Epidemiology of internet behaviors and addiction among adolescents in six Asian countries

Quantifying gender differences in the impact of internet addiction on adolescent depression: A causal inference approach

BACKGROUND

The rising prevalence of adolescent depression in China has raised concerns about internet influence. This study identified predictors of internet addiction (IA) and quantified its gender-specific impact on depression.

METHOD

In April-May 2023, 8176 adolescents from six (6) junior high schools in Henan, China, were randomly sampled. IA and depression were assessed via the 20-item internet addiction test (IAT) and 10-item Center for Epidemiologic Studies Depression (CESD-10) scale, respectively. IA's impact on depression was analyzed using four approaches: IPW (confounder weighting), DML (high-dimensional control), PSM (covariate balancing), and RA (residual adjustment).

RESULTS

Among the males, 31.8 % reported depression and 17.7 % reported IA while females, 49.4 % reported depression and 21.3 % IA. The mean ages were 14.5 ± 0.94 (males) and 14.4 ± 0.93 (females). DML revealed the overall effect of 0.22 (95 % CI: 0.17-0.23; p < 0.001), higher in males (95 % CI: 0.23, 95 % CI: 0.18-0.31) than females (0.17, 95 % CI: 0.11-0.23). IPW estimated an effect of 0.30 (95 % CI: 0.25-0.34; p < 0.001), also higher in males (0.34, 95 % CI: 0.28-0.39) than females (0.29, 95 % CI: 0.23-0.36). PSM and RA yielded similar results. Predictors of IA included low self-esteem, history of negative life events, poor sleep quality, and one-child family status.

CONCLUSION

Internet addiction (IA) exacerbates adolescent depression, disproportionately affecting males. Addressing self-esteem, negative life events, poor sleep, and one-child family challenges can mitigate IA's effects. Gender-sensitive interventions, school-based programs, and parental guidance are critical.

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.

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.

Psychological Compensation or Drinking Poison to Quench Thirst: The Dual Effects of Smartphone Use Habits on Depression in Chinese Left-Behind Adolescents

With the popularity of smartphones, their impact on the physical and mental health of left-behind adolescents has become the focus of social attention. Some believe that smartphone use will provide emotional compensation for left-behind adolescents, while others believe that the lack of supervision of smartphone use among left-behind adolescents will exacerbate their psychological problems. To explore the mechanisms of the dual effects, we conducted a field survey of 848 left-behind adolescents (male = 446, age between 12 and 19) in Shicheng County in Gannan Region of China. It was found that social smartphone use, recreational smartphone use, frequency, and duration of smartphone use, mediated by smartphone dependence, were positively associated with social anxiety, stress perception, and sleep disorder, and further with depression of left-behind adolescents. Although social uses of smartphones were positively associated with online social support, they were not related to loneliness and depression. Based on our results, left-behind adolescents' smartphone use habits have shown more harmful than good effects on their psychological well-being.

Development of the psychopathological vulnerability index for screening at-risk youths: a Rasch model approach

Accumulating research on mental health emphasizes the general factor of psychopathology (p-factor) that unites various mental health issues. This study develops a psychopathological vulnerability assessment for youths, evaluating its psychometric properties and clinical utility. An umbrella review conceptualized multifactor psychopathological vulnerability, leading to a 57-item pool. A total of 11,224 individuals participated in this study. The resulting 22-item psychopathological vulnerability index (PVI) fitted the unidimensional Rasch model, demonstrating a person separation reliability of 0.78 and a Cronbach's alpha of 0.84. Cut-off points of 11 and 5, derived from latent class analysis, were used to distinguish vulnerable and high-protection populations. The PVI's concurrent and predictive hit rates ranged from 36.00% to 53.57% in clinical samples. The PVI concretized the vulnerability-stress model for identifying at-risk youths and may facilitate universal interventions by integrating the theoretical foundations of bifactor S-1 models with key symptoms from network models for theoretically grounded approaches.

The Impact of Digital Devices on Children's Health: A Systematic Literature Review

BACKGROUND

The impact of prolonged digital device exposure on physical and mental health in children has been widely investigated by the scientific community. Additionally, the lockdown periods due to the COVID-19 pandemic further exposed children to screen time for e-learning activities. The aim of this systematic review (PROSPERO Registration: CRD42022315596) was to evaluate the effect of digital device exposure on children's health. The impact of the COVID-19 pandemic was additionally explored to verify the further exposure of children due to the e-learning environment.

METHODS

Available online databases (PubMed, Google Scholar, Semantic Scholar, BASE, Scopus, Web of Science, and SPORTDiscus) were searched for study selection. The PICO model was followed by including a target population of children aged 2 to 12 years, exposed or not to any type of digital devices, while evaluating changes in both physical and mental health outcomes. The quality assessment was conducted by using the Joanna Briggs Institute (JBI) Critical Appraisal Tool. Synthesis without meta-analysis (SWiM) guidelines were followed to provide data synthesis.

RESULTS

Forty studies with a total sample of 75,540 children were included in this systematic review. The study design was mainly cross-sectional (n = 28) and of moderate quality (n = 33). Overall, the quality score was reduced due to recall, selection, and detection biases; blinding procedures influenced the quality score of controlled trials, and outcome validity reduced the quality score of cohort studies. Digital device exposure affected physical activity engagement and adiposity parameters; sleep and behavioral problems emerged in children overexposed to digital devices. Ocular conditions were also reported and associated with higher screen exposure. Home confinement during COVID-19 further increased digital device exposure with additional negative effects.

CONCLUSIONS

The prolonged use of digital devices has a significant negative impact on children aged 2 to 12, leading to decreased physical activity, sleep disturbances, behavioral issues, lower academic performance, socioemotional challenges, and eye strain, particularly following extended online learning during lockdowns.

Unveiling the YouTube addiction: Understanding the spectrum of digital dependency

Background

Excessive use of YouTube is increasingly being as a source of technological addiction in both adolescent and adult population worldwide.

Objective

The aim of this study is to assess YouTube addiction among adolescents and adults and the ways to reduce its usage.

Methods

After obtaining Institutional ethical clearance and informed consent, we collected data from adolescent and adult male and female using a 22-item YouTube addiction scale (YAS) questionnaire. Face-to-face interview was conducted by the principal investigator. The principal component analysis (PCA) of the YAS questionnaire was performed. Manual content analysis was conducted for the qualitative data.

Results

We enrolled 54 (50.9%) male and 52 (49.1%) female participants. The majority of them use YouTube and Instagram. Severely addicted were 38.7%, who spent all seven days watching YouTube videos. A principal component analysis revealed a four-component YAS structure based on an eigenvalue cutoff (>1), Kaiser-Meyer-Olkin (KMO) measure of sampling adequacy was more than 0.5, and Bartlett's test of sphericity was <0.001. We grouped 22 items into four dimensions: Impaired control, decrease alternate pleasure, intense desire, and measures taken to reduce usage.

Conclusion

Behaviour modification needed to promote healthier YouTube usage habits.

Exploring the Relationship of Smartphone Addiction on Attention Deficit, Hyperactivity Symptoms, and Sleep Quality Among University Students: A Cross-Sectional Study

BACKGROUND

The prevalence of smartphone usage is steadily rising, leading to the potential development of addiction due to problematic use. This study examined the relationship between smartphone addiction, self-perceived attention deficit and hyperactivity symptoms, and sleep quality among 443 university students at Bingöl University.

METHODS

Participants completed several questionnaires, including the Smartphone Addiction Scale-Short Version, the Pittsburgh Sleep Quality Index, and the Adult ADHD Self-Report Scale.

