Internet addiction among adolescents in Macau and mainland China: prevalence, demographics and quality of life

Internet addiction and suicidal ideation in Chinese children with migrant parents: Mediating role of anxiety and moderating role of social support

INTRODUCTION

The prevalence of internet addiction among Chinese left-behind children, coupled with its potential to exacerbate anxiety and suicidal ideation, has become a critical issue. This study seeks to address the dearth of research on the psychological underpinnings of this phenomenon, particularly the mediating role of anxiety and the moderating effect of social support across different parental migration statuses. Understanding these relationships is crucial for developing targeted interventions and informing policy decisions.

METHODS

In a cross-sectional study, we administered Young's Internet Addiction Test, alongside scales for anxiety, social support, and suicidal ideation, to 2882 middle school students in China with diverse parental migration backgrounds. Utilizing an online survey approach, we ensured broad participation and participant anonymity. Advanced statistical analyses, including regression models for mediation and moderation effects, were employed to rigorously test our hypotheses.

RESULTS

Among all participants, a significant positive correlation was observed between Internet addiction and suicidal ideation. Anxiety mediated the relationship between Internet addiction and suicidal ideation across all groups, including those with mother-only migration (Effect = 0.383, 95%CI: 0.107,0.943), father-only migration (Effect = 0.806, 95%CI: 0.487-1.230), both-parent migration(Effect = 0.289, 95%CI: 0.105-0.521), and non-left-behind children (Effect = 0.469, 95%CI: 0.342-0.630). Particularly in families where only the mother was absent, the moderating role of social support was especially prominent (B = 1.174, t = 6.446, p < 0.001 for low social support), underscoring the importance of family structure in the context of Internet addiction.

CONCLUSION

Internet addiction has both direct and indirect effects on suicidal ideation, with anxiety playing a mediating role in the indirect effects. Social support moderates and alleviates the relationship between Internet addiction and anxiety specifically in the mother-only migration group. Therefore, clarifying these relationships helps in developing and implementing effective interventions to specifically improve the mental health and living conditions of left-behind children.

Coping Tendency as a Mediator in the Relationship Between Psychological Resilience and Health Problems Among College Students

Purpose

The study aimed to explore the status of four common health problems (ie, smoking, internet addiction, physical inactivity, psychological disorder) among college students and analyze the relationship between psychological resilience, coping tendency and health problems.

Participants and Methods

The convenience sampling method was used to recruit 500 college students from four universities. The General Information Questionnaire, Adolescent Psychological Resilience Scale, Simplified Coping Style Questionnaire and Health Risk Behavior Questionnaire were used for survey.

Results

Among the students, there were 71 smokers (15.4%) and 61 internet addicts (13.2%). Over a third of the students reported physical inactivity (35.9%) and a minority had psychological disorder (6.3%). The psychological resilience score differed between students who smoked, had internet addiction, physical inactivity, psychological disorder and those without these health-risk behaviors. Logistic regression analysis showed that negative coping tendency was the common contributing factor of physical inactivity, internet addiction and psychological disorder. Coping tendency played a partial mediating effect in the relationship between psychological resilience and health problems, with a mediating effect of 37.93%.

Conclusion

Psychological resilience can not only affect health problems directly but also influence health problems indirectly through coping tendency. Educators and administrators in universities can apply effective measures to improve psychological resilience and positive coping to prevent or reduce health problems among undergraduates.

The relationship between childhood trauma and internet addiction in adolescents: A meta-analysis

Objective

Many studies have explored the relationship between childhood trauma and internet addiction from different theoretical perspectives; however, the results have been inconsistent. The purpose of this meta-analysis was to examine the relationship between childhood trauma and internet addiction.

Methods

The PubMed, Web of Science, Embase, CNKI, Wanfang and VIP electronic databases were searched to identify studies examining the correlation between childhood trauma and adolescent internet addiction. The databases were searched from inception to December 31, 2022. Two researchers independently screened the literature, extracted the data, and evaluated the risk of bias of the included studies. Then, Stata 17.0 software was used to perform meta-analysis.

