Prevalence of Internet-based addictive behaviors during COVID-19 pandemic: a systematic review

Depression fully mediates the effects of problematic internet use on nonsuicidal self-injury among adolescents during the COVID-19 outbreak

The outbreak of the coronavirus disease 2019 (COVID-19) pandemic threatened adolescents' mental health and livelihoods, which can worsen their non-suicidal self-injury (NSSI) behaviors. With the significant increase of total online time use, adolescents become more prone to problematic internet use (PIU). This study examined whether depression mediated the relationship between PIU and NSSI among adolescence during the COVID-19 outbreak. Constructed with a cross-sectional design during the COVID-19 outbreak in Taiwan, 1060 participants were drawn from junior high schools through stratified and cluster sampling, and completed a set of comprehensive surveys. The mediation model demonstrated a good fit to the data, GFI = .96, CFI = .97, NFI = .97, NNFI = .95, IFI = .97, and SRMR = .02. The overall fit of the mediational model was adequate. The path from PIU to depression, β = .41, p < .001, and the path from depression to NSSI, β = .40, p < .001, were both significant. Moreover, the effect of PIU to NSSI decreased from .23 (p < .001) to .05 (p = .099) when depression was incorporated into the analysis. Moreover, results in bootstrapping analysis displayed that the indirect effect (PIU on NSSI via depression) was statistically significant (p < .001) and the direct effect (PIU on NSSI) was statistically non-significant (p = .134). The full mediation model was confirmed. The findings of the structure equation modeling and bootstrap analysis showed that PIU significantly and positively predicted NSSI, and that depression fully mediated this relationship.

Rates and psychological stress predictors of problematic internet use (PIU) during the COVID-19 pandemic in a racially diverse sample of young adults

BACKGROUND

Problematic internet use (PIU), which includes social media misuse (SMM) and gaming misuse (GM), is uncontrollable and associated with significant psychological impairment. PIU is a coping behavior for COVID-19-related stress. We explored distress-related predictors of PIU in a young adult racially diverse sample during the pandemic.

METHODS

Analyses used cross-sectional survey data (N = 1956). Psychological diagnoses, financial distress, COVID-19-related emotions, psychological distress, distress tolerance, social support, loneliness, SMM and GM were measured. Hierarchical multiple regressions identified predictors of PIU. Race-stratified exploratory analyses sought to understand if predictors held true across racial groups.

RESULTS

Low distress tolerance was associated with SMM and GM, as were depression symptoms, with racial differences observed. SMM was associated with younger age, and GM was associated with male gender. PTSD symptoms predicted more GM. SMM and GM rates varied between racial groups. COVID-19-related adjustment challenges and stress predicted SMM and GM respectively, with racial differences observed.

CONCLUSION

Individual psychological distress and low distress tolerance markedly increased PIU risk. Clinicians should screen for stress-related PIU risk factors and bolster distress tolerance in vulnerable patients. Comparing PIU to different forms of coping in a larger sample would further clarify groups differences in stress coping behaviors.

Excessive internet use among Finnish young people between 2017 and 2021 and the effect of COVID-19

PURPOSE

An increase in excessive Internet use (EIU) among adolescents during the COVID-19 pandemic was suggested in many studies. However, these studies were mostly based on cross-sectional and/or unrepresentative samples.

METHODS

Using data from a nationwide Finnish school survey in the years 2017, 2019 and 2021 (N = 450,864; aged 13-20 years), changes in the prevalence of EIU (EIUS, 5-item) were assessed. The effects of COVID-19 (year 2021 vs. 2017/2019 combined) and linear trend were analyzed in logistic regression models. Models were adjusted for loneliness, depression, anxiety, and sociodemographic factors.

RESULTS

Among males, EIU prevalence varied minimally (7.8-8.1%) from 2017 to 2021. Among females, the prevalence increased from 6.8 to 11.7% and the effect of COVID-19 was significant (OR = 1.53; p < 0.001). Including the linear trend in the model turned the COVID-19 effect on EIU among females non-significant (p = 0.625), whereas the trend was significant (OR = 1.17; p < 0.001). Adjusting the models with mental health-related factors attenuated the effect of COVID-19 to some extent, but not the effect of linear trend.

CONCLUSIONS

There is a sex difference in the way the prevalence of EIU developed from 2017 to 2021 among Finnish adolescents. In males, there was no indication of increased prevalence of EIU and among females, while the effect of COVID-19 was first found, it was also suggested to be a product of a trend already started before the COVID-19 pandemic. These results are in contrast with some earlier studies suggesting an effect of COVID-19 on EIU.

Post-COVID-19 internet addiction, depression, and pornography addiction among adolescents: Findings from a nationwide study in Bangladesh

Background and Aims

Regulations response to COVID-19 has increased internet addiction (IA), depression, and pornography addiction (PA) among adolescents worldwide. The objective of this nationwide study was to assess the current prevalence rate of IA, depression, and PA after the post-COVID-19 period among school-going adolescents in Bangladesh.

Methods

A total of 8832 male and female adolescents participated in this research. The cross-sectional study was conducted online using a simple random sampling method. Including the sociodemographic variables, Young's IA Test (IAT-20) Scale, Patient Health Questionnaire (PHQ-9), and Pornography Craving Questionnaire (PCQ-12) were used to measure IA, depression, and PA. By SPSS version 25.0, the prevalence and correlation between IA, depression, and PA were analyzed using the Chi-square test, binary logistic regression, and a bivariate co-relation matrix.

Results

Sixty-three percent, 76.6%, and 62.9% of the students were suffering from IA, depression, and PA respectively. Depressive and anxious symptoms were significantly associated with IA. Female students were more depressed than males. Males were more addicted to pornography than females. Students who utilized social media but didn't exercise had greater depression and PA. IA, depression, and PA were correlated.

Conclusion

The research emphasizes the need for comprehensive mental health treatments, digital literacy programs, and family and teacher participation to reduce IA, depression, and PA among adolescents post-COVID-19. Promotion of physical exercise and supporting policies to build safer online settings for adolescents are also encouraged.

Fatigue, Internet Addiction and Symptoms of Long COVID-A Cross-Sectional Study of Polish Students

Introduction: Fatigue is the most persistent symptom in patients with long COVID. Moreover, Internet addiction itself has become a pandemic long-term effect. The aim of this study was to investigate the degree of fatigue and Internet addiction in a group of students with COVID-19 and to determine the relationship between fatigue and addiction in students with and without long COVID symptoms. Material and methods: A cross-sectional study was conducted among 402 Polish students aged 19-26. The 183 students who had COVID-19 signaled the presence of long COVID symptoms, which corresponded to 45.5% of the surveyed group. The Modified Fatigue Impact Scale was used to assess the level of fatigue, and the Kimberly Young questionnaire was used to assess the level of Internet addiction. Results: 19.7% (95% c.i.: 15.9-23.9%) of the students surveyed had a moderate level of Internet dependence (Internet addiction measure value of 50 points or more). Most of them did not complain of high levels of fatigue. Higher levels of dependence and fatigue were observed in subjects with long COVID symptoms (MFIS mean value was 26.5 in this group vs. 17.7 in the others; p = 0.0000 ***). The higher the respondents' level of dependence, the more they tended to feel tired (correlations were stronger in those with long COVID symptoms: rS = 0.23; p = 0.0017 **). Conclusions: In view of the results obtained, the study presented here has the potential to contribute to the international debate on the long-term health consequences of the COVID-19 pandemic and strategies to address them. The study provides data that may be useful in the development of educational and health policies that target the psychophysical well-being of patients with long COVID symptoms. This process should be considered as a long-term endeavor.