RESULTS

This study examined 443 participants, with a mean age of 20.97 ± 3.29, of whom 72.7% (n = 322) were female. Results showed that the majority of participants primarily used smartphones (94.8%, n = 420) for social media browsing (49.9%, n = 221). Factors such as smoking, preference for smartphone screens, and prolonged screen exposure significantly affected sleep quality. Smartphone addiction rates were notable, with 50.4% (n = 61) of males and 47.2% (n = 152) of females being affected; this addiction was associated with poorer sleep quality. Correlations were found between age, sleep duration, and scores on smartphone addiction, sleep quality, and attention deficit scales. Linear regression analysis revealed that age, attention deficit scores, and sleep quality scores significantly influenced levels of smartphone addiction.

CONCLUSIONS

These findings contribute valuable insights into the impact of smartphone addiction on attention and sleep in university students.

Family factors related to adolescent screen media use and mental health outcomes: A systematic review and recommendation for practices

INTRODUCTION

Screen media serves an essential role in adolescents' lives, posing growth opportunities and mental health challenges. Family plays a crucial role in mitigating these challenges. This systematic review offers a comprehensive analysis of the family factors related to adolescent screen media use and mental health.

METHODS

A systematic search was conducted in PubMed, CINAHL, PsycINFO, Scopus, and Embase, adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines using the following inclusion criteria: English, peer-reviewed, observational design, and published since 2013; adolescent samples aged 10-17 years; and examining screen media use, family factors, and internalizing problems. The role of family factors as predictors, moderators, and mediators was also examined.

RESULTS

Of the 3587 records, 32 met the inclusion criteria. These studies, primarily cross-sectional, presented a global perspective of 14 countries. A heterogeneous range of family factors, screen media use, and mental health outcomes were examined, revealing significant associations between elevated screen media use and internalizing problems. Positive family processes and democratic media-specific parenting mitigate such association. A few studies underscored family socioeconomic status (SES), noting elevated screen media use and mental health risks among adolescents in families of low SES.

CONCLUSIONS

Accumulating evidence supports the important role of positive family contexts in fostering balanced screen media use and mental health in adolescents, accentuating the need for professional screening and education to promote positive screen media use among adolescents and families. Further research requires refinement in measurement and methodology to better capture the intricate relationship between family dynamics, screen media use, and adolescent mental health.

School Bullying Victimization and Depression Symptoms in Adolescents: The Mediating Role of Internet Addiction and Moderating Role of Living Areas

School bullying and depression are both serious social and public health problems among adolescents. Prior studies indicated a correlation between bullying and depression. However, the potential moderators remain largely unexplored. This study aimed to identify the mediating effect of Internet addiction and the moderating effect of living in urban or rural areas in the relationship between school bullying victimization and depression symptoms among Chinese adolescents. This cross-sectional study of adolescents was conducted using two-stage random cluster sampling of students in urban and rural public high schools in China. A moderated mediation model was constructed to uncover the underlying mechanism of school bullying victimization and depression symptoms. A total of 2,376 adolescents (52.65% females, mean age ± SD a 14.69 ± 1.76 years) were included in the study. The prevalence of clinical depression symptoms with a cut-off value of 16 on the Center for Epidemiological Studies Depression Scale (CES-D) was 21.76% (95% CI: 20.15, 23.46), and with a cut-off value of 20 on the CES-D was 13.85% (95% CI: 12.51, 15.30) for overall. Our findings indicated a significant positive association between school bullying victimization and depression symptoms (p < 0.01) and a significant mediating effect of Internet addiction in the association between school bullying victimization and depression symptoms (indirect effect = 1.143, 95% CI: 0.677, 1.609; percentage of mediation: 16.7%, 95% CI: 10.3, 23.1). This indirect relationship was partially moderated by the living in urban or rural areas in the mediation process. Specifically, the effect of school bullying victimization on Internet addiction was greater among urban adolescents (simple slope: 0.774, 95% CI: 0.524, 1.024, p < 0.01) than among rural adolescents (simple slope: 0.337, 95% CI: 0.132, 0.543, p < 0.01), but moderating effect of urban-rural areas was not significant on the relationship between Internet addiction and depression symptoms. These findings highlight the mediating role of Internet addiction and the moderating role of living areas in school bullying victimization and adolescents' depression symptoms, which provide evidence for social work, mental health services, and policy interventions for adolescents in China.

Associations between cognitive disengagement syndrome, Internet addiction, and Internet gaming disorder among medical students - A cross-sectional study

Background

Internet addiction (IA) and gaming disorder (IGD) are emerging public health concerns among youth. Sluggish cognitive tempo (SCT)/cognitive disengagement syndrome has been linked with risky online behaviors, but the literature on medical students is limited.

Aim

To determine associations between SCT, IA, and IGD in Indian medical undergraduates.

Materials and Methods

The study included 303 medical students (ages: 18-24, 66% male). The Sociodemographic Information Form, Barkley SCT Scale, Young Internet Addiction Test-Short Form, and The Digital Game Addiction Scale were utilized to collect data. Contingency Table analyses, Mann-Whitey U-test, Chi-square test, and correlation analyses were used for analysis.

Results

The prevalence of IA and IGD was 101 (33.3%) and 61 (20%), respectively. Students with IA or IGD had significantly higher SCT, daydreaming, and sluggishness scores (P < 0.01). SCT, daydreaming, and sluggishness showed significant positive correlations with IA and IGD severity (P < 0.01).

Conclusion

Greater SCT symptoms demonstrated significant associations with increased risk of IA and IGD among medical students. Screening for SCT alongside IA and IGD may enable targeted interventions to promote healthy Internet use.

Family functioning and problematic usage of the internet in youth: A cross-sectional investigation

BACKGROUND

Problematic usage of the internet (PUI) refers to maladaptive use of the Internet linked to functional impairment as a growing concern in many countries. Youths are often considered more vulnerable to PUI than other age groups. The relationship between PUI and family dynamics is likely bidirectional and complex, warranting further research. Using a cross-sectional study design, we aimed to determine the rate of PUI and the association between PUI and family functioning in a South African sample between the ages of 18 and 30 years.

METHODS

South African youths were recruited via email and social media. Respondents completed an online survey as part of a cross-sectional study to assess the extent and the types of activities for which they use the internet, as well as the quality of their family relationships and functioning, employing standardised questionnaires (including the IAT-10) and the General Functioning Scale of the Family Assessment Device (GF-FAD). The sample included 814 participants (65% female; aged 21 years; SD 3 years).

RESULTS

15.5% of our sample presented with PUI. There was a significant, moderate positive correlation between totals on the IAT-10 and GF-FAD (r = 0.33, p < .001). An independent samples t-test found that individuals with self-reported PUI (GF-FAD: M = 2.57, SD = 0.51) had significantly poorer quality family functioning than individuals without PUI (GF-FAD: M = 2.13, SD = 0.61; t (812) = -7.52, p < .001; Cohen's d = -0.73, 95% CI [-0.92, -0.54]). Correlations were found between increased time spent on various online activities, including pornography (r = 0.20, p < 0.001), cyberbullying (r = 0.17, p < 0.001), social networking (r = 0.11, p = 0.003), and streaming media (r = 0.11, p = 0.003), and poorer quality family functioning.

CONCLUSION

PUI is common in South African youth. Presence of PUI and increased PUI severity were associated with worse family functioning in this sample. We recommend using family-based approaches in promoting a healthy family environment, and in the prevention of PUI and mitigation of its effects, with the goal of striking a balance between the benefits of the internet and its potential role in compromising aspects of family relationships.

