Internet Addiction and Psychosocial Maladjustment: Avoidant Coping and Coping Inflexibility as Psychological Mechanisms

Exploring the Effects of Coping Flexibility on Sleep Quality via Subjective Distress: A Longitudinal Study of Young Adults

BACKGROUND

Coping flexibility is one's ability to modify their coping strategies and adapt to the demands of stressful situations. However, limited studies have demonstrated that coping flexibility directly influenced sleep quality. This study examined the relationships between coping flexibility, subjective distress, and sleep quality. We hypothesized that coping flexibility would enhance sleep quality via subjective distress.

METHODS

In total 99 male and 151 female college students completed questionnaires on coping flexibility, subjective distress, and sleep quality. Subsequently, they completed the questionnaire on sleep quality six months later.

RESULTS

Structural equation modeling showed a significant indirect effect of coping flexibility, which indicated that higher coping flexibility was associated with higher sleep quality via reduced subjective distress.

CONCLUSIONS

Our findings suggested that subjective distress and lower coping flexibility were risk factors for poor sleep quality.

The Association Between Internet Addiction and the Risk of Suicide Attempts in Chinese Adolescents Aged 11-17 Years: Prospective Cohort Study

BACKGROUND

Suicide is a critical public health issue in adolescents worldwide. Internet addiction may play a role in the increased rate of suicide attempts in this population. However, few studies have explored the relationship between pathological internet use and suicide attempts among adolescents.

OBJECTIVE

This study aimed to conduct a prospective cohort study to examine whether higher severity of pathological internet use was associated with an increased risk of suicide attempts among Chinese adolescents.

METHODS

A total of 782 adolescents were recruited from a middle school from November 2020 to December 2020 and followed up for 6 months. An online self-reported questionnaire was used to collect the participants' demographic data and assess their mental health. The Depression, Anxiety, and Stress Scale-21 items (DASS-21) was used to evaluate depression, anxiety, and stress. The Chen Internet Addiction Scale-Revised (CIAS-R) was used to assess the symptoms and severity of pathological internet use. χ2 test and ANOVA were used for intergroup comparison, and logistic regression analysis was used to examine the relationship between the severity of pathological internet use and suicide attempts. We also used a restricted cubic splines model to investigate the pattern of the association.

RESULTS

The participants had an average age of 12.59 (SD 0.64) years, with the majority being of Han ethnicity (743/782, 95.01%) and more than half being male (426/782, 54.48%). Most participants had no previous history of depression (541/782, 69.18%), anxiety (415/782, 53.07%), or stress (618/782, 79.03%). The rate of newly reported suicide attempts was 4.6% (36/782). A significant positive association was observed between internet addiction and suicide attempts (odds ratio 3.88, 95% CI 1.70-8.82), which remained significant after adjusting for age, sex, ethnicity, anxiety, depression, and stress (odds ratio 2.65, 95% CI 1.07-6.55). In addition, this association exhibited a linear pattern in the restricted cubic spline regression model.

CONCLUSIONS

This study suggested that internet addiction, rather than internet overuse, was associated with a higher likelihood of suicide attempts, which highlighted the importance of addressing internet addiction symptoms among Chinese adolescents for suicide prevention.

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.

Problematic internet use profiles and their associated factors among adolescents

The cognitive-behavioral model of generalized Problematic Internet Use (PIU) is the theoretical approach that has obtained the most evidence on the study of this problem, which includes four components: Online Social Preference, Mood Regulation, Deficient Self-Regulation, and Negative Outcomes. This study aimed to identify PIU profiles using Latent Profile Analysis, and to analyze the differences in them attending to some of the principal PIU risk and protective factors. A total of 675 Spanish adolescents completed questionnaires assessing PIU, Internet usage, mental health problems, personality, psychological strengths, and family relationships. Four profiles were obtained: Nonproblematic use (68.30% of the sample), Slightly problematic use (17.90% of the sample), Problematic use (8.50% of the sample), and Severe problematic use (5.40% of the sample). Results showed differences between them, with the profile with more PIU having more risk factors and less protective factors. Results showed that many different personal and social variables included in the study play a role in PIU. Knowing the different PIU profiles can help in the design of more specific and precise procedures and instruments for risk assessment, as well as aiding in prevention and in the design of more individualized treatments.

Screen time trajectories and psychosocial well-being among Chinese adolescents: a longitudinal study

BACKGROUND

While the association between screen time (ST) and psychosocial well-being has been extensively examined, limited studies have investigated the dynamic patterns of ST, and their impact on subsequent psychosocial well-being among adolescents. Therefore, this longitudinal study aimed to examine the association between ST trajectories and the subsequent psychosocial well-being among Chinese adolescents.

METHODS

Data were drawn from the Longitudinal Study of Adolescents' Mental and Behavioral Well-being Research (Registration No. ChiCTR1900022032). The final analysis included 1480 participants who completed baseline and two follow-up surveys. Standardized measures were employed to assess ST and multiple psychosocial well-being, including depressive symptoms, anxiety, externalizing problems, and coping style. Group-based trajectory modeling and generalized linear mixed models were performed.

RESULTS

Over the two-year follow-up period, two distinct ST trajectories emerged: continued high (298 [20.1%]) and continued low (1182 [79.9%]). Compared with those in the continued low ST group, adolescents in the continued high group exhibited a higher likelihood of presenting depressive symptoms (β = 0.97, 95% CI = 0.43 ~ 1.50), anxiety symptoms (β = 0.29, 95% CI = 0.05 ~ 0.53), and emotional problems (β = 0.35, 95% CI = 0.22 ~ 0.48), and were less likely to demonstrate prosocial behavior or employ positive coping style. The stratified analysis demonstrated that the aforementioned associations only existed among female adolescents.

CONCLUSIONS

Persistent high exposure to ST was associated with an increased odds of emotional problems and a decreased probability of engaging in prosocial behavior and positive coping style, with particularly noteworthy effects observed among female adolescents. These findings underscore the importance of reducing ST exposure to improve the psychological well-being of adolescents.

Coping with provoked vestibulodynia in a relational context-A cluster analysis of coping patterns and their associations with relational cognitions and goals

BACKGROUND

Provoked vestibulodynia (PVD) is a common pain condition, negatively impacting the relationships and sexual lives of sufferers. Women's coping behaviour has been associated with psychosexual outcomes, yet coping patterns in clinical PVD samples are unexplored, and it is not known how women's coping relates to their relational context.