Risk and protective factors for substance use and media addictive behaviors in adolescents during the COVID-19 pandemic

OBJECTIVE

This study examined the long-term effects of the COVID-19 pandemic on adolescents' substance use, digital media use, and symptoms of internet, gaming, and social media addiction.

METHOD

A nationally representative longitudinal cohort of 1665 Israeli teens and preteens, aged 9-16, completed questionnaires assessing substance use prevalence, daily screen time, symptoms of media addiction, and potential risk and protective factors. Data were collected before the pandemic (October 2019), after the second wave lockdown (November 2020), and after the fifth wave (April 2022) in Israel.

RESULTS

The analysis documented significant increases in substance use, daily screen time, and social media addiction indices over time. Gratitude, life satisfaction, positive emotions, future orientation, grit, and secure attachment emerged as significant protective factors. Sensation-seeking, negative emotions, and mental health symptoms were identified as risk factors.

CONCLUSIONS

These findings highlight the importance of educational and public mental health services in addressing the pandemic's long-term impact on the mental health and addictive behaviors of adolescents. They also emphasize the significance of enhancing protective factors and reducing risk factors to effectively mitigate substance and digital media abuse among adolescents.

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

BACKGROUND

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

METHODS

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

RESULTS

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

LIMITATIONS

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

CONCLUSIONS

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

Prevalence and Predictors of Internet Addiction Among Adolescents Before the First Wave of COVID-19 Lockdown in India

Background Internet dependency behavior was found to be prevalent among adolescents even before the first wave of COVID-19 lockdowns across the world including India. Adolescent users develop Internet addiction due to various risk factors. Aim The aim is to measure the prevalence and psychosocial predictors of internet addiction among adolescents before the first wave of the COVID-19 lockdown in India. Methods A cross-sectional, descriptive study before the first wave of the COVID-19 lockdown, included 1199 adolescents of both genders, aged 11 to 19 years, at selected educational settings from a city in south India, by using Young's Internet addiction test (IAT)-20 and structured questioner. Results The study found almost all the participants (100%) were using the internet in a day and the highest number of subjects started using the internet during their 6th standard of education (13%). Before the first wave of COVID-19 lockdown, the prevalence of a total of mild, moderate, and severe forms of internet addiction among adolescents was 65%. Individual, family, and community-related risk factors were found significant association with Internet addiction. The age of 14-16 years (OR 2.050, p= 0.000), duration of internet use in a day (OR 0.740, p= 0.064), financial matters (OR 0.981, p=0.016), total internet addiction score (OR 1.03, p=0.035) and timings of internet use (OR 1.161, p=0.004), were significant predictors of Internet addiction. Conclusion Internet addiction was prevalent and a notable behavior addiction among adolescents during the margin time of pre-pandemic and the first wave of the COVID-19 lockdown in India. The study highlighted many significant psychosocial risk factors and predictors of Internet Addiction in adolescents, thus the need for a panoramic approach to identify internet addiction in adolescents, to bring the modest behavior of healthy use of the internet in adolescents.

Social histories of public health misinformation and infodemics: case studies of four pandemics

Recognition of misinformation as a public health threat and interest in infodemics, defined as an inundation of information accompanying an epidemic or acute health event, have increased worldwide. However, scientists have no consensus on how to best define and identify misinformation and other essential characteristics of infodemics. We conducted a narrative review of secondary historical sources to examine previous infodemics in relation to four infectious diseases associated with pandemics (ie, smallpox, cholera, 1918 influenza, and HIV) and challenge the assumption that misinformation is a new phenomenon associated with increased use of social media or with the COVID-19 pandemic. On the contrary, we found that the spread of health misinformation has always been a public health challenge that has necessitated innovative solutions from medical and public health communities. We suggest expanding beyond the narrow scope of addressing misinformation to manage information ecosystems, defined as how people consume, produce, interact with, and behave around information, which include factors such as trust, stigma, and scientific literacy. Although misinformation can spread on a global scale, this holistic approach advocates for community-level interventions that improve relationships and trust between medical or public health entities and local populations.

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.

Internet Addiction and Psychological Distress: Can Social Networking Site Addiction Affect Body Uneasiness Across Gender? A Mediation Model

Introduction

The Internet, with its unlimited information, revolutionary communication capabilities, and innovative potential to expand knowledge, is ubiquitous throughout the world, but it also has significant implications for users' mental health. Given the not yet clearly defined and distinguishable nosographic categories of online addiction and the resulting difficulties in describing the impact on users' mental health, the present cross-sectional study aimed to gain new insights into the relationship between Internet addiction (especially social networking site [SNS] addiction), psychological distress, and physical discomfort, as well as gender differences in impact among users.

Method

A sample of 583 Italian speakers (50.8% males; 48.7% females) with a mean age of 30.96 (SD = 12.12) completed an online survey in July 2021. A set of psychometric self-report instruments was administered to assess the study variables. Mediation analyses were performed for both the whole sample and across genders.

Results

The study found that men exhibited higher levels of Internet addiction and craving than women, but no differences were found for SNS addiction. Furthermore, indicators of psychological distress (i.e., anxiety, depression, stress, loneliness, insomnia, and self-esteem) mediated the association between SNS addiction and body uneasiness, with slight differences across genders.

Conclusion

This paper contributes to the existing literature on online addictive behaviors by also highlighting gender differences. The findings underscore the need for educational experiences that can prevent problematic use of the Internet and SNSs.

The association between the use of video games, social media and online dating sites, and the symptoms of anxiety and/or depression in adults aged 25 and over

People tend to spend more time in front of their screens, which can have repercussions on their social life, physical and mental health. This topic has mainly been studied in adolescents. Therefore, our study tested associations between the use of video games, social media and online dating leading to sexual relations (ODLSR), and symptoms of anxiety and/or depression among adults aged 25 and over. Data from the 2018 TEMPO cohort study were analyzed (n = 853, 65.0% women, aged 25-44, with an average of 37.4 ± 3.7 years). The exposure variables were as follows: (a) the frequency of video game use, (b) time spent on social media and (c) ODLSR. Data were analyzed using multivariate logistic regression models, adjusted for participants' sociodemographic characteristics as well as history of mental health problems. Among the participants, 8.6% presented symptoms of anxiety and/or depression. An association between ODLSR and symptoms of anxiety and/or depression was found, especially among women. The results of this study will facilitate the improvement of support and care for adults, especially those with symptoms of anxiety and/or depression using dating applications. Future studies should investigate the determinants of using online meeting websites and their relationship with the occurrence of psychological difficulties in longitudinal studies to establish causality.

Problematic Gaming during COVID-19 Pandemic: A Systematic Review, Meta-Analysis, and Meta-Regression

The COVID-19 pandemic led to government measures enforcing isolation in order to mitigate the spread of the virus. Consequently, online activities, including gaming, increased during this challenging period. Thus, it was possible that problematic gaming (PG) patterns also increased. In this systematic review and meta-analysis, we estimated the prevalence of PG during the COVID-19 pandemic and examined differences among subpopulations. The evaluation of 38 studies revealed that the overall prevalence of PG during the COVID-19 pandemic was 3.6%. Furthermore, higher PG scores were found in undergraduate and gamer subpopulations, as well as in studies using the Gaming Addiction Scale. Finally, meta-regression analyses suggest that stricter government measures, as identified by the Government Stringency Index, may have contributed to a lower prevalence of PG behaviors. A potential explanation of this finding is that containment measures had a protective function with respect to emotional distress, and thus towards PG; alternatively, it could be that current measures for PG become less precise if an individual's functioning is already impaired due to other reasons, such as COVID-19 restrictions. Further theoretical, methodological, and practical implications of the findings are discussed.

