Relationship between psychological inflexibility and experiential avoidance and internet addiction: Mediating effects of mental health problems

The Relationship Between Obesity and Internet Addiction in University Students: A Cross-Sectional Study

PURPOSE

The purpose of this study was to investigate the relationship between obesity and internet addiction in first-year university students (aged 18-25 years).

DESIGN

The study was designed using a cross-sectional analytic model.

SETTING

Data collection took place at Dokuz Eylul University, involving a diverse group of first-year students from different faculties.

SUBJECTS

The study population comprised 12,365 students, with 2890 individuals selected using cluster sampling.

MEASURES

Internet addiction was evaluated using the Online Cognition Scale (OCS). Data on obesity-related variables and demographic details were collected through a questionnaire. Descriptive statistics, chi-square analysis, t test, and ANOVA were applied for statistical evaluation.

RESULTS

The study included 2105 participants, with 43.8% males and 56.2% females. A significant positive correlation was found between body mass index (BMI) and OCS scores (P = .000), indicating a higher prevalence of internet addiction among individuals with higher BMI. Males had higher mean OCS scores (91.19 ± 35.14) than females (80.21 ± 30.51) (P = .00). Overweight and obese individuals exhibited higher scores on OCS sub-dimensions (P < .005). Notably, individuals with a BMI over 25 were categorized as overweight, and those with a BMI over 30 were classified as obese.

CONCLUSIONS

The findings demonstrate a noteworthy relationship between internet addiction and obesity among university students. The study emphasizes the necessity of increased attention to this issue in Turkey for the implementation of effective interventions and preventive measures.

The development and evolution of the research topic on the mental health of college students: A bibliometric review based on CiteSpace and VOSviewer

Background

With the advances in society and in response to changing times, college students have had to face multiple challenges. These challenges frequently affect the mental health of college students, leading to significant consequences for their social lives, personal well-being, and academic achievements, thereby attracting extensive societal attention. Therefore, examining the current status of research topics related to the mental health of college students can assist academia in dissecting the influencing factors and seeking solutions at their source or through early intervention. This can contribute to a better understanding of and effectively address this challenge.

Method

CiteSpace and VOSviewer were used to conduct a bibliometric analysis of 1609 journal articles indexed in the Web of Science (WoS) database over the past two decades (2000-2022), which helped identify the current state of research and hot topics in the field based on development trends. Furthermore, this study analyzes and discusses the core authors, high-productivity countries and organizations, key journals, and keyword clustering in this field. This study clarifies the current research landscape, analyzes evolving trends based on developmental trajectories, and identifies forefront research hotspots. This study provides scholars with reference research directions and ideas for conducting subsequent studies.

Results

Since the beginning of the 21st century, research on college students' mental health has increased, especially in the past three years, and due to the impact of the COVID-19 pandemic and online distance learning, the number of publications has increased rapidly. With the increase in attention and publication volume, the countries and organizations contributing papers as well as core journals have all started to take shape. Cluster and evolution analyses found that several stable research topics have been formed in this research field, and many new and diverse topics are continuously emerging with time.

Conclusion

and prospect: The findings prove that the field of college students' mental health has begun to take shape, gradually shifting from conceptual research to the implementation of specific interventions. However, whether specific interventions are effective and how effective they are require further investigation.

Growing propensity of internet addiction among Asian college students: meta-analysis of pooled prevalence from 39 studies with over 50,000 participants

OBJECTIVES

Rapid internet penetration and technological advancements have facilitated accessibility to internet-enabled devices globally. Since Asia lacks comprehensive data on internet addiction among college students, this review aims to estimate its pooled prevalence.

STUDY DESIGN

This was a systematic review and meta-analysis.

METHODS

Searches were conducted in PubMed, Scopus, CINAHL, and MEDLINE from their inception through August 2022 using terms appropriate to internet addiction and Asian countries/territorial for publications in English peer-reviewed journals. The studies included those done on current college students and provided unambiguous indicators of the threshold of internet addiction. The pooled prevalence was calculated through a random-effects meta-analysis by RStudio software, and I2 statistic was used to assess heterogeneity. The Joanna Briggs Institute critical appraisal checklist was used for quality assessment.