Results

This study was registered on PROSPERO (CRD42023388699). A total of 19 studies involving 21,398 adolescents were included in this meta-analysis. The random effects model was used for pooled analysis, and the results revealed a strong positive association between childhood trauma and internet addiction (r = 0.395, 95% CI [0.345, 0.442]). The relationship between childhood trauma and internet addiction was moderated by sample size, survey area, and internet addiction measurement tools. There were significant differences between the associations based on the various child trauma measurement tools and study quality scores. However, interstudy heterogeneity was not significantly affected by study year, sample source, or participant age.

Conclusion

Internet addiction is positively correlated with childhood trauma. Therefore, it is extremely important for parents to provide a good growth environment during childhood to enhance the physical and mental development of adolescents. A warm family atmosphere helps individuals develop a healthy personality, thereby reducing or preventing the occurrence of internet addiction. Due to the limited number and low quality of the included studies, the above conclusions need to be verified by additional high-quality studies.

Internet addiction and depression among Chinese adolescents: anxiety as a mediator and social support as a moderator

This study constructed a moderated mediation model to investigate the mediating effect of anxiety and the moderating effect of social support between Internet addiction and depression. A sample of 17 058 middle school students in one district of Chengdu were selected. The Internet Addiction Test (IAT), Generalized Anxiety Disorder (GAD-7), Patient Health Questionnaire (PHQ-9), and Social Support Scale for adolescents were used to investigate their Internet addiction, anxiety, depression and social support. The descriptive statistics and Spearman correlation analysis were performed with SPSS 25.0. An SPSS macro process was used to analyze the data from complex models that contained mediators and moderators. The results show that adolescents with Internet addiction are more likely to suffer from depression. Anxiety partially mediated the relations between Internet addiction and depression. Social support moderated both direct and indirect pathways leading from Internet addiction to depression, and these two effects were stronger for adolescents with low social support than for those with high social support. It will be possible for researchers to gain a better understanding of the conditions, pathways, and effects of Internet addiction on depression in adolescents through the results of this study.

Parental control and adolescent internet addiction: the moderating effect of parent-child relationships

Introduction

The present study investigated how maternal and paternal controls, including behavioral and psychological controls, predict adolescent Internet addiction, as well as the potential moderating effects of adolescent gender and parent-child relationships on the predictions.

Methods

Data were collected from 1,974 Chinese adolescents (age range = 14-22; mean = 16.47; SD = 0.87; 1,099 girls) in Guizhou Province, mainland China in November 2021. Internet addiction was measured using the ten-item Internet Addiction Test developed by Kimberly Young, and Parental control and parent-child relationships were measured by the respective subscales derived from the validated Chinese Parent-Child Subsystem Quality Scale.

Results

Hierarchical regression analyses revealed that after the covariates were statistically controlled, both parents' behavioral controls showed significant negative predictions on adolescent Internet addiction, while their psychological control tended to positively predict Internet addiction among adolescents, although the effect was only marginal. In addition, the impacts of maternal and paternal controls were equal, and such impacts did not vary between sons and daughters. While adolescent gender was not a significant moderator, the parent-child relationship quality significantly moderated the effects of paternal behavioral control, paternal psychological control, and maternal psychological control on adolescents' Internet addiction. Specifically, the prediction of paternal behavioral control was stronger while the effect of paternal and maternal psychological control was weaker among adolescents with a positive father-child relationship than those with a moderate or poor father-child relationship.

Discussion

These findings indicate the protective function of parents' behavioral control and the negative impact of psychological control on the development of adolescent Internet addiction. Further, a positive relationship between the father and the adolescent can strengthen the positive effect of paternal behavioral control and mitigate the negative effects of both parents' psychological controls.

The role of depressive symptoms and social support in the association of internet addiction with non-suicidal self-injury among adolescents: a cohort study in China

BACKGROUND

Both internet addiction (IA) and non-suicidal self-injury (NSSI) are major public health concerns among adolescents, however, the association between IA and NSSI was not well understood. We aimed to investigate the association between IA and NSSI within a cohort study, and explore the mediated effect of depressive symptoms and the moderating effect of social support in the association.

METHODS

A total of 1530 adolescents aged 11-14 years who completed both the baseline (T1) and 14-month follow-up (T2) survey of the Chinese Adolescent Health Growth Cohort were included for the current analysis. IA, NSSI, depressive symptoms and social support were measured at T1; depressive symptoms and NSSI were measured again at T2. Structural equation models were employed to estimate the mediated effect of depressive symptoms and the moderating effect of social support in the association between IA and NSSI at T2.