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.

Social media addiction as a mediator of the associations between fear of COVID-19, mental health symptoms, and problematic alcohol use

Background

Fear of COVID-19 is a risk factor for anxiety and depressive symptoms. During the COVID-19 pandemic, drinking to cope with psychological distress has been proposed as a key mechanism leading to problematic drinking. The goal of this study was to test social media addiction as a mediator linking fear of COVID-19 to mental health symptoms and problematic alcohol use.

Methods

In between April 6 and July 2 of 2022, 250 participants completed an online survey as part of the National Institute on Alcohol Abuse and Alcoholism COVID-19 Pandemic Impact on Alcohol Study. Path analyses were conducted to test the mediational pathways.

Results

Using the polythetic classification scheme, 13.2% (n = 33) of participants were classified as having social media addiction. Compared with participants without social media addiction, participants with social media addiction spent significantly more time on social media platforms and on digital communications with a family member or friend. They also reported greater fear of COVID-19, higher anxiety symptoms, and higher depressive symptoms. Path analyses indicated that social media addiction mediated the associations of fear of COVID-19 with anxiety and depressive symptoms. Furthermore, there were indirect pathways linking fear of COVID-19 to problematic alcohol use through higher social media addiction and higher anxiety and depressive symptoms.

Conclusion

Social media addiction may be a maladaptive coping mechanism that individuals with high fear of COVID-19 utilized to deal with uncertainty and perceived risks during the pandemic. Findings underscore the need to examine cognitions related to fear of COVID-19 and address excessive social media use in the context of mental health and alcohol interventions.

A School-Based Program for Problematic Internet Use for Adolescents in Japan

Despite the serious influence of problematic Internet use on mental health among Japanese adolescents, no randomized clinical trials have investigated universal school-based interventions for this potential health challenge. Therefore, this study aimed to assess the efficacy of a school-based educational program. This two-armed, parallel, cluster-based randomized clinical trial included 5312 students from 13 high schools situated in a mid-sized Japanese city. The students in the intervention arm received 10 weekly standardized sessions, including a combination of information provision and interactive sessions by schoolteachers. The students in the control group followed a standard school curriculum. A generalized estimating equation model was applied to assess the primary (Korean Scale for Internet Addiction [K-scale] score) and secondary (behavioral change status according to changes in the transtheoretical model smartphone addiction score and Internet usage time) outcomes two months after intervention completion. The intention-to-treat analysis included 2597 (97.2%) and 2504 (94.9%) students in the intervention and control groups, respectively. Nevertheless, a significant discrepancy emerged regarding the behavioral change status. Therefore, this school-based program did not improve the Internet or smartphone addiction scores among Japanese adolescents. Further studies are needed to develop appropriate interventions for adolescents.

Efficacy of a short-term webcam-based telemedicine treatment of internet use disorders (OMPRIS): a multicentre, prospective, single-blind, randomised, clinical trial

Background

Evidence-based treatments for internet use disorders (IUDs) are limited, and online therapy approaches are poorly studied. We investigated the efficacy of a manualised therapist-guided online intervention (OMPRIS) to reduce IUD symptoms and improve psychological well-being.

Methods

In this multicentre, two-arm, single-blinded trial, individuals ≥16 years suffering from IUD symptoms were recruited in Germany from August 16, 2020, to March 11, 2022, through media advertisements and healthcare providers. Participants were randomly allocated by sequential balancing randomisation (1:1) to either the manualised webcam-based OMPRIS intervention or a waitlist control (WLC) group. OMPRIS provided strategies from motivational interviewing, behavioural therapy, and social counselling. The primary outcome at the end of treatment was a reduction in IUD symptoms as measured by the Assessment of Internet and Computer Scale (AICA-S). Follow-up assessments were conducted at 6 weeks and 6 months. Analyses were performed in the intention-to-treat population. This trial was registered (German Clinical Trial Register, DRKS00019925) and has been completed.

Findings

A total of 180 individuals were randomly assigned to the OMPRIS intervention (n = 89) or WLC (n = 91) arm. After treatment, 81 (91.0%) participants in the OMPRIS intervention group and 88 (96.7%) in the WLC group completed the outcome assessment. The ANCOVA model showed that OMPRIS participants had a significantly greater reduction in AICA-S scores from baseline (mean score 12.1 [SD 4.6]) to post-treatment (6.8 [5.2]) than those in the WLC group (from 12.6 [5.1] to 11.0 [5.4]; estimated mean difference -3.9; [95% CI -5.2 to -2.6]; p < 0.0001; d = 0.92). No adverse events were reported to the trial team.

Interpretation

Webcam-based OMPRIS therapy was effective and superior to waiting list conditions in reducing IUD symptoms. Webcam-based, specialised online therapy thus increases IUD treatment options.

Funding

German Innovation Fund of Germany's Federal Joint Committee (G-BA), grant number 01VSF18043.

The association between depression and addictive social media use during the COVID-19 pandemic: The mediating role of sense of control

BACKGROUND

COVID-19 precipitated a plethora of mental health difficulties, particularly for those with pre-existing mental health concerns such as depression or addictive tendencies. For some, the distress that emanated from the experience of the pandemic prompted excessive engagement in the safety of online interactions on social media. The present study examined whether variation in individuals' sense of control explained the association between depression and addictive social media use.

METHOD

A sample of 1322 participants from two Middle Eastern nations provided data collected during the peak of the pandemic from February to May 2021. A combination of convenience and snowball sampling were used to recruit and collect data from college-aged students enrolled at two universities in Egypt and the United Arab Emirates, respectively. This study adopted a cross-sectional design in which participants completed a self-administered survey that consisted of measures that assessed depressive affect, sense of control, and addictive social media use.

RESULTS

Depression was significantly and positively associated with addictive SMU. Sense of control was negatively related to both depression and SMU and significantly mediated the association between these two variables (β = .62, SE = .03, 95%CI .56, .68).

CONCLUSION

This study identified a potential protective variable that could be targeted by psychological treatment to ameliorate the potential onset of addictive SMU in individuals with depressive symptoms under conditions of immense psychological distress such as a worldwide pandemic.

Bored with boredom? Trait boredom predicts internet addiction through the mediating role of attentional bias toward social networks

Internet addiction is an emerging issue, impacting people's psychosocial functioning and well-being. However, the prevalence and the mechanisms underlying internet misuse are largely unknown. As with other behavioral addiction disorders, the increase and persistence of internet addiction may be favored by negative affect such as boredom. In this study, we examined the role of boredom susceptibility, as a personality trait, in predicting the risk of internet addiction. Furthermore, we analyzed the attentional mechanisms that may exacerbate dysfunctional internet behaviors. Specifically, we assessed the mediating role of attentional bias toward social media cues on the relation between boredom susceptibility and internet addiction. Sixty-nine young adults were administered a dot-probe task assessing internet-related attentional bias (AB) and questionnaires measuring internet addiction (IAT) and boredom susceptibility (BS-BSSS). Correlation and t-test analyses confirmed that the tendency to experience boredom and selective attention toward social network information was related to internet addiction. Furthermore, the mediation model indicated that AB fully explains the link between BS-BSSS and IAT. The study highlighted the crucial role of selective attentional processing behind internet addiction. The current results are useful for both researchers and clinicians as they suggest that intervention programs for internet addiction should include strategies to cope with dysfunctional cognitive processes.