METHOD

Women (N = 128) with PVD answered questionnaires about psychosexual function, pain coping (avoidance and endurance), relational- and pain catastrophizing, sexual goals and perceived partner responses. Cluster analysis was used to explore coping patterns; clusters were validated on measures of pain and psychosexual function and compared on catastrophizing, sexual goals and partner responses using multivariate analyses of variance.

RESULTS

The analysis yielded four clusters: endurance; combined high avoidance and endurance; avoidance; and combined low. The group with high levels of both avoidance and endurance coping displayed the worst psychosexual outcomes and high levels of pain- and relational catastrophizing, approach and avoidance goals and perceived negative partner responses.

CONCLUSION

There are distinct patterns of coping among women with PVD, and these coping patterns are associated with psychosexual outcomes and relational cognitions and goals, and perceived partner responses. Women who alternate between avoidance and endurance are more distressed and report worse psychosexual functioning. This pattern needs to be identified and addressed in the treatment of PVD.

SIGNIFICANCE STATEMENT

This study extends previous findings on vulvar pain coping patterns to a clinical population of women with PVD. It is further the first study to address the relationship between relational variables, such as partner responses and relational catastrophizing and different coping patterns. Thus, the contribution of this study is the contextualizing of coping patterns among women with PVD. The results showed that a combined pattern of avoidance and endurance coping is associated with high distress, poor psychosexual outcomes, and indications of insufficient relational coping, highlighting the need for clinical assessment and intervention to target both women's individual coping patterns and their relational context.

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

INTRODUCTION

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

METHODS

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

RESULTS

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

CONCLUSION

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

Social media addiction, escapism and coping strategies are associated with the problematic internet use of adolescents in Türkiye: a multi-center study

Introduction

The literature highlighted that problematic internet use can have detrimental consequences on individuals' well-being. Social media addiction, escapism and coping skills are closely related to problematic internet use. However, no study has currently examined the relationship between problematic internet use and social media use, escapism and coping skills.

Method

This multicenter cross-sectional designed study evaluated the relationships between problematic internet use and social media addiction, escapism, and coping skills in 508 adolescents (319 female) aged 14-18 years. In order to collect data, sociodemographic data form, Internet Addiction Scale, Social Media Addiction Scale, Escapism Scale and Kidcope Adolescent Version have been used. First, adolescents who scored ≥50 on the Internet Addiction Test were classified as the problematic internet use group; adolescents who scored <50 were classified as the control group. Then, the relationships between problematic internet use and social media addiction, escapism and coping skills were evaluated.

Results

The results showed that problematic internet use was associated with duration of social media use, impairment in social media-related functionality, preferring virtual life, and virtual pleasure, escapism, avoidant and negative coping strategies.

Conclusion

These findings may provide an empirical basis for problematic internet use prevention and intervention in adolescence.

Adolescent coping and social media use moderated anxiety change during the COVID-19 pandemic

INTRODUCTION

Adolescence is a sensitive period during which stressors and social disruptions uniquely contribute to anxiety symptoms. Adolescent's coping strategies (i.e., avoidance and approach) during the coronavirus disease 2019 (COVID-19) pandemic may be differentially related to anxiety symptom changes. Further, social media use (SMU) is ubiquitous and may serve as an avenue to deploy avoidant and/or approach coping.

METHOD

Participants included 265 adolescents (ages 12-20 years; 55.8% female, 43.8% male) and one parent per adolescent. At two time points separated by ~6 months, adolescents reported on SMU and coping strategies, and parents and adolescents reported demographic information and adolescents' anxiety symptoms. Data were collected online in the United States, from summer 2020 through spring 2021.

RESULTS

Increases in avoidant coping predicted increasing anxiety, particularly when approach coping decreased. Decreases in both avoidant coping and SMU coincided with decreasing anxiety. Older adolescents showed decreasing anxiety when avoidant coping declined and SMU increased.

CONCLUSION

Coping strategies and SMU predicted patterns of adolescent anxiety symptom change across 6 months during the COVID-19 pandemic. Results highlight that coping and SMU should be contextualized within the time course of stressors.

Suicide and Non-Suicidal Self-Injury From Internet Addiction Among Korean Adolescents

Objectives

This study examined the associations between Internet addiction and suicide and non-suicidal self-injury (NSSI) among South Korean adolescents.

Methods

We conducted a cross-sectional study of 1694 Korean adolescents. The suicidal Ideation Questionnaire and Deliberate Self- Harm Inventories were used to identify high-risk suicide and NSSI groups, respectively. Internet addiction was assessed using the Internet Addiction Scale. Other questionnaires included sociodemographic data, perceived academic stress, and daily life-related factors. We also performed a logistic regression analysis using the high suicide risk and NSSI groups as dependent variables.

Results

The high suicide risk and NSSI prevalence rates among participants were 11.8% and 28.3%, respectively. A multivariable logistic regression analysis revealed that Internet addiction is associated with higher suicide risk and NSSI. Additionally, being female and academic stress were significant suicide risk factors, while male participants had a higher NSSI prevalence.

Conclusion

Our results suggest that monitoring adolescents' Internet use and providing education to prevent Internet addiction would lower high suicide and NSSI risk. Moreover, suicide and NSSI risk screening in adolescents with Internet addiction and providing suitable interventions will be essential for the preventing suicide and NSSI.

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

Background

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

Methods

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

Results

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

Conclusions

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

Revealing the Intellectual Structure and Evolution of Digital Addiction Research: An Integrated Bibliometric and Science Mapping Approach

The current study uses "digital addiction" as an umbrella term to refer to addiction to the Internet, social media, smartphones, digital devices, video games, or similar digital technologies. The study aims to investigate the scientific landscape of the digital addiction research field through combining bibliometric and science mapping analysis and to facilitate insight into the development and evolution of this knowledge base. Data for the analysis were extracted from the Scopus database, which covers a wide range of journal articles, with 429 articles addressing digital addiction included in the analysis. The science mapping analysis was performed over three consecutive time periods using SciMAT software to observe the thematic evolution. The results indicated that addictive behavior was the most significant theme across the three time periods. Cross-sectional studies addressing the risk factors or outcomes of addiction among adults and different sexes were prevalent during the first period (1997-2012), while interest moved to the addictive behavior of adolescents and students during the second period (2013-2017). Research during the third period (2018-2022) was driven by smartphone and social media addiction, and resilience as a preventive factor garnered more research interest than previously studied risk factors, which may indicate a perspective change by researchers. Implications are suggested for future investigations of digital addiction.

