Internet Addiction: The Emergence of a New Clinical Disorder

People are not becoming "AIholic": Questioning the "ChatGPT addiction" construct

Generative artificial intelligence (AI) chatbots such as ChatGPT have rapidly gained popularity in many daily life spheres, even sparking scholarly debate about a potential "ChatGPT addiction." Throughout history, new technologies have repeatedly been associated with widespread concerns and "moral panics," especially when their adoption is sudden and involves significant changes in daily functioning. It is thus no surprise that researchers have examined whether intensive use of ChatGPT can be considered an addictive behavior. At least four scales measuring ChatGPT addiction have been developed so far, all framed after substance use disorder criteria. Drawing parallels with previous cases of pathologizing everyday behaviors, we caution against labeling and defining intensive or habitual chatbot use as addictive behavior. To label a behavior as addictive, there must be convincing evidence of negative consequences, impaired control, psychological distress, and functional impairment. However, the existing research on problematic use of ChatGPT or other conversational AI bots fails to provide such robust scientific evidence. Caution is thus warranted to avoid (over)pathologization, inappropriate or unnecessary treatments, and excessive regulation of tools that have many benefits when used in a mindful and regulated manner.

The temporal stability of problematic gaming and gaming disorder: A systematic review and meta-analysis

Classifying problematic gaming/gaming disorder as a formal psychiatric diagnosis requires data on its level of temporal stability: are the dysfunctional symptoms transient or can they persist in the absence of treatment? To evaluate this question, we conducted a literature review and meta-analysis to investigate temporal stability in problematic gaming/gaming disorder. We identified 50 relevant longitudinal studies on PubMed, PsycINFO, and SCOPUS. Our review and meta-analysis engaged on two types of temporal stability: categorical stability and dimensional stability. We used MetaXL to run the meta-analysis for categorical stability. Our meta-analysis revealed that overall, the categorical stability rate was approximately 34-38% for the 2-year follow-up studies and approximately 43-45% for the 1-year follow-up studies. This indicates that between 1/3 and 1/2 of the gamers who initially met the threshold for problematic gaming/gaming disorder continued to meet such a threshold at follow-ups. Our meta-analysis included predominantly adolescent groups, which should be noted when generalizing the obtained categorical stability rates. Our review results also showed that overall, the dimensional stability was positive and statistically significant, indicating moderate or high correlations between symptom severity at baseline and at follow-ups. Temporal stability can be a complex concept. Our results suggest that although the categorical stability of problematic gaming/gaming disorder is not as strong as some major psychiatric disorders such as schizophrenia and bipolar disorder, it is similar to personality disorder and gambling disorder. Many complex factors may affect the temporal stability of problematic gaming/gaming disorder, possibly including severity of the disorder, whether the data is from clinical or nonclinical populations, and an individual's age group or developmental stage. More methodologically rigorous longitudinal studies that address these issues are needed.

Network analysis of Internet addiction and depression among Chinese adolescents

BACKGROUND

Internet addiction (IA) and depression are common mental health concerns, with burgeoning empirical evidence highlighting their significant comorbid relationship among adolescents. We aimed to establish network structures for IA and depression among Chinese adolescents, and to identify the core and bridge symptoms.

METHODS

A total of 8176 participants were recruited from Henan Province, Central China. The 10-item Center for Epidemiological Studies Depression Scale (CESD) and 20-item Self-report Internet Addiction Test (IAT) was used to measure depression and IA, respectively. IA, depression and the co-occurrence network structures were constructed using network analysis. Strength, the centrality index, was used to identify the core symptoms. Bridge symptoms were assessed using the bridge strength.

RESULTS

Node CESD7 ("Could not get things going") was the most influential node in the depression network model, followed by CESD1 ("Felt sadness") and CESD2 ("Everything was an effort"). Node IAT16 ("Reluctant to be offline") was the most influential node in the IA network model, followed by IAT20 ("Web made you feel better"), IAT15 ("Fantasized about being on the web") and IAT2 ("Neglected household chores"). CESD7 ("Could not get things going") in the depression-IA network was the most key bridge symptom linking depression and IA, followed by CESD8 ("Trouble focus"). Significant gender difference in edge weights was observed (p = 0.002).

LIMITATIONS

This cross-sectional study collected data through self-report measures.

CONCLUSIONS

The core symptoms and key bridge symptoms in the networks are crucial for the precise intervention of adolescent depression and IA.

Adolescent Girls With Anorexia Nervosa Clinical Profiles in Relation to Their Social Networks Use

BACKGROUND

In recent years, social networks (SNs) have increasingly become a core activity adolescent's daily life. Their impact on mental health is an actual worldwide concern. This massive usage of social network has been suggested to increase the risk of depressive and anxiety disorders, as well as alterations in sleep quality and quantity. In particular, it has been suggested that it could increase concerns about body image and thereby encourage eating disorders. Aiming at further investigating these relations, this study examined, for the first time, the links between the clinical profile of adolescents with anorexia nervosa and SNs use patterns.

METHODS

The sample included 131 adolescent girls with anorexia nervosa who completed an online survey assessing their SNs practices in terms of duration, intensity and function of SNs use, misuse and addictive tendencies, as well as the number of online peers. Clinical characteristics such as eating behaviours, body image perception, depression, anxiety and sleep quality were also assessed.

RESULTS

showed that adolescents with anorexia nervosa spend more than 3 h per day on SNs. Those spending 5 h per day or more preferred a passive use, with limited connection with peers and greater clinical difficulties. In addition, high problematic use of SNs significantly aggravated eating behaviour, dysmorphophobia, depressive symptoms and sleep impairment. The activities performed on SNs were not significantly associated with variations in clinical characteristics.

CONCLUSION

Presents findings suggests that a profile of social networking marked by a problematic, prolonged and passive use, is associated with more severe symptomatology in adolescent girls with anorexia nervosa. These first data could inspire professionals to encourage a SNs use favouring care and recovery, thereby supporting adolescents with an eating disorder but also their relatives.

Association between internet addiction and insomnia among college freshmen: the chain mediation effect of emotion regulation and anxiety and the moderating role of gender

BACKGROUND

The advancement of the information age has led to the widespread use of the internet, accompanied by numerous internet-related issues that often correlate with various physical and mental health conditions, particularly among college freshmen. We examined the relationship between internet addiction (IA) and insomnia among these students, using emotion regulation (ER) and anxiety as mediators and gender as a moderating variable.

METHODS

This cross-sectional study included 7,353 freshmen from a university in Jingzhou City, Hubei Province, China. Data were collected through an online self-administered questionnaire, including the Internet Addiction Test (IAT), the Emotion Regulation subscale (ER), the Generalized Anxiety Disorder 7-item scale (GAD-7), and the Insomnia Severity Index (ISI). Data analysis was conducted using SPSS 21.0 and PROCESS version 4.1 to test the hypothesized relationships among variables.

RESULTS

In our survey, correlation analysis showed that ER was significantly negatively correlated with IA, anxiety, and insomnia; IA was significantly positively correlated with anxiety and insomnia (all p < 0.01). The mediating effect analysis indicated that IA was a significant positive predictor of insomnia. ER and anxiety played a chain - mediating role in the development of insomnia (β = 0.039, 95% confidence interval = 0.035-0.043). The moderating effect analysis showed that the interaction term of IA and gender had a significant negative predictive effect on ER (β = -0.014, 95% confidence interval [-0.027, -0.001]) and insomnia (β = -0.022, 95% confidence interval [-0.036, -0.007]). Males (direct effect: β = 0.048, 95% confidence interval = [0.037, 0.059]) had a stronger predictive ability for the level of insomnia than females (direct effect: β = 0.026, 95% confidence interval = [0.014, 0.037]). Females (indirect effect 1: β = 0.015, 95% confidence interval = [0.010, 0.020]; indirect effect 2: β = 0.041, 95% confidence interval = [0.037, 0.045]) had a stronger predictive ability for the level of insomnia through the level of IA than males (indirect effect 1: β = 0.014, 95% confidence interval = [0.009, 0.018]; indirect effect 2: β = 0.037, 95% confidence interval = [0.033, 0.041]).

CONCLUSION

IA can exacerbate insomnia in college freshmen by compromising their ER, subsequently triggering anxiety symptoms. The process differs by gender, suggesting tailored strategies for each. These findings may play crucial roles in promoting the physical and mental well-being of college freshmen.

Multi-Informant Profiles of Helicopter Parenting and Parent-Child Intimacy: Longitudinal Links with Adolescents' Self-Discipline and Problematic Internet Use

Family systems theory emphasizes the combined influence of various family factors and the heterogeneity across families. Prior research has separately examined the effects of helicopter parenting and parent-child relationships on adolescent self-regulation-related behaviors, leaving their combined influence unclear. This study adopts a person-centered approach to identify latent profiles of helicopter parenting and parent-child intimacy and examine their longitudinal links with self-discipline and problematic internet use. Matched data on fathers (Mage = 42.65, SD = 4.34), mothers (Mage = 41.60, SD = 3.88), and children (Mage = 12.78, SD = 0.94, 51.6% female) from 283 families were included at two time points (T1 and T2, six months apart). Three distinct profiles emerged: moderate helicopter parenting with low intimacy, low helicopter parenting with moderate intimacy, and moderate helicopter parenting with moderate intimacy. At T2, compared to adolescents in moderate helicopter parenting with moderate intimacy families, those in moderate helicopter parenting with low intimacy families exhibited lower self-discipline and higher problematic internet use, and those in low helicopter parenting with moderate intimacy families demonstrated higher self-control. Additionally, compared to adolescents in low helicopter parenting with moderate intimacy families, those in moderate helicopter parenting with low intimacy families had lower self-control and higher problematic internet use. These findings underscore the importance of considering both helicopter parenting and parent-child intimacy when examining adolescent self-regulation.