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

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

Psychometric Properties of the Metacognitions About Online Gaming Scale in the Chinese Population and Its Relationship With Internet Gaming Disorder: Cross-Sectional Study

BACKGROUND

Metacognitions about online gaming have been shown to be correlated with Internet Gaming Disorder (IGD). Knowledge of metacognitions about online gaming can help to understand IGD. The Metacognitions about Online Gaming Scale (MOGS) is a reliable and valid tool to measure specific metacognitions about online gaming in both adults and adolescents, which is lacking in China.

OBJECTIVE

This study was conducted to assess the psychometric properties of the Chinese version of the MOGS (C-MOGS) and its relationship with IGD in the Chinese population.

METHODS

A total of 772 Chinese individuals (age: mean 21.70, SD 8.81 years; age range: 13-57 years; 458/772, 59.3% male) completed a web-based questionnaire survey, including the C-MOGS and a battery of validated scales measuring IGD, gaming motives, depression, and anxiety.

RESULTS

Through exploratory and confirmatory factor analyses, the 3-factor structure was confirmed to have adequate model fit and internal consistency reliability (Cronbach α≥.799, Guttman split-half coefficients≥0.754). Concurrent validity of the C-MOGS was supported by its correlations with IGD (P<.001), gaming motives (P<.001), depression (P<.001), and anxiety (P<.001). Furthermore, the incremental validity analysis showed that the C-MOGS predicted 13% of the variance in IGD while controlling for gender, age, weekly gaming hours, gaming motives, depression, and anxiety.

CONCLUSIONS

This study provides evidence that the psychometric properties of the C-MOGS are appropriate and emphasizes its positive association with IGD. The C-MOGS is a reliable and valid instrument for mental health workers to assess metacognitions about online gaming in the Chinese population.

Treatment readiness and prognosis for problematic smartphone use: Evaluation of the Stages of Change, Readiness, and Treatment Eagerness Scale (SOCRATES) and log data

Aim

While moderate smartphone use contributes to information gathering and relationship building, excessive smartphone use, also referred to as problematic smartphone use (PSU), has raised concerns because of its addictive nature and associated health consequences. This study aimed to investigate the relationship between treatment readiness and prognosis in individuals with PSU and to assess the predictive ability of smartphone log data in evaluating treatment readiness.

Methods

A sample of 47 patients with PSU participated in this study. Treatment readiness was assessed using the Stages of Change, Readiness, and Treatment Eagerness Scale (SOCRATES), and log data were collected using a smartphone log application.

Results

The results showed a significant correlation between baseline SOCRATES scores and the difference in Global Assessment of Functioning scores between baseline and 6 months (Spearman's ρ = 0.640, P-value = .001), suggesting that treatment readiness may explain part of the treatment outcomes (Pearson's r 2 = 0.379, P-value = 0.032). In addition, baseline log data, including the log acquisition rate, showed a positive correlation with treatment readiness (Spearman's ρ = 0.328, P-value = 0.045).

Conclusion

These findings provide valuable insights into the relationship between treatment readiness and clinical outcomes in patients with PSU, and suggest the potential of log data as objective indicators of treatment motivation.

Measurement Invariance of the Lemmens Internet Gaming Disorder Scale-9 Across Age, Gender, and Respondents

Although Internet gaming disorder (IGD) has gained increased attention in scientific, clinical, and community contexts, there is still a lack of consensus regarding the best assessment tools (i.e., self-report or other reports) for assessing its symptoms. The present study aimed to investigate the reliability, validity, and measurement invariance of both versions (youth and parent) of The Lemmens Internet Gaming Disorder Scale-9. To achieve this goal, we recruited between June and October 2019 from five Romanian highschools a total of 697 adolescents (11-19 years old) and one of their parents (N = 391). The internal consistency was good in both versions of the instrument (α = 0.772 for the youth version and α = 0.781 for the parent version). Construct validity assessed through confirmatory factor analysis showed support for the one factor structure of the scales, while multigroup confirmatory factor analysis endorsed the invariance across age, gender, and respondents (i.e., parent vs. youth report). The current research identifies both IGD scales to be reliable and valid, arguing for their utility for assessing IGD symptomatology among adolescents. Implications for theory, assessment, and future directions are discussed.

How and when is academic stress associated with mobile phone addiction? The roles of psychological distress, peer alienation and rumination

BACKGROUND

Mobile phone addiction has a high detection rate among adolescents and is thought to be related to academic stress. However, the underlying mechanisms in this relation were still unclear. The present study tested the mediating role of psychological distress and the moderating roles of peer alienation and rumination in the relationship between academic stress and mobile phone addiction.

METHODS

A total of 742 middle school students were recruited to complete measures of academic stress, psychological distress, mobile phone addiction, peer alienation, rumination, and demographic variables. Regression-based statistical mediation and moderation were conducted using the PROCESS macro for SPSS.

RESULTS

The results indicated that academic stress was significantly and positively associated with mobile phone addiction, and this link could be mediated by psychological distress. Moreover, this indirect effect was moderated by both peer alienation and rumination. Specifically, the mediating effect of psychological distress was stronger for adolescents with higher levels of peer alienation or adolescents with higher levels of rumination, as well as those with both higher levels of peer alienation and rumination.

CONCLUSION

The findings of this study enrich our understanding of how and for whom academic stress is correlated with mobile phone addiction. Education experts and parents should pay special attention to adolescents suffering from academic stress, especially those with higher peer alienation and rumination, and help them get rid of mobile phone addiction.

Internet Addiction and Its Association with Demographic Variables, Depression, Anxiety, and Psychological Well-being in College Students. Ann Neurosci 2024;31:21-27. [PMID: 38584979 PMCID: PMC10996870 DOI: 10.1177/09727531231171979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0]

Background

Internet is an integral part of the daily life of everyone. Internet addiction (IA) is one of the major concerns, specifically among young adults. The association between IA, depression, anxiety, and psychological well-being (PWB) is least studied in young adults.

Purpose

To evaluate IA and its association with psychological morbidity and PWB in a larger sample size. In addition, to examine the factors that are associated with IA.

Methods

A total of 1287 young students were evaluated in the present study. Participants were evaluated on the Internet Addiction Test (IAT), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and Psychological Well-Being Index-22.

Results

The mean age of the study's participants is 19.5 years. The majority were female (68.9%), from nuclear families (61.8%), and belonged to urban localities (61.5%). On IAT, 15.9% had a presence of IA with a cut-off score of 50. 27.4% and 20.5% had a presence of depression and anxiety with a cut-off score of 10 on the PHQ-9 and GAD-7, respectively. Approximately two-thirds (66.7%) reported poor PWB. IA had a significant positive association with depression and anxiety and a negative association with PWB. Male students, the presence of depression, anxiety, and poor PWB were independent factors associated with IA.

Conclusion

Internet addiction is highly prevalent among college students and has a significant association with anxiety, depression, and poor PWB. There is a need to develop a structured plan, educational strategy, and program to minimize IA in young adults.

Investigation of the correlation between internet addiction, obesity risk and sleep disorder in children

AIM

This study was performed with the aim of investigating the correlation and the effective factors between internet addiction, obesity risk and sleep disorders in children.

MATERIAL AND METHOD

The sample for this descriptive and relational search type study comprised the parents of 458 children aged 7-10 years attending a primary school in Turkey. Data were collected the Parent and Child Descriptive Information Form, Family Child Internet Addiction Scale (FCIAS), Family Nutrition and Physical Activity Tool (FNPAT) and Sleep Disturbance Scale for Children (SDSC).

