path analyses showed that the indirect effects of PIU on SI through insomnia symptoms, frequent nightmares, and social jetlag were significant. Conversely, social jetlag significantly mediated the pathway from SI to PIU. The mediation effect sizes of these sleep and circadian problems were slightly larger in females than in males.

LIMITATIONS

Cross-sectional design limited the capacity to infer causal relationships.

CONCLUSIONS

The associations between PIU and SI were mediated by sleep and circadian problems. These findings underscore the importance of assessing and intervening in sleep and circadian problems among adolescents with PIU or SI.

Exploring the relationship between distress rumination, resilience, depression, and self-injurious behaviors among Chinese college athletes infected with COVID-19: a cross-sectional study

Objectives

Distress rumination is a cause of suicidality and self-injurious behavior (SSIB) among individuals. Although previous studies have shown that distress rumination, SSIB, resilience, and depression are significantly related, the interaction mechanism remains unclear. This study aimed to evaluate resilience and depression as mediators of the relationship between distress rumination and SSIB among Chinese college athletes infected with COVID-19.

Methods

Convenience sampling was used to recruit participants from the National College Football Championship in Guangxi City, China from January to February 2023. Participants completed the Ruminative Responses Scale (RRS), a subscale of the Health-Risk Behavior Inventory (HBI), the Mental Toughness Index (MTI) and the Patient Health Questionnaire (PHQ-9). We used the PROCESS macro for SPSS to determine the mediating effect of resilience and depression between distress rumination and SSIB.

Results

A total of 350 Chinese college athletes participated in this study and completed the questionnaire survey. 289 (81.7% boys; Mage = 20.31 years, SD = 1.60) of them have been infected with COVID-19. 59.9% (n = 173) participants were from urban areas and 15.6% (n = 45) of participants have engaged in self-injurious behaviors or suicidal ideation. College athletes' distress rumination was significantly negatively correlated with resilience (r = - 0.28, p < 0.01), and was significantly positively correlated with depression (r = 0.49, p < 0.01) and SSIB (r = - 0.18, p < 0.01). Resilience was significantly negatively correlated with depression (r = - 0.35, p < 0.01) and SSIB (r = - 0.30, p < 0.01). Finally, depression was significantly positively correlated with SSIB (r = - 0.38, p < 0.01). Resilience and depression played a mediating role of the total effects of distress rumination and SSIB, respectively. Meanwhile, the chain mediating effect of resilience and depression was also significant.

Conclusion

This study found that distress rumination can directly predict SSIB, and indirectly predict SSIB through the mediating effect of resilience and depression, and the chain mediating effect of resilience-depression. Therefore, reducing the degree of distress rumination of college athletes infected by COVID-19 and improving their resilience, as well as reducing their depression may help prevent SSIB.

Internet use time and mental health among rural adolescents in China: A longitudinal study

BACKGROUND

The digital divide between urban and rural adolescents is widening. Many existing studies have found an association between internet use and adolescent mental health, but few use longitudinal data to focus on rural adolescents. We aimed to identify the causal relationships between internet use time and mental health in Chinese rural adolescents.

METHODS

Using a sample of 3694 participants (aged 10-19) from the 2018-2020 China Family Panel Survey (CFPS). Fixed effects model, mediating effect model and instrumental variables method was used to evaluate the causal relationships between internet use time and mental health.

RESULTS

We find that more time spent on the internet has a significant negative effect on participants' mental health. This negative impact is stronger in female and senior students groups. Mediating effects analysis suggests that more time spent on the internet increase risk of mental health problems by reducing sleep duration and parent-adolescent communication. Further analysis find that online learning and online shopping is associated with higher depression scores, while online entertainment with lower depression scores.

LIMITATIONS

The data do not investigate the specific time spent on internet activities (e.g., learning, shopping, and entertainment), and the long-term impacts of internet use time and mental health have not been tested.

CONCLUSIONS

Internet use time has a significant negative impact on mental health by crowding out sleep duration and parent-adolescent communication. The results provide an empirical reference for the prevention and intervention of mental disorders in adolescents.