Protocol for a Randomized Controlled Trial to Enhance Executive Function via Brief Mindfulness Training in Individuals with Internet Gaming Disorder

BACKGROUND

Internet Gaming Disorder (IGD) is characterized by uncontrolled gaming behavior, leading to emotional distress, neglect of academic or life responsibilities, and damage to interpersonal relationships, all of which have serious negative impacts on individuals and society. IGD has been associated with neuropsychological impairments, especially executive function deficits, and emotional difficulties. Mindfulness interventions have been indicated to improve executive functions to varying degrees in individuals with IGD. The purpose of this study is to investigate whether the three subcomponents of executive function (i.e., inhibition, updating, and shifting) are impaired in individuals with internet gaming disorder, as well as to examine the effectiveness of a brief mindfulness intervention on executive function.

METHODS

A total of 82 individuals diagnosed with IGD and 40 non-addicted gamers will be recruited for this study. These participants will be evenly divided into an intervention group and a control group at a ratio of 1:1. The intervention group will undergo a 7-day mindfulness training program focusing on breathing meditation, while the control group will receive progressive muscle relaxation training. Both groups' outcomes will be assessed at seven different time points. Primary outcome measures will include electroencephalography (EEG) data (band power, functional connectivity, source localization, and N2/P3 amplitudes), behavioral metrics (response times and accuracy from psychological experimental paradigms), physiological indices (specifically heart rate variability), self-reported measures (game craving and mindfulness levels, executive function performance, and impulsivity emphasizing inhibitory control). Secondary outcome measures will encompass anxiety, stress, positive and negative affect, sleep quality, and other indicators such as demographic information, physical and mental health status, and the Big Five personality traits.

DISCUSSION

This study aims to explore the efficacy of a brief mindfulness intervention on executive function impairments in IGD individuals and to elucidate its underlying neural mechanisms. It is anticipated that the findings will contribute to more targeted intervention strategies for executive function research, offering novel insights into the treatment of IGD and related cognitive dysfunctions. This study is expected to explore the effectiveness of brief mindfulness intervention on IGD and its underlying brain functional mechanisms, particularly providing more targeted intervention strategies for improving executive functions in this population.

TRIAL REGISTRATION

Trial registration number: ChiCTR2400081509, registered on March 4th 2024. Protocol Version1.0.

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

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

Psychometric evaluation and measurement invariance of the problematic smartphone use scale among college students: A national survey of 130 145 participants

BACKGROUND AND AIMS

Given the insufficient validation of previously imported smartphone addiction scales in China, this study revised and evaluated the Problematic Smartphone Use Scale among Chinese college students (PSUS-C).

METHODS

We based our research on a national sample comprising 1324 higher education institutions and 130 145 participants. Using cross-sectional data, comprehensive methods were employed to examine validity, reliability and measurement invariance.

RESULTS

The final scale consists of 20 items across four dimensions: withdrawal and loss of control, negative impact, salience behaviors and excessive use. All Heterotrait-Monotrait (HTMT) values were below 0.85, and the lower 90% and upper 95% confidence intervals were also below 0.85, except for factors 1 and 3. The amount of variance (AVE) values were greater than 0.5, composite reliability (ω) values exceeded 0.89 and all factor loadings were above 0.5. The criterion validity was supported as expected: problematic smartphone usage positively correlated with depression (r = 0.451), loneliness (8 items, r = 0.455), loneliness (6 items, r = 0.504), social media use (r = 0.614) and phone usage duration (r = 0.148); and negatively correlated with life satisfaction (r = -0.218) and self-esteem (r = -0.416). Across sex, type of university and place of residence, the measurement invariance performed well, with most changes in root mean square error of approximation (ΔRMSEA), comparative fit index (ΔCFI) and Tucker-Lewis index (ΔTLI) values being less than 0.005, and no indicator showing a difference greater than 0.010.

CONCLUSIONS

The Problematic Smartphone Use Scale for College Students (PSUS-C) demonstrated good factor structure, internal consistency, construct validity, discriminant validity and criterion validity. Strict and structural invariance were demonstrated across sex, type of university and place of residence. The PSUS-C has the potential to assess smartphone addiction among Chinese university students.

Prevalence and correlates of problematic pornography use among undergraduate medical students in Egypt

ObjectivePornography use can become an addiction when a person loses control in watching sexual materials, such as sex graphic images and movies, and is unable to stop doing so despite the negative consequences. Pornography addiction is a disorder that can impair mental health, behavior, and performance. The purpose of this study was to determine the prevalence and correlates of problematic pornography use among medical students in Egypt.MethodsThis study cross-sectional study included 614 undergraduate medical students who were selected from each of the 6 academic years of those studying to become physicians at a faculty of medicine in Egypt. The short version of the problematic pornography consumption scale (PPCS-6) was used to determine problem pornography use. Sociodemographic information and academic performance data were collected, and the Depression Anxiety Stress Scale-21 (DASS-21) was administered to assess depression, anxiety, and stress symptoms.ResultsNearly one-quarter (23.3%) of students had problematic pornography use. Problematic pornography use was associated with older age and with male sex. Students with problematic pornography reported fewer hours studying and had lower test scores in the previous year than those without problematic pornography use. Medical students with problematic pornography had significantly higher levels of depression, anxiety and stress symptoms compared to those without.ConclusionsProblematic pornography use is a common problem among medical students at a university in Egypt, is present in nearly one-quarter of students, and is significantly associated with older age, male sex, and depression, anxiety, and stress symptoms, as well as poorer academic performance.

Short video addiction scale for middle school students: development and initial validation

The rise of short video platforms has increased concerns about addiction, especially among adolescents. This study aimed to develop a Short Video Addiction Scale for middle school students. A sample of 1492 middle school students participated in the study. Initial items were derived from qualitative interviews and refined through psychometric analyses, including Exploratory and Confirmatory Factor Analyses. The final scale, consisting of 15 items across five factors (Academic Procrastination, Interpersonal Strain, Social Communication Difficulties, Attention Concentration Difficulties, and Impaired Control over Short Video Use), demonstrated high internal consistency (Cronbach's α = 0.900), test-retest reliability, and strong validity. The Short Video Addiction Scale, a 15-item scale, demonstrates robust psychometric properties. It is reliable and valid for assessing short video addiction among middle school students and will be a valuable tool for identifying and addressing the growing concerns of short video addiction in adolescents.

Emotion recognition in individuals with elevated internet addiction scores: An event-related potential study

The current study aims to elucidate the electrophysiological correlates of performance patterns in an emotion recognition task among individuals with higher internet addiction (HIA) scores compared to those with lower internet addiction (LIA) scores. Forty participants, with twenty in the HIA group and twenty in the LIA group, completed an emotion recognition task, involving five facial expressions: anger, fear, disgust, neutral, and sadness. Additionally, cognitive flexibility and working memory were assessed to examine their link to emotion recognition abilities. No significant differences in accuracy or reaction times (RTs) were observed between the groups in the emotion recognition task. However, the HIA group showed reduced P150 amplitudes, but increased N250 amplitudes relative to the LIA group. There was a positive correlation between the RTs and cognitive flexibility, only in the LIA group. Although the groups demonstrated comparable behavioral performance, the stages of stimuli processing differed. The LIA group appeared to process the stimuli more efficiently in the early stage, while the HIA group required greater effort in decoding the stimuli at a later stage. This suggests that the HIA group may rely on over-processing at a later stage due to reduced early processing efficiency, potentially suggesting an early vulnerability marker.

Problematic internet use among people with dentofacial deformity: a preliminary study

Objective

Class III malocclusion represents one type of anterior malocclusions, characterised by a longer face and a more prominent chin. Class III malocclusions are a type of malocclusion related to the relationship between the maxilla and mandible. They are often characterized by mandibular protrusion relative to the maxilla, and in some cases, features such as elongation of the lower facial third or a more prominent chin may also be present. Due to their appearance, patients experience a range of psychosocial and emotional difficulties, which have also been identified as risk factors for problematic internet use (PIU), including depression, negative body image, and lower self-esteem.

Methods

A cross-sectional study was conducted and 170 fully completed questionnaires were obtained, 85 from people with Class III malocclusions aged between 18 and 42 years, and 85 from individuals without Class III malocclusions aged between 18 and 40 years.

Results

Participants with Class III malocclusions obtained statistically significantly more PIU points than participants without Class III malocclusions (p < 0.001). Among people with Class III malocclusions 45.9% showed a high or very high risk of Internet addiction, while in the comparison group, it was only 9.4% (p < 0.001). Among participants with Class III malocclusions, there was a statistically significant, although weak, correlation between the PIU score and feeling uncomfortable when being the centre of attention (rho = 0.284; p < 0.01), and between the PIU score and concern with appearance (rho = 0.272; p < 0.05).

Conclusion

Individuals with Class III malocclusion are at a much higher risk of problematic Internet use than people without the disorder. This problem especially concerns patients who feel discomfort when being the centre of attention and are more concerned about their appearance. Therefore, it seems that people suffering from disorders that cause changes in appearance should have access to extensive psychological support, including the prevention of problematic Internet use.