RESULTS

IA was independently associated with an increased risk of NSSI at T2, with the total effect of 0.113 (95%CI 0.055-0.174). Depressive symptoms mediated the association between IA and NSSI at T2, and social support moderated the indirect but not the direct effect of IA on NSSI at T2. Sex differences were found on the mediated effect of depressive symptoms and the moderated mediation effect of social support.

CONCLUSIONS

Interventions that target adolescents' NSSI who also struggle with IA may need to focus on reducing depressive symptoms and elevating social support.

Negative Life Events, Negative Copying Style, and Internet Addiction in Middle School Students: A Large Two-year Follow-up Study

Through a two-year follow-up study among 2,845 middle school students, we examined the impact of baseline negative life events (NLE) on follow-up negative copying style (NCS) and Internet addiction (IA), and the mediation of NCS between NLE and IA. We found that all NLE, NCS, and IA were correlated, and that both NLE and NCS were risk factors for IA. Structural equation modeling (SEM) results showed that NLE were associated with increased NCS (β = 0.17, p < 0.01) and IA (β = 0.16, p < 0.01), that NCS was associated IA ( β = 0.33, p < 0 0.01), and that NCS partially mediated the effect of NLE on IA ( β = 0.17, p < 0.01). This large longitudinal study provided solid empirical evidence that NLE and NCS played important roles in IA among middle school students. Educators and policy makers may adopt corresponding approaches to address IA among this population.

Vicious circle of family dysfunction and adolescent internet addiction: Do only child and non-only child exhibit differences?

The primary aim of the current study was to probe the longitudinal relationships between family dysfunction (FD) and adolescent Internet addiction (IA), as well as the group difference between only child and non-only child. Data were from a three-wave longitudinal data of 1301 Chinese adolescents, collected when adolescents were at Grade 7, Grade 8, and Grade 9. FD and IA were assessed via adolescent self-reported questionaries of Chinese Family Assessment Instrument and Internet Addiction Test. Cross-lagged panel model was constructed to estimate possible associations between FD and adolescent IA after controlling for demographic variables. Our results suggest that adolescents might get stuck in a vicious cycle of dysfunctional family and addictive Internet use: adolescents who lived in a dysfunctional family showed increased risk in IA in the subsequent year; in turn, adolescent IA further increased the possibility of FD. Moreover, multigroup comparison analysis revealed that the vicious cycle between FD and adolescent IA could be applied to both the only child and the non-only child. The findings may enrich the application of the Developmental Contextualism Theory and contribute to the identification of the starting points for intervention strategies of adolescent IA.

Childhood trauma and psychological sub-health among Chinese adolescents: the mediating effect of Internet addiction

BACKGROUND

The factors related to psychological sub-health (PSH) have been widely described, but the research on the mechanism behind the complex relationship between childhood trauma and PSH is limited. This study investigated the current situation and risk factors of PSH among Chinese adolescents. And further, explore whether Internet addiction (IA) plays a potential mediating effect in childhood trauma and PSH.

METHODS

The study was conducted in October 2020 in Anhui Province, China. The PSH state of 866 adolescents was investigated, including demographic information such as gender, age, and grade. Childhood trauma, IA, and PSH were measured by the Childhood Trauma Questionnaire Short Form (CTQ-SF), Young's Internet Addiction Test (IAT), and the Multidimensional Sub-health Questionnaire of Adolescents (MSQA). The mediating effect is further verified by the structural equation model (SEM).

RESULTS

In this study, 866 adolescents were selected as subjects, and the proportion of male and female is roughly equal. The prevalence of PSH in adolescents was 25.8%, and left-behind children, boarding, or adolescents who have had non-suicidal self-injury (NSSI) are more likely to have PSH. Through the mediation test, the direct effect of childhood trauma on PSH was 0.23 (95% CI [4.91,9.00],p <0.001), and the mediating effect of IA on childhood trauma and PSH was 0.07 (95% CI [1.42, 3.32],p <0.001). and the proportion of them is 75.14% and 24.86% respectively.