School Burnout and Mind Wandering among Adolescents: The Mediating Roles of Internet Addiction and the Moderating Role of Resilience

School burnout is a worldwide issue that affects adolescents at every academic level. Despite the significant impact of this issue on adolescents' mental health and academic performance, few studies have examined its influence on mind wandering and its underlying mechanisms. This research endeavors to address this knowledge gap by examining the mediating role of Internet addiction in the relationship between school burnout and mind wandering and the moderating role of resilience among 2329 Chinese adolescents (Mage = 14.9 years, SD = 1.73) through an online questionnaire assessment. Participants completed measures of school burnout, Internet addiction, resilience, and mind wandering, which were analyzed using structural equation modeling (SEM) with SPSS 23.0 and Mplus 8.0. Results demonstrated that school burnout was positively linked with mind wandering, while Internet addiction mediated this relationship. Additionally, resilience moderated the association between Internet addiction and mind wandering. These findings significantly improve our comprehension of the consequences of mind wandering and offer valuable insights into possible intervention approaches for adolescents experiencing this phenomenon.

Internet Addiction and Physical Activity among Polish and Portuguese Students in the Final Year of the COVID-19 Pandemic

AIM

The purpose of this study was to analyze the level of Internet addiction and physical activity, as well as the relationship between internet addiction and physical activity, among Polish and Portuguese students in the final year of the COVID-19 pandemic.

METHODS

A web-based online survey was conducted among students in Poland and Portugal (398 respondents) aged between 17 and 26 in October 2022. The level of internet addiction was assessed by the Kimberly Young questionnaire in Polish and in Portuguese. The level of physical activity was measured by the international physical activity questionnaire in Polish and in Portuguese.

RESULTS

In the study population, the majority of the respondents were mildly addicted to the internet. The average level of addiction was reported by 9.3-23.5% of the respondents. The average level of internet addiction was higher among Portuguese students and among men. Those who had suffered from COVID-19 (especially more than once) and were more physically active showed a higher tendency towards internet addiction.

CONCLUSIONS

Internet addiction is a problem that has to be monitored and given more attention, particularly among male students. The results presented provide the first statistical insight into the problem of internet addiction among students in both countries and form the basis for further studies. They also highlight the severity of the problem and point to the need for early preventive and protective interventions against problematic internet use. It appears that effective strategies should include promoting the benefits of physical activity.

Association between problematic Internet use and specific Internet activities and COVID-19- and earthquake-related stress, anxiety, and depression symptoms among Croatian young adults

Background

During the COVID-19 pandemic and concomitant earthquakes in Croatia in 2020, increased Internet use (IU) and Internet-based addictive behaviors were associated with decreasing mental well-being. We determined the changes in IU, problematic IU (PIU), and problematic specific Internet activities in young adults during the prolonged stress caused by the pandemic and earthquakes, age differences in PIU and differences in perceived source of stress (pandemic or earthquakes), and association between PIU and increase in specific Internet activities and stress, anxiety, and depression symptoms in young adults.

Methods

A cross-sectional online survey conducted from September 30, 2021 to October 17, 2021 included 353 young adults aged 22.6 ± 2.1 years, 382 early adults aged 32.1 ± 4.4 years, and 371 middle-aged adults aged 49.0 ± 6.5 years. Data on sociodemographic characteristics, stressors (without perceived stressors, only pandemic-related stressor, only earthquake-related stressor, and both pandemic and earthquake-related stressors), PIU and IU were collected with a self-report questionnaire. The Impact of Event Scale and the Hospital Anxiety Depression Scale were used to evaluate mental symptoms. PIU and problematic specific Internet activities were assessed using Tao et al.'s criteria. Data were anaylzed with paired-sample Wilcoxon test, McNemar's and Pearson's chi-square tests, and structural equation modeling.

Results

In 17% of young adults, we found increased PIU (OR = 5.15, 95% CI [2.82, 10.18]), problematic social media use (OR = 2.77, 95% CI [1.56, 5.14]), and uncontrolled online shopping (OR = 5.75, 95% CI [1.97, 22.87]) (p < 0.001 for all). PIU and problematic social media use were more common among young adults (60.8%), as well as problematic online gaming (25.9%). Problematic social media use was more frequent among young adults reporting pandemic stress than among those without perceived stress (69.9% vs. 43.2%). Increased online gaming predicted more severe avoidance symptoms (p = 0.041), increased social media use predicted more severe depression symptoms (p = 0.017), increased online shopping predicted more severe intrusion (p = 0.013) and anxiety symptoms (p = 0.001). PIU predicted more severe intrusion (p = 0.008), avoidance (p = 0.01), anxiety (p < 0.001), and depression (p = 0.012) symptoms.

Conclusion

Different effects of the pandemic and earthquakes on IU could reflect a different effect of various stressors on Internet behavior of young adults. Type of problematic Internet behavior may predict for the type of mental health problem.

Moderating the impact of the COVID-19 pandemic on children's and adolescents' substance use, digital media use, and mental health: A randomized positive psychology addiction prevention program

OBJECTIVE

Previous research suggests that well-being interventions are effective in moderating substance and digital media use and improving mental health. This study evaluated the feasibility and preliminary efficacy of a school-based Positive Psychology Addiction Prevention (PPAP) intervention aimed at reducing substance and digital media use and increasing the mental health of school children during the COVID-19 pandemic.

METHODS

The sample was composed of 1,670 children and adolescents (Mean age = 12.96, SD = 2.01) from six elementary and secondary schools in Israel who were randomly assigned to the PPAP intervention (n = 833) or the waiting-list control conditions (n = 837). A three-year longitudinal repeated-measures randomized control design was used to examine modifications in substance use, digital media use, and psychological symptoms in the intervention and control groups assessed on the pre-test (before the outbreak of COVID-19, September 2019), the post-test (May 2021), and the 12-month follow-up (May 2022).

RESULTS

The 12-month prevalence of tobacco use, alcohol use, and cannabis use decreased significantly from the pre- to the follow-up period in the intervention group, and increased significantly in the control group. Daily digital media use increased during the pandemic period in both groups, with a significantly higher increase in the control group. The intervention group reported significantly lower psychological symptoms and negative emotions, and greater positive emotions and life satisfaction after the intervention and at follow-up compared to the control group.

CONCLUSIONS

The COVID-19 pandemic has profoundly disrupted the lives of children and adolescents. Well-being and addiction prevention interventions may be effective in improving the mental health of school children during pandemics and crisis periods.

Impact of COVID-19 on Adolescents' Smartphone Addiction in South Korea

The outbreak of COVID-19 impacted numerous people globally, but most notably affected adolescents negatively by contributing to the increase in their use of media and smartphones and therefore their susceptibility to smartphone addiction. Based on the social-ecological model, this study seeks to identify the individual-, family-, and school-level factors of smartphone addiction through two groups of users: a first group whose smartphone usage time increased after the outbreak of COVID-19, and a second group whose usage time did not. Based on the data collected from 360 Korean adolescents aged 15 to 18, results reveal that personal-level factors (i.e., gender, depressive symptoms, self-control, and cyberbullying victimization) are associated with smartphone addiction. For the group whose smartphone usage time increased after the outbreak, economic status, academic performance, and academic year were related to smartphone addiction. Based on these findings, the study makes specific guidelines and suggestions on addressing the smartphone addiction among Korean adolescents.