RESULTS

Overall, between 2007 and 2021, 39 papers comprising 45 effect sizes and totaling 58,058 participants met the inclusion criteria. The pooled prevalence of internet addiction among Asian college students was 24.3% (95% confidence interval: 19.8%-29.5%, Q = 6234, df = 44, τ2 = 0.79, I2 = 99.29%), and strikingly, this percentage increased over time. A high degree of heterogeneity was seen, and no publication bias was found.

CONCLUSIONS

To our knowledge, this is the first comprehensive review report on Asian college students, which found that one-fifth suffer from internet addiction. The findings emphasize the significance of multidisciplinary prevention and management strategies to mitigate the harmful effects of internet addiction. Further research is warranted to develop a standardized diagnostic tool for a more precise estimation of internet addiction among this population.

Relationship between fruit and vegetable consumption and internet addiction with insomnia and depression as multiple mediators during the COVID-19 pandemic: a three-wave longitudinal study in Chinese college students

BACKGROUND

The relationships between fruit and vegetable consumption (FV) and Internet addiction (IA) in college students still remained unknown together with the internal mechanisms. Given the limitations of previous cross-sectional design, longitudinal research was necessary to be conducted to explore more precise correlations. Using the three-wave data in a longitudinal design, this study aimed to explore the association between FV and IA among Chinese college students and potential multiple mediators of insomnia and depression during the COVID-19 pandemic.

METHODS

A total of 579 college students were recruited during three waves (T1: August 2020; T2: November 2020; T3: February 2021). FV (T1), insomnia (T2), depression (T2) and IA (T3) symptoms were reported. The descriptive statistics of the sociodemographic characteristics and correlation analyses of the study variables were calculated. The significance of the mediation effects was measured conducting a bootstrap method with SPSS PROCESS macro.

RESULTS

FV was negatively correlated with IA, and lower FV predicted higher risk of IA. Depression mediated the association between FV and subsequent IA. Insomnia and depression were multiple mediators, which in turn mediated the links between FV and subsequent IA.

CONCLUSIONS

The three-wave longitudinal study has revealed that FV had indirect effects on IA through individual mediating factor of depression and multiple mediating roles of insomnia and depression sequentially. The policy makers, educators and researchers should pay attention to the impact of the interventions from healthy diet, in order to optimize the coping strategies for preventing college students from IA.

[Childhood trauma and adolescent game addiction: the mediating effects of self-control]

OBJECTIVES

To investigate the association between childhood trauma and game addiction in adolescents, as well as the mediating effect of self-control.

METHODS

A cross-sectional study was conducted using cluster random sampling. The participants were 2 664 adolescents from a senior high school in Henan Province. The research tools included a demographic data questionnaire, Childhood Trauma Questionnaire-Short Form, Self-Control Scale, and Game Addiction Scale for Adolescents. The Bootstrap method was used to test the parallel mediating effect, with the five dimensions of self-control as mediators.

RESULTS

The prevalence of game addiction among the adolescents was 17.68% (471/2 664). There was a positive correlation between childhood trauma and game addiction scores (P<0.01), and a negative correlation between childhood trauma scores and each dimension of self-control (P<0.01). Moreover, all five dimensions of self-control were negatively correlated with game addiction scores (P<0.01) and acted as parallel mediators between childhood trauma and game addiction. The mediating effects of restraint from entertainment (accounting for 15.6% of the total effect) and resistance to temptation (accounting for 10.6% of the total effect) were stronger.

CONCLUSIONS

Childhood trauma may increase the risk of game addiction by impairing adolescents' self-control abilities. The reduction of childhood trauma can cultivate self-control in adolescents and prevent the occurrence of game addiction.