CONCLUSIONS

Childhood trauma has direct and indirect effects on PSH, and IA plays a mediating effect in the indirect effect. Therefore, clarifying these relationships helps formulate and implement effective interventions to improve psychological health (PH) in Chinese adolescents.

Exploring the connection between parental bonding and smartphone addiction in Chinese medical students

BACKGROUND

Smartphone addiction bodes adverse consequences, affecting different populations, including medical students. Parental bonding in childhood had been associated with addiction and recovery in later life. Therefore, this study aimed to examine the associations between parental bonding and smartphone addiction among Chinese medical students.

METHOD

Binary logistic regressions were used to investigate the associations between parental bonding with mothers and fathers, respectively, and smartphone addiction. Interaction terms of care and protection were included in the models.

RESULTS

A total of 517 medical students were included in the study. The prevalence of smartphone addiction was 48.16% (n = 249). The estimated effects of maternal and paternal parenting on smartphone addiction differed. Maternal protection was positively associated with smartphone addiction (OR, 1.046;95% CI, 1.005-1.087), and maternal care enhanced the estimated effect of protection on smartphone addiction. Paternal care was negatively associated with smartphone addiction (OR, 0.954;95% CI, 0.919-0.989).

CONCLUSIONS

Chinese medical students with overprotective mothers or with indifferent fathers tended to exhibit traits of smartphone addiction. Further studies on factors influencing the associations between parental bonding and smartphone addiction may pave the way for potential family-oriented interventions for smartphone addiction.

The Effect of COVID-19 Perceived Risk on Internet Addiction among College Students in China: An Empirical Study Based on the Structural Equation Model

This study focused on COVID-19 perceived risk and Internet addiction among Chinese college students during the lockdown. On the basis of the Social Cognitive Theory, this study proposed a mediating model to evaluate the mediating role of difficulties in regulating emotion between the COVID-19 perceived risk and Internet addiction. A questionnaire survey was conducted among 690 college students during the COVID-19 lockdown in China. The results showed that the COVID-19 perceived risk was significantly positively associated with Internet addiction (r = 0.236, p < 0.001) and difficulties in emotion regulation (r = 0.220, p < 0.001), difficulties in emotion regulation was significantly positively associated with Internet addiction (r = 0.368, p < 0.001). The COVID-19 perceived risk had a significant and positive predictive effect on Internet addiction (β = 0.233, p < 0.001) among Chinese college students. The analysis of the mediation model showed that difficulties in emotion regulation partially mediated the relationship between COVID-19 perceived risk and Internet addiction (indirect effect value was 0.051 with 95% Confidence Interval ranging from 0.027 to 0.085). The findings not only enhanced our understanding of the internal influence mechanism of COVID-19 perceived risk on Internet addiction but also provided a practical basis for college education works. Finally, discussions and suggestions were provided on the basis of the results.

The relationship between Internet addiction and childhood trauma in adolescents: The mediating role of social support

Background

Adolescents are at high risk of Internet addiction (IA). Previous studies have shown that the occurrence of IA may be associated with childhood trauma and social support to varying degrees. This study aimed to investigate the pathogenesis of IA in adolescents. Further, to explore the potential mediating role of social support in childhood trauma and IA. This study provides theoretical support for future interventions targeting IA in adolescents.

Methods

This study used a descriptive cross-sectional design. The Childhood Trauma Questionnaire (CTQ), Social Support Rating Scale (SSRS), and Young’s Internet Addiction Test (IAT) were used to conduct an anonymous questionnaire survey among randomly selected adolescents aged less than 18 years old in two cities in southern Anhui Province. Descriptive statistics and correlation analysis were used to test the correlation between IA and other variables. A binary logistic regression model was used to explore the influencing factors of IA. Multiple regression models were examined with process macro and bootstrapping to confirm significant mediating effects.

Results

A total of 844 adolescents, equally divided between males and females, participated in this study, and the prevalence of IA in the region was 23.0%. Through the mediation test, the direct effect of childhood trauma on IA was 0.20 (95% CI [0.12, 0.27], p < 0.001), and the mediating effect of social support on childhood trauma and IA was 0.09 (95% CI [0.06, 0.14]).

Conclusion

The study showed that childhood trauma significantly affected the incidence of IA in adolescents. Social support had a significant mediating effect on childhood trauma and IA and attenuated its negative effects.

The prevalence of internet addiction and its association with quality of life among clinically stable patients with major depressive disorder

BACKGROUND

Internet addiction (IA) is associated with mental health problems but its impact on quality of life (QOL) is understudied. We examined the prevalence of IA and its association with QOL in clinically stable patients with major depressive disorder (MDD).

METHODS

In a cross-sectional survey between September 2020 and July 2021, the Young's Internet Addiction Test (IAT), the Patient Health Questionnaire-2 (PHQ-2) and the World Health Organization Quality of Life Brief version scale (WHOQOL-BREF) were administered to 1267 patients with MDD. Logistic regression was used to examine the correlates of IA, while analysis of covariance (ANCOVA) was used to examine the association between IA and QOL."

RESULTS

The prevalence of IA (IAT total scores ≥50) was 27.2 % (95 % CI: 24.7 %-29.6 %) in MDD patients. Compared to patients without IA, those with IA had lower QOL (F_{(1, 1267)} = 19.1, P < 0.001). Logistic regression revealed that higher education (senior high school and above; OR = 1.85, 95 % CI: 1.13-3.03), family history of psychiatric disorders (OR = 1.72, 95 % CI: 1.08-2.73), and higher PHQ-2 total score (OR = 1.23, 95 % CI: 1.14-1.32) were positively associated with IA while older age (OR = 0.93, 95 % CI: 0.91-0.96) was inversely related to IA.

CONCLUSION

IA is much more common in clinically stable patients with MDD compared to the reported figures in the general population. It would be prudent to screen and monitor internet use in MDD patients and treat those with IA.

Problematic Internet Use Among School-Going Adolescents in India: A Systematic Review and Meta-Analysis

Background

Problematic internet use (PIU) among school going adolescents constitutes a major area of concern. However, no comprehensive reports are available to determine the magnitude of the problem. This study aimed to estimate the pooled prevalence of PIU among school going adolescents in India.

Methods

We conducted a systematic review and meta analysis of 15 studies conducted in various parts of India.

Results

The prevalence of moderate and severe PIU among Indian school going adolescents was 21.5% (95% CI: 17.0%-26.8%) and 2.6% (95% CI: 1.6%-4.2%) based on the Young Internet Addiction Test (Y IAT) cutoff points of 50 and 80, respectively. In subgroup analysis, it was found that the year of publication, gender, sampling method, and severity of addiction had a significant effect on the prevalence estimates.

Conclusions

Currently, the use of the internet is rampant in India and our findings reflect nationally representative data on the magnitude of PIU among school going adolescents. About one fifth of school going adolescents are at risk of PIU in this setting. There is a need for further research in the reconsideration of cut off points of the Y IAT among Indian adolescents.

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).

An Investigation of Changing Attitudes and Behaviors and Problematic Internet Use in Children Aged 8 to 17 Years During the COVID-19 Pandemic

PURPOSE

To examine the effects of the COVID-19 pandemic on the lifestyle, habits, and behavioral differences in children, and their changing internet use habits.

METHODS

The research was planned as a cross-sectional study involving 4892 children aged 8 to 17 years attending schools in the city center of Trabzon, Turkey. Children's daily living activities, social habits, mood and temperament changes, and internet use were investigated before and during the pandemic. In terms of problematic internet use, internet addiction rates were evaluated using the validated Turkish-language version of the Parent-Child Internet Addiction Scale (PCIAT-20).

RESULTS

The children's mean age was 13 ± 2.45 years, and 17.1% (n = 837) exhibited problematic internet use features on the PCIAT-20. Problematic internet use was higher in boys and in children older than 13 years. The presence of COVID-19 infection among members of the household, quarantine measures, attending private schools, the mother's occupation, the time spent by the mother and father on their mobile phones, and high parental education levels were associated with a high level of internet addiction. Families also described significant changes in their children's temperament and character compared with the pre-pandemic period.

CONCLUSION

The prevalence of problematic internet use increased during the COVID-19 pandemic compared with previous studies from Turkey. Children were also more introverted, irritable, and pessimistic during the pandemic.