Problematic Media Use among Children up to the Age of 10: A Systematic Literature Review

INTRODUCTION

Digital screen media use has significantly grown in all age groups and at an increasingly young age, including toddlers, schoolers, and primary school children. Although there is evidence that excessive early childhood media exposure can lead to several negative developmental outcomes, no systematic review on Problematic Media Use (PMU) of children under 10 years old have been provided. The aim of the present systematic review was to identify (i) the main instruments used to measure children's PMU across different studies; (ii) the risk and protective factors which might increase or reduce children's PMU; and (iii) the negative outcomes associated with children's PMU.

METHODS

This study was conducted following the systematic review guidelines proposed in the PRISMA statement. A total of 35 studies published between 2012-2022 and with a mean sample age between 0 and 10 years old were ultimately included in this literature review.

RESULTS

Use of media for more than 2 h a day, male gender, and higher age increased the risk of developing PMU among children. PMU led to several negative consequences for children's development and well-being (e.g., more problematic behaviors, sleep problems, higher depressive symptoms, lower emotional intelligence, and lower academic achievements). Children who experienced negative psychological symptoms, a dysfunctional parent-child relationship, and difficulties in school context were more prone to develop PMU. However, an authoritative parenting style and restrictive parental mediation reduced the risk of developing PMU among children. Finally, self-report measures specifically designed to get the younger children's perspective are still few and not so widely used.

CONCLUSIONS

Overall, this research field is still in its infancy and needs further investigation. Likely, a dysfunctional family system can lead children to experience emotional distress and negative psychological symptoms, which they try to manage by escaping into the virtual world, thus increasing the risk of developing PMU. As the children's PMU is closely affected by the family environment, future prevention interventions should target both children and their parents to improve their self-regulatory and mentalizing capabilities, as well as parental mediation strategies and general parenting practices.

Nomophobia and smartphone addiction amidst COVID-19 home confinement: the parallel mediating role of digital gaming and social media tools usage across secondary school students

Introduction

With the inevitable technological boom enforced by the COVID-19 lockdowns and online emergency remote teaching practices, the prevalence of nomophobia (NMP) and smartphone addiction (SA) among adolescents has become a pressing issue, which has come under scrutiny. However, the impact of social media tools usage (SMTU) and digital gaming behavior (DGB) on these phenomena remains unclear since there is little research focusing on the complex interplay among these variables. Regarding this context, the present study aimed to explore the parallel mediating role of secondary school students' SMTU and DGB in the relation between NMP and SA.

Methods

In line with this aim, we employed a cross-sectional design with a critical case sampling strategy and collected data through an online survey from a total of 427 secondary school students in Istanbul in the 2021-2022 academic year. In order to test the parallel mediation model, we employed multiple linear regression models by utilizing PROCESS models with 5000 BC bootstrap samples and 95% CI.

Results and discussion

Results illustrated that there was an increase in the prevalence of NMP and SA during the COVID-19 home confinement as consistent with the previous research. The results also indicated that among the multiple mediators, the mediating role of SMTU was significant in the relation between NMP and SA. This means NMP has direct and indirect significant impact on SA through SMTU. However, the mediating role of DGB was found nonsignificant in this relationship. Our results are robust and hold key contributions to both theoria and praxis in educational psychology research realm by disentangling the complex underlying mechanism between NMP, SMTU, DGB, and SA. On the practical side, our results provide insightful implications for school boards and researchers in the development of effective interventions.

Perception of Internet Use in Relation to Health Decision-Making among Nursing Students

Internet use has increased worldwide during the COVID-19 pandemic, to the point where it has inadvertently integrated into our lives. University students use the Internet daily for different purposes: seeking information, entertaining, as a teaching and learning tool, they consider social networks as a means of connection and social interaction, and to seek information to make health decisions. Because of this, the Internet and social networks have gained popularity among this group, to the point of developing an abusive use that is not perceived as an addictive risk. A descriptive analysis was performed through the adaptation of a survey about Internet use, social networks and health perception; this survey was given to nursing students of the Gimbernat School during the academic year 2021-2022. Students completed the ad hoc questionnaire (N = 486; 83.5% female, 16.3% male; only 1 declared to be non-binary gender). Our hypothesis had to do with whether the population of nursing students at Gimbernat School had increased, after the pandemic, its use of the Internet and social networks to make decisions about health problems. The objective of the study was to analyse differences in students' habits of use of the Internet and social networks as they look for health information, their decision-making when they find the information and their perception of health as nursing students from a gender perspective. The results showed a clear positive relationship between the variables studied. Of nursing students, 60.4% spend between 20 and more than 40 h a week using the Internet, and 43.6% of these hours are spent on social networks. Of students, 31.1% make health decisions by searching for information on the Internet and consider it useful and relevant. The use of the Internet and social media in relation to health decisions is clearly affected. To try to reduce the incidence of the problem, interventions are needed regarding the prevention and/or consequences of Internet abuse and health education of student nurses as future health assets.

The association between online learning, parents' marital status, and internet addiction among adolescents during the COVID-19 pandemic period: A cross-lagged panel network approach

INTRODUCTION

Previous research has identified the association between online learning and Internet addiction (IA) and the role of family factors in it. However, few studies have treated IA as a multidimensional mechanism and explored the underlying linkage of online learning, IA, and parental marital status with a cross-lagged network approach. The study aimed to examine the relationship between online learning during the COVID-19 pandemic, Internet addiction (IA), and parental marital status among Chinese adolescents.

METHODS

The sample consisted of 2356 adolescents who completed the Internet Addiction Test twice over a four-month period. Four symptom networks and two cross-lagged panel networks were performed.

RESULTS

The results showed that adolescents from divorced families had a higher prevalence of IA (27 %) compared to those from non-divorced families (17 %). The strongest cross-lagged association was found between "spending more time online" and "preferring the excitement online". In the divorced group, "school grades suffering" had the highest influence, while in the non-divorced group, "anticipation" had the highest influence.

CONCLUSION

This study highlights the relationship between online learning, IA, and parental divorce and suggests that long-term online learning may contribute to IA, and parental divorce may exacerbate problematic Internet use and increase IA levels.

Inferiority feelings and internet addiction among Turkish University students in the context of COVID-19: The mediating role of emotion dysregulation

Emotion dysregulation is a major predictor of increased internet addiction. However, the psychological experiences linked to increased internet addiction through higher emotion dysregulation are poorly understood. The aim of this study was to investigate if inferiority feelings, an Adlerian construct theorized to be rooted in childhood, are associated with increased Internet addiction through emotion dysregulation. Another objective of the study was to determine if the internet use characteristics of young adults changed during the pandemic. A conceptual model was validated statistically using the PROCESS macro with a survey method involving 443 university students living in different regions of Turkey. The results support the significance of all three effects of inferiority feelings on internet addiction, namely the total (B = 0.30, CI = [0.24, 0.35]), the direct (B = 0.22, BootCI = [0.15, 0.29]), and the indirect (B = 0.08, BootCI = [0.04, 0.12]). In other words, inferiority feelings are associated with a greater level of internet addiction both directly and indirectly through greater emotion dysregulation. Moreover, the overall prevalence of Internet addiction was 45.8% among the participants and that of severe Internet addiction was 22.1%. Almost 90% of the participants reported an increase in their recreational Internet use during the pandemic, with an average daily increase of 2.58 h (SD = 1.49), the significance of which was supported by the t-test results. The results provide important insights for parents, practitioners, and researchers on addressing the internet addiction problem among young adults living in Turkey or other countries that are similar to Turkey.

Does Smartphone Use Really Impact Cervical Rotation and Cervical Proprioception in Asymptomatic Individuals?