Adolescent psychiatry of Y. Kasahara and succeeding research on Hikikomori in Europe and in Japan

This paper will focus on the works of one of Japan's representative psychiatrists, Yomishi Kasahara, particularly on his works in the 1970s in which he proposed the concept of student apathy, and will discuss how this work was carried over into a contemporary topic, the study of "Hikikomori." Kasahara's well-known paper "Clinical Classification of Depression" (Kasahara and Kimura, 1975) described the present state of patients with Type III as "they do not have a complete set of symptoms as in Type I, but sometimes show dependency, strong exaggeration, complication of other neurotic symptoms, little tendency of self-reproaching, and tendency of accusing others"; the two subtypes as Type III-1 "those that remain at the neurotic level" and Type III-2 "those that transiently drop to the psychotic level." We have summarized and introduced below the case presented in the paper with this Type III-1. From today's perspective, where the concept of "Hikikomori" exists, this case could be considered as a typical case of "Hikikomori," that is, a person with a tendency to avoid social roles and responsibilities and to immerse oneself in areas with no responsibilities, such as hobbies. "Hikikomori" was discovered in the late 1980s, but to be precise, it was just that the concept emerged. The same clinical condition had already been brilliantly found by Kasahara in the 1970s under the concept of "apathy syndrome," which was distinguished from depression.

Depression mediates the relationship of experiential avoidance and internet addiction: a cross-lagged mediation analysis

Previous research has identified the contemporaneous association between experiential avoidance, depression, and Internet addiction. However, the mechanisms underlying this association are not well acknowledged. The present study aimed to use cross-lagged panel modeling to examine whether depression mediates the relation between experiential avoidance and Internet addiction and whether gender plays a role in the relation. A total of 2731 participants (934 male, Meanage=18.03) were recruited from a university at the baseline study (December 2019). Data was collected at all 3 time points across one year (2019?2020), using 6-month intervals. Experiential avoidance, depression and Internet addiction were assessed using the Acceptance and Action Questionnaire-II (AAQ-II), the Beck Depression Inventory-II (BDI-II) questionnaire, and Young?s Internet Addiction Test (IAT), respectively. Cross-lagged panel models were used to evaluate the longitudinal association and the mediating effect. Multigroup analyses were conducted to examine gender differences in the models.Cross-lagged models indicated that experiential avoidance significantly predicted subsequent depression, and depression significantly predicted subsequent Internet addiction. Furthermore, mediation analyses showed that depression has a mediating effect in the relation between experiential avoidance and Internet addiction (? = 0.010, 95%CI[0.003, 0.018], p>0.001). Multigroup analyses demonstrated that the pattern of structural relations stayed consistent across gender. The findings indicated that experiential avoidance is indirectly related to Internet addiction through depression, suggesting that treatments targeted at reducing experiential avoidance could help relieve depression and thus decrease the risk of Internet addiction.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12144-023-04511-6.

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.

Association of Individual and Neighborhood Characteristics to Problematic Internet Use among Youths and Adolescents: Evidence from Vietnam

INTRODUCTION

This study aimed to determine latent profiles from the Problematic Internet Use Questionnaire Short Form-6 (PIUQ-SF-6) score of Vietnamese youths and adolescents, which supports the diagnosis of problematic internet use among a large sample size. Moreover, it also explored factors that affect each latent profile of the PIUQ-SF-6 score among participants.

METHODS

A sample of 1477 Vietnamese people, aged 14 to 24, across five provinces participated in the study. Multinomial logistic regression determined factors related to the levels of the Problematic Internet Use Questionnaire Short Form-6 (PIUQ-SF-6) after using latent profile analysis.

RESULTS

Participants were divided into three profiles, including those at low, moderate, and high risk of internet addiction. The high-risk latent profile was obtained for 23.1% of adolescents, and the remaining percentages were, respectively, 40.2% and 36.7% of adolescents belonging to the moderate and low-risk groups. Moreover, factors including age, living alone, high Kessler psychological distress scale, excessive time on the internet, living in central cities, and high neighborhood disorder scores were found to be related to moderate- and high-risk internet addiction profiles.