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSION

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

Association between screen time and hyperactive behaviors in children under 3 years in China

BACKGROUND

Screen time during early life has increased dramatically among Chinese children. Excessive screen time has raised growing concerns about the neuropsychological development of children. The effects of screen exposure on early life and the boundary between screen time and hyperactive behaviors are well worth investigating. We examined associations between screen time and hyperactive behaviors in children under the age of 3 years using data from the Longhua Children Cohort Study (LCCS).

METHODS

A cross-sectional study was conducted among 42,841 3-year-old children from Longhua District, Shenzhen. Information on socio-demographic characteristics, children's annual screen time since birth, and hyperactive behaviors (measured by the Conners Parental Symptom Questionnaire) was collected through self-administered structured questionnaires completed by the primary caregiver. A series of logistic regression models assessed the association between screen time and hyperactive behaviors.

RESULTS

The average daily screen time of children under the age of 3 years was 55.83 ± 58.54 min, and screen time increased with age. Binomial logistic regression analysis found that the earlier the screen exposure, the greater the risk of hyperactive behaviors. Using binary logistic regression model, after controlling for confounding factors, the study found that more screen time was more associated with hyperactive behaviors. For children aged 0-3 years with daily screen time exceeding 90, 120, 150, and 180 min, the risk values for hyperactive behaviors were 1.98 [95% confidence interval (CI): 1.05, 3.78), 2.71 (95%CI:1.38, 5.30), 3.17 (95% CI: 1.50, 6.65), and 4.62 (95% CI: 2.45, 8.71)], respectively.

CONCLUSION

Early screen exposure may be associated with hyperactive behaviors in children under the age of 3 years. More than 90 min of screen time per day in children under 3 years was associated with hyperactive behaviors. The findings support the importance of screen time interventions for children under 3 years.

Quality of Life in Internet Use Disorder Patients With and Without Comorbid Mental Disorders

INTRODUCTION

Evidence from clinical studies on quality of life (QoL) in patients suffering from internet use disorders (IUD) is still limited. Furthermore, the impact of additional mental comorbidities on QoL in IUD patients has rarely been investigated yet.

MATERIALS AND METHODS

In a cross-sectional clinical study 149 male subjects were analyzed for the presence and severity of an IUD as well as other mental disorders by experienced clinicians. The sample consisted of 60 IUD patients with and without comorbid mental disorders, 34 non-IUD patients with other mental disorders, and 55 healthy participants. Standardized clinical interviews (M.I.N.I. 6.0.0) and questionnaires on IUD symptom severity (s-IAT), QoL (WHOQOL-BREF), depression and anxiety symptoms (BDI-II and BAI), and general psychological symptoms (BSI) were used.

RESULTS

Internet use disorder patients showed significantly reduced QoL compared to healthy controls (Cohen's d = 1.64-1.97). Furthermore, IUD patients suffering from comorbid mental disorders showed significantly decreased levels of physical, social, and environmental QoL compared to IUD patients without any comorbidity (p < 0.05-0.001). Multiple linear regression analyses revealed that low levels of psychological, social and environmental QoL were mainly predicted by symptoms of depression. IUD factors were only significant predictors for the social and physical QoL.

DISCUSSION

Internet use disorder patients with comorbid mental disorder reported the lowest QoL. Depression symptom severity was the most significant predictor of low QoL in IUD. Strategies to reduce depressive symptoms should therefore be considered in IUD treatment to increase patients' QoL.

The Association of Internet Addiction with Burnout, Depression, Insomnia, and Quality of Life among Hungarian High School Teachers

The extensive availability of Internet has led to the recognition of problematic Internet use (so called Internet addiction, IA) mostly involving adolescents. There are limited data about the prevalence and consequences of IA in adults especially among high school teachers. Here, we present a cross-sectional prospective study focusing on the association of Internet addiction with burnout, depression, insomnia, and lower quality of life among high school teachers taking many co-variates into account. Overall, 623 males (34.3%) and 1194 females (65.7%) participated in our study. Internet addiction was detected in 5.2% (95/1817) based on the Problematic Internet Use Questionnaire. Internet addiction was associated with severe burnout (10.5 vs. 2.7%, p < 0.001), moderate (36.8 vs. 1.7%, p < 0.001), and severe (6.3 vs. 0.1%, p < 0.001) depression, insomnia (23.1 vs. 11.4%, p < 0.001), and severe sleep disturbance (severe insomnia, 27.4 vs. 3.8%, p < 0.001) and lower quality of life in all domains (p < 0.001). There was also a significant correlation of the severity of the above-mentioned parameters and the severity of IA (overall scores, p < 0.001 in all cases). In a multivariate analysis including demographic criteria, risk factors medical conditions and the above-mentioned parameters as co-variates internet addiction was significantly associated with depression (OR = 3.836, CI: 2.92-5.44, p = 0.03), and insomnia (OR: 3.932, CI: 3.6-5.69, p = 0.002). This is the first study from Hungary and is one of the first studies showing the association of IA with mental issues, burnout, and lower quality of life among adults. It underlines the clinical importance of problematic Internet use among adults.

Internet Addiction and Emotional and Behavioral Maladjustment in Mainland Chinese Adolescents: Cross-Lagged Panel Analyses

Adolescence is a developmental stage when adolescents are vulnerable to addictive behaviors, such as Internet addiction (IA), which refers to pathological use of the Internet. Although there are views proposing that the links between IA and adolescent problem behavior may be bidirectional in nature, few studies have examined the reciprocal relationships between IA and other maladjustment indicators, and even fewer studies have simultaneously employed both emotional and behavioral maladjustment indicators in a single study. To address the above research gaps, the present study investigated how IA is associated with both depression and delinquency among Chinese adolescents. Two waves of data were collected at two consecutive years, respectively, with 1year apart, from 3,010 students (Mean age=13.16, SD=0.81; 57.48% boys) in four junior high schools in mainland China. These students completed the same questionnaire containing measures of IA, depression, and delinquency at each wave. The proposed cross-lagged panel model fitted the data very well, and there were significant positive reciprocal effects between IA and depression as well as delinquency after controlling for background socio-demographic factors. Gender differences were also observed in multi-group comparisons. Specifically, IA showed a stronger longitudinal impact on delinquency among boys than among girls. While depression significantly predicted IA in 1year among boys, such a prediction was not significant among girls. These findings delineate the bidirectionality of the associations between IA and emotional and behavioral maladjustment indexed by depression and delinquency, respectively. The findings also suggest that researchers and practitioners have to take gender differences as well as different developmental indicators in understanding the bidirectional influences between IA and adolescent behavioral and emotional development.

Prevalence of Internet Addiction Disorder and Its Correlates Among Clinically Stable Adolescents With Psychiatric Disorders in China During the COVID-19 Outbreak

Background: Since the Coronavirus disease 2019 (COVID-19) pandemic emerged, Internet usage has increased among adolescents. Due to this trend, the prevalence of Internet addiction disorder (IAD) may have increased within this group. This study examined the prevalence of IAD and its correlates among clinically stable adolescents with psychiatric disorders in China during the COVID-19 outbreak. Method: A multi-center, cross-sectional study was carried out between April 29 and June 9, 2020 in three major tertiary mental health centers in China. IAD and depressive symptoms were assessed using the Internet Addiction Test (IAT) and the 9-item Patient Health Questionnaire (PHQ-9), respectively. Results: A total of 1,454 adolescent psychiatric patients were included in final analyses. The prevalence of IAD was 31.2% (95% CI: 28.8-33.6%) during the COVID-19 pandemic. A multiple logistic regression analysis revealed that poor relationships with parents (P < 0.001, OR = 2.34, 95%CI: 1.49-3.68) and elevated total PHQ-9 scores (P < 0.001, OR = 1.19, 95%CI: 1.16-1.21) were significantly associated with higher risk for IAD while longer daily physical exercise durations (P = 0.04, OR = 0.67, 95%CI: 0.46-0.98) and rural residence (P = 0.003, OR = 0.62, 95%CI: 0.46-0.85) were significant correlates of lower risk for IAD. Conclusions: IAD was common among adolescent patients with clinically stable psychiatric disorders during the COVID-19 pandemic; regular physical exercise, healthy relationships with parents and fewer symptoms of depression were associated with lower risk within this population.