Background and objective Smartphone use has increased exponentially over the last two years worldwide. The outbreak of the coronavirus disease 2019 (COVID-19) pandemic led to significantly higher dependence on the smartphone for information exchange and communication among the general public. Currently, India has hundreds of millions of smartphone users, and their numbers are on the rise. This has raised concerns regarding the adverse effects of smartphone use on mental and musculoskeletal health. In light of this, this study aimed to determine and evaluate the musculoskeletal consequences of smartphone use. Method A total of 102 participants (50 adolescents and 52 adults) who were smartphone users and are asymptomatic for cervical spine-related disorders were included based on convenience sampling. The components assessed were cervical rotation using tape measurement and cervical proprioception using the head repositioning accuracy test. Frequency distribution tables and text were used to report the results. Results The results of this research indicated reduced cervical rotation range and cervical proprioception deficits in both adolescent and adult smartphone users. Furthermore, no correlation was found between cervical rotation (right and left) and cervical proprioception (right and left rotation). Conclusion Though the results showed that both the individual components - cervical rotation and cervical proprioception - were significantly affected, there was no correlation between the components, which indicates that these asymptomatic individuals who are marginally excessive smartphone users are at increased risk for reduced cervical mobility and deficits in cervical proprioception.

Impact of COVID-19 on adolescent sexual life and attitudes: have we considered all the possible secondary effects of the pandemic?

A significant increase in pornography use has been reported in the adolescent population worldwide over the past few years, with intensification of the phenomenon during the COVID-19 pandemic. The aim of the present review is to provide data on the frequency of pornography consumption among adolescents during the pandemic and raise awareness about its potential impact on personal beliefs and sexual attitudes in the long term. A comprehensive literature review was performed in two scientific databases using the crossmatch of the terms "pornography", "adolescents" and "COVID-19". A significant increase in pornography consumption in adolescents was documented during the COVID-19 pandemic as a result of social detachment. Fulfilment of sexual desires in the context of social distancing, alleviation of COVID-19-related boredom and psychological strain, and coping with negative emotions are some of the reported reasons for increased pornography use during the pandemic. However, concerns have been raised in the literature regarding potentially negative effects of excessive pornography use from an early age, including the development of pornography addiction, sexual dissatisfaction and aggressive sexual attitudes reinforced by gender preoccupations and sexual inequality beliefs.

CONCLUSION

The extent to which increased pornography consumption from an early age during the COVID-19 pandemic may have affected adolescents' mental well-being, personality construction and sexual behaviour is yet to be seen. Vigilance from the society as a whole is required so that potential negative adverse effects of adolescent pornography use and potential social implications are recognized early and managed. Further research is needed so that the full impact of the COVID-19-related pornography use in the adolescent population is revealed.

WHAT IS KNOWN

•A significant increase in pornography consumption has been documented in the adolescent population worldwide over the past decades due to its quick, affordable and easy access from electronic devices and the possibility of anonymous and private participation. •During the COVID-19 pandemic, this phenomenon was intensified as a coping mechanism to social isolation and increased psychosocial strain.

WHAT IS NEW

•Concerns have been raised regarding the risk of pornography addiction in adolescents during the COVID-19 pandemic, making the post-pandemic adaptation challenging. •Awareness is raised in parents, health care providers and policy makers about the potential negative impacts of pornography consumption from an early, vulnerable age, such as sexual dissatisfaction and development of aggressive sexual attitudes and sex inequality beliefs.

Is Satisfaction with Online Learning Related to Depression, Anxiety, and Insomnia Symptoms? A Cross-Sectional Study on Medical Undergraduates in Romania

The objective of this study was to investigate online learning satisfaction in a sample of university students and its relationship with depression, anxiety, insomnia, and the average number of hours spent online. A total of 463 medical students were recruited for an online survey conducted from February to March 2022 with the main objective of estimating online learning satisfaction, while secondary outcomes involved assessing the relationship between online learning and depression, anxiety, insomnia, and the average number of hours spent online. A total of 285 participants were female (71.4%) and the mean age was 20.2 years. The results revealed that depression, anxiety, and insomnia are negatively correlated with overall satisfaction with e-learning. The more time students spent online, the greater the overall satisfaction. There are significant differences regarding student perceptions of interactivity in online learning satisfaction outcomes (p < 0.05, η2 partial Eta Squared-0.284). The opportunity to learn via chat-box presented differences in overall satisfaction while pleasant aspects of online learning, such as “no travel” and “economy”, were related to satisfaction. The students revealed that the higher the psychopathology scores, the less satisfied they were with online learning, while a higher number of hours spent online contributed positively to satisfaction.

The Role of Internet Use and Offline Social Engagement in the Health of Chinese Older Adults: Evidence from Nationally Representative Samples

This study investigated the association between internet use as a novel type of social engagement and the health of older adults, and evaluated the role of online versus offline social activities through nationally representative samples. Participants aged ≥ 60 in the datasets from the Chinese sample of the World Value Survey (N_{Sample 1} = 598) and the China Health and Retirement Longitudinal Study (CHARLS, N_{Sample 2} = 9434) were selected. Correlation analysis presented the positive relationships between internet use and self-reported health in both Sample 1 (r = 0.17, p < 0.001) and Sample 2 (r = 0.09, p < 0.001). In addition, the relationships between internet use and both self-reported health and depression (r = -0.14, p < 0.001) were stronger than the correlation between offline social activities and health outcomes in Sample 2. After accounting for the frequency of traditional social activities, regression analysis revealed the relationship between internet use and higher self-reported health (β_{Sample 1} = 0.16, p < 0.001; β_{Sample 2} = 0.04, p < 0.001) and lower depressive symptom scores (β = -0.05, p < 0.001) This research contributes to the existing body of literature on the favorable relationship between social engagement and health outcomes among Chinese older adults. Additionally, it identifies the social benefits of internet use for health promotion among older adults.

Engaging in physical activity instead of (over)using the smartphone: An experimental investigation of lifestyle interventions to prevent problematic smartphone use and to promote mental health

Aim

Tendencies of problematic smartphone use (PSU) have risen during the past decade. As PSU is consistently linked to mental health issues, measures to prevent its appearance and to promote mental health are urgently required.

Subject and Methods

The present study investigated the impact of three interventions on health behavior, PSU, positive mental health (PMH), and depression and anxiety symptoms. Overall, 503 persons from Germany (M age = 29.19, SD age = 10.51, range: 18-79) participated in the study. Over 14 days, the three experimental groups (a) reduced their daily smartphone use time by 60 minutes, (b) increased their daily level of physical activity by 30 minutes, and (c) combined both measures. The control group continued its behavior as usual. Outcomes were assessed via online surveys at five measurement time points (baseline, intermediate, post-intervention, and 1 and 3 months after the intervention).

Results

All interventions resulted in a significant increase in weekly physical activity and in reduced symptoms of PSU, depression, and anxiety. Furthermore, the smartphone reduction and the combination of both measures contributed to a significant reduction of participants' daily smartphone use and higher levels of PMH. The effects of the reduction of smartphone use time and its combination with increased physical activity were more stable in the longer term than the increase in physical activity only.

Conclusion

Combined with an increase in physical activity, the reduction of smartphone use time could serve as an efficient and cost-effective measure for the prevention of PSU and the promotion of mental health.

A Study on the Relationship between Internet Overdependence and Anger Response among Young Adults during COVID-19 Pandemic: Moderating Effect on Negative Emotions

The aim of this study is to examine how Internet dependence affects anger responses during the COVID-19 pandemic. Owing to social distancing policies, Internet dependence has intensified, and the prevalence of anger has significantly increased. To understand this phenomenon and draw some implications, the "frustration-aggression hypothesis" was utilized for the theoretical framework and anger response was categorized into functional and dysfunctional anger responses. An analysis shows that overdependence on the Internet has a positive effect on the dysfunctional anger response. At the same time, other negative emotions replace anger, reducing the possibility of a dysfunctional anger response. Accordingly, a need for a constant effort to understand the circumstances of the young generation living in the "new normal" is emphasized; moreover, this paper suggests some theoretical and practical implications.

Associations Between Problematic Internet Use and Mental Health Outcomes of Students: A Meta-analytic Review

The increasing prevalence of problematic internet use has heightened concerns about its adverse impact on internet users' mental health. Despite reviews investigating the associations between problematic internet use and mental health outcomes, there is a lack of understanding of various aspects of students' mental health. This study aimed to bridge this gap by providing a more comprehensive overall picture of this issue through a quantitative synthesis based on three-level random-effects meta-analytic models. In total, 223 studies with a cumulative total of 498,167 participants and 512 effect sizes were included in this synthesis. The results showed that problematic internet use was moderately and positively associated with depressive symptoms, anxiety, loneliness, and other mental health outcomes, and negatively related to subjective well-being. Moderator analyses revealed that several study features (i.e., school grade, region, measure of problematic internet use, publication year, and gender) could explain the variations in the findings across individual studies. These research results provide solid evidence for the link between problematic internet use and different mental health outcomes and have implications for future research and interventions on students' problematic internet use.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s40894-022-00201-9.

Prevalence of Internet gaming disorder and its association with psychiatric comorbidities among a sample of adults in three Arab countries

Abstract

Background

As Internet gaming became publicly available over the past 25 years, Internet gaming disorder emerged as a new diagnostic entity and became established in psychiatric diagnostic systems as a form of addiction. Given the recency of its advent, reliable data on the epidemiology and psychiatric comorbidity of this disorder in specific geographic regions are scarce and dearly needed for appropriate treatment.

Results

A total sample of number = 1332 participants completed the questionnaire. Four-hundred twenty-three of them were gamers; in this cohort, the prevalence of Internet gaming disorder was 6.1%. A strong association between Internet gaming and several psychiatric disorders (attention deficit, hyperactivity, depression, and anxiety) was found.

Conclusions

Internet gaming disorder is frequent in adults from Arab countries. It is associated with psychiatric comorbidities in this current sample; the nature of this association needs to be properly investigated.

Problematic internet use in adolescents: A phenomenological study

WHAT IS KNOWN ON THE SUBJECT?: Problematic internet use (PIU) negatively affects adolescents' lives biopsychosocially. There is limited qualitative research examining the problem of PIU in adolescents. These studies focused more on the non-clinical population. Adolescents' perceptions of the internet, their thoughts, feelings and behaviours in situations where they can and cannot access the internet have rarely been examined. WHAT DOES THE PAPER ADD TO EXISTING KNOWLEDGE?: This research provides an in-depth look at the experiences of adolescents with PIU in a clinical population. Unlike previous studies, adolescents mentioned that they turned to the internet for reasons such as lack of activity, their need to spend time with their friends and better getting along with people they met on the internet. They also described a world without internet as apocalypse, desert and grave. In this study, a holistic emphasis was placed on the thoughts, feelings and behaviours of adolescents in situations where they could and could not access the internet. This may contribute especially to mental health nurses working in clinics in terms of understanding the thought-emotion and behaviour patterns of adolescents with PIU. Adolescents also stated that their lives were affected positively and negatively as a result of PIU. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Mental health nurses can use activity therapy, behaviour modification: social skills, coping enhancement, parent education: adolescent, self-awareness enhancement, cognitive restructuring, emotion and behaviour management interventions to reduce the risk of PIU and the problems it causes for adolescents. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Mental health nurses can use activity therapy, behaviour modification: social skills, coping enhancement, parent education: adolescent, self-awareness enhancement, cognitive restructuring, emotion and behaviour management interventions to reduce the risk of PIU and the problems it causes for adolescents.

ABSTRACT

INTRODUCTION: Studies on problematic internet use (PIU) are mostly on the non-clinical population. Understanding the experiences of adolescents with PIU is critical in shaping nursing interventions and improving the quality of care.

AIMS

A comprehensive description of the experiences of adolescents with PIU.

METHODS

In the study, descriptive phenomenology design, one of the qualitative research methods, was used. Data were collected using a personal information form and a semi-structured interview form and analysed using Giorgi's phenomenological method (n = 11).

RESULTS

As a result of the content analysis, five main themes were identified: reasons of PIU, internet-related perceptions, experiences in accessing the internet, experiences in not being able to access the internet and consequences of internet use.

DISCUSSION

Different from previous studies, adolescents stated that they use the internet because of their lack of activity and their need to spend time with their friends. They stated that when they could not access the internet, they thought they could never live without the internet and started quarrel.

The longitudinal association between internet addiction and depressive and anxiety symptoms among Chinese adolescents before and during the COVID-19 pandemic

Background

The COVID-19 pandemic and related prevention policies, such as home quarantine or online courses, could increase the risks of experiencing internet addiction and mental health problems among Chinese adolescents. There is a lack of longitudinal evidence to show the association between internet addiction symptoms and psychological consequences (e.g., depressive and anxiety symptoms).

Objective

This study aimed to explore the association between internet addiction and depressive and anxiety symptoms before and during the coronavirus disease 2019 (COVID-19) pandemic.

Methods

An effective sample of 7,958 Chinese adolescents was recruited for this two-wave longitudinal survey conducted over a six-month interval. All participants completed two-wave surveys before and during the COVID-19 pandemic. A longitudinal cross-lagged path model was used to analyze the associations between internet addiction and depressive and anxiety symptoms after controlling for four covariates (i.e., age, sex, minority, and COVID-19 influence).

Results

Higher depressive and anxiety symptoms before COVID-19 significantly predicted severe internet addiction during COVID-19. Results showed a significant bidirectional relationship between internet addiction and depressive symptoms. Furthermore, the prevalence of internet addiction displayed an increasing trend over the two waves. Conversely, a reduced prevalence of anxiety and depressive symptoms was observed over the two waves.

Conclusion

This current study provided valuable evidence that psychological problems and internet addiction significantly influenced each other before and during the COVID-19 outbreak. Consequently, the presence of psychological problems before and during the COVID-19 outbreak could indicate internet addiction. Thus, depression- and anxiety-related psychotherapies should be developed to prevent internet addiction among Chinese adolescents.

Internet-Based Self-Assessment for Symptoms of Internet Use Disorder-Impact of Gender, Social Aspects, and Symptom Severity: German Cross-sectional Study

BACKGROUND

Internet use disorder (IUD) is a new type of behavioral addiction in the digital age. At the same time, internet applications and eHealth can also provide useful support in medical treatment.

OBJECTIVE

The purpose of this study is to examine if an internet-based eHealth service can reach individuals with IUD. In particular, it should be investigated whether both male and female individuals with more severe IUDs can be reached.