Associations between childhood psychological trauma, posttraumatic stress symptoms, and mental health in female college students: Mediation of coping styles

PURPOSE

To investigate the associations between childhood psychological trauma, posttraumatic stress symptoms (PTSS), and mental health in adulthood and to identify the mediation of active and passive coping on these associations in Korean female undergraduates.

CONCLUSIONS

Childhood psychological trauma had a direct association with current mental health in adulthood (β = 0.15, p < 0.001), which was mediated by PTSS (β = 0.34, p < 0.001). Each coping style partially mediated the relationship between (a) childhood psychological trauma and mental health and (b) PTSS and mental health.

PRACTICE IMPLICATIONS

It is necessary to develop nursing interventions to enhance coping strategies in female undergraduates to ensure better mental health and well-being.

Lower Avoidant Coping Mediates the Relationship of Emotional Intelligence With Well-Being and Ill-Being

Emotional intelligence (EI) abilities relate to desirable outcomes such as better well-being, academic performance, and job performance. Previous research shows that coping strategies mediate the effects of ability EI on such outcomes. Across two cross-sectional studies, we show that coping strategies mediate the relationships of ability EI with both well-being (life satisfaction, psychological well-being) and ill-being (depression, anxiety, stress). Study 1 (N = 105 first-year university students, 78% female) assessed EI with the Situational Test of Emotion Understanding (STEU) and Situation Test of Emotion Management (STEM). Avoidant coping significantly mediated the relationship of both the STEU and STEM with depression, anxiety, stress, and psychological well-being. EI was associated with lower avoidant coping, higher well-being and lower ill-being. Study 2 (N = 115 first-year university students, 67% female) assessed EI with the Mayer–Salovey–Caruso Emotional Intelligence Test (MSCEIT). Avoidant coping mediated the relationship between EI and ill-being, but not the relationship between EI and well-being. These effects were significant for three of the four EI branches—emotion perception, understanding, and management. We discuss possible reasons why avoidant coping may be an active ingredient by which lower EI relates to lower well-being. We also discuss a possible application of our findings—that EI training programs might benefit from including content aimed at reducing avoidant coping.

The Effects of Playing Video Games on Stress, Anxiety, Depression, Loneliness, and Gaming Disorder During the Early Stages of the COVID-19 Pandemic: PRISMA Systematic Review

During the initial phases of the COVID-19 pandemic, playing video games has been much more than just a pastime. Studies suggested that video games for many individuals have helped to cope with such difficult life experience. However, other research indicates that gaming may have had harmful effects. Within this context, this systematic review aimed to describe the literature on the effects of video games during the early stages of the COVID-19 crisis on stress, anxiety, depression, loneliness, and gaming disorder (GD), examining the study characteristics and outcomes. A systematic search of the literature was made following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. It was preregistered in the International Platform of Registered Systematic Review and Meta-Analysis Protocols (INPLASY)-INPLASY202180053. The search databases were PsycINFO, Web of Science, and Medline. The search string was: [("video game*") OR ("computer game*") OR ("gaming")] AND [("COVID-19")]. Twenty-four studies met the inclusion criteria. Four research explored the effects of playing video games during the COVID-19 pandemic on stress, anxiety, and depression. Four studies investigated loneliness, while 18 research investigated game disorder. Video games, especially augmented reality and online multiplayer ones, mitigated stress, anxiety, depression, and loneliness among adolescents and young adults during stay-at-home restrictions. However, in the case of at-risk individuals (i.e., particularly male youths), playing video games had detrimental effects.

Effects of Psychological Distress and Coping Resources on Internet Gaming Disorder: Comparison between Chinese and Japanese University Students

The high prevalence of Internet gaming disorder (IGD) among Asian youth indicates an urgent need to identify protective factors and examine their consistency across Asian cultures in order to facilitate cost-effective interventions. Based on the transactional theory of stress and coping, this study collected data of 1243 online gamers (45% males; 18-25 years) through an anonymous survey from universities in China and Japan and investigated whether three coping resources (i.e., mindfulness, coping flexibility, and social support) serve to protect Chinese and Japanese youth from the impact of psychological distress on IGD tendency. After adjusting for the measurement non-invariance across samples, we found that Japanese students reported higher levels of IGD tendency and psychological distress than Chinese students. The results of multiple-group SEM analyses showed that, after controlling for other predictors, mindfulness served as the strongest protective factor against IGD across samples. Moreover, the buffering effect of mindfulness on the association between psychological distress and IGD tendency of female (but not male) students was observed. Our findings highlighted the cross-cultural invariance of the impact of psychological distress and coping resources on IGD in Chinese and Japanese youth, which can be considered in future IGD prevention programs.

Exploration of Psychological Mechanism of Smartphone Addiction Among International Students of China by Selecting the Framework of the I-PACE Model

The I-PACE (interaction of person-affect-cognition-execution) model explains that the causes of addiction are the result of individual susceptibility (genetic and personality), psychopathological factors (negative emotions), and cognitive and affective factor interaction. The issue of smartphone addiction and its emerging effects are now becoming an essential social enigma. This study is aimed at exploring how personal, affective, cognitive, and execution factors accelerate the mechanism of smartphone addiction among international students. Randomly selected, six hundred international students have constituted the population for our study. All participants were asked to complete self-administered questionnaires. The questionnaire included demographics (gender, place of stay, educational level, and reason for smartphone usage), Mobile Phone Addiction Index, Loneliness Scale (UCLA), Rosenberg Self-Esteem Scale, Beck Depression Inventory, Perceived Stress Scale, Eysenck Personality Questionnaire, and Simplified Coping Style Questionnaire. Statistical analysis was performed using SPSS. 20.3% (n = 122) of international students are agonized with smartphone addiction, while 79.7% (n = 478) use smartphones at an average level. Students' place of stay, neuroticism personality, social desirability, self-esteem, loneliness, depression, perceived stress, and passive coping are associated with smartphone addiction. Loneliness and depression show a strong positive significant correlation, among other variables while loneliness, neurotic personality, depression, low self-esteem, stress, and passive coping are risk factors for smartphone addiction. This study reveals that international students are a high-risk group for smartphone addiction. It has a great deal of impact on students' behavior and psyche. Multiple social, psychological, affective, and cognitive factors affect smartphone addiction. It would be beneficial to direct the students to limit their phone usage and indulge in other healthy physical activities to complete academic goals.