CONCLUSIONS

Factors analyzed according to individual and social characteristics further explore the reasons underlying increasing internet addiction among Vietnamese youths and inform early interventions.

Prevalence of Internet Addiction Among Iranian University Students: A Systematic Review and Meta-analysis

This systematic review and meta-analysis aims to estimate the overall prevalence of Internet addiction among Iranian university students. A total of 49 articles written in Persian or English, without time limitation, were gathered. Databases of Scientific Information Database, MagIran, PubMed, Scopus, and Web of Science were searched during the period from February 13 to March 13, 2018. The following keywords and their possible combinations were used: Iran, student, Internet dependency, Internet addiction, and problematic Internet use. The Cochran's Q test was used to test the heterogeneity among the studies, and because heterogeneity was not significant, the random effects model was used to estimate the overall prevalence of Internet addiction. Data analysis was performed using STATA, version 12. Meta-analysis of 49 selected articles with a total sample size of 16,585 indicated that the overall prevalence of Internet addiction among Iranian students was 31.51 percent (95% confidence interval: 26.47-36.55). In addition, meta-regression analysis showed no significant relationship between Internet addiction and year of publication (p = 0.972) and sample size (p = 0.915). About one-third of Iranian students have Internet addiction. It is necessary to provide training workshops on learning about the consequences of Internet addiction and its management.

Psychological Flexibility, Coronavirus Anxiety, Humor and Social Media Addiction During COVID-19 Pandemic in Turkey

Psychological flexibility is associated with psychological health and affected by various factors. The aim of the present study is to examine the role of coronavirus anxiety, humor and social media addiction on psychological flexibility during the COVID-19 pandemic in Turkey. Variables were measured with online self-report surveys and data were gathered from December 2020 to January 2021 in Turkey. The sample consisted of 376 people (295 female, M = 29.88, SD = 11.05). The relationships between the variables were tested with path analysis using structural equation modelling (SEM). According to results, the constructed model showed that COVID-19 anxiety significantly and directly increased social media addiction (β = .17, p < .01), decreased coping humor (β = -.11, p < .05) and decreased psychological flexibility indirectly through social media addictions (β = -.08, p < .01). Humor coping significantly and directly increased psychological flexibility (β = .25, p < .01), and social media addiction significantly and directly decreased psychological flexibility (β = -.31, p < .01). Findings indicated that psychological flexibility is influenced by coronavirus anxiety, social media addiction and humor coping.  Supporting humor coping and reducing anxiety and problematic social media use would be helpful to enhance psychological flexibility of individuals during the pandemic.

Effects of harassment on psychological inflexibility/experiential avoidance among Taiwanese emergent adult gay and bisexual men

BACKGROUND/PURPOSE

Gay and bisexual men are at a higher risk of mental and physical health problems than heterosexual men, reporting higher frequencies of harassment and discrimination in both housing and employment domains. Psychological inflexibility/experiential avoidance (PI/EA) refers to behaviors that are rigidly guided by psychological reactions rather than direct contingencies or personal values; PI/EA referring to a key psychopathology behavior related to greater mental illness. The objective of the study was to examine the association of various types of harassment with PI/EA and the effects of multiple types and site harassment on PI/EA among Taiwanese emergent adult gay and bisexual men.

METHODS

A total of 305 gay and bisexual men aged between 20 and 25 years were recruited into this study. The level of PI/EA and types of harassment were evaluated and further analysis the effect of harassment on PI/EA.

RESULTS

Findings indicated that various types of harassment exerted significant effects on PI/EA in emergent adult gay and bisexual men; furthermore, the effect was cumulative. The result also revealed that victims of verbal ridicule and relational exclusion, victims of physical aggression and theft of belongings, and victims of cyber harassment had significantly higher PI/EA.

CONCLUSION

Harassment experiences appeared to be significantly associated with PI/EA, and the effects could be cumulative. It would be beneficial to construct a friendly world for emergent adult gay and bisexual men. Evaluation and intervention with PI/EA improvement should be considered for emergent adult gay and bisexual men with traditional and cyber harassment experiences.

Exploring the Effects of Problematic Internet Use on Adolescent Sleep: A Systematic Review

Adolescent suse internet via several devices to gather information or communicate. Sleep, as a key factor of adolescents' development, contributes to their physical and mental health. Over the past decades insufficient sleep among adolescents has been wide spread, and one of its attributing factors is the increased availability of technology. This review aims to investigate the body of evidence regarding the impact of problematic internet use on adolescent sleep. Extensive search of databases was performed according to PRISMA guidelines for studies published within the last decade, regarding subjects aged 10-19. The final step of the search yielded 12 original studies. The quality of extracted data was evaluated with the AXIS tool, in order to estimate the risk of bias. All studies showed a negative correlation between adolescent sleep and problematic internet use. It was found to affect sleep quality and quantity and provoke insomnia symptoms. Interestingly, adolescent's sex, parental educational level, type of family and use for leisure or academic reasons appeared as affecting factors of the problematic internet use-sleep relationship. Problematic internet use has several effects on adolescents' sleep. Results of relevant studies should be embedded in educational interventions addressed to adolescents as well as parents, to eliminate the negative outcomes of problematic internet use on sleep and adolescence's health in general.

Relationship between Difficulty in Emotion Regulation and Internet Addiction in College Students: A One-Year Prospective Study

This prospective study evaluated the predictive effect of difficulty in emotion regulation on the occurrence and remission of Internet addiction (IA) and determined whether IA has a role in changing emotion regulation among college students during a follow-up period of 1 year. A total of 500 college students (262 women and 238 men) were recruited. In baseline and follow-up investigations, the levels of IA and difficulty in emotion regulation were evaluated using the Chen Internet Addiction Scale and the Difficulties in Emotion Regulation Scale (DERS), respectively. The results indicated that the subscale of impulse control difficulties on the DERS predicted the incidence of IA during the follow-up period of 1 year in male participants (t = −2.875, p = 0.005), whereas no subscale on the DERS predicted the remission of IA. IA did not predict the change in difficulties in emotion regulation. The subscale of impulse control difficulties on the DERS predicted the occurrence of IA in the college students and warrants early intervention.

An emotional and cognitive model of problematic Internet use among college students: The full mediating role of cognitive factors

Numerous researches have shown that the problematic Internet use (PIU) is significantly associated with a variety of psychological problems among young people. However, limited research has focused on the psychological mechanism underlying PIU. The purpose of this study was to investigate the relationship between several emotional and cognitive factors in predicting PIU in a sole model. In this model, difficulties in emotion regulation was the independent variable, three cognitive variables (i.e. experiential avoidance, desire thinking, and intolerance of uncertainty) were the mediators, and PIU was the dependent variable. Participants were 300 college students from four universities in Tehran (60% females; Mean age = 20.27). Results of the Structural Equation Modeling analysis revealed a full mediation role of experiential avoidance and desire thinking in the relationship between difficulties in emotion regulation and PIU (R² = 57%). Based on these findings a special attention to cognitive factors is suggested in the treatment of PIU.

Using Reflective Teaching Program to Explore Health-Promoting Behaviors in Nursing Students

BACKGROUND

The attitudes of nurses toward health promotion affect patients. However, current classroom teaching does not provide nursing students with actual experiences. An experiential and reflective teaching design will help nursing students practice actual health behaviors and record their feelings. This will help nursing students better understand the difficulties and feelings experienced by nurses when encouraging patients to make behavioral changes in clinical settings.

PURPOSE

This study aimed to explore the experiences and factors affecting health-promoting learning with reflective teaching in nursing students.

METHODS

This explorative study integrated the "reflective assessment, engagement, and action-reflection" strategy of reflective teaching into the standard health-promotion teaching curriculum to understand the experiences of nursing students when executing health-promoting behaviors. Fifty-seven second-year nursing students from a university in northern Taiwan participated in this course, which was conducted between September 2017 and January 2018. The data were collected from the contents of the reflective journals written by the nursing students and analyzed using thematic analysis.