The Suppressing Effect of Self-Presentation on Social Networks on the Relationship Between Interpersonal Distress and Emotional Experience Among Late Adolescents in a Chinese University: The Moderating Role of Internet Addiction Tendency

This study investigates how self-presentation on social networks suppresses the relationship between interpersonal distress and emotional experience among college students. It also examines the moderating role of internet addiction tendency. A total of 153 college students were surveyed over 8 days. The results showed the following: (1) interpersonal distress is negatively correlated with positive emotions; (2) at both the inter-individual and intra-individual levels, self-presentation on social networks suppresses the negative relationship between interpersonal distress and positive emotions; (3) internet addiction tendency only moderates the relationship between interpersonal distress and self-presentation on social networks at the inter-individual level. These findings suggest that colleges and universities can guide students to use resources on social networks as a means of coping with interpersonal distress.

Assessing Short-Video Dependence for e-Mental Health: Development and Validation Study of the Short-Video Dependence Scale

BACKGROUND

Short-video dependence (SVD) has become a significant mental health issue around the world. The lack of scientific tools to assess SVD hampers further advancement in this area.

OBJECTIVE

This study aims to develop and validate a scientific tool to measure SVD levels, ensuring a scientifically determined cutoff point.

METHODS

We initially interviewed 115 highly engaged short-video users aged 15 to 63 years. Based on the summary of the interview and references to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria for behavioral addictions, we proposed the first version of the short-video dependence scale (SVDS). We then screened the items through item analysis (second version) and extracted common factors using exploratory factor analysis (third version) and confirmatory factor analysis (final version). Convergent validity was tested with other scales (Chinese Internet Addiction Scale [CIAS] and DSM-5). Finally, we tested the validity of the final version in 16,038 subjects and set the diagnostic cutoff point through latent profile analysis and receiver operating characteristic curve analysis.

RESULTS

The final version of the SVDS contained 20 items and 4 dimensions, which showed strong structural validity (Kaiser-Meyer-Olkin value=0.94) and internal consistency (Cronbach α=.93), and good convergent validity (rCIAS=0.61 and rDSM-5=0.68), sensitivity (0.77, 0.83, 0.87, and 0.62 for each of the 4 dimensions), and specificity (0.75, 0.87, 0.80, and 0.79 for each of the 4 dimensions). Additionally, an SVDS score of 58 was determined as the best cutoff score, and latent profile analysis identified a 5-class model for SVD.

CONCLUSIONS

We developed a tool to measure SVD levels and established a threshold to differentiate dependent users from highly engaged nondependent users. The findings provide opportunities for further research on the impacts of short-video use.

The relationship between digital addiction and social anxiety, trait anger and anger expression style in adolescents

OBJECTIVE

This study aimed to investigate the relationship between adolescents' digital addiction levels and their social anxiety, trait anger and anger expression styles.

METHOD

The study was devised as a descriptive and correlational research study. The sample consisted of 958 adolescents in Konya, Turkey. The data were collected via Personal Information Form, Digital Addiction Scale for Children, Social Anxiety Scale for Adolescents, and Trait Anger and Anger Expression Style Scale.

RESULTS

The total mean score of digital addiction in adolescents was found as 56.74 ± 19.02. A significant relationship was found between digital addiction, and trait anger, anger out, anger in, anger control and social anxiety levels (p < 0.01). Grade, mother's educational and employment status, trait anger, anger out, anger in, anger control, and social anxiety explain 69.3 % of the variation on digital addiction levels.

CONCLUSION

As digital addiction levels increase, social anxiety, trait anger, anger in, and anger out levels also increase. However, the level of anger control decreases as digital addiction levels rise. These variables are predictors of digital addiction levels.

IMPLICATIONS FOR NURSING PRACTICE

To protect and improve adolescent health concerning biopsychosocial aspects, comprehensive educational programs and seminars about digital addiction should be organized for families and adolescents by nurses in collaboration with educational institutions. To assist adolescents in managing negative emotions such as social anxiety and anger more effectively, nurses should encourage the engagement in a variety of activities and hobbies in educational and extracurricular social settings in addition to developing and implementing relevant psychoeducational programs.

Depression, anxiety, and stress associated with Internet addiction in Iranian general population: A cross-sectional study

BACKGROUND

This study aims to comprehensively investigate the association between Internet addiction (IA) and mental health, focusing on depression, anxiety, and stress in the Iranian general population. By employing a cross-sectional design, we surveyed 2012 individuals using a validated questionnaire. Our primary objectives were to assess the prevalence of IA, identify demographic factors influencing addiction scores, and explore the interplay between addiction, depression, anxiety, and stress. The findings contribute to the understanding of IA's impact on mental health in the Iranian context.

MATERIALS AND METHODS

In 2023, 2012 Iranian individuals were surveyed using convenience sampling. Participants completed a questionnaire on demographics, internet addiction (Internet Addiction Test), and mental health (Depression, Anxiety, and Stress Scale). Statistical analysis with SPSS 27.0 included normal distribution assessment, descriptive statistics, and group comparisons using Chi-square, Mann-Whitney, and Kruskal-Wallis tests. Multiple linear regression explored the relationships between mental health, problematic social media use, and overall social media use. Generalized Linear Models assessed the nuanced association between mental health and internet addiction, addressing collinearity. This comprehensive approach unveils the complex relationships in demographic factors, internet addiction, and mental health outcomes.

RESULTS

The 2012 participants were predominantly men (60.3%), married (59.3%), and of age 26-35 (45.8%); the mean IA score was 45.67 (SD = 15.49). Notably, lower income (5-10 million tomans) correlated with reduced IA scores (P < 0.05). Multivariable models identified significant associations. Participants with Master's and Ph.D. degrees had higher IA scores (β* = 2.59, 95% confidence interval: 0.75-4.43, P = 0.006). Increasing severity in depression and anxiety consistently correlated with higher addiction scores (P < 0.001), with substantial impact (β* = 12.02 and 10.66, respectively). Correlation analysis revealed strong positive relationships between depression, anxiety, and stress (r = 0.747, 0.775, and 0.786, respectively). Variations in depression by marital status, anxiety by BMI, and stress by both income and BMI were significant (P < 0.05).

CONCLUSION

The study highlights IA as a prevalent and significant issue in Iran, influenced by diverse psychological and demographic factors. The findings suggest that interventions targeting IA should take into account the roles of depression, anxiety, stress, education, income, marital status, and BMI. The study recommends further research to delve into the causal mechanisms and long-term consequences of IA in Iran.

The Moderated Mediating Effects of Social Media Identity and Loneliness on the Relationship Between Problematic Internet Use and Mental Health in China: Nationwide Cross-Sectional Questionnaire Study

BACKGROUND

Mental health disorders are a major public health challenge, and problematic internet use (PIU) may play an important role in this issue. However, the underlying mechanisms of PIU and its effects on mental health have not yet been elucidated.

OBJECTIVE

This study examines the mediating effect of loneliness on the relationship between PIU and mental health, as well as the moderating effect of social media identity on the relationships among PIU, loneliness, and mental health.

METHODS

A cross-sectional questionnaire survey was conducted on 21,292 participants recruited using a multistage stratified sampling strategy from 31 provinces/regions in mainland China from June 20 to August 31, 2022. This study assesses PIU (PIU questionnaire-short form-6), depression (9-item Patient Health Questionnaire [PHQ-9]), anxiety (7-item Generalized Anxiety Disorder scale [GAD-7]), loneliness (3-item loneliness scale), and social media identity (identity bubble reinforcement scale). Additionally, we collected the sociodemographic characteristics of the participants. Participants whose total score of PHQ-9≥15 or total score of GAD-7≥10 were considered to have moderate or severe symptoms of depression or anxiety, respectively. A moderated mediation model was established to examine the mediating effect of loneliness on the association between PIU and mental health outcomes (depression and anxiety), moderated by social media identity.

RESULTS

Approximately 22.80% (4854/21,292) and 14.20% (3023/21,292) of the respondents reported moderate or severe symptoms of depression and anxiety, respectively. Loneliness significantly mediated the association between PIU and mental health outcomes, explaining 42.53% and 45.48% of the total effect of PIU on depression and anxiety, respectively. Social media identity significantly moderated the associations between PIU and depression (β=0.002, 95% CI 0.001-0.002), PIU and anxiety (β=0.001, 95% CI 0.000-0.002), loneliness and depression (β=0.010, 95% CI 0.007-0.013), and loneliness and anxiety (β=0.007, 95% CI 0.004-0.010), but not between PIU and loneliness (β=0.000, 95% CI -0.003 to 0.003). Higher levels of social media identity were significantly associated with lower levels of loneliness (β=-0.018, 95% CI -0.020 to -0.016).

CONCLUSIONS

Addressing loneliness may serve as a valuable approach to mitigate the impact of PIU on mental health outcomes. However, social media identity poses a significant challenge in addressing health issues linked to PIU.

Translation and validation of the Portuguese version of the internet severity and activities addiction questionnaire (ISAAQ-10) towards the identification of problematic social media use: A population study

BACKGROUND

Problematic usage of the internet (PUI) refers to a pattern of internet use that results in negative consequences in an individual's life. It encompasses a broad spectrum of activities, which require assessment in terms of both severity and diversity, for a comprehensive understanding. This study aimed to translate the Internet Severity and Activities Questionnaire (ISAAQ-10) into Portuguese, to analyze its psychometric properties and to explore the validity of the ISAAQ-10 social networking use activity score towards identifying problematic social media use.

METHODS

A snowball sampling method was used, with participants completing an online survey comprising sociodemographic questions and the Portuguese versions of the ISAAQ-10, Internet Addiction Test-10 (IAT-10), Internet Gaming Disorder Scale-Short-Form (IGDS9-SF), and Bergen Social Media Addiction Scale (BSMAS). The psychometric analysis included internal reliability testing using Cronbach's alphas and test-retest reliability, a confirmatory factor analysis (CFA), and convergent validity testing between the ISAAQ-10 and IAT-10. The concurrent validity of the ISAAQ-10 was also examined.

RESULTS

A total of 590 young adults (85.1 % female), aged between 18 and 35 years, participated in this study. The ISAAQ-10 presented good internal consistency (α = 0.93), with a test-retest correlation of r = 0.865; 95 % CI: 0.669-0.939. and a unidimensional structure that explained 48.3 % of the total variance. The convergent validity of the ISAAQ-10's total score was established through a high Pearson's correlation (r = 0.574; p ≤ .001) with the IAT-10's total score. Pearson's correlations between the ISAAQ-10 gaming activity score and the IGDS9-SF (r = 0.873; p < .001), and between the ISAAQ-10 social networking use activity score and the BSMAS (r = 0.670; p < .001), respectively, supported the instrument's concurrent validity.

CONCLUSION

This work provides support for the Portuguese translation of the ISAAQ-10, which can be employed to identify the severity of problematic usage of the internet in a population sample. It also provides the first validation of the ISAAQ-10 social networking use activity score, which can be employed to identify problematic social media use within a predominately female university student sample. This study further establishes the ISAAQ-10 as a valid and reliable tool for population studies and, specifically, for the identification of problematic social media use.

French Versions of 4 English Questionnaires on Problematic Smartphone Use: Cross-Cultural Linguistic Translation and Adaptation Study

BACKGROUND

Excessive use of smartphones is recognized as a major problem in our modern society and can have dramatic consequences on the health of adolescents and young adults. Measuring problematic smartphone use in research and clinical practice is generally operationalized with self-reported questionnaires. In order to comprehensively assess the issue of problematic smartphone usage within the French population, it is imperative to employ validated French-language questionnaires. However, at this point, existing questionnaires are primarily available in English. Furthermore, to the best of our knowledge, these English questionnaires have yet to undergo validation processes for French-speaking cohorts.

OBJECTIVE

The aim of this study was to perform a cross-cultural translation of the Smartphone Addiction Scale, Nomophobia Questionnaire, Problematic Use of Mobile Phones scale, and Smartphone Addiction Proneness Scale to French.

METHODS

The translation process was performed using the forward/backward method. The first translation phase involved asking 4 independent French translators to translate the original English version of the questionnaires into French. In the second phase, the French version was backtranslated to English by a native English speaker. In the third phase, 2 concept experts were asked to comment and suggest modifications to the statements if necessary. Finally, the last version of the translated questionnaires was presented to 18 participants to assess the clarity, intelligibility, and acceptability of the translations.

RESULTS

During the forward translation step, the translation differences were minor. During the backward translation, the English native speaker correctly backtranslated 18 of the 33 items of the Smartphone Addiction Scale, 17 of the 20 items of the Problematic Use of Mobile Phones scale, and 13 of the 15 items of the Smartphone Addiction Proneness Scale. Backtranslation for the Nomophobia Questionnaire was less satisfactory, with only 10 out of 20 items that were correctly backtranslated. The linguistic verification step revealed a minimal modification for the 4 questionnaires. The participants also suggested few improvements that we have considered for the final version. We produced the final version directly after this step.

CONCLUSIONS

We successfully adapted and effectively translated 4 questionnaires that assess problematic smartphone use to French. This step is a prerequisite for the validation of the French questionnaires. These adapted measures can serve as valuable research instruments for investigating and addressing issues related to problematic smartphone use in French-speaking countries and for making international comparisons.

Examining the Roles of Problematic Internet Use and Emotional Regulation Self-Efficacy on the Relationship Between Digital Game Addiction and Motivation Among Turkish Adolescents

Digital game addiction and problematic internet use have emerged as significant issues, attracting growing attention from educators, psychologists, and policymakers. This study aimed to examine the mediating role of emotional regulation self-efficacy and the moderating role of problematic internet use in the effect of digital game addiction on academic motivation in Turkish adolescents. A correlational research method was utilized to address research questions. A total of 1156 high school students voluntarily participated in the study. Self-report questionnaires (the Short Academic Motivation Scale, Digital Game Addiction Scale, Regulatory Emotional Self-Efficacy Scale and Young's Internet Addiction Scale Short Form) were used to collect data in 2024. In the analysis of the data, Pearson Product Moment Correlation Coefficient, mediator and moderator analyses were conducted using statistical software. The analysis provided evidence of the negative effect of digital game addiction on academic motivation. Additionally, emotional regulation self-efficacy was found to partly mediate the relationship between digital game addiction and academic motivation. Furthermore, problematic internet use moderated the relationship between digital game addiction and academic motivation in adolescents. The results suggested enhancing adolescents' emotional regulation self-efficacy and reducing problematic internet use are crucial steps towards mitigating the negative effects of digital game addiction on academic motivation.

Adverse childhood experiences and problematic use of the internet among a child and adolescent psychiatric clinical population

BACKGROUND

Internet use, specifically problematic use of the internet (PUI), needs to be considered in child and adolescent psychiatric (CAP) settings. Besides psychological symptomatology, childhood trauma (intrafamilial abuse and neglect) has been associated with PUI. The impact of various adverse childhood experiences (ACEs) on PUI, particularly in CAP populations, is understudied.

OBJECTIVE

This study aimed to investigate associations between PUI and various ACEs in a CAP population, considering gender differences and psychological symptomatology.

METHODS AND MATERIALS

104 adolescents (69 girls) were included, aged 14-17 years, undergoing inpatient CAP treatment, between August 2018 and March 2020. Participants completed the Interview for the Assessment of Internet and Computer Game Addiction (AICA), the Youth Self-Report (YSR), and the Multidimensional Clinical Screening Inventory (MCSI). Statistical analyses examined associations between PUI and ACEs, after controlling for age, gender, and psychological symptomatology.

RESULTS

Extrafamilial emotional abuse was significantly associated with higher AICA scores and likelihood of PUI. Extrafamilial separation and loss was associated with a significant decrease in the internet use and to the likelihood of PUI. Suicide of a mother significantly increased the odds of moderate to severe PUI. School absenteeism and alcohol abuse were associated with higher AICA scores irrespective of age and gender, though these associations diminished when controlling for psychological symptomatology.

CONCLUSIONS

Extrafamilial emotional abuse, particularly social receptive environments and relationships, play a significant role in developing PUI among CAP populations. The complex interplay of emotional trauma, family dynamics, peer relationships and individual behaviors regarding PUI should be addressed in CAP interventions.

Examining the comorbidity network of Internet addiction and depression: the role of effortful control on their bridge symptoms in adolescents

Background and aims

Internet addiction (IA) and depression commonly co-occur in adolescents, yet the mechanisms underlying their comorbidity remain unclear. This study aims to elucidate the comorbidity mechanism through network analysis, identifying bridge symptoms linking IA and depression, and exploring sex differences. Additionally, the study examines the association between effortful control (EC) and bridge symptoms, providing insights for interventions.

Methods

A school-based survey was conducted among 7th to 9th-grade students in Japan. Participants completed questionnaires assessing IA (measured by the Young Diagnostic Questionnaire), depression (measured by the Patient Health Questionnaire for Adolescents), and EC (measured by the Early Adolescent Temperament Questionnaire). Network analysis was employed to identify bridge symptoms and examine their association with EC. Bootstrapping for network analysis was conducted to assess network accuracy and stability as well as sex differences in the network structures.

Results

Among the 4,111 students approached, 3,909 (1,904 male and 2,005 female) students filled out the survey. Bridge symptoms such as "Escape" (from the IA cluster) and "Concentration" (from the depression cluster) were found important in both male and female students. Our analysis also revealed differences in the importance of the bridge symptoms across males and females with "Psychomotor" symptoms (from the depression cluster) predominantly in males and "Feeling Guilty" (from the depression cluster) and "Functional impairment" (from the IA cluster) predominantly in females. EC showed a notable negative association with "Concentration", suggesting important relationships between the transdiagnostic factor and bridge symptoms in understanding the comorbid conditions. The network comparison test did not reveal significant differences in the network structures across sexes.

Discussion and conclusions

The study revealed differences in bridge symptoms linking IA and depression between male and female students. Our findings provide valuable insights for understanding the comorbidity mechanisms of IA and depression in adolescents. Further research using a longitudinal study design is warranted to identify the directionality between EC and bridge symptoms.

Assessing the Relationship Between the Type of Internet Use and Internet Addiction in Early and Middle Adolescents: Cross-Sectional Study From Qatar

BACKGROUND

With the increasing prevalence of digital technology, adolescent internet addiction (IA) has become a global concern. Excessive internet use, especially among adolescents, has been linked to various negative outcomes such as poor academic performance, social isolation, and mental health issues. Conducted among adolescents of Arab origin, our study addressed the limitations of the literature, which predominantly focuses on Western, educated, industrialized, rich, and democratic populations.