RESULTS

There was a statistically significant, positive and weak correlation between the Body Mass Index (BMI) and FCIAS scores of children (p < 0.001). There was a statistically significant, negative and very weak correlation between FNPAT total score with FCIAS total score (p = 0.007). There was a statistically significant, positive and moderate correlation between SDSC total score and FCIAS total score (p < 0.001). According to regression analysis, FCIAS was a determinant at significant levels for FNPAT and SDSC (p < 0.05).

CONCLUSION

There was a relationship between internet addiction and obesity and sleep quality. As a result of the study, the increase in internet use was determined to negatively impact physical activity and health nutrition behavior, and to increase sleep disturbance.

IMPLICATIONS FOR PRACTICE

Pediatric nurses are recommended to give counseling to children and families about preventing obesity and the risk of sleep disorders by identifying children at risk in terms of internet addiction in the early period.

The relationship between loneliness and problematic smartphone use among adolescents during the COVID-19 pandemic: The mediating role of negative emotions and maladaptive coping

INTRODUCTION

Given the observed increased feelings of loneliness and problematic smartphone use among adolescents during the COVID-19 pandemic, further research was needed to determine whether and how the increased loneliness of adolescents during such major public health crisis events affects the risk of problematic smartphone use among adolescents. This study aimed to examine the relationship between loneliness and problematic smartphone use among Chinese adolescents (aged 10-16 years) during the COVID-19 pandemic and to investigate the possible mediating role of negative emotions and maladaptive coping.

METHODS

A total of 672 Chinese adolescents (Mage  = 13.05, SD = 1.51, 50.4% boys, 93.8% from rural areas, 22.5% of whom were only children) took part in this cross-sectional study in April 2022 by completing the Chinese adolescent version of the Loneliness Scale, the Positive and Negative Affect Scale (subscale), the Ways of Coping Questionnaire, and the Mobile Phone Addiction Index Scale.

RESULTS

The serial mediation model revealed that negative emotions and maladaptive coping independently mediated the relationship between adolescents' loneliness and problematic smartphone use. In addition, the mediation effects of "negative emotions-maladaptive coping" could also mediate the relationship between loneliness and problematic smartphone use.

CONCLUSIONS

Loneliness may be positively related to problematic smartphone use through negative emotions and maladaptive coping among adolescents during major public health crisis events, such as the COVID-19 pandemic.

Exploring internet addiction and its associated factors among college students in Western Rajasthan, India: A mixed-methods study

Background

With near universal use of internet by college students, there is propensity for internet addiction (IA) among them. This study aimed to estimate the prevalence and predict the factors for internet addiction among college students in Jodhpur, Rajasthan, India, and qualitatively explore the factors associated with internet addiction.

Materials and Methods

Explanatory sequential (QUAN-QUAL) mixed-methods design was used. A cross-sectional questionnaire-based survey was conducted among three streams of undergraduate colleges (health, engineering, and others). Survey instruments included Young's internet addiction test (IAT), Pittsburgh Sleep Quality Index (PSQI), and Depression, Anxiety, and Stress Scale-21 (DASS-21) Items. Focus group discussions (FGDs) and in-depth interviews (IDIs) among the students with mild-to-moderate levels of addiction were conducted to understand the reasons for excessive internet use.

Results

The prevalence of internet addiction (IA) among the college students was 51% and the rates for mild, moderate, and severe addiction were 31.8%, 18.5%, and 0.7%, respectively. Predictors of IA were male gender, age in years, age of first internet use in years, urban origin, accessing internet at college, mobile internet use, using internet to make online friendship, sleep disturbance, depression, anxiety, and stress. Qualitative study identified five major themes related to situations initiating internet use for nonacademic purpose, content of internet use, triggers for internet overuse/addiction (IA), perceived impact of IA, and measures to overcome IA.

Conclusions

Internet addiction was found to be highly prevalent in college students across various streams. Qualitative results provide deeper insights into IA among college students. It is imperative to screen for IA among the students and devise suitable preventive interventions, which can be easily implemented at community level.

Excessive use of electronic devices among children and adolescents is associated with musculoskeletal symptoms, visual symptoms, psychosocial health, and quality of life: a cross-sectional study

Objective

Electronic devices have become an indispensable part of our daily lives. The frequency and duration of device use in children and adolescents have increased drastically over the years and the study of its negative musculoskeletal, visual and psychosocial health impacts is necessary.

Materials and methods

This cross-sectional study aimed to evaluate the associations between electronic device use and the prevalence and severity of musculoskeletal symptoms, visual symptoms, psychosocial health, and quality of life in children and adolescents studying at primary and secondary schools. Data were collected through confidential online and paper-and-pencil questionnaires. Primary 4-5 and Secondary 1-4 students were recruited from 3 schools in Hong Kong. Demographics, frequency and duration of electronic device use, frequencies of musculoskeletal symptoms, visual symptoms, psychosocial health, and quality of life outcomes were measured.

Results

1,058 children and adolescents aged 9-17  years participated. Sixty-one percent and 78% of all students spent more than 2  h per day using electronic devices during school days and weekend/holidays, respectively. Extended electronic device use was associated with increased prevalence and severity of musculoskeletal symptoms (ρ's = 0.28-0.33, P's < 0.001), visual symptoms (ρ's = 0.33-0.35, P's < 0.001), and poorer device use-related psychosocial health (ρ's = 0.38-0.47, P's < 0.001). Secondary school students reported greater device use and severity of symptoms than primary school students.

Conclusion

Excessive electronic device use was associated with increased prevalence and severity of physical and psychosocial symptoms, and such use is more prevalent in adolescents when compared to the children. The findings have important health implications for children and adolescents, suggesting that early intervention is needed to reduce the risk of developing device use-related disorders.

Social anhedonia affects the trajectory of internet addiction in the college students: A latent growth curve analysis

BACKGROUND/AIM

There is growing awareness that anhedonia plays a critical role in the development of Internet Addictions (IA). However, anhedonia is a multidimensional construct and different aspects of anhedonia may exert different effects on IA. This study was designed to distinguish the effects of social anhedonia and physical anhedonia on the developmental trajectory of IA among college students.

METHODS

A total of 3577 Chinese college freshmen (M_age = 18.01, SD = 0.77; 65.4 % girls) participated in a 2-year, four waves longitudinal tracking study. The latent growth curve model (LGCM) was constructed to examine the impacts of different types of anhedonia on the developmental trajectories of IA. Gender was also added to the conditional LGCM as time-invariant variable.

RESULTS

The results of unconditional LGCM showed a U-shape developmental trajectory of IA. Social anhedonia significantly affected the intercept (β = 0.468, p < 0.001) and significantly affected the linear slope (β = -0.259, p < 0.05), but not the quadratic slope (β = 0.293, p > 0.05). Physical anhedonia was not significantly associated with intercept, linear slope and quadratic slope. There was no sex difference in both initial levels and change rate of IA.

CONCLUSIONS

Social anhedonia while not physical anhedonia has prediction effect on IA. College students with high levels of social anhedonia experienced high levels of IA at baseline, and performed a slower rate in downward trend of IA. The findings of the current study provide implications for prevention of IA in college students.

Clinical Usefulness of a Short Version of the Internet Addiction Test to Screen for Probable Internet Addiction in Adolescents with Autism Spectrum Disorder

Internet addiction (IA) is defined as the condition of being addicted to all sorts of activities on the Internet. Individuals with neurodevelopmental disorders, including autism spectrum disorder (ASD), may be susceptible to IA. Early detection and intervention for probable IA are important to prevent severe IA. In this study, we investigated the clinical usefulness of a short version of the Internet Addiction Test (s-IAT) for the screening of IA among autistic adolescents. The subjects were 104 adolescents with a confirmed diagnosis of ASD. They were requested to answer 20 questions from the original Internet Addiction Test (IAT). In the data analysis process, we comparatively calculated the sum of scores to the 12 questions of s-IAT. In total, 14 of the 104 subjects were diagnosed as having IA based on the face-to-face clinical interview that was regarded as the gold standard. Statistical analysis suggested that the optimal cut-off for s-IAT was at 35. When we applied the cut-off of 70 on the IAT, only 2 of 14 subjects (14.3%) with IA were screened positive, whereas 10 (71.4%) of them were screened by using the cut-off point of 35 on s-IAT. The s-IAT might be useful for the screening of IA in adolescents with ASD.

A Bibliometric Analysis of Research into Internet Gaming Disorders in Korea

After the concept of "Internet addiction" was first proposed in 2004, "Internet gaming disorder" (IGD) was included in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as a disorder requiring further research. IGD is prevalent in South Korea, and many studies have been conducted on the disorder. Previous studies have helped in understanding various aspects of IGD, but a comprehensive understanding of the research trends is required to identify research gaps. Therefore, we conducted a bibliometric review of all published IGD studies in South Korea. For the identification of articles, the Web of Science database was used. Data analysis was performed using Biblioshiny. A total of 330 publications were included in the analysis. The average number of citations per document was 17.12. These publications were written by a total of 658 authors, and the number of coauthors per document was 5.07. The years with the most publications were 2018 (n = 57), 2017 (n = 45), and 2019 (n = 40). The top three journals containing publications were the Journal of Behavioral Addictions (n = 46), Frontiers in Psychiatry (n = 19), and Psychiatry Investigation (n = 14). In a keyword analysis (apart from "IGD", "internet addiction", and "addiction"), the keywords "adolescent" (n = 31), "self-control" (n = 11), and "impulsivity" (n = 11) were included. T. This bibliometric analysis explores and summarizes the publications on IGD in South Korea. The results are expected to provide researchers with insights for further studies into IGD.

Factors associated with test anxiety among adolescents in Shenzhen, China

BACKGROUND

Test anxiety is prevalent among adolescents and may have long-term negative consequences on their physical and mental health. The aim of this study was to assess the prevalence of test anxiety and its related attributing factors among adolescents in Shenzhen, China.

METHODS

A cross-sectional study was conducted from November 18, 2020 to January 12, 2021 in Shenzhen, China. Test anxiety symptoms were measured by using the Test Anxiety Scale. Descriptive statistics and multivariate logistic regression were used to assess test anxiety and risk factors.

RESULTS

In total, 7047 students aged 10 to 19 were included for this survey. The prevalence of test anxiety was found to be 46.7 %. In multivariate analysis, gender, age, frequency of feeling lonely, parents' marital status, family functioning, emotional abuse, physical abuse, sexual abuse, academic performance level, relationship with classmates, school bullying and Internet addiction were positive related to test anxiety.

LIMITATIONS

This cross-sectional design limits the establishment of causal relationships. Reporting bias and recalling bias may be possible.

CONCLUSIONS

Our study suggested that a significant number of adolescents in Shenzhen had test anxiety symptoms. Also, we found some risk factors, which might help to provide new guidance of psychological interventions to promote adolescents' mental health.

Cyberbullying, Social Media Addiction and Associations with Depression, Anxiety, and Stress among Medical Students in Malaysia

This study aims to determine the prevalence and factors associated with cyberbullying and social media addiction. This cross-sectional study was conducted among 270 medical students from a public university in Kuching, Malaysia. The instruments used in this study included the cyberbullying questionnaire survey, Bergen Social Media Addiction Scale (BSMAS), and the Depression Anxiety Stress Scale 21-item (DASS-21). The prevalence of cyberbullying victimization was 24.4%, whilst 13.0% reported cyberbullying perpetration over the past six months. Male gender was positively associated with both cyberbullying perpetration and cybervictimization, whilst social media addiction was positively associated with cybervictimization. Psychological motives such as positive attitudes toward cyberbullying and gaining power were associated with cyberbullying perpetration. Cybervictimization doubled the tendency to depression (aOR 2.50, 95% CI [1.23, 5.08], p = 0.012), anxiety (aOR 2.38, 95% CI [1.29, 4.40], p = 0.006), and stress (aOR 2.85, 95% CI [1.41, 5.77], p = 0.004), whilst social media addiction was associated with a higher tendency to depression (aOR 1.18, 95% CI [1.10, 1.26], p < 0.001), anxiety (aOR 1.15, 95% CI [1.08, 1.22], p < 0.001), and stress (aOR 1.21, 95% CI [1.12, 1.32], p < 0.001). Medical schools in Malaysia need policies and guidelines against cyberbullying.

Problematic Internet Use among Adults: A Cross-Cultural Study in 15 Countries

BACKGROUND

The present study compared adult usage patterns of online activities, the frequency rate of problematic internet use (PIU), and risk factors (including the psychopathology associated with PIU, i.e., distress and impulsivity) among adults in 15 countries from Europe, America, and Asia.

METHODS

A total of 5130 adults from Belgium, Finland, Germany, Italy, Spain, France, Switzerland, Hungary, Poland, UK, Norway, Peru, Canada, US, and Indonesia completed an online survey assessing PIU and a number of psychological variables (i.e., depression, anxiety, stress, and impulsivity). The sample included more females, with a mean age of 24.71 years (SD = 8.70).

RESULTS

PIU was slightly lower in European countries (rates ranged from 1.1% in Finland to 10.1% in the UK, compared to 2.9% in Canada and 10.4% in the US). There were differences in specific PIU rates (e.g., problematic gaming ranged from 0.4% in Poland to 4.7% in Indonesia). Regression analyses showed that PIU was predicted by problematic social networking and gaming, lack of perseverance, positive urgency, and depression.

CONCLUSIONS

The differences in PIU between countries were significant for those between continental regions (Europe versus non-European countries). One of the most interesting findings is that the specific PIU risks were generally low compared to contemporary literature. However, higher levels of PIU were present in countries outside of Europe, although intra-European differences existed.

Investigating problematic uses of Facebook and other Internet activities among university students in Bangladesh during the COVID-19 pandemic

Problematic use of Internet (PUI) and problematic use of Facebook (PUF) has been linked to escalating behavioral health issues among university students and has increased during the COVID-19 pandemic. This study estimated the prevalence of and explored associated factors for PUI and PUF among Bangladeshi university students during the COVID-19 pandemic. A cross-sectional online survey was undertaken among 1101 Bangladeshi university students between November and December 2020. The Internet Addiction Test and Facebook Addiction Scale were used to assess PIU and PUF, respectively. A multiple linear regression analysis was performed to adjust for confounders. Among the participants, PUI and PUF were found in 39.3% and 37.1%, respectively. The multiple linear regression model indicated PUI was significantly associated with participants residing in a village, arts majors, those unsatisfied with their major, having mediocre parental relationships, failure in romantic relationships, physical comorbidities, longer use of the Internet, using the Internet for purposes other than education, using social media, and downloading movies/TV series. PUF was significantly associated with village residence, lower income, arts majors, failure in romantic relationships, longer use of the Internet, using the Internet for purposes other than education, and downloading movies/TV series. Both PUI and PUF have been prevalent among Bangladeshi university students during the COVID-19 pandemic. Longitudinal & exploratory studies are warranted in the future to identify causal factors for PUI and PUF and appropriate interventions should be designed quickly for this population.

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

INTRODUCTION

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Effects of a Physical Exercise Program and Health Advice on Sedentary Behavior of Adolescents

Sedentary behavior (SB) is a risk factor for chronic non-communicable diseases. This study aimed to assess the effects of an extracurricular physical exercise program and health advice on SB in adolescents. This was a non-randomized experimental study involving 19 adolescents divided into an intervention group (IG) and a control group (CG), aged 13-16 years from a public school in a Brazilian municipality. SB was measured using self-reports and accelerometers. The intervention included physical exercise and health advice. Repeated measures analysis of variance with a significance level of α = 5% was used. There was a time*group interaction for the subscapular fold ((pre IG = 16.30 mm vs. CG = 13.44 mm, post IG = 14.00 mm vs. CG = 15.89 mm) p = 0.001), and VO2MAX ((pre IG = 32.75 mL/kg/min vs. CG = 30.66 mL/kg/min, post IG = 35.76 mL/kg/min vs. CG = 29.28 mL/kg/min) p = 0.008). The accelerometer showed significant differences between groups in the total SB ((pre IG = 647.49 min/day vs. CG = 535.24 min/day, post IG = 614.02 min/day vs. CG = 586.97 min/day) p = 0.045), with a significant decrease in the IG. In conclusion, an extracurricular physical exercise program and health advice was effective in reducing SB in adolescents.

The relationship between social support and Internet addiction among Chinese college freshmen: A mediated moderation model

Purpose

Internet addiction has become a worldwide mental health problem, and this problem is particularly prominent in China. Although current studies have shown that social support is closely related to Internet addiction, the mechanism of the relationship between the two is not clear at present. This study aimed to find out the influencing factors and the mechanism of Internet addiction among college freshmen, and to form scientific prevention and intervention plan on this basis.

Method

This study adopts the cluster sampling method to select 322 college freshmen in a typical postsecondary school in Shandong Province, using Chinese Internet Addiction Scale (CIAS), Social Support Rating Scale (SSRS), and Network-related Maladaptive Cognition Scale (NRMCS) to investigate the relationship between social support, network-related maladaptive cognition, gender, and the degree of Internet addiction.

Results

The findings of this study are as follows: (1) After controlling age and family location, social support had a significant negative predictive effect on Internet addiction; (2) Gender acted as a moderator between the relationship of social support and Internet addiction; and (3) Additionally, the moderating effect of gender was completely mediated by network-related maladaptive cognition.

Conclusion

There is a mediated moderating effect between social support and Internet addiction. That is, gender plays a moderating role between social support and Internet addiction, and this moderating effect is mediated by network maladaptive cognition.

The relationship between social support and Internet addiction among Chinese college freshmen: A mediated moderation model

Purpose

Internet addiction has become a worldwide mental health problem, and this problem is particularly prominent in China. Although current studies have shown that social support is closely related to Internet addiction, the mechanism of the relationship between the two is not clear at present. This study aimed to find out the influencing factors and the mechanism of Internet addiction among college freshmen, and to form scientific prevention and intervention plan on this basis.

Method

This study adopts the cluster sampling method to select 322 college freshmen in a typical postsecondary school in Shandong Province, using Chinese Internet Addiction Scale (CIAS), Social Support Rating Scale (SSRS), and Network-related Maladaptive Cognition Scale (NRMCS) to investigate the relationship between social support, network-related maladaptive cognition, gender, and the degree of Internet addiction.

Results

The findings of this study are as follows: (1) After controlling age and family location, social support had a significant negative predictive effect on Internet addiction; (2) Gender acted as a moderator between the relationship of social support and Internet addiction; and (3) Additionally, the moderating effect of gender was completely mediated by network-related maladaptive cognition.

Conclusion

There is a mediated moderating effect between social support and Internet addiction. That is, gender plays a moderating role between social support and Internet addiction, and this moderating effect is mediated by network maladaptive cognition.

Problematic internet use and attachment styles among adolescents in Japan

BACKGROUND

Problematic Internet use (PIU) remains a significant social concern in Japan and across the globe. Numerous studies have been conducted to examine the prevalence of PIU, and its association with lifestyle habits and mental health status. To the best of our knowledge, few studies have examined the association between parental attachment and PIU in Japan. Furthermore, preventive measures in Japan have primarily targeted adolescents via education. Therefore, in this study we explored the association between PIU and attachment styles among adolescents to seek a new approach for the development of appropriate, effective measures.

METHODS

A self-administered survey was conducted at one private (in 2018) and two public junior high schools (in 2020) in Kagawa Prefecture, western Japan. We used the Internet Addiction Test (IAT), the Experiences in Close Relationships-Relationship Structures (ECR-RS) questionnaire, and the Birleson Depression Self-Rating Scale for Children (DSRS-C). Multiple regression analysis was performed to examine the association between IAT scores and attachment styles.

RESULTS

Of 1,413 participants (grades 7-9; 700 boys and 713 girls), 39% of the students showed possible PIU and 3% showed PIU. Students with PIU tended to sleep for shorter durations, access the Internet for long hours, and have a poor mental health status (p < 0.01). PIU was significantly associated with insecure attachment (p < 0.0001).

CONCLUSIONS

The findings of our study imply that improving attachment styles and developing secure attachment between the child and parent might help mitigate and/or prevent PIU.

The impact of media on children during the COVID-19 pandemic: A narrative review

Although mobile technologies are a fundamental part of daily life, several studies have shown increased use of electronic devices, TV, and gaming during childhood in conjunction with the COVID-19 pandemic. The virus affected almost every country, causing uncertainty about the future, social isolation, and distress. This narrative review has searched the scientific literature in the field focusing on children. A non-systematic literature review was conducted in May 2022. Various databases were employed to conduct the document research for this paper, such as "Google Scholar", "PubMed", "Web of Science". Keywords for the search included "screen time", "media", "digital use", "social media", "COVID-19", "pandemic", "lockdown", "children", "effect of media on children during COVID". It was found that both children and adolescents seem to have used technologies to confront struggles provoked by COVID-19, such as the onset or exacerbation of symptoms of anxiety, depression, and attention-deficit/hyperactivity disorder. However, moreover, other studies have suggested that increased media use can have positive effects on children depending on usage and monitoring by the parents.

The associations between smartphone addiction and self-esteem, self-control, and social support among Chinese adolescents: A meta-analysis

Background

Smartphone addiction has become a social problem that affects the healthy growth of adolescents, and it is frequently reported to be correlated with self-esteem, self-control, and social support among adolescents.

Methods

A meta-analysis was conducted by searching the PubMed, Web of Science, Embase, PsycINFO, PsycArticles, China National Knowledge Infrastructure (CNKI), WANFANG DATA, and Chongqing VIP Information Co., Ltd. (VIP) databases. Stata 16.0 was used to analyse the overall effect and test the moderating effect.

Results

Fifty-six studies were included, involving a total of 42,300 participants. Adolescents' smartphone addiction had a moderately negative correlation with self-esteem (r = -0.25, 95% CI = -0.29 to -0.22, p < 0.001), a strong negative correlation with self-control (r = -0.48, 95% CI = -0.53 to -0.42, p < 0.001), and a weak negative correlation with social support (r = -0.16, 95% CI = -0.23 to -0.09, p < 0.001). Moderation analysis revealed that the correlation between adolescents' smartphone addiction and self-esteem was strongest when smartphone addiction was measured with the Mobile Phone Addiction Tendency Scale for College Students (MPATS; r = -0.38). The correlation between adolescents' smartphone addiction and self-control was strongest when self-control was measured with the Middle school students' Self-control Ability Questionnaire (MSAQ; r = -0.62). The effect of dissertations on smartphone addiction, self-control, and social support among adolescents was significantly larger than that of journal articles. The correlation between adolescents' smartphone addiction and social support was strongest when smartphone addiction was measured with the Mobile Phone Addiction Index (MPAI; r = -0.24). However, the correlations between adolescents' smartphone addiction and self-esteem, self-control, and social support were not affected by age or gender.

Conclusion

There was a strong relationship between smartphone addiction and self-esteem, self-control, and social support among adolescents. In the future, longitudinal research should be carried out to better investigate the dynamic changes in therelationship between smartphone addiction and self-esteem, self-control, and social support.

Systematic review registration

https://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42022300061.

Internet Addiction and Social Media Addiction in Medical Faculty Students: Prevalence, Related Factors, and Association with Life Satisfaction

Internet addiction is a growing behavioral health problem in modern societies. In this study, we aimed to determine the prevalence of internet addiction (IA) and social media addiction (SMA) and their relationship with sociodemographic factors, lifestyle habits, and internet usage patterns among medical students. This cross-sectional study was conducted among 280 medical students in a medical faculty, in Istanbul. Self-report questionnaires comprised sociodemographic status, lifestyle habits, internet and social media usage behavior, the Young Internet Addiction Test-short form (s-IAT), and the Bergen Social media addiction scale. The total prevalence of IA was 16.1% (11.8-20.4%), 17.2% (12.8-21.7%) in males and 14.8% (10.7-19.0%) in females. The total prevalence of SMA was 6.1% (3.3-8.9%), 4.8% (2.3-7.3%) in males and 7.4% (4.3-10.5%) in females. No significant difference was found between the sexes in terms of IA and SMA. IA was higher in grade 3 students than in grade 6 students. Multivariate logistic regression analyses showed that reading books at least once per month, high life satisfaction, performing physical activity at least twice per week, and using the internet for communication purposes were independent preventive factors for IA. The current study shows that IA and SMA are common in medical school students. Moreover, IA is associated with socioeconomic characteristics and lifestyle habits such as reading books, life satisfaction, and physical activity. To protect medical school students from IA and develop healthy behaviors, it is necessary to develop prevention strategies and design and implement awareness and education programs.

Associations among internet addiction, lifestyle behaviors, and dental caries among high school students in Southwest Japan

Internet addiction (IA) negatively affects adolescents' lifestyle behaviors. Inappropriate lifestyle behaviors could have negative effects on dental health. This cross-sectional study aimed to test whether IA was indirectly associated with dental caries through unhealthy lifestyle behaviors among high school students in southwest Japan. IA was characterized by a Young's Internet Addiction Test score of ≥ 50, unhealthy lifestyle behaviors by a cumulative count of 8 different lifestyle behaviors (termed the unhealthy lifestyle behavior index [ULBI]), and dental caries by the number of decayed, missing, and filled permanent teeth (DMFT). Poisson regression and linear regression models were fitted to the relationship, with IA as the exposure, the ULBI as the mediator, and the DMFT as the outcome. The natural indirect effect (NIE) and the proportion mediated by the ULBI were estimated by performing a mediation analysis. Overall, 1562 high school students were included. IA was observed in 406 participants and was associated with a larger DMFT. The ULBI significantly mediated the association between IA and the DMFT (NIE: incidence rate ratio = 1.05, 95% confidence interval = 1.03-1.07, proportion mediated = 64.3%). Dental caries was more common in our cohort of high school students with IA, which is partially explained by these students having unhealthy lifestyle behaviors.

The emotional state of young people in northern Spain after one year and a half of the COVID-19 pandemic

BACKGROUND AND OBJECTIVES

: Since the beginning of the COVID-19 pandemic, the young population has been suffering from an accumulation of psychological symptoms in northern Spain. The main objectives of this study were (1) to assess whether psychological symptoms persisted after one year and a half of the COVID-19 pandemic in northern Spain sample of young people, and (2) to analyze whether pandemic-specific variables (having a chronic illness, living with a person who has a chronic illness, having been infected with COVID-19, having a close person who has died or believing that people are respecting the measures imposed) are related to psychological symptomatology.

METHODS

: Symptoms of stress, anxiety, and depression were measured using the Depression and Stress Anxiety Scale-21 (DASS-21). An ad hoc online questionnaire was used to collect socio-demographical information related to chronic illnesses of the participants, living with a chronically ill person, contact with a person diagnosed with COVID-19, having people close to them who have died of COVID-19, and their perception of whether or not people respect the health measures.

RESULTS

: Young people have suffered higher stress, anxiety, and depression levels than at the beginning of the pandemic.

CONCLUSIONS

: The present study highlights the importance of addressing young people's mental health, and ensure that future adults emerge from the COVID-19 pandemic in a psychologically strong state.

Internet use and internet-based addictive behaviours during coronavirus pandemic

PURPOSE OF REVIEW

The COVID-19 outbreak profoundly influenced human lives on different levels. This narrative review aims to present recent data relating to the COVID-19 pandemic and internet use and internet-based addictive behaviours [problematic Internet use (PIU), Internet addiction, Internet gaming disorder, problem gambling or gambling disorder, social media addiction including smartphone use disorder, problematic pornography use, and compulsive buying].

RECENT FINDINGS

During the COVID-19 pandemic, the prevalence of Internet use and Internet-based addictive behaviours increased in all age groups. The COVID-19 pandemic and related containment measures were been associated with increased levels of stress, anxiety, and depression in the general population, especially among children and adolescents, which are the vulnerable groups for the development of mental disorders during the crisis. Furthermore, the fear resulting from the disease, the 'lockdown' measures, high levels of uncertainty regarding the future, and financial insecurity increased levels of loneliness, PIU, and Internet addiction.

SUMMARY

Longitudinal researches focused on the negative impacts of Internet use in prolonged stress situations on mental health, vulnerable groups, and quality of life (QoL) are needed to help clinicians and policymakers to reduce adverse consequences. Prevention programs for Internet use and Internet-based addictive behaviours must be customized to meet the needs of children, adolescents, and adults. Also, treatment programs must be tailored to the needs of patients with different Internet-based addictions.

Investigating Internet Addiction and Sleep Quality Correlation Among Students of Isfahan University of Medical Sciences in 2021

Background: The quality of sleep plays an important role in physical development, as well as maintaining physical and mental health. Approximately 20% of Iranian students suffer from Internet addiction, and 56% suffer from insomnia. Objectives: This study aimed to investigate the relevance of Internet addiction and sleep quality among Isfahan University of medical sciences students. Methods: This cross-sectional study was conducted as a questionnaire at the Medical Sciences University of Isfahan. The collected data had three components: (1) Demographic information, (2) sleep quality with the Pittsburgh Sleep Quality Index (PSQI), and (3) amount of internet use with a questionnaire of 20 Internet Addiction Tests (IAT). Logistic regression was used to find any association between Internet Addiction and Sleep quality. Results: A total of 562 female and male students participated in the study, with a mean age of 21.41 ± 1.87. Internet users with moderate and mild addiction had poorer sleep quality than those with normal and severe Internet addiction. Logistic regression analysis showed an association between Internet addiction scores and sleep quality (OR = 1.035: 1.02, 1.04, P < 0.001). In addition, poor sleep quality was also predicted by the subgroups "excessive internet use" and "anticipation". Conclusions: The relationship between internet addiction and sleep quality was significantly negative. Universities and all educational institutions can use it to control the effects of Internet abuse and the quality of sleep of students.

Internet Addiction among Brazilian Students: Prevalence and Association with Emotional Problems

The objective of this study was to evaluate the prevalence of Internet addiction (I.A.) among students and its association with emotional problems. A total of 2,214 students (M = 21.9; SD = 1.86) from all Brazilian regions responded to an online questionnaire and were classified according to the IAT instrument score in NRU= No-risk Users, LRU= Low-risk Users, and RHU= Risk and High-risk Users. DASS-21 measured emotional problems, and the data were analyzed using descriptive and inferential statistics. It was observed that 12.5% were classified as URAR and presented higher levels of depression (p< 0.001), anxiety (p< 0.001), and stress (p< 0.001). The main predictors for I.A. were depression (aOR = 3.2), anxiety (aOR = 2.5), and stress (aOR = 2.6). These results confirm an association between DI and emotional problems, as indicated in the literature.

Relationship between time spent playing internet gaming apps and behavioral problems, sleep problems, alexithymia, and emotion dysregulations in children: a multicentre study

BACKGROUND

Internet gaming addiction (IGA) is a serious condition that can significantly impact personal and social functioning. Many studies of IGA have been conducted in adolescents and young adults, but there are limited data available in children. We investigated the time spent using internet gaming apps in children and its association with behavioral problems, sleep problems, alexithymia, and emotional regulation.

METHODS

The research populations (N = 564) were categorized based on the number of hours spent using online gaming applications. The Strengths and Difficulties Questionnaire, the Children's Sleep Habits Questionnaire Abbreviated, the Children's Alexithymia Measure (CAM), and the Clinical Evaluation of Emotional Regulation-9 were used to assess all participants.

RESULTS

Compared to other groups, children who used internet gaming applications for more than 6 h had a higher proportion of abnormal responses on the emotional symptoms and hyperactivity scales. Children who used internet gaming applications for more than 6 h had the poorest sleep quality (75%), while children who used internet gaming applications for 1-2 h had the best (36.7%). Participants who used internet gaming apps for 1-2 h had significantly lower mean total scores on the emotional regulation scale and total CAM, whereas those using internet gaming apps for more than 6 h had the highest mean scores in the CAM.

CONCLUSIONS

Excessive use of internet gaming apps during childhood may be associated with hyperactivity, peer problems, high socioeconomic level, alexithymia concerns, shorter daytime sleep duration, and a delayed morning wake-up.

Prevalence and Factors Associated with Gaming Disorder in Latin America and the Caribbean: A Systematic Review

We aimed to determine the prevalence and factors associated with gaming disorder (GD) in the population of Latin America and the Caribbean (LAC). A systematic review was performed (PROSPERO protocol registration: CRD42021230565). We included studies that identified participants with GD and/or factors associated with this condition, reported the prevalence of GD, or contained data that assisted in its estimation, were published after 2013 (the year of inclusion of GD in the Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders) and were carried out in a population residing in an LAC country. Evaluation of the quality of the studies was carried out using the Joanna Briggs Institute Critical appraisal checklist tool. A qualitative synthesis of the data was performed. Of the total of 1567 records identified, 25 passed the full-text review phase, and 6 met the selection criteria. These studies were published between 2018 and 2021 and had a cross-sectional design (three in Brazil, one in Ecuador, Mexico, and the other was multi-country, including a LAC country [Peru]). The prevalence of GD ranged from 1.1% to 38.2%. The three studies in Brazil had the highest figures of GD prevalence (20.4-38.2%). Four studies evaluated factors associated with GD. Characteristics regarding the game (type), pattern of use (hours played), as well as gender (higher in men), tobacco and alcohol consumption, poor interpersonal relationships, and the presence of mental disorders were found to be associated with GD in LAC. Evidence on the prevalence and factors associated with GD in LAC is limited. Studies on GD in LAC evaluate different population subgroups, describing a wide prevalence of this condition (present in up to 38 out of 100 evaluated). Characteristics such as the type and hours of use of the games, sociodemographic data, lifestyles, interpersonal relationships, and the presence of mental disorders increase the probability of presenting GD.

Risk factors of hikikomori among office workers during the COVID-19 pandemic: A prospective online survey

The global pandemic of COVID-19 has forced people to restrict their outings. In Japan, self-restraint behavior (SRB) has been requested by the government, and some of those decreasing their outings may shift to pathological social withdrawal; hikikomori. The purpose of this study was to examine the risk factors of hikikomori conducting an online prospective survey. An online survey was conducted in June 2020 and December 2020; (1) SRB-related indicators (degree of SRB, motivation for SRB, stigma and self-stigma toward COVID-19, anxiety and depressive feelings toward COVID-19) and (2) general mental health (hikikomori tendency, depressive symptoms, modern type depression (MTD) tendency, internet addiction) were collected. A cross-lagged effects model was performed to examine the association between these variables. Lack of emotional support and lack of socialization in June 2020 increased isolation in December 2020. Besides, MTD and hikikomori interacted with each other. Interestingly, although hikikomori tendency increased depressive tendencies, SRB itself did not have a significant path on any mental health-related variables. Poor interpersonal relationships, rather than SRB per se, are suggested to be a risk factor for increased isolation among office workers in the COVID-19 pandemic. Appropriate early interventions such as interpersonal or emotional support may prevent the transition to pathological hikikomori. The association between MTD and hikikomori seems to reveal the interesting possibility that MTD is a gateway to increased risk of hikikomori, and that hikikomori is a gateway to MTD as well. Future research is required to elucidate the relationship between hikikomori and MTD.

Ecological correlates related to adolescent movement behaviors: A latent class analysis

The ecological model has been widely used to help researchers understand the multiple influences in the physical activity (PA) and in the sedentary behaviors in isolated forms. To date, few correlates concerning the behavioral groupings of PA and sedentary behaviors have been studied. In this context, this study aimed to identify movement behaviors' latent classes related to the different adolescents' PA and sedentary time expressions, as well as their associations with individual, sociodemographic, family, and environmental correlates. This is a cross-sectional study with 309 students aged between 14 and 16. Latent Class Analysis was used to identify movement behavior classes based on light PA, moderate to vigorous PA, number of steps, sedentary time, and screen time (ST). An accelerometer was used to evaluate movement behaviors. The individual, sociodemographic, family, and environmental correlates were assessed by questionnaires. Three classes were identified: Class 1, "Active and Non-Sedentary" (8.10% of the sample), Class 2, "Active and Sedentary" (28.5%), and Class 3, "Inactive and Sedentary" (63.4%). Those with low fruit intake, low aerobic fitness, stressed and whose head of the family obtained an 'elementary school' level education were, respectively, 7.17, 3.59, 3.56, and 4.40 times more likely to belong to class 3 than class 1. Those with medium and high socioeconomic status were 82% and 83% less likely to belong to class 1 than classes 2 and 3, respectively. Adolescents who perceived the neighborhoods with the best access to diversified land use, street connectivity, walking/pedaling ease, and traffic safety attributes, were 84%, 85%, 82%, and 82%, respectively less likely to belong to class 1 than class 2. It is concluded that distinct correlates can be associated with the movement behaviors classes.