RESULTS

The three health-promoting behaviors performed by most of the students were regular exercise, balanced and healthy diet, and adequate daily water intake. The feelings experienced by the nursing students during the execution of health-promoting behaviors included easier said than done, compromise and adjustment, and continuation of health behaviors. Accommodation, peer encouragement, and support were important, facilitating factors of health-promoting behaviors in this study.

CONCLUSIONS/IMPLICATIONS FOR PRACTICE

The results of this study may serve as a reference for nursing lecturers when employing reflective teaching in the classroom. Reflective teaching designs for actual experiences help nursing students experience the crucial factors and benefits of executing health-promoting behaviors.

Relationship between Self-Identity Confusion and Internet Addiction among College Students: The Mediating Effects of Psychological Inflexibility and Experiential Avoidance

Internet addiction (IA) has become a major public health problem among college students. The aim of this study was to examine the relationship between self-identity confusion and IA and the mediating effects of psychological inflexibility and experiential avoidance (PI/EA) indicators in college students. A total of 500 college students (262 women and 238 men) were recruited. Their levels of self-identity were evaluated using the Self-Concept and Identity Measure. Their levels of PI/EA were examined using the Acceptance and Action Questionnaire-II. The severity of IA was assessed using the Chen Internet Addiction Scale. The relationships among self- identity, PI/EA, and IA were examined using structural equation modeling. The severity of self-identity confusion was positively associated with both the severity of PI/EA and the severity of IA. In addition, the severity of PI/EA indicators was positively associated with the severity of IA. These results demonstrated that the severity of self-identity confusion was related to the severity of IA, either directly or indirectly. The indirect relationship was mediated by the severity of PI/EA. Self-identity confusion and PI/EA should be taken into consideration by the community of professionals working on IA. Early detection and intervention of self-identity confusion and PI/EA should be the objectives for programs aiming to lower the risk of IA.

The Predictive Value of Emotional Intelligence for Internet Gaming Disorder: A 1-Year Longitudinal Study

This one-year longitudinal study examined trait emotional intelligence as a predictor of Internet gaming disorder (IGD). To date, only cross-sectional research has been conducted to test the protective effects of emotional intelligence against IGD tendency. Based on the Interaction of Person-Affect-Cognition-Execution (I-PACE) model, this study aimed to address the research gap by examining not only the direct effects of trait emotional intelligence, but also its indirect effects (via depressive symptoms and coping flexibility) on IGD, with both a cross-sectional and longitudinal design. The participants were 282 Chinese university students (mean age = 20.47; 39.4% males) who voluntarily completed an anonymous questionnaire at both baseline (W1) and one-year follow-up (W2). Path analysis results revealed that trait emotional intelligence had a protective but indirect effect on IGD tendency in both our cross-sectional and longitudinal data. Depression was found to have a significant, full mediating effect on the relationship between: (i) trait emotional intelligence and IGD tendency (W2) and (ii) coping flexibility and IGD tendency (W2), after adjusting for IGD tendency at the baseline (W1). Gender invariance of the path coefficient was also observed in the prospective model. This study provided longitudinal evidence to support the I-PACE model. Interventions should address both IGD and depressive symptoms, and school-based workshops to increase emotional intelligence and coping flexibility are also recommended.

The Relationship Between Sleep Quality and Internet Addiction Among Female College Students

BACKGROUND

Over 40% of Taiwanese College students experience sleep problems that not only impair their quality of life but also contribute to psychosomatic disorders. Of all the factors affecting the sleep quality, internet surfing is among one of the most prevalent. Female college students are more vulnerable to internet-associated sleep disorders than their male counterparts. Therefore, this study aims to investigate (1) the relationship between internet addiction and sleep quality, and (2) whether significant variations in sleep quality exist among students with different degrees of internet use.

METHODS

This structured questionnaire-based cross-sectional study enrolled students from a technical institute in southern Taiwan. The questionnaire collected information on the following three aspects: (1) demography, (2) sleep quality with Pittsburgh Sleep Quality Index (PSQI), and (3) severity of internet addiction using a 20-item Internet Addiction Test (IAT). Multiple regression analysis was performed to examine the correlation between PSQI and IAT scores among the participants. Logistic analysis was used to determine the significance of association between PSQI and IAT scores.

RESULTS

In total, 503 female students were recruited (mean age 17.05 ± 1.34). After controlling for age, body mass index, smoking and drinking habits, religion, and habitual use of smartphone before sleep, internet addiction was found to be significantly associated with subjective sleep quality, sleep latency, sleep duration, sleep disturbance, use of sleep medication, and daytime dysfunction. Worse quality of sleep as reflected by PSQI was noted in students with moderate and severe degrees of internet addiction compared to those with mild or no internet addiction. Logistic regression analysis of the association between scores on IAT and sleep quality, demonstrated significant correlations between quality of sleep and total IAT scores (odds ratio = 1.05:1.03 ∼ 1.06, p < 0.01).

CONCLUSION

The results of this study demonstrated significant negative association between the degree of internet addiction and sleep quality, providing reference for educational institutes to minimize adverse effects associated with internet use and improve students' sleep quality.

An exploration of the associations among positivity, general distress and internet addiction: The mediating effect of general distress

The aim of the present study was to examine the relationships between positivity and general distress (including depression, anxiety, stress) and internet addiction and the mediating effects of general distress. The theoretical model was examined with 392 volunteers who were university students. Participants filled out the Positivity Scale (POS), Depression, Anxiety, Stress Scale (DASS) and Short Form of Young's Internet Addiction Test (YIAT-SF). The results revealed that there were significant associations among positivity, general distress and internet addiction. According to the results of mediation analysis using structural equation modelling and bootstrapping, depression fully mediated the positivity-internet addiction relationship, whilst anxiety and stress partially mediated it. Bootstrap analysis indicated that positivity exerted a significant indirect effect on internet addiction through depression. Overall, the results implied the potential therapeutic effect of positivity which leads to a direct decrease in general distress and an indirect decrease in internet addiction through general distress. In addition, internet addiction may be considered as a secondary problem rather than a primary disorder. The results provide opportunities to design psychological interventions focused on improving positivity which may lead to a decrease in general distress which involves a mechanism preventing individuals from applying a positive reinforcement process.

Predicting Effects of Psychological Inflexibility/Experiential Avoidance and Stress Coping Strategies for Internet Addiction, Significant Depression, and Suicidality in College Students: A Prospective Study

The aims of this study were to evaluate the predicting effects of psychological inflexibility/experiential avoidance (PI/EA) and stress coping strategies for Internet addiction, significant depression and suicidality among college students during the follow-up period of one year. A total of 500 college students participated in this study. The level of PI/EA and stress coping strategies were evaluated initially. One year later, 324 participants were invited to complete the Chen Internet Addiction Scale, Beck Depression Inventory-II and the questionnaire for suicidality to evaluate depression symptoms and internet addiction and suicidality. The predicting effects of PI/EA and stress coping strategies were examined by using logistic regression analysis controlling for the effects of gender and age. The results indicated that PI/EA at the initial assessment increased the risk of Internet addiction (OR = 1.087, 95% CI: 1.042–1.135), significant depression (OR = 1.125, 95% CI: 1.081–1.170), and suicidality (OR = 1.099, 95% CI: 1.053–1.147) at the follow-up assessment. Less effective coping at the initial assessment also increased the risk of Internet addiction (OR = 1.074, 95% CI: 1.011–1.140), significant depression (OR = 1.091, 95% CI: 1.037–1.147), and suicidality (OR = 1.074, 95% CI: 1.014–1.138) at the follow-up assessment. Problem focused and emotion-focus coping at the initial assessment was not significantly associated with the risks of Internet addiction, significant depression, and suicidality at the follow-up assessment. College students who have high PI/EA or are accustomed to using less effective stress coping strategies should be the target of prevention programs for IA (internet addiction), depression, and suicidality.