OBJECTIVE

This study aimed to differentiate between essential and nonessential internet use and how they relate to IA in early and middle adolescents, as well as the relationship between subjective happiness with the amount of time spent on nonessential internet use and IA.

METHODS

A cross-sectional survey was conducted among 377 students from 16 schools in Qatar. The survey measured essential and nonessential internet use, subjective happiness with nonessential use, and IA symptoms using the Internet Addiction Diagnostic Questionnaire, as well as participant demographics. To explore age-specific associations, participants were categorized into early (age 11-13 years) and middle (age 14-17 years) adolescents. Factorial analysis, multiple regression, and logistic regression were used for statistical analysis.

RESULTS

Nonessential internet use significantly predicted IA in both early (P<.001) and middle (P<.001) adolescents, with early adolescents showing a stronger association. Subjective happiness with nonessential internet use negatively predicted IA only in middle adolescents (P<.001) as greater dissatisfaction led to a higher IA risk. Essential internet use did not predict IA in either group.

CONCLUSIONS

Differentiating between essential and nonessential internet use is crucial in understanding IA. This study highlights the importance of developmental differences in shaping IA symptoms. The findings suggest that interventions aimed at addressing IA should be age specific and focus on addressing nonessential use specifically rather than considering internet use and screen time in general as a single entity. Cultural and regional factors also play a role in shaping internet use patterns and IA in the Middle East, necessitating context-specific, culturally sensitive approaches to IA prevention.

Variation in and Factors Associated with Youth Self-Harm in College Students - Jiangsu Province, China, 2019-2023

What is already known about this topic?

Self-harm represents a significant public health challenge that disproportionately affects young adults. Understanding individual- and institutional-level risk factors is crucial for developing and implementing effective mental wellness intervention programs for college students.

What is added by this report?

The prevalence of youth self-harm fluctuated between 2.21% and 3.83% from 2019 to 2023. Risk factors associated with self-harm included unhealthy lifestyle behaviors, particularly internet addiction, while the implementation of regular family psychological forums was associated with reduced self-harm risk.

What are the implications for public health practice?

Effective campus-based psychosocial support systems must incorporate person-centered approaches and context-specific needs, optimize resource allocation through targeted interventions, and prioritize high-risk groups exhibiting unhealthy lifestyle behaviors.

The effect of physical activities on internet addiction in college students: the mediating effect of self-control

Objective

To investigate the relationship between college students' physical activities and Internet addiction, to investigate the role self-control control plays in this relationship, and to provide a theoretical foundation for the alleviation of college students' tendency to Internet addiction and intervention treatment.

Methods

A questionnaire survey was conducted on 471 college students using the International Physical Activity Questionnaire (IPAQ), the Revised Chen Internet Addiction Scale (CIAS-R), and the Self-Control Scale (SCS).

Results

Internet addiction was significantly negatively correlated with physical activities (overall; min/WK, r = -0.115, P < 0.05), with high-intensity physical activities (min/WK, r = -0.179, P < 0.01), and with low-intensity physical activities (r = -0.103, P < 0.05); self-control was significantly positively correlated with physical activities (overall; min/WK, r = 0.150, P < 0.01), with moderate-intensity physical activities (min/WK, r = 0.139, P < 0.01) while it was significantly negatively correlated with Internet addiction (min/WK, r = -0.349, P < 0.01). The mediating effect follows the path: physical activity → self-control → internet addiction.

Conclusion

Physical activity can have a direct negative effect on college students' Internet addiction, and also influence Internet addiction through the mediating effect of self-control.

Problematic Online Video Watching, Boredom Proneness and Loneliness Among First-Year Chinese Undergraduates: A Two-Wave Longitudinal Study

Purpose

While previous cross-sectional studies have investigated the relationship between problematic online video watching and mental health issues, longitudinal studies exploring their bidirectional relationship remain relatively scarce. This study aimed to fill this gap by conducting a two-wave longitudinal design.

Participants and Methods

Six hundred and ninety-nine first-year undergraduates voluntarily completed two rounds of questionnaire surveys assessing problematic online video watching, boredom proneness and loneliness with an interval of 4 months. To test the research hypotheses, cross-lagged panel models were performed using AMOS 24.0.

Results

Our results revealed the that (1) Boredom proneness and problematic online video watching were mutually influenced. (2) Loneliness at T1 positively predicted the level of problematic online video watching at T2 but not vice versa. (3) Boredom proneness mediated the link between loneliness and problematic online video watching. (4) Chinese first-year undergraduates' levels of problematic online video watching and boredom proneness significantly increased during their educational transition period from high school to university.

Conclusion

The present study enhances our understanding of the dynamic relationships between problematic online video watching, boredom proneness and loneliness, highlighting the targeted prevention and interventions for first-year undergraduates.

Longitudinal relationship between internet addiction and psychotic-like experiences among Chinese college students

BACKGROUND

While previous cross-sectional studies have suggested a link between psychotic-like experiences (PLEs) and internet addiction (IA), longitudinal evidence remains scarce. This study aimed to explore the prospective relationship between IA and PLEs among college students.

METHOD

A total of 636 college students (80 % female) were assessed in November 2022 and again one year later. IA was measured using the Internet Addiction Diagnosis Questionnaire (IADQ), and PLEs were assessed with the 16-item Prodromal Questionnaire (PQ-16). Demographic, psychological, and environmental factors were collected and controlled. Multiple logistic regression and cross-lagged panel analyses examined the longitudinal associations between IA and PLEs.

RESULTS

At baseline, the prevalence of IA and PLEs was 11.3 % and 16.8 %, respectively. Higher baseline IADQ scores (Adjusted odds ratio = 1.035; 95 % confidence interval = 1.002-1.069; p = 0.036) were independently associated with an increased risk of PLEs at follow-up, while baseline PQ-16 scores were not linked to later IA. Cross-lagged panel analysis revealed that IA at baseline predicted later PLEs (β = 0.082, p = 0.043), whereas baseline PLEs did not predict IA (β = 0.049, p = 0.255). Specifically, IA predicted unusual thoughts (β = 0.122, p = 0.003) and negative PLEs (β = 0.111, p = 0.008), but not perceptual abnormalities (β = 0.040, p = 0.301).

CONCLUSION

IA may be an independent risk factor for PLEs in college students, particularly for unusual thoughts and negative PLEs, but not for perceptual abnormalities. Targeted interventions addressing IA may help reduce PLEs.

Characteristic Structure of the Relationships Among Depression, Maladaptive Cognition, and Internet Addiction and Its Temporal Evolution in University Students: A Network Analysis

This study explored the structure and temporal evolution of the relationship among depression, maladaptive cognition, and internet addiction (DMI) among university students by focusing on topological and dynamic properties in a network analysis. A 3-year longitudinal survey was conducted with 873 university students (Mage = 18.32, SD = 0.74). The results of network analysis showed "compulsive internet use and withdrawal symptoms" as part of internet addiction and "depressive emotions" as part of depression were the core characteristics in the DMI relational structure. Additionally, "compulsive internet use and withdrawal symptoms" was most pronounced for freshmen, whereas "depressive emotions" were most pronounced for sophomores and juniors. These findings suggest that interventions addressing DMI among university students should not only focus on the key aspects of "compulsive internet use and withdrawal symptoms" and "depressive emotions," but also consider differences between students at different years of study.

Childhood maltreatment and its dose-response relation with non-suicidal self-injury among adolescents: The mediating role of mobile phone addiction

OBJECTIVES

The associations between childhood maltreatment (CM) and mobile phone addiction (MPA), as well as non-suicidal self-injury (NSSI) have been extensively explored. However, the dose-response relationship between CM and NSSI remains inconsistent. Furthermore, there is limited understanding of the potential mediation effect of MPA on the relationship between CM and NSSI. This study aimed to explore the dose-response relationship between CM and NSSI and investigate the potential mediating role of MPA in this relationship.

STUDY DESIGN

Cross-sectional study. Cross-sectional study.

METHODS

In the cross-sectional study, a total of 21481 adolescents were selected using a multi-stage cluster sampling method in China. CM, MPA, and NSSI were obtained via self-reports. Data were analyzed using logistic regression models, restricted cubic spline (RCS) functions, and mediation models.

RESULTS

A total of 38.1 % of adolescents reported engaging in NSSI at least once. Compared with participants without CM, participants with more types of CM (cumulative childhood maltreatment, CCM) had a higher risk of NSSI (P-trend in all models <0.001). RCS further confirmed the dose-response relationships between the continuous change in CM (scores) and the risk of NSSI (P for non-linearity <0.001). Mediation analysis indicated that the relationship between CM (scores) and NSSI was mediated by MPA, and the indirect effect (β = 1.07 × 10-3, 95 % CI: 9.62 × 10-4, 1.19 × 10-3) accounted for 22.23 % of the total effect.

CONCLUSIONS

There was a dose-response relationship between CM and the NSSI, and the relationship was mediated by MPA. Interventions targeting MPA may reduce the risk of NSSI among adolescents who have experienced CM, particularly those with CCM.

Structural Validity of the Diagnostic Interview for Internet Addiction Scale for Clinical Samples in Korean Children and Adolescents: Exploratory and Confirmatory Factor Analysis

OBJECTIVE

This study aimed to validate the reliability and validity of the Diagnostic Interview for the Internet Addiction Scale (DIA) among Korean children and adolescents in the clinical setting.

METHODS

We collected the clinical data from university hospitals in South Korea and 194 children and adolescents (aged 7-18 years) completed the questionnaire. The content validity was conducted on 10 items of the DIA and an internal consistency test was performed for the verification of reliability.

RESULTS

Participants on average, aged 13.17 years (standard deviation=2.46), and 75.3% (n=146) were boys. The DIA was highly correlated with the scores of the Korean scale for Internet addiction for adolescents, Young's Internet Addiction Test, Internet addiction proneness scale for children and adolescents. The overall sampling suitability of the 10-item scale was tested using the Kaiser-Meyer-Olkin, resulting in a high value of 0.861. The DIA revealed a two-factor structure and the Cronbach's alpha correlation coefficient for the total scale was 0.806. Confirmatory factor analysis showed an acceptable model fit (root-mean square error of approximation=0.058, comparative fit index=0.950, and Tucker-Lewis Index=0.919).

CONCLUSION

The DIA may suggest in-depth-scale examinations of the factors that influence Internet addiction. We may expect that DIA would be used efficiently for the diagnosing of Internet addiction and further studies for the assessment.

Bayesian method for comparing F1 scores in the absence of a gold standard

In the field of medicine, evaluating the diagnostic performance of new diagnostic methods can be challenging, especially in the absence of a gold standard. This study proposes a methodology for assessing the performance of diagnostic tests by estimating the posterior distribution of the F 1 score using latent class analysis, without relying on a gold standard. The proposed method utilizes Markov Chain Monte Carlo sampling to estimate the posterior distribution of the F 1 score, enabling a comprehensive evaluation of diagnostic test methods. By applying this method to internet addiction, we demonstrate how latent class analysis can be effectively used to assess diagnostic performance, offering a practical solution for situations where no gold standard is available. The effectiveness of the proposed approach was evaluated through simulation studies by examining the coverage probability of the 95% highest density interval of the estimated posterior distributions.

Cross-cultural insights into internet addiction and mental health: a network analysis from China and Malawi

BACKGROUND

Internet addiction has emerged as a significant mental health issue among university students. The study aimed to compare the network structures of Internet addiction and mental health symptoms among university students in China and Malawi, which provide insights into culturally sensitive prevention and intervention strategies.

METHODS

Network analysis was used on two datasets: Malawi (n = 688) and China (n = 975) using the Internet Addiction Test and the Self-Reporting Questionnaire. Network estimation, centrality, bridge estimation and network comparison, were conducted using R software.

RESULTS

The prevalence of internet addiction and mental health was significantly higher in China than Malawi. In Malawi, the strongest edges were "school work" - "job performance" and "worthless" - "unable to play a useful part". The central nodes were "daily work suffering", "fantasize" and "lost interest". In China, the strongest edges were "neglect household" - "neglect partner" and "difficult to enjoy" - "daily work suffering". The central nodes were "trouble thinking", "unhappiness", and "unable to play a useful part". Bridge symptoms varied between the countries, with functional impairments (school work, daily work suffering and difficult to make decision) being more prominent in Malawi and emotional disturbances (daily work suffering, act annoyed and difficult to enjoy) in China.

CONCLUSIONS

The study highlights significant differences in the network structures of internet addiction and mental health between China and Malawi, which underscore the importance of culturally sensitive mental health interventions. In Malawi, addressing functional impairments related to academic and work performance is crucial, while in China, interventions should focus on emotional and relational aspects.

Risk perception of COVID-19, depressive symptoms and Internet addiction among undergraduates: a longitudinal study

Background

The COVID-19 pandemic has caused serious negative psychological effects worldwide, relatively little research has been performed on the potential enduring effects of COVID-19 on people's emotional health and Internet addiction. This study was to examine the longitudinal associations between risk perception of COVID-19, depressive symptoms, and Internet addiction among Chinese undergraduates.

Methods

We conducted a two-wave longitudinal survey by convenience sampling, a total of 1,153 Chinese undergraduate students completed questionnaires measuring their COVID-19 risk perception and post-traumatic growth (PTG) in December 2022 (T1) via an online survey. Subsequently, 1,008 of the T1 participants (87.42%) completed the depressive symptoms scale and Internet addiction scale 6 months later, in June 2023 (T2).

Results

(1) Risk perception of COVID-19 was significantly and positively predicted depressive symptoms and Internet addiction 6 months later; (2) Depressive symptoms played a mediating role between risk perceptions and Internet addiction; (3) PTG moderated the first-stage link between risk perception and Internet addiction, and this relationship was more robust for low PTG than for high PTG.

Conclusion

These findings advance our understanding of the relationship and mechanisms between risk perception of COVID-19 and Internet addiction, and further support developing interventions to strengthen PTG for mitigating negative outcomes during major crises.

Exploring the association between sleep quality, internet addiction, and related factors among adolescents in Dakshinkali Municipality, Nepal

BACKGROUND

Poor sleep quality and internet addiction are significant issues affecting adolescents globally, and Nepal is no exception. Several studies have independently assessed the prevalence and associated factors of poor sleep quality and internet addiction among Nepali adolescents and youth, but the relationship between sleep-related attributes and internet addiction remains unexplored. This study aimed to explore the prevalence and contributing factors of poor sleep quality and internet addiction along with the relationship between sleep quality-related attributes and internet addiction.

MATERIAL AND METHODS

A cross-sectional study was conducted among 243 adolescents of Dakshinkali Municipality, Nepal. Pittsburgh Sleep Quality Index and Young's Internet Addiction Test scale were used to measure sleep quality and internet addiction. Pearson's chi-square test and binary logistic regression were performed at a 5% level of significance to examine the associated factors.

RESULTS

The prevalence of poor sleep quality was 27.6% (95% CI: 22.6-33.7) while potential internet addiction was 49.4% (95% CI: 42.0-56.7). Poor sleep quality was associated with internet addiction (aOR: 1.845; 95% CI: 1.344-3.608), poor perceived relation with teachers (aOR: 2.274; 95% CI: 1.149-4.497), and presence of family conflict (aOR: 2.355; 95% CI: 1.040-5.329). Bad subjective sleep quality (aOR: 5.613; 95% CI: 2.007-15.701), sleep disturbance (aOR: 1.781; 95% CI: 1.251-4.872), frequent daytime dysfunction (aOR: 1.902; 95% CI: 1.083-4.638), and poor perceived relation with teachers (aOR: 2.298; 95% CI: 1.233-4.285), and presence of family conflict (aOR: 1.606; 95% CI: 1.202-3.675) were associated with internet addiction.

CONCLUSION

Almost a quarter of adolescents' experience poor sleep quality, while nearly half screened positive for potential internet addiction. Established interrelations between sleep quality and internet usage underscore the importance of integrated intervention approaches combining lifestyle modification and family/school support to protect and promote the mental health and well-being of Nepalese adolescents.

The Relationship Between Empirical Avoidance, Anxiety, Difficulty Describing Feelings and Internet Addiction Among College Students: A Moderated Mediation Model

With the increasing detection rate of Internet addiction in college students, the correlation between Internet addiction and emotional problems is further strengthened. Therefore, it is crucial to actively investigate the emotional mechanisms underlying college students' internet addiction to foster their healthy development. This study establishes a moderated mediation model based on the relationships among experiential avoidance, internet addiction, anxiety, and difficulty describing feelings to explore the link between experiential avoidance and internet addiction, the mediating role of anxiety, and the moderating effect of difficulty describing feelings. The study collected data from 1,591 Chinese college students across seven provinces (municipalities), utilizing measures such as the Experiential Avoidance Questionnaire, the Internet Addiction Scale, the Anxiety Subscale, and the Difficulty Describing Feelings Scale. A cross-sectional analysis was conducted to further investigate the potential emotional mechanisms behind college students' internet addiction. The results indicated that experiential avoidance significantly predicts internet addiction among college students, with anxiety mediating the relationship between experiential avoidance and internet addiction. Additionally, difficulty describing feelings moderate the relationship between experiential avoidance and anxiety. These findings further suggest that emotional disorders such as experiential avoidance, anxiety, and difficulty describing feelings are potential risk factors behind college students' internet addiction. The study recommends enhancing psychological counseling and other intervention measures in interventions for college students' internet addiction.

Socioeconomic status and internet addiction: double-mediated moderation

BACKGROUND

Internet addiction is typically linked with a variety of psychological and behavioral problems, the prevalence of Internet addiction among Chinese college students was higher than that of the general population.

OBJECTIVE

The present study aimed to test the mediating and moderating effects of socioeconomic status (SES), loneliness, alienation and grade on Internet addiction among Chinese college students.

METHODS

Total of 496 college students were studied, partial least square structural equation modeling (PLS-SEM) was conducted to analyze the obtained data.

RESULTS

The study found that SES can negatively predict Internet addiction (β=-0.145, p < 0.001). Moreover, loneliness and alienation play separate (β=-0.098, p < 0.001; β=-0.046, p < 0.01) and serial (β=-0.071, p < 0.001) mediating roles between SES and Internet addiction, and multigroup analysis showed that grade (sophomore year as the baseline) plays a moderation role in the association between SES → Internet addiction (sophomores vs. juniors; β = 0.249, p < 0.05) and SES →loneliness (sophomore vs. seniors; β = 0.255, p < 0.05). The VAF value was 70.27% for the mediation effect of the loneliness and alienation in the relationship between SES and Internet addiction.

CONCLUSIONS

SES not only has a direct effect on college students' Internet addiction behavior but also has an indirect effect on it through the chain mediation effect of loneliness and alienation. The study reveals that grade level moderates the effects, suggesting tailored interventions are needed. This research could inform measures to mitigate addiction by addressing SES, loneliness, and alienation.

A Multi- Mediation Analysis on the Impact of Social Media and Internet Addiction on University and High School Students' Mental Health Through Social Capital and Mindfulness

INTRODUCTION

Social media addiction (SMA) and internet addiction (IA) are increasingly prevalent, impacting mental health (MH) globally. This study investigates the mediating roles of mindfulness and social capital (SC) in the relationship between SMA, IA, and MH among Ethiopian high school and university students, contributing to the Sustainable Development Goal (SDG) 3 of good health and well-being.

METHODS

A cross-sectional study was conducted with 1160 university and 1473 high school students in Dessie, Ethiopia. Participants completed validated questionnaires assessing SMA, IA, mindfulness, SC, and MH. Structural Equation Modeling (SEM) with a multi- mediation Model (SMM) was used to examine the hypothesized relationships.

RESULTS

SEM revealed that both SMA and IA had a direct negative effect on mindfulness, SC, and MH in in both high school and university students. Notably, mindfulness and SC significantly and positively predicted MH, indicating their protective role against the negative effects of SMA and IA. Furthermore, both mindfulness or SC fully or partially mediated the relationship between SMA, IA, and MH, highlighting their crucial role in explaining the association.

CONCLUSIONS

This study provides evidence for the crucial roles of mindfulness and SC in buffering the negative effects of SMA and IA on MH among Ethiopian students. The findings highlight the need for educational and health interventions that foster mindfulness and SC to enhance student mental health and promote a healthy digital environment. These results offer valuable insights for educators, health professionals, and policymakers in Ethiopia and other developing countries facing similar challenges.

Online social support and problematic Internet Use-a meta-analysis

INTRODUCTION

The internet is a crucial platform for individuals to gain social support, enhancing their well-being. However, research indicated that while online social support (OSS) has positive aspects, it also carries potential drawbacks and can lead to problematic Internet use (PIU). This study aims to examine the complex relationship between OSS and PIU.

METHODS

Adhering to the PRISMA guidelines, a systematic literature search was performed across five English and three Chinese databases. A total of 1966 articles were initially screened by title, followed by abstract, and finally, full text. And the random-effects model was used to synthesize the included 31 studies.

RESULTS

31 studies were identified, encompassing a total sample of 22,375 participants. Meta-analysis revealed a moderate and significant correlation between OSS and PIU (r = 0.293), and it was significantly moderated by gender and the measurement methods of PIU. Notably, the relationship was more pronounced in studies with a higher proportion of female participants; when PIU was measured by problematic social media use, the relationship with OSS was stronger than studies that measured PIU by general problematic Internet use or problematic mobile phone use.

CONCLUSION

These findings contribute to a comprehensive understanding of the association between OSS and PIU, and carry implications for identifying and addressing the potential risks associated with social support provision in the digital realm.

Effects of exercise interventions on Internet addiction among college students: A systematic review and meta-analysis of randomized controlled trials

BACKGROUND

Internet addiction (IA) has gradually emerged as a significant public health concern, especially among college students. This study aims to systematically investigate and quantitatively analyze the effects of exercise interventions on IA among college students and provides an objective assessment of the available evidence. For this study, IA is defined as compulsive, excessive Internet use, including via mobile phones, that disrupts daily life and causes significant distress, and we combine Internet addiction and mobile phone addiction in our analysis to provide a comprehensive understanding of this phenomenon.

METHODS

The search for eligible studies was conducted from inception until May 2024 across various databases including Web of Science, PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), and Wan Fang. The risk of bias within the included studies was assessed utilizing the Cochrane Collaboration's risk of bias tool, while methodological quality was evaluated using the modified Jadad Scale.

FINDINGS

A meta-analysis of 19 pairwise comparisons showed that exercise interventions significantly reduced the total IA scores (g = -1.25). Furthermore, the interventions resulted in significant reductions in anxiety (g = -1.30), loneliness (g = -1.57), stress (g = -0.77), inadequacy (g = -1.77), mental health (g = -1.08), fatigue (g = -0.66), and depression (g = -0.56).

CONCLUSIONS

Exercise interventions showed efficacy in decreasing levels of IA and alleviating psychological symptoms in college students with IA. The optimal types of exercise for college students suffering from IA are open motor skill and the combination of both open and closed skill. However, future work is needed given the limited randomized controlled trials and the high heterogeneity of the included studies.

Similarities and differences in core symptoms of problematic smartphone use among Chinese students enrolled in grades 4 to 9: A large national cross-sectional study

Children and adolescents are highly susceptible to problematic smartphone usage. We employed network analysis to explore the similarities and differences in the core symptoms of problematic smartphone use across grades 4-9, using a large nationwide sample. This study included 8552 children and adolescents (Mage = 12.98, SD=1.51) who met the critical value for problematic smartphone use. The results showed that the core symptoms of problematic smartphone use exhibit both similarities and differences between grades 4 and 9. 'Withdrawal symptoms' and 'preoccupation symptoms' were the stable core symptoms of problematic smartphone use across grades 4 to 9, suggesting that problematic smartphone use begin to appear from earlier grades, such as grade 4. 'Feel impatient and fretful', 'never give up' and 'always thinking about' were the core symptoms in grades 4 and 5. 'Longer than I had intended' and 'hard to concentrate' emerged as additional core symptoms in grade 6, with the intensity indicators peaking in grades 8 and 9, suggesting that the issue of problematic smartphone use among Chinese children and adolescents has become intensified and intricate. Symptoms of problematic smartphone use vary across grades and exhibit both continuity and stage specificity. Consequently, to address this issue, the formulation of intervention measures should comprehensively consider both the grade levels and symptoms.

The effect of TikTok use on internet addiction of college students in Somalia: a cross-sectional study

This study aimed to assess the effect of TikTok use on the internet addiction of college students in Somalia. This cross-sectional study was conducted with 210 students at the faculty of health sciences of a university in Mogadishu, Somalia. The data were obtained with the Individual Information Form and Young Internet Addiction Test-Short Form. The students' internet addiction average score was 31.93±7.14. A positive, very weak, significant correlation was determined between the students' daily time spent on TikTok and internet addiction (r=.190, p=.006). Internet addiction scores of students having a TikTok account and using the TikTok application were found to be significantly higher than students not having (p=.027) and not using the application (p=.032). This study shows that most students had a TikTok account and actively used this application, and their internet addiction level was moderate. The students having a TikTok account and using the application had higher internet addiction.

The Association of Sleep Quality and Internet Addiction With Health Status in Hospital Nurses

AIM

The aims of this study were to explore the correlation of sleep quality and Internet addiction (IA) with the health status of hospital nurses and to investigate whether sleep quality is a mediator in the influence of IA on the health of the nurses.

BACKGROUND

Excessive Internet use is a public health concern. However, few researchers have investigated the interrelationship of the IA, sleep quality, and health status of hospital nurses.

DESIGN

This study used a descriptive and cross-sectional design.

METHODS

The study was conducted using survey data from a medical center in Taiwan. The Chen Internet Addiction Scale, Chinese version of the Pittsburgh Sleep Quality Index, and Chinese Health Questionnaire-12 were provided to the participants. Independent t tests, chi-square test, and structural equation model were performed for analysis.

RESULTS

A total of 628 participants were recruited. The participants with IA exhibited significantly worse health status and poorer sleep quality compared with the participants without IA. Participants with poor sleep quality exhibited significantly worse health status and higher IA than those with normal sleep quality. The influence of IA on health status was indirect, with sleep quality as a mediator.

CONCLUSIONS

Hospital nurses with IA or poor sleep quality exhibited poor health status. Sleep quality mediated the influence of IA on the health status of the nurses. Hospital administrators should identify nurses at a high risk of IA, provide support strategies, and schedule work shifts more reasonably to improve their sleep quality. The hospital nurses' health and patients' safety could be further protected.

Age Differences in the Associations Between Interpersonal Relationships and Short-Form Video Addiction Symptoms: A Network Analysis

Purpose

A considerable body of evidence indicated that interpersonal relationships were significantly associated with short-form video addiction (SFVA) among adolescents, but how they are related on a symptom level at different ages remains unclear. This study aimed to explore the central symptoms of SFVA and distinct associations between three primary interpersonal relationships (ie, teacher-student relationships, parent-child relationships, peer relationships) and SFVA symptoms in early and middle adolescence.

Participants and Methods

After completing scales of SFVA, teacher-student relationship, parent-child relationship and peer relationship in 2022, a sample of 1579 fourth-grade students (age range: 10-12; M age = 10.91, SD = 0.48; 38.6% females) and 2229 eighth-grade students (age range: 13-15; M age = 14.82, SD = 0.36; 44.5% females) who were at high risk of SFVA were included in this study. A network analysis approach was conducted to analyze the data.

Results

SFVA3 hard to control and SFVA2 increasing time for satisfaction were the most central symptoms of SFVA in both early and middle adolescence. Among interpersonal relationships, teacher-student relationships and peer relationships were the most influential bridge nodes that exerted the largest impact on SFVA in early and middle adolescence, respectively. Comparison of the networks indicated no significant differences in overall network structures, global strength and most edge connections between early and middle adolescence.