METHODS

Data were retrieved from the OMPRIS (online-based motivational intervention to reduce problematic internet use and promote treatment motivation in internet gaming disorder and internet use disorder) project (DRKS00019925), an internet-based motivational intervention to reduce problematic internet use and promote treatment motivation in internet gaming disorder and IUD. During the recruitment process (August 2020-March 2022), a total of 3007 individuals filled out the standardized scale for the assessment of internet and computer game addiction (AICA-S). The assessment was accessible via the project homepage. There was no preselection of participants at this stage of the study; however, the offer was addressed to people with hazardous internet use and IUDs. The web-based assessment was free and could be found via search engines, but attention was also drawn to the service via newspaper articles, radio reports, and podcasts.

RESULTS

Out of 3007 who participated in the web-based self-assessment, 1033 (34.4%) are female, 1740 (57.9%) are male, 67 (2.2%) are diverse individuals, and 167 (5.5%) did not disclose their gender. The IUD symptom severity score showed a wide range between the AICA-S extreme values of 0 and 27 points. On average, the total sample (mean 8.19, SD 5.47) was in the range of hazardous IUD behavior (AICA-S cutoff>7.0). Furthermore, 561 individuals (18.7% of the total sample; mean 17.42, SD 3.38) presented severe IUD (AICA-S cutoff>13.5). Focusing on female and male participants, 20.9% (363/1740) of the men and 14.9% (151/1033) of the women scored above 13.5 points, which can be considered pathological IUD behavior (χ²_2,2773=16.73, P<.001, effect size: Cramér V=0.078). Unemployment, being in vocational training or studying at a university, and being male were significantly associated with high IUD symptoms.

CONCLUSIONS

Using a large sample, the study showed that both mildly and severely IUD-affected individuals can be reached via the internet. An internet-based eHealth offer can thus be a good way to reach patients with IUD where they are addicted-on the internet. In addition, eHealth services increase the likelihood of reaching female patients, who hardly ever come to specialized outpatient clinics and hospitals. Since social problems, especially unemployment, have a strong association with disease severity, the integration of social counseling into treatment seems advisable in terms of a multidisciplinary approach.

TRIAL REGISTRATION

German Clinical Trials Register (DRKS) DRKS00019925; https://drks.de/search/de/trial/DRKS00019925.

Impact of COVID-19 on public social life and mental health: a statistical study of google trends data from the USA

The COVID-19 pandemic has caused a significant disruption in the social lives and mental health of people across the world. This study aims to asses the effect of using internet search volume data. We categorize the widely searched keywords on the internet in several categories, which are relevant in analyzing the public mental health status. Corresponding to each category of keywords, we conduct an appropriate statistical analysis to identify significant changes in the search pattern during the course of the pandemic. Binary segmentation method of changepoint detection, along with the combination of ARMA-GARCH models are utilized in this analysis. It helps us detect how people's behavior changed in phases and whether the severity of the pandemic brought forth those shifts in behaviors. Interestingly, we find that rather than the severity of the outbreak, the long duration of the pandemic has affected the public health status more. The phases, however, align well with the so-called COVID-19 waves and are consistent for different aspects of social and mental health. We further observe that the results are typically similar for different states as well.

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.

Network analysis of internet addiction and depression among Chinese college students during the COVID-19 pandemic: A longitudinal study

Background

There has been growing evidence of comorbidity between internet addiction and depression in youth during the COVID-19 period. According to the network theory, this may arise from the interplay of symptoms shared by these two mental disorders. Therefore, we examined this underlying process by measuring the changes in the central and bridge symptoms of the co-occurrence networks across time.

Methods

A total of 852 Chinese college students were recruited during two waves (T1: August 2020; T2: November 2020), and reported their internet addiction symptoms and depressive symptoms. Network analysis was utilized for the statistical analysis.

Results

The internet addiction symptoms "escape" and "irritable," and depression symptoms "energy" and "guilty" were the central symptoms for both waves. At the same time, "guilty" and "escape" were identified as bridge symptoms. Notably, the correlation between "anhedonia" and "withdrawal" significantly increased, and that between "guilty" and "escape" significantly decreased over time.

Conclusions

This study provides novel insights into the central features of internet addiction and depression during the two stages. Interestingly, "guilty" and "escape," two functions of the defense mechanism, are identified as bridge symptoms. These two symptoms are suggested to activate the negative feedback loop and further contribute to the comorbidity between internet addiction and depression. Thus, targeting interventions on these internalized symptoms may contribute to alleviating the level of comorbidity among college students.

Public Health Approach to Problems Related to Excessive and Addictive Use of the Internet and Digital Media

Purpose of Review

Advances in digital technology and media have provided convenience and advantages in all areas of our daily lives. However, there is a risk of excessive and addictive use, which increases the risk of addiction as a disease and other related mental and physical problems. This article reviews the public health approach to problems related to excessive and addictive use of the Internet and digital media.

Recent Findings

The public health model views addiction as the result of interactions among individuals, digital media, and the environment; therefore, interventions should aim to reduce risk factors and increase protective factors in these three areas. This includes developing and providing evidence-based services according to each individual's problem type and severity. Regarding interventions for digital media and the environment, restricting accessibility and regulating content may be necessary. This calls for an integrative, comprehensive, and continuous intervention strategy, and to achieve such a framework, we need to establish an information system to monitor the magnitude and patterns of related problems.

Summary

This review suggests a surveillance system that provides a list of evidence-based policies from the public health perspective. Suggestions for an advanced international information, policy, and monitoring system are discussed.

A short-term manual for webcam-based telemedicine treatment of Internet use disorders

In recent decades, the number of people who experience their Internet use behavior as problematic has risen dramatically. In Germany, a representative study from 2013 estimated the prevalence of Internet use disorder (IUD) to be about 1.0%, with higher rates among younger people. A 2020 meta-analysis shows a global weighted average prevalence of 7.02%. This indicates that developing effective IUD treatment programs is more critical than ever. Studies show that motivational interviewing (MI) techniques are widely used and effective in treating substance abuse and IUDs. In addition, an increasing number of online-based health interventions are being developed to provide a low-threshold treatment option. This article presents a short-term online-based treatment manual for IUDs that combines MI techniques with therapy tools from cognitive behavioral therapy (CBT) and acceptance and commitment therapy (ACT). The manual includes 12 webcam-based therapy sessions, each lasting 50 min. Each session is framed by a standardized beginning, conclusion, outlook, and flexible session content. In addition, the manual contains example sessions to illustrate the therapeutic intervention. Finally, we discuss the advantages and disadvantages of online-based therapy compared to analog treatment settings and provide recommendations for dealing with these challenges. By combining established therapeutic approaches with an online-based therapeutic setting based on flexibility and motivation, we aim to provide a low-threshold solution for treating IUDs.

A Systematic Overview of Adolescents’ Smartphone Habits and Internet Addiction During the COVID-19 Era

In order to prevent the spread of the virus during the Covid-19 epidemic period, measures such as maintaining social distance, quarantine practices, and keeping schools closed have been taken in many countries. In this process, individuals' internet use has also increased in order to restore interpersonal relationships that have decreased with staying at home. In addition, the transfer of educational activities, which are risky to be carried out face-to-face during the epidemic period, to online platforms, as in many countries, brought about an increase in the time spent on devices with internet providers in adolescents. For this reason, it is important to evaluate the results of studies examining the concepts of internet and smartphone addiction in relation to the use of the internet in the Covid-19 period. In this context, in this systematic review, "What is the status of adolescents' smartphone and internet addictions in the Covid-19 Era?" The question has been tried to be answered. As a result of the searches made in the databases, fourteen studies were reached and these studies were examined in depth. The findings showed that adolescents’ internet/smartphone addictions were higher than before the epidemic, the prevalence of internet/smartphone addictions increased in general, and internet/smartphone addictions were associated with adolescents' mental disorders and problems.