Internet addiction and nonsuicidal self-injury in adolescence: Associations with offline and online social support

OBJECTIVES

Both nonsuicidal self-injury (NSSI) and Internet addiction (IA) are important health issues for adolescents, and social support has been extensively examined as a protective factor for both. This study aims to compare the effect of offline and online social support on IA, and that on NSSI as well.

METHOD

A total of 1911 Chinese adolescents (53.27% females, M_age  = 16.83 ± 0.37) completed self-report questionnaires assessing offline social support, online social support, IA, and NSSI.

RESULTS

The structural equation modeling analysis showed that offline social support was negatively associated with IA and NSSI, while online social support was positively associated with IA and NSSI; IA was positively associated with NSSI. Furthermore, implications for preventions and interventions of IA and NSSI were discussed. The indirect model explained a relatively small variance of NSSI, indicating the possibility of additional factors in the development of NSSI that should be further investigated.

CONCLUSION

This study indicated the differences between offline and online social support, and their different associations with IA and NSSI.

Coping with Stress, Executive Functions, and Depressive Symptoms: Focusing on Flexible Responses to Stress

Coping flexibility is conceptually similar to both inhibition and set-shifting. Though they serve different functions, all three are robustly associated with depression. Coping flexibility is the ability to relinquish a coping strategy regarded as ineffective and to devise and implement an alternative one; the concept is based on stress and coping theory. Inhibition is the ability to suppress responses selectively according to a change in the situation, while set-shifting is the process of switching flexibly between task sets, mental sets, or response rules. Inhibition and set-shifting are both executive functions in cognitive mechanisms. We hypothesized that coping flexibility was associated with a lower risk of depression, even when the effects of inhibition and set-shifting were controlled for. In total, 200 Japanese university students (100 women and 100 men) completed questionnaires that measured coping flexibility and depression and performed the Stroop Color and Word Test and the Wisconsin Card Sorting Test, which measured inhibition and set-shifting. We found that greater coping flexibility was associated with a lower risk of depression, even when the effects of inhibition and set-shifting were controlled for. Our findings suggest that, although coping flexibility is conceptually similar to inhibition and set-shifting, its association with depression differs from theirs.

Effects of Coping Flexibility in Young Women on Depressive Symptoms during Chronic Pain

Chronic pain is a worldwide problem that has a high prevalence rate and is often comorbid with depression. Coping flexibility, which is defined as the ability to discontinue an ineffective coping strategy-evaluation coping-and to produce and implement an alternative strategy-adaptive coping-has attracted much interest as an important factor that attenuates pain-induced stress responses, including depression. This study hypothesized that greater coping flexibility would be associated with lower depression in both women with chronic pain and those with menstrual pain. The participants included women with chronic pain (n = 292) and those with menstrual pain (n = 181) who completed questionnaires on pain intensity, pain acceptance, psychological inflexibility, and coping flexibility for chronic pain. The hierarchical multiple regressions revealed that both evaluation coping and adaptive coping predicted depression even after controlling for the effects of pain intensity, pain acceptance, and psychological inflexibility, which are well-known for their association with depression in patients with chronic pain. The hypothesis was supported in our samples. Our findings may contribute to the development of self-management without self-medication using over-the-counter analgesics by acquiring coping flexibility for chronic pain.

Associations Between Defence-Style, Eating Disorder Symptoms, and Quality of Life in Community Sample of Women: A Longitudinal Exploratory Study

Background and Aim: Eating Disorders (EDs) impact an estimated 15% of the global population and are linked to maladaptive defence-styles (coping strategies) and poorer mental health outcomes. Defence-styles have been grouped into immature, neurotic, and mature behaviours. Studies have yet to examine all three defence-styles in ED symptomatic individuals over an extended period of time. The current study aimed to investigate using converse analysis the relationships between defence-style and ED outcomes over a 5-years period. Methods: Participants (n = 216, mean age 33 years) were recruited through the Women's Eating and Health Literacy study, with the current study examining a 5-years period of two waves (year-4 and year-9). The current study tested associations over time between eating pathology (EDE-Q), psychological distress (K10), mental and physical health related quality of life (M/PHRQoL, SF-12), and defence-style (DSQ-40). Results: Mature, immature and neurotic defence-styles did not significantly change over 5 years. Over the same period, only PHRQoL significantly predicted mature defence-styles having positive effect. Both MHRQoL and PHRQoL significantly predicted immature defence-styles having positive and negative effects, respectively. Psychological distress, PHRQoL and weight concern significantly predicted neurotic defence-styles having positive effects except for psychological distress. PHRQoL, MHRQoL, restraint and eating concern significantly predicted overall eating pathology having positive effects except for PHRQoL and MHRQoL. Conversely, among the defence-style variables, over 5 years, both immature and neurotic defence-styles significantly predicted psychological distress having positive effects, immature and mature defence-styles significantly predicted MHRQoL having negative and positive effects, respectively, while only immature defence-styles significantly predicted overall eating pathology having positive effect. Conclusions: The results of the current study suggest that immaturity and neuroticism but not maturity were the defence-style variables predicting psychological distress over a 5-years period while conversely psychological distress predicted only neurotic defence styles. The findings of the current study may suggest that without intervention, mature, immature and neurotic defence-styles may largely remain immutable to significant shifts over time. Limitations in the current study included limited demographic representation. The current study is anticipated to generate considerations into treatments that could strengthen defence-styles in individuals with increased eating pathology.

Can Adverse Childhood Experiences Heighten Risk for Problematic Internet and Smartphone Use? Findings from a College Sample

Background: College students are among the heaviest users of smartphones and the Internet, and there is growing concern regarding problematic Internet (PIU) and smartphone use (PSU). A subset of adverse childhood experiences, household dysfunction [(HHD) e.g.; parental substance use, mental illness, incarceration, suicide, intimate partner violence, separation/divorce, homelessness], are robust predictors of behavioral disorders; however, few studies have investigated the link between HHD and PIU and PSU and potential protective factors, such as social support, among students. Methods: Data are from a diverse California student sample (N = 1027). The Smartphone Addiction Scale—Short Version and Internet Addiction Test assessed dimensions of addiction. Regression models tested associations between students’ level of HHD (No HHD, 1–3 HHD, ≥4 HHD) and PSU and PIU, and the role of extrafamilial social support in these relationships, adjusting for age, gender, ethnicity, SES, employment loss due to COVID-19, and depression. Results: Compared to students reporting no HHD, students with ≥4 HHD had twice the odds (AOR: 2.03, 95% CI: 1.21–3.40) of meeting criteria for PSU, while students with 1–3 HHD and ≥4 HHD had three and six times the odds of moderate to severe PIU (AORs: 2.03–2.46, CI:1.21–3.96) after adjusting for covariates. Extrafamilial social support was inversely associated with PIU and moderated the HHD–PSU association for students with 1–3 HHD. Conclusion: Students exposed to HHD may be especially vulnerable to developing behavioral addictions such as PSU and PIU. Extrafamilial social support offset the negative effects of HHD for PSU among the moderate risk group; implications for prevention efforts are discussed.

Internet Gaming Disorder, Risky Online Behaviour, and Mental Health in Hong Kong Adolescents: The Beneficial Role of Psychological Resilience

In the present cyber age, Internet gaming disorder (IGD) and risky online behaviour are prevalent, and adolescents are especially vulnerable to such emergent problems. Few studies have explored the protective factors that mitigate harm caused by IGD and various common risky online behaviours. This study examined the prevalence of IGD and risky online behaviour, their hypothesised associations with depressive symptoms, and the beneficial role of psychological resilience as an underlying psychological mechanism. The participants included 1,099 Chinese junior secondary school students (33% boys, mean age = 13.5 years, age range = 10-17 years) who completed a battery of validated self-report questionnaires at their schools. The results revealed that 4% of the participants were at high risk of IGD and 6% were at an overall risk level of IGD. Depressive symptoms were positively associated with IGD and risky online behaviour, and psychological resilience mediated both of these associations. These results imply that clinicians and teachers should incorporate psychological resilience training into intervention approaches to mitigate IGD and risky online behaviour.

Social Capital-Accrual, Escape-From-Self, and Time-Displacement Effects of Internet Use During the COVID-19 Stay-at-Home Period: Prospective, Quantitative Survey Study

BACKGROUND

COVID-19 has spread like wildfire across the globe, prompting many governments to impose unprecedented stay-at-home orders to limit its transmission. During an extended stay-at-home period, individuals may engage in more online leisure activities. Internet use is a double-edged sword that may have both desirable and undesirable effects on psychological well-being, and this study sought to disentangle adaptive from maladaptive internet use amidst this unusual health crisis.

OBJECTIVE

The objectives of this study were to assess the prevalence of probable depression during the COVID-19 stay-at-home period and to test three hypothesized risk reduction or risk elevation mechanisms, namely social capital-accrual, escape-from-self, and time-displacement effects.

METHODS

This study took place from March to May 2020 at the early stage of the pandemic. The study adopted a prospective design, with an online survey administered to 573 UK and 474 US adult residents at two assessment points 2 months apart.

RESULTS

The prevalence of moderate to severe depression was 36% (bootstrap bias-corrected and accelerated [BCa] 95% CI 33%-39%) at Time 1 (ie, initial time point) and 27% (bootstrap BCa 95% CI 25%-30%) at Time 2 (ie, follow-up time point). The results supported the social capital-accrual hypothesis by showing that the approach coping style was inversely associated with Time 2 depression through its positive associations with both social networking and perceived family support. The results also supported the escape-from-self hypothesis by revealing that the avoidant coping style was positively associated with Time 2 depression through its positive associations with both gaming and cyberbullying victimization, but the serial mediation model was no longer significant after Time 1 depression and some demographic risk factors had been controlled for. Finally, the results supported the time-displacement hypothesis by showing that gaming was positively associated with Time 2 depression through its inverse associations with social networking and perceived family support.

CONCLUSIONS

During the extended stay-at-home period in the early stages of the COVID-19 pandemic, the prevalence of probable depression during the 2-month study period was high among the UK and US residents. Individuals with distinct coping styles may engage in different types of online leisure activities and perceive varying levels of social support, which are associated with risks of probable depression.

Examination of the Coping Flexibility Hypothesis Using the Coping Flexibility Scale-Revised

Coping flexibility, as defined by the dual-process theory, refers to one’s ability to relinquish a coping strategy recognized as ineffective—abandonment—and to devise and implement an alternative and more effective strategy—re-coping. The coping flexibility hypothesis (CFH) dictates that richer coping flexibility produces more adaptive outcomes caused by stress responses, such as reduced psychological and physical dysfunction. We tested the reliability and validity of the Coping Flexibility Scale-Revised (CFS-R) and the CFH using the CFS-R, which was developed to measure coping flexibility. In total, we performed three studies involving 6,752 participants. Study 1 provided the psychometric properties of the CFS-R and tested this factorial structure by a confirmatory factor analysis. Study 2 estimated the validity of the CFS-R by examining the associations between its three subscales and variables that were conceptually similar to them. Study 3 tested the CFH using a longitudinal design after controlling for the effects of typical coping strategies and other types of coping flexibility. Overall, the CFH was supported by the use of the CFS-R, and the findings in Studies 2 and 3 showed that it had acceptable validity and reliability. Our findings implied that abandonment and re-coping can predict reduced depressive symptoms more than other types of theoretical framings for coping flexibility. Additionally, a meta-analysis of the Cronbach’s alphas for all samples in this study (k = 9, N = 6,752) showed that they were 0.87 (95% CI [0.87, 0.88]) for abandonment, 0.92 (95% CI [0.91, 0.92]) for re-coping, and 0.86 (95% CI [0.85, 0.87]) for meta-coping.

Contextualising video game engagement and addiction in mental health: the mediating roles of coping and social support

INTRODUCTION

A challenge in defining Internet Gaming Disorder (IGD) is discriminating pathological gameplay from an excessive, yet benign, involvement in video games. Although previous research has explored this theoretical distinction in the context of general computing activities, it merits consideration with regards to online gaming. Additionally, whilst comorbidities of addicted gaming and mental health outcomes have been robustly demonstrated, few studies have examined the role of mediating factors that may contextualise this relationship. As such, the present study aims to validate the distinction between addiction and engagement in online gaming, by considering the mediating roles of coping and social online and offline support in mental health.

METHOD

One hundred and thirty-five participants completed the Computer Engagement/Addiction Questionnaire (CEAS), Depression-Anxiety-Stress Scale (DASS-21), Brief Approach-Avoidance Coping Questionnaire (BACQ) and two versions of the Multidimensional Scale of Perceived Social Support (MSPSS).

RESULTS

Correlational analyses showed a clear distinction between gaming addiction and engagement in the context of all of depression, stress and in particular anxiety (DAS) not found in previous studies. Multiple mediation analysis showed a significant mediating effect of coping, (specifically withdrawal/resignation coping) on the relationship between video game addiction and symptoms of DAS. Offline perceived social support was a significant partial mediator in the relationship between gaming addiction and depression, as compared to any kind of online social support. The results support the distinction of the addiction and engagement concepts in gaming. This study may inform future clinical classifications of IGD, with implications on how pathological gaming is treated.

Prevalence and Predisposing Factors of Suicidal Ideation Among the University Students in Bangladesh: A Single-Site Survey

Recently, suicide among Bangladeshi university students has become a serious problem. However, to date, there have been no studies assessing suicidal behaviors among Bangladeshi students. Therefore, the present study investigated suicidal ideation (SI) and its risk factors among this population. A classroom-based convenience sampling method was utilized to survey 665 students of a university in Bangladesh (67.5% males; aged 21.16 years: SD ± 1.6). In addition to socio-demographic questions, the survey also included the Smartphone Application-Based Addiction Scale, Bergen Facebook Addiction Scale, and Depression Anxiety Stress Scale–21. Results showed that the prevalence of suicidal ideation was 2.3% in the past 24 h, 4.8% in the past 15 days, 6.9% in the past month, 14.7% in the past year, and 61.1% in the lifetime. The unadjusted regression model showed that being divorced (or separated) from a partner (OR = 4.486, 95% CI = 1.972–10.207, p < 0.0001), Facebook addiction (OR = 1.550, 95% CI = 1.006–2.388, p = 0.047), depression (OR = 1.657, 95% CI = 1.677–4.211, p < 0.0001), anxiety (OR = 2.649, 95% CI = 1.624–4.320, p < 0.0001), and stress (OR = 2.626, 95% CI = 1.673–4.122, p < 0.0001) were the risk factors of past-year SI. Compared with global prevalence rates, the present study reported higher levels of SI prevalence. Therefore, supportive suicide prevention programs are needed to tackle SI and alongside comorbid psychopathology.

Do smartphones and social network sites become more important when experiencing stress? Results from longitudinal data

Previous research on stress and media use mainly concentrated on between-person effects. We add to this research field by additionally assessing within-person associations, assuming that experiencing more stress than usual goes along with more nomophobia (“no-mobile-phone phobia”) and more passive and active Facebook use than usual, cross-sectionally and over time, and by exploring potential age differences. We conducted a secondary analysis of three waves of a representative multi-wave survey of adult Dutch internet users (N = 861). Specifically, we used two subsamples: (1) smartphones users for the analyses on nomophobia (n = 600) and (2) Facebook users for the analyses on social media (n = 469). Employing random-intercept cross-lagged panel models, we found within-person correlations between nomophobia and stress at one time-point, but not over time. For the younger age group (18–39 years), more passive Facebook use than usual was associated with more stress than usual six months later, and more stress than usual was followed by less passive Facebook use six month later. There were no longitudinal relationships for active Facebook use across the different age groups. Methodological and theoretical implications are discussed.

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We study the relationships of nomophobia, Facebook use and stress over time.

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Nomophobia and stress correlate on the within-person level at one time-point.

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Passive Facebook use is associated with more stress over time for younger adults.

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Stress relates to less passive Facebook use six months later for younger adults.

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There are no longitudinal effects for nomophobia, active Facebook use, and stress.

Problematic Internet use and the risk of suicide ideation in Chinese adolescents: A cross-sectional analysis

To evaluate the relationships between problematic Internet use (PIU) and suicidal ideation (SI) among adolescents, we encompassed 12,507 participants (16.6 ± 0.8 years). The occurrence of mood disorders, quality of life (QOL), personality traits and SI were compared in adolescents with and without PIU. Multilevel logistic regression models, trend analysis and interaction analysis were employed. A total of 2,809 (22.46%) adolescents reported SI. PIU was assessed using Internet Addiction Test score (IATs), and 3,442 (27.52%) participants met the criteria for PIU (IATs ≥ 40). PIU was significantly and independently associated with SI [AOR for suicidal ideation (vs. IATs < 40): 1.00 for 40-59 points; 1.3 (CI, 1.2-1.5): 60-79 points; 1.7 (CI, 1.4-2.1): 80-100 points; and 2.2 (CI, 1.2-3.9)]. Trend analysis demonstrated that PIU increased the risk of SI in each of the subgroups (p for trend ≤ 0.001 for each). Interaction analysis showed an association of PIU and SI that were dependent on mood disorders, QOL, impulsivity and aggression (p-value for interaction < 0.05). These findings highlight the need for a range of cross disciplinary health interventions to afflicted families, students, and clinicians, to increase the awareness of adverse PIU effects.

Suicidal ideation among Lebanese adolescents: scale validation, prevalence and correlates

BACKGROUND

In addition to the unstable political situation, Lebanon had experienced a cycle of wars, local armed conflicts, terrorist attacks, and crises (lack of clean water, recurrent power failure, and waste mismanagement, in addition to the growing number of unemployed people, as the number of Syrian refugees has dramatically increased, and led to competition for jobs with locals. All these factors make the Lebanese population prone to mental disorders, particularly suicide, without clear management policies. This study aims to validate the Columbia-Suicide Severity Rating Scale (CSSRS), and determine the prevalence of suicidal ideation and associated factors among a Lebanese nationally representative sample of adolescents from 9th to 12th grades.

METHODS

Participants were 1810 adolescents who enrolled in this cross-sectional study (January-May 2019), using a proportionate random sample of schools from all Lebanese Mohafazat. The Columbia-Suicide Severity Rating Scale was used to screen for suicidal ideation.

RESULTS

The results showed that 28.9% had some type of suicidal ideation [95% CI 26.7-31.1%]. The CSSRS items converged on a one-factor solution, accounting for a total of 85.40% of the variance (αCronbach = 0.966). Higher psychological abuse (Beta = 0.041), child physical abuse (Beta = 0.030), alcohol dependence (Beta = 0.062), social fear (Beta = 0.028), victimization/bullying score (Beta = 0.028), impulsivity (Beta = 0.028) and internet addiction (Beta = 0.010) scores were significantly associated with higher suicidal ideation. Same applies to adolescents whose parents are separated compared to living together (Beta = 0.992) and in females compared to males (0.311). On another hand, a higher age (Beta = - 0.182) was significantly associated with lower suicidal ideation.

CONCLUSION

This study provides insights about suicidal ideation among Lebanese adolescents and related risk factors, such as child psychological and physical abuse, alcohol use disorders, social fear, bullying and victimization, impulsivity, and internet addiction.

Prevalence of internet addiction among medical students: a study from Southwestern Iran

OBJECTIVE

In today's world, despite the numerous benefits, increasing demand for computer technology and the influence of widespread internet technology, many people, especially students, have faced impaired mental health and social relationships resulting from internet addiction; therefore, with regard to the contradictory results of preceding studies in the field of internet addiction, this study was designed to determine the prevalence of internet addiction in students of Ahvaz Jundishapur University of Medical Sciences.

METHODS

This descriptive study was conducted on all students of Ahvaz Jundishapur University of Medical Sciences. For data collection questionnaire and demographic profile of internet addiction test was used.

RESULTS

The results showed that internet addiction is common among university students (t = 23.286, p < 0.001). Internet addiction is significantly different between males and females and more prevalent in the male users (t = 4.351, p = 0.001). The prevalence of internet addiction in various categories was 1.6% normal, 47.4% mild, 38.1% moderate, and 12.9% severe. Our analysis also showed a significantly higher proportion of senior students with severe internet addiction (16.4%) compared to junior students (χ² = 30.964; p < 0.001).

CONCLUSION

Based on the findings of this study it can be concluded that there is a considerable internet addiction in medical students, and to prevent risks and complications, health considerations and proper treatments seem to be necessary.

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

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

Moderating effects of information-oriented versus escapism-oriented motivations on the relationship between psychological well-being and problematic use of video game live-streaming services

BACKGROUND AND AIMS

Video game live-streaming platforms are widely used by gamers. However, the excessive use of such services has rarely been examined. Although psychosocial well-being and motivations for use have been demonstrated to play major roles in online addiction, understanding the moderating mechanism of these two factors is warranted. Video game live-streaming platforms are an ideal context for studying the moderating role of both informational and escapism motivations, because viewers on such platforms can learn gaming strategies or escape from the reality.

METHODS

This study collected survey data from 508 users of the highly popular game-streaming service Twitch. The sample was divided into two groups based on the respondents' use motivations. Regression models with interaction terms were fitted, followed by a simple slope test, to verify the hypotheses.

RESULTS

For the escapism-oriented group, a moderating effect of escapism on the relationship between loneliness and negative outcomes was found; the relationship was positive for low and moderate levels of escapism, but it was non-significant for individuals with high levels of escapism. For the information-oriented group, information seeking was observed to exert a moderating effect on the relationship between stress and negative outcomes; the relationship was negative for low and moderate levels of information seeking, but it was non-significant for individuals demonstrating high levels of information seeking.

DISCUSSION AND CONCLUSIONS

The findings promote understanding regarding how individuals using similar Internet-related coping strategies to deal with problems differ in their propensity for experiencing negative consequences when motivation levels and online environments are considered.

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

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

S. W. Psychometric validation of the Internet Gaming Disorder-20 Test among Chinese middle school and university students

BACKGROUND AND AIMS

Internet gaming disorder (IGD) was proposed in Diagnostic and Statistical Manual of Mental Disorders of American Psychiatric Association as an area warranting more research attention. High prevalence of excessive Internet game use and related addictions has been reported in China, especially among youth; however, there is a lack of psychometrically and theoretically sound instruments for assessing IGD in the Chinese language.

METHODS

This study aimed to examine the psychometric properties of a Chinese version of the Internet Gaming Disorder Test (IGD-20 Test) among Chinese middle school (n = 569; Mage = 13.34; 46.2% females) and university students (n = 523; Mage = 20.12; 48.4% females) samples in Beijing, China. All participants voluntarily completed an anonymous questionnaire.

RESULTS

Confirmatory factor analysis results showed that the Chinese version of the IGD-20 Test had five factors (i.e., salience-tolerance, mood modification, withdrawal, conflict, and relapse). Measurement invariance was confirmed across the two samples. The test score was positively associated with the modified Young's Internet Addiction Test for gaming addiction. Concurrent validation was further demonstrated by the IGD-20 Test's positive correlation with weekly gameplay and depression symptoms. The latent profile analysis showed four different gamer classes (i.e., regular gamers, low-risk engaged gamers, high-risk engaged gamers, and probable disordered gamers), with the estimated prevalence of 2.1% of the last group.

DISCUSSION AND CONCLUSION

The IGD-20 Test was applicable to Chinese youth and its Chinese version generally demonstrated good psychometric properties.

Attachment and behavioral addictions in adolescents: The mediating and moderating role of coping strategies

Gambling, video gaming, and Internet use are typically included as everyday activities that could potentially become behavioral addictions. There is growing evidence that views non-substance related addictions as coping mechanisms, and considers that attachment styles are likely to play a pivotal role on the development of such addictions, especially on young people. Therefore, the present study aimed to: (1) explore the association between attachment, coping, and behavioral addictions (i.e., gambling disorder, video game addiction, and problematic Internet use); and (2) to analyze the mediating/moderating effect that coping has in the relationship of attachment and these behavioral addictions. A sample consisting of 472 students from secondary education (Mean age = 15.6; SD = 1.33; 51.6% females) was recruited. The findings showed a negative association between attachment and behavioral addictions. Most coping strategies were found to be associated with attachment styles, except for self-critique and emotional avoidance. In particular, problem avoidance was significantly correlated to all behavioral addictions. In addition, self-blame and problem solving were significantly correlated to video game addiction and problematic Internet use. Finally, coping was found to act as a mediator and moderator between attachment and video game addiction and problematic Internet use.

Unpacking the mechanisms underlying the relation between ostracism and Internet addiction

Prior studies have mainly focused on the psychological correlates of Internet addiction, but scant research has tested how actual interpersonal experience can influence people's tendency to spend an excessive amount of time online. The present research aimed to fill the research gap by investigating the potential relationship between ostracism and Internet usage as well as the mechanisms underlying such a linkage. Participants completed a series of well-validated measures assessing their ostracism experience in school, solitude seeking, self-control, and Internet addiction. The results established a significant positive association between ostracism and Internet addiction and demonstrated this relation was mediated by enhanced solitude seeking and impaired self-control. These findings advanced our current knowledge by showing that adverse interpersonal experiences in school can predict Internet addiction and by unveiling the underlying psychological mechanisms that can account for such a relation. They also highlight the importance of everyday interpersonal experiences in understanding people's behaviors in the cyberspace.

The relationship between coping style and Internet addiction among mainland Chinese students: A meta-analysis

The matter of whether different coping styles are correlated with increased Internet addiction or not remains a topic of debate. Most researchers have argued that Internet addiction is linked to low positive coping and high negative coping; however, others have rejected this opinion. Consequently, this meta-analysis examined the link between coping style and Internet addiction to address this controversy. Seventy-seven studies comprising 46,025 Chinese adolescent students were analyzed. The results suggested a medium negative correlation between positive coping and Internet addiction and a medium positive correlation between negative coping and Internet addiction. Furthermore, coping style measures, Internet addiction, region, and gender moderated these links. The link between negative coping and Internet addiction was largest when positive coping was measured with the Coping Style Questionnaire (CSQ), smaller when using the Simplified Coping Style Questionnaire, and smallest when using other measures. The negative correlation between positive coping and Internet addiction was largest when Internet addiction was measured with the Internet Addiction Test, smaller when using revised Chinese Internet Addiction Scale, and smallest when using other measures. For both positive and negative coping and Internet addiction, the correlations were largest in Eastern China, smaller in Central China, and smallest in Western China.

Association between problematic Internet use, sleep disturbance, and suicidal behavior in Chinese adolescents

BACKGROUND AND AIMS

This large-scale study aimed to test (a) associations of problematic Internet use (PIU) and sleep disturbance with suicidal ideation and suicide attempts among Chinese adolescents and (b) whether sleep disturbance mediates the association between PIU and suicidal behavior.

METHODS

Data were drawn from the 2017 National School-based Chinese Adolescents Health Survey. A total of 20,895 students' questionnaires were qualified for analysis. The Young's Internet Addiction Test was used to assess PIU, and level of sleep disturbance was measured by the Pittsburgh Sleep Quality Index. Multilevel logistic regression models and path models were utilized in analyses.

RESULTS

Of the total sample, 2,864 (13.7%) reported having suicidal ideation, and 537 (2.6%) reported having suicide attempts. After adjusting for control variables and sleep disturbance, PIU was associated with an increased risk of suicidal ideation (AOR = 1.04, 95% CI = 1.03-1.04) and suicide attempts (AOR = 1.03, 95% CI = 1.02-1.04). Findings of the path models showed that the standardized indirect effects of PIU on suicidal ideation (standardized β estimate = 0.092, 95% CI = 0.082-0.102) and on suicide attempts (standardized β estimate = 0.082, 95% CI = 0.068-0.096) through sleep disturbance were significant. Conversely, sleep disturbance significantly mediated the association of suicidal behavior on PIU.

DISCUSSION AND CONCLUSIONS

There may be a complex transactional association between PIU, sleep disturbance, and suicidal behavior. The estimates of the mediator role of sleep disturbance provide evidence for the current understanding of the mechanism of the association between PIU and suicidal behavior. Possible concomitant treatment services for PIU, sleep disturbance, and suicidal behavior were recommended.

Internet Addiction among Adolescents May Predict Self-Harm/Suicidal Behavior: A Prospective Study

OBJECTIVE

To explore the role of Internet addiction in the development of self-harm/suicidal behavior among adolescents after 1-year of follow-up.

STUDY DESIGN

We conducted this 1-year, prospective cohort study of 1861 adolescents (mean age 15.93 years) attending a senior high school in Taiwan; 1735 respondents (93.2%) were classified as having no history of self-harm/suicidal attempts in the initial assessment and were referred to as the "noncase" cohort. The Chen Internet Addiction Scale was used to identify individuals with Internet addiction. The participants were evaluated for self-harm/suicidal behavior again 1 year later and the "noncase" cohort was selected for statistical analysis. To examine the relationship between Internet addiction and self-harm/suicidal behavior, multivariate logistic regression analysis was performed using Internet addiction at baseline as the predictor for newly developed self-harm/suicidal behavior in the next year, after adjustment for potential confounding variables.

RESULTS

The prevalence rate of Internet addiction at baseline was 23.0%. There were 59 students (3.9%) who were identified as having developed new self-harm/suicidal behaviors on follow-up assessments. After controlling for the effects of potential confounders, the relative risk of newly emerging self-harm/suicidal behavior for participants who were classified as Internet addicted was 2.41 (95% CI 1.16-4.99, P = .018) when compared with those without Internet addiction.

CONCLUSIONS

Our findings indicate that Internet addiction is prospectively associated with the incidence of self-harm/suicidal behavior in adolescents.

Social Capital Accumulation in Location-Based Mobile Game Playing: A Multiple-Process Approach

In the summer of 2016, the widespread popularization of the game Pokémon Go brought the public's attention to the possible socialization benefits associated with location-based mobile games (LBMGs), yet no studies to date have investigated this issue. LBMGs deserve greater research attention because this type of game provides a unique gaming experience that encourages players to leave their homes and navigate around their neighborhood. This distinctive feature may promote more face-to-face interactions among LBMG players. Grounded in social capital theories, the present study compared the levels of both bridging and bonding social capital between LBMG and non-LBMG players. More important, we formulated a multiple-process model to explain the hypothesized psychological mechanisms underlying social capital accumulation among LBMG players. Participants were 349 U.S. participants (57 percent men; M_age = 32.40, SD_age = 7.92, age range = 19-66). Results supported the proposed model by revealing that face-to-face interaction was crucial to the accrual of both bridging and bonding social capital among LBMG players, through enhancing their levels of communication frequency and self-disclosure. The present findings have implications for the utilization of LBMG as a potential tool to promote face-to-face interactions and accumulate social capital.