Conclusion

These findings uncover the interconnections between heterogeneous SFVA symptoms and underscore the unique importance of teacher-student relationships and peer relationships on SFVA in different stages of adolescence, which can be harnessed in the design of future preventive interventions.

The relationships between short video addiction, subjective well-being, social support, personality, and core self-evaluation: a latent profile analysis

BACKGROUND

The proportion of short video addiction (SVA) is increasing among different populations, and its impact on the adolescent group has attracted research attention in recent years. To better explore the heterogeneity of individuals addicted to short videos and the antecedents of their addiction, the present study used quantitative research to conduct a latent profile analysis (LPA) of college students' SVA from the perspective of internal and external resources.

METHODS

Referring to the Interaction of Person-Affect-Cognition-Execution (I-PACE) theory, this study explores the relationship between subgroups of SVA on the one hand and subjective well-being (SWB), social support (SS), core self-evaluation (CSE), and extraversion on the other using latent profile analysis. The research participants consisted of 694 college students aged between 18-25 years. The research tools used were the SVA Scale for College Students, Subjective Well-Being Scale, Perceived Social Support Scale, Core Self-Evaluation Scale, and the Big Five Personality Traits Scale.

RESULTS

The results revealed three subtypes of adolescent SVA: high (28.8%), medium (56.6%), and low (14.6%), demonstrating significant heterogeneity among groups. These groups also showed significant differences in terms of their internal and external resource scores. Specifically, the high-addiction group scored significantly lower on extraversion and SS than the other two groups. The medium-addiction group had the lowest score on CSE among the three groups. The low-addiction group scored significantly higher on SS, CSE, and SWB compared with the high-addiction and medium-addiction groups.

CONCLUSION

This study reveals that students with low extraversion, low SS and CSE scores tend to become addicted to short videos. SVA has negatively affected these personal traits. Our study explored the heterogeneity of SVA among college students from an individual-centered perspective, providing empirical support for scientifically and reasonably guiding the use of short videos among college students.

Associations between internet addiction and suicidal ideation in depressed adolescents: the mediating effect of insomnia as well as sex differences

BACKGROUND

Insomnia may mediate the association between internet addiction (IA) and suicidal ideation (SI). However, such association has not been thoroughly investigated in adolescents with major depressive disorder (MDD). Thus, our study aimed to explore whether insomnia significantly affects the association between IA and SI in adolescents with MDD, as well as any sex differences.

METHODS

From January 2021 to September 2023, this cross-sectional study included 502 adolescents with MDD and 123 healthy controls (HCs). The Clinical Global Impression-Severity (CGI-S), the Internet Addiction Test (IAT), the Insomnia Severity Index Scale (ISI) and the Positive and Negative Suicidal Ideation Scale (PANSI) were used to assess subjects' severity of depression, IA, insomnia and SI. And we employed the PROCESS macro program to examine the mediating role of insomnia between IA and SI.

RESULTS

Compared to HCs, adolescents with MDD had significantly higher levels of SI and their prevalence of IA and insomnia were 50.0% and 35.7%. In patients, PANSI scores correlated negatively with age and age of onset, and positively with disease duration as well as the scores of the CGI-S, IAT, and ISI (all p < 0.01). Moreover, above-mentioned correlations were more significant in girls. Mediation analyses showed that insomnia mediated the effect of IA on SI, and the total, direct, and indirect effects were 0.197 (95% CI: 0.132-0.262), 0.157 (95% CI: 0.096-0.218) and 0.040 (95% CI: 0.014-0.068), respectively. In female patients, the total, direct, and indirect effects were 0.224 (95% CI: 0.151-0.296), 0.191 (95% CI: 0.124-0.257) and 0.033 (95% CI: 0.002-0.068), respectively. In male patients, insomnia acted as a fully mediated effect between IA and SI, with an effect value of 0.045 (95% CI: 0.008-0.093).

CONCLUSION

Depressed adolescents have higher suicide risk, and SI is significantly associated with IA and insomnia, especially in girls. Moreover, insomnia may mediate the association between IA and SI. However, given the small sample size of this study and the limitations of assessment tools used, the results need to be viewed with caution. Regardless, clinical interventions should be strengthened for IA and insomnia in adolescents with MDD to reduce suicide risk.

Analysis of Influencing Factors and Construction of Nomogram of School Bullying Suffered by Middle School Students in Beijing in 2022

Purpose

School bullying has become increasingly serious among children, causing serious damage to their physical and mental health. Previous studies lacked data on bullying of middle school students in Beijing and rarely visualized the risks of bullying. This study investigated the situation and related risk factors of school bullying of middle school students in Beijing in 2022 and established a Nomogram prediction model to visualize the risk of school bullying for its prevention.

Methods

This study is a cross-sectional survey conducted from September 2022 to November 2022 to investigate the bullying situation and related risk factors of the 17729 middle school students in 16 districts of Beijing. Logistic regression is used to analyze the influencing factors of bullying, and then a Nomogram prediction model is established to quantitatively analyze the risk of bullying.

Results

In 2022, 2.69% of middle school students in Beijing reported being bullied. Multivariate analysis results showed that in the past 30 days, being beaten by parents, abnormal families, poor diet, depression, and internet addiction were risk factors for school bullying. Being female, non-residents, moderate-to-high-intensity exercise 3 to 4 days per week, and 2 to 3 physical education classes per week were protective factors against bullying.

Conclusion

Parents, schools, and society should form a joint force, pay attention to parent-child relationships and mental health, encourage students to go outside, strengthen physical exercise, and prevent the occurrence of school bullying.

The relationship between parental smartphone dependence and elementary students' internet addiction during the COVID-19 lockdown in China: the mediating role of parent-child conflict and the moderating role of parental roles

During the COVID-19 lockdown in China, the shift of family members' work and study to online platforms accelerated internet proliferation and led to a growing prominence of internet addiction among younger age groups, posing a threat to individual and societal health development. Previous research has primarily focused on upper-grade elementary students, with relatively less attention given to younger age groups, resulting in insufficient representativeness of the elementary student samples. Additionally, research exploring how parental addictive behaviors are associated with the mechanisms of internet addiction among elementary students has been limited, which affects the development of scientifically based and effective intervention measures for addressing internet addiction in this population. This study, grounded in Family Systems Theory, explores the associative mechanisms between parental smartphone dependence and elementary students' internet addiction, specifically examining the mediating role of parent-child conflict and the moderating role of parental roles. Using a convenience sampling method, questionnaires were administered to parents from two elementary schools, resulting in 433 valid responses. Structural equation modeling analysis revealed that parental smartphone dependence is associated with elementary students' internet addiction and that this association is further influenced by the mediating role of parent-child conflict. Additionally, parental roles moderate the relationships between parental smartphone dependence and parent-child conflict, as well as between parent-child conflict and elementary students' internet addiction. Compared to mothers, fathers' smartphone dependence is more significantly correlated with parent-child conflict, and conflicts initiated by fathers are more strongly associated with elementary students' internet addiction. This may be related to China's traditional "male breadwinner, female homemaker" family culture. Mothers typically assume more parenting responsibilities and establish closer emotional bonds with their children, serving as a protective factor against internet addiction. Therefore, it is recommended that parents reduce smartphone dependence to avoid parent-child conflicts, and that fathers increase their involvement in parenting activities to build stronger emotional connections with their children, thereby fostering healthier internet use behaviors among elementary students. The findings provide valuable insights for developing effective family-based interventions to address internet addiction in children.

The TikTok Addiction Scale: Development and validation

Background

There is an absence of valid and specific psychometric tools to assess TikTok addiction. Considering that the use of TikTok is increasing rapidly and the fact that TikTok addiction may be a different form of social media addiction, there is an urge for a valid tool to measure TikTok addiction.

Objective

To develop and validate a tool to measure TikTok addiction.

Methods

First, we performed an extensive literature review to create a pool of items to measure TikTok addiction. Then, we employed a panel of experts from different backgrounds to examine the content validity of the initial set of items. We examined face validity by performing cognitive interviews with TikTok users and calculating the item-level face validity index. Our study population included 429 adults who have been TikTok users for at least the last 12 months. We employed exploratory and confirmatory factor analysis to examine the construct validity of the TikTok Addiction Scale (TTAS). We examined the concurrent validity by using the Bergen Social Media Addiction Scale (BSMAS), the Patient Health Questionnaire-4 (PHQ-4), and the Big Five Inventory-10 (BFI-10). We used Cronbach's alpha, McDonald's Omega, Cohen's kappa, and intraclass correlation coefficient to examine reliability.

Results

We found that the TTAS is a six-factor 15-item scale with robust psychometric properties. Factor analysis revealed a six-factor structure, (1) salience, (2) mood modification, (3) tolerance, (4) withdrawal symptoms, (5) conflict, and (6) relapse, which accounted for 80.70% of the total variance. The concurrent validity of the TTAS was excellent since we found significant correlations between TTAS and BSMAS, PHQ-4, and BFI-10. Cronbach's alpha and McDonald's Omega for the TTAS were 0.911 and 0.914, respectively.

Conclusion

The TTAS appears to be a short, easy-to-use, and valid scale to measure TikTok addiction. Considering the limitations of our study, we recommend the translation and validation of the TTAS in other languages and populations to further examine the validity of the scale.