Internet Addiction and Relationships with Insomnia, Anxiety, Depression, Stress and Self-Esteem in University Students: A Cross-Sectional Designed Study

Mental health in the virtual world: Are we ready for the metaverse era?

The advent of the metaverse, including virtual reality, augmented reality, and artificial intelligence, is an undeniable issue that health care scientists need to update. It influences all fields of knowledge, interpersonal relationships, and health. Regarding mental health since the post-coronavirus disease 2019 pandemic, it is necessary to consider and understand the potential, possibilities, weaknesses, and consequences arising from and provided by this new scenario. Due to the increasing need for mental health monitoring and care, mental health treatments require in-depth training and preparation to achieve the maximum use of the metaverse advantages and possibilities. Currently, very little is known about the effectiveness of remote mental health treatment, but it is certainly suggested that accessibility and the characteristics associated with the use of metaverse technologies may represent new horizons for accessibility and approach tools, as long as more studies are carried out and more evidence is collected to develop accurate guidelines, safe training, solve ethical concerns, and overcome limitations.

The role of physical activity in mitigating stress-induced internet addiction among Chinese college students

BACKGROUND

This study addresses the nexus of stress, physical exercise, and internet addiction in college students, aiming to unravel their complex interactions. With prior research hinting at correlations, this study seeks deeper insights into the optimal exercise duration and the mediating role of physical activity in the stress-internet addiction relationship.

METHODS

We examined 2892 Chinese college students, assessing psychosocial traits via established scales: the Chinese Internet Addiction Scale (CIAS-R), International Physical Activity Questionnaire (IPAQ), and DASS-21 for stress. We adopted a questionnaire survey method to collect data, and through convenience sampling, participants were selected. Analysis involved Structural Equation Model (SEM) and restricted cubic splines (RCS).

RESULTS

Among participants, 22.0 % self-reported internet addiction symptoms. Notably, a non-linear correlation between moderate (MPA) and vigorous physical activity (VPA) and internet addiction was evident (P < 0.001), while light physical activity (LPA) showed no significant association (P = 0.182). MPA initially reduced internet addiction as activity hours increased, but its efficacy lessened after 0.8 h/day. Conversely, VPA's impact fluctuated, declining from 0 to 0.18 h/day, then stabilizing. SEM analysis highlighted VPA and MPA's partial mediation in the stress-internet addiction relationship. Specifically, the path coefficient from stress to MPA was -0.037 (P < 0.05), and the path coefficient from MPA to internet addiction was -0.056 (P < 0.01). Additionally, the path coefficient from stress to VPA was -0.067 (P < 0.001), and the path coefficient from VPA to internet addiction was -0.102 (P < 0.001).

CONCLUSION

This study unveils the intricate interplay between physical activity, stress, and internet addiction among college students. With 22.0 % reporting addiction symptoms, urgent interventions tailored to promoting healthy physical activity levels are imperative to mitigate internet addiction risks.

LIMITATIONS

The cross-sectional nature of our design precludes the establishment of causal relationships between psychological stress and internet addiction.

Examining the interplay between physical activity, problematic internet use and the negative emotional state of depression, anxiety and stress: insights from a moderated mediation path model in university students

BACKGROUND

The aim of this study was to investigate the relationship between Problematic Internet Use (PIU), emotional states of stress, anxiety and depression, and the practice of physical activity among Tunisian students.

METHODS

Cross-sectional data were collected from 976 university students aged 20.76 ± 1.63 years (46.8% female). They filled out an online survey comprised of a socio-demographic questionnaire, the depression, anxiety and stress scale- 21 items (DASS-21), the international physical activity questionnaire (IPAQ) and the compulsive internet use scale (CIUS). Students were divided, based on their economic levels, into three groups: low (n = 256, 26.23%), medium (n = 523, 53.59%) and high (n = 197, 20.18%).

RESULTS

Mediation analysis: Indirect effects of IPAQ and gender on DASS-21 were highlighted: β= -0.18 (p < 0.01) and β= -0.04, P < 0.01) respectively. In addition, a significant and negative effect of IPAQ on CIUS was demonstrated (β = -0.45, P < 0.01). In addition, the effect of CIUS on DASS-21 was significant (β = 0.39, P < 0.01). Also, the effect of gender on CIUS was significant (β=-0.10, P < 0.01) However, its effect on DASS-21 was not significant (β = 0.05, p = 0.078). The total effect of IPAQ on DASS21 was significant (β= -0.52, p < 0.01) but the effect of Gender on DASS-21 was not significant (β = 0.01, p = 0.817). Moderation analysis: the results showed a significant moderation effect of the interaction between IPAQ and Gender on CIUS (β = 0.07, p < 0.01). However, it was not significant between Gender and CIUS on DASS-21 (β = 0.09, p = 0.390) and between IPAQ and Gender on DASS21 (β = 0.01, p = 0.736) Also, the interaction between IPAQ and CIUS did not have a significant moderation effect on DASS-21 (β = 0.15, p = 0.115).

CONCLUSIONS

Findings suggest that relationships between PIU and negative emotional state of depression, anxiety and stress are mediated via physical exercise. These results underscore the importance of the physical activity factor in the studies analyzing longitudinal effects of PIU on mental health outcomes.

Prevalence of Internet Addiction and Its Association with Psychological Disorders Among Medical Students in Saudi Arabia

Background

Internet addiction is increasing worldwide. Internet addiction (IA) refers to excessive Internet usage in an uncontrolled and time-consuming manner, causing loss of time and disruption of daily life. However, the prevalence of IA may vary according to age, sex, and ethnicity, and is more prevalent among college students. There is a strong link between problematic Internet usage and an increased risk of developing Post Traumatic Stress Disorder PTSD and depression symptoms. Medical students were chosen for this study due to their unique stressors, including rigorous academic demands, extensive study hours, and clinical practice requirements. It is critical to address behavioral addictions and their psychological effects in this group, as they are linked to the future quality of healthcare provision compared with their non-medical peers.

Objective

To estimate the prevalence of Problematic Internet Use (PIU) in medical students and explore their correlation with the medical students' PTSD and Patient Health Questionnaire -9 (PHQ9) scores.

Methods

A cross-sectional online survey was conducted including 506 medical students in the second year of medical school up to internship year at Imam Abdulrahman bin Faisal University (IAU) between June 2021 and January 2022. The questionnaire consisted of consent forms, sociodemographic data, and screening tools for PTSD, the GPIU, and PHQ-9.

Results

The prevalence of problematic internet usage (PIU) was 30.6% in the sample group. Students with moderate-to-moderately severe PTSD were 1.7 times more likely to have PIU OR (95% CI): 1.7 (1.091, 2.879). Students with moderate to severe depression were 2.2 times more likely to have PIU OR (95% CI); 2.2 (1.333, 3.950).Having a Saudi nationality, lower income, and being single was significantly associated with PIU.

Conclusion

Single Saudi medical students with lower income are at risk of developing more problematic internet use. Especially those who score moderate to high on PTSD and PHQ-9 scales.

Heterogeneity in the co-occurrence of depression and anxiety among adolescents: Results of latent profile analysis

BACKGROUND

Depression and anxiety co-occur frequently and there is heterogeneity in the co-occurrence of such symptoms; however, few previous studies investigated the heterogeneity based on person-centered perspectives in adolescents. The primary aim of our study was to explore it using latent profile analysis (LPA), a person-centered statistical approach.

METHOD

The Patient Health Questionnaire-9 (PHQ-9) and General Anxiety Disorder-7 (GAD-7) were used to examine depression and anxiety symptoms in 7422 Chinese adolescents from 23 primary and secondary schools. To investigate latent profiles and assess profile validity, we employed Latent Profile Analysis (LPA), multinomial logistic regression, and analysis of variance.

RESULTS

A three-profile model was suggested as the optimum: low (69.9 %), moderate (21.6 %), and high depression/anxiety (8.5 %). Female with higher negative cognitive bias and higher emotional regulation difficulty are more likely to be categorized in the high depression/anxiety group. Internet addiction, academic "Lying flat" and involution are significantly and positively linked with the severity of anxiety and depression.

LIMITATIONS

Reliance on self-reported measures may lead to response bias; the cross-sectional design limits our ability to study how symptom profiles and category membership change over time.

CONCLUSIONS

Three latent profiles of the co-occurrence of depression and anxiety presented a parallel pattern, which serves as a poignant reminder of the imperative need to identify Chinese adolescents who may be at elevated risk for depression and/or anxiety, and promoting intervention that are meticulously tailored to address the unique symptom presentations of each individual.

Decreased Serum Cocaine- and Amphetamine-Regulated Transcript Level in Internet Gaming Disorder

OBJECTIVE

Vulnerability to internet gaming disorder (IGD) has increased as internet gaming continues to grow. Cocaine- and amphetamine-regulated transcript (CART) is a hormone that plays a role in reward, anxiety, and stress. The purpose of this study was to identify the role of CART in the pathophysiology of IGD.

METHODS

The serum CART levels were measured by enzyme-linked immunosorbent assay, and the associations of the serum CART level with psychological variables were analyzed in patients with IGD (n=31) and healthy controls (HC) (n=42).

RESULTS

The serum CART level was significantly lower in the IGD than HC group. The IGD group scored significantly higher than the HC group on the psychological domains of depression, anxiety, the reward response in the Behavioral Activation System and Behavioral Inhibition System. There were no significant correlations between serum CART level and other psychological variables in the IGD group.

CONCLUSION

Our results indicate that a decrease in the expression of the serum CART level is associated with the vulnerability of developing IGD. This study supports the possibility that CART is a biomarker in the pathophysiology of IGD.

The relationship between internet addiction and stress, anxiety, and depression in adolescents in Saudi Arabia

BACKGROUND

There is an increasing rate of Internet addiction among adolescents that may lead to many negative psychological outcomes. This study assessed the relationship between Internet addiction and stress, anxiety, and depression in adolescents in Saudi Arabia.

METHODS

A correlational online survey captured data on Internet use and psychological outcomes from 462 adolescents between March and May 2022. Young's Internet Addiction Scale assessed the degree of Internet addiction. The Depression, Anxiety, and Stress Scale (DASS21) assessed the perceived level of stress, anxiety, and depression. Bivariate and multivariate analyses determined the relationship between Internet addiction and depression, anxiety, and stress.

RESULTS

Sixty-eight percent of adolescents had mild to severe Internet addiction. Sixty percent of the adolescents perceived mild to extremely severe depression, 58% perceived mild to extremely severe anxiety, and 44% perceived mild to extremely severe stress. Adolescents with more Internet addiction scores perceived more stress, anxiety, and depression (p ≤ 0.05).

CONCLUSIONS

The Internet addiction rate is high among adolescents in Saudi Arabia. Adolescents with more Internet addiction scores are prone to perceive higher levels of stress, anxiety, and depression.

APPLICATION TO PRACTICE

Interventional multidisciplinary programs are needed to make adolescents, parents, schoolteachers, and school nurses in Saudi Arabia aware of Internet addiction and methods to reduce the dependence of those adolescents on the Internet. School nurses should provide adolescents and parents with means to reduce their Internet dependence.

Factors associated with problematic internet use among University of Gondar undergraduate students, Northwest Ethiopia: Structural equation modeling

BACKGROUND

For young adults and adolescents, excessive internet use has become a serious public health concern due to its negative impact on their health. It has been associated with detrimental effects on both physical and mental health. Negative academic outcomes were observed in the students, including missing classes, lower grades, and academic dismissal. Therefore, the purpose of the current study was to identify factors associated with PIU among undergraduate students at the University of Gondar.

METHOD

A cross-sectional study was conducted at the University of Gondar among 1514 undergraduate students from June 1-20, 2022. The study participants were selected using a stratified simple random selection procedure. Using structural equation modeling, the degree of relationship was ascertained. A p-value of less than 0.05 and an adjusted regression coefficient with a 95% confidence interval (CI) were used to interpret the data.

RESULTS

In our study, being from non-health departments [β = 0.11, 95% CI: 0.037, 0.181], current alcohol use [β = 0.12, 95% CI: 0.061, 0.187], depressive symptoms [β = 0.23, 95% CI: 0.175, 0.291], insomnia symptoms [β = 0.12, 95% CI: 0.060, 0.196], and ADHD symptoms [β = 0.11, 95% CI: 0.049, 0.166] had a significant positive effect on PIU, while having a history of head injury had a significant negative effect [β = -0.12, 95% CI: -0.226, -0.021] on PIU.

CONCLUSION AND RECOMMENDATION

Factors such as current alcohol use, non-health department type, depressive symptoms, insomnia, and ADHD symptoms were positively associated with PIU. However, a history of head injuries was negatively associated with PIU. Therefore, strategies aimed at the early identification of PIU may lead to an improvement in the psychosocial health of university students.

Insomnia among college students: A bibliometric analysis from 2003 to 2022

BACKGROUND

Insomnia has become a common health problem in modern society, especially among college students. The purpose of this study was to analyze the research status, research hotspots and frontier trends of insomnia among college students over the past 20 years.

METHODS

VOSviewer 1.6.19 and CiteSpace 6.2 were used. R4: This study conducts a bibliometric and visualization analysis of the annual publications, authors, countries/regions, institutions, categories, journal/literature cocitations and keywords related to insomnia among college students in the Web of Science (WoS) core collection from 2003 to 2022.

RESULTS

A total of 590 studies were included, and the number of studies on insomnia among college students has steadily increased over the last 20 years. The authors of high yield are represented by Taylor DJ and Miller MB. The countries/regions with high yields were the USA and China. The institutions of high yield were King Saud University and Southern Medical University. Its research fields were mainly Clinical Neurology, Psychiatry and Neurosciences. Mental health and insomnia, sleep quality and the impact of coronavirus disease 2019 (COVID-19) on insomnia are current research hotspots. Future research could focus on predicting the chronotype and physical activity of insomnia students.

CONCLUSION

Through bibliometric and visualization analysis, this study investigated insomnia among college students over the past 20 years and preliminarily revealed the findings of coauthors and institutions. This study provides a general understanding of the research hotspots and frontier trends of insomnia among college students and provides some references for future research.

Social media addiction: associations with attachment style, mental distress, and personality

BACKGROUND

Social media bring not only benefits but also downsides, such as addictive behavior. While an ambivalent closed insecure attachment style has been prominently linked with internet and smartphone addiction, a similar analysis for social media addiction is still pending. This study aims to explore social media addiction, focusing on variations in attachment style, mental distress, and personality between students with and without problematic social media use. Additionally, it investigates whether a specific attachment style is connected to social media addiction.

METHODS

Data were collected from 571 college students (mean age = 23.61, SD = 5.00, 65.5% female; response rate = 20.06%) via an online survey administered to all enrolled students of Sigmund Freud PrivatUniversity Vienna. The Bergen Social Media Addiction Scale (BSMAS) differentiated between students addicted and not addicted to social media. Attachment style was gauged using the Bielefeld Partnership Expectations Questionnaire (BFPE), mental distress by the Brief Symptom Inventory (BSI-18), and personality by the Big Five Inventory (BFI-10).

RESULTS

Of the total sample, 22.7% of students were identified as addicted to social media. For personality, it was demonstrated that socially media addicted (SMA) students reported significantly higher values on the neuroticism dimension compared to not socially media addicted (NSMA) students. SMA also scored higher across all mental health dimensions-depressiveness, anxiety, and somatization. SMA more frequently exhibited an insecure attachment style than NSMA, specifically, an ambivalent closed attachment style. A two-step cluster analysis validated the initial findings, uncovering three clusters: (1) secure attachment, primarily linked with fewer occurrences of social media addiction and a lower incidence of mental health problems; (2) ambivalent closed attachment, generally associated with a higher rate of social media addiction and increased levels of mental health problems; and (3) ambivalent clingy attachment, manifesting a medium prevalence of social media addiction and a relatively equitable mental health profile.

CONCLUSIONS

The outcomes are aligned with previous research on internet and smartphone addiction, pointing out the relevance of an ambivalent closed attachment style in all three contexts. Therapeutic interventions for social media addiction should be developed and implemented considering these findings.

Correlation of negative emotion, fatigue level and internet addiction in college students: implication for coping strategies

BACKGROUND

Internet addiction has an important influence on the development of physical and mental health of college students. The purpose of this study is to evaluate the current status and the correlation between college students' negative emotion, fatigue level and Internet addiction disorder, and to provide reference for the care and management of college students.

METHODS

We conducted a questionnaire survey on a cluster sample of college students from October to November 15, 2022. Internet addiction scale, fatigue assessment scale and positive and negative emotion scale were used for survey. Pearson correlation analysis and mediating effect test were performed to analyze the correlation and effects.

RESULTS

A total of 1546 valid questionnaires were collected. The incidence of internet addiction in college student was 20.38%. The total score of internet addiction was 52.94 ± 12.47, the total fatigue score was 69.27 ± 3.19, the score of positive emotion of college students was 31. 41 ± 5.09, and the negative emotion score was 18.54 ± 5.68. The total score of internet addiction were positively correlated with score of negative emotion (all P < 0. 05). The total score of internet addiction scale of college students were positively correlated and each factor score of with the score of fatigue severity (all P < 0. 05). Fatigue played an intermediary role in the prediction of negative emotion and internet addiction of college students, with an intermediary role of-0.433, accounting for 76.35% of the total effect.

CONCLUSION

The college students' positive emotion may be strengthened to reduce their fatigue level and negative emotion so as to reduce internet addiction.

Internet addiction, new contemporary reality in Benin: exploratory analysis of associated factors among medical and paramedical students in 2022

INTRODUCTION

Nowadays, Internet addiction is a major concern due to the growing number of Internet users and the consequences associated with this addiction.

PURPOSE OF THE RESEARCH

In this study, we aimed to determine the prevalence of and factors associated with Internet addiction among health sciences students at the University of Abomey-Calavi.

METHODS

A cross-sectional study was conducted among 346 students from the Faculty of Health Sciences and the National Institute of Medical and Health Sciences at the University of Abomey-Calavi. Participants were selected using simple random sampling. Internet addiction was assessed using K. Young’s “Internet Addiction Test.” Logistic regression modeling was employed to explore factors associated with Internet addiction. The strength of the association was assessed using odds ratios; the confidence interval (CI) was 95%; and a p-value < 0.05 in the final model was considered significant.

RESULTS

The prevalence of Internet addiction was 31.8% (95% CI: [23.26% - 41.38%]). Factors associated with Internet addiction were the participant’s field of study, poor relationships with friends and family, communication difficulties, depression, and psychoactive substance consumption.

CONCLUSIONS

Evidence of Internet addiction exists among students in health sciences institutions in Benin. These findings can support the development of prevention and intervention strategies centered on addressing a public health issue that is still insufficiently recognized.

Effects of internet and smartphone addiction on cognitive control in adolescents and young adults: A systematic review of fMRI studies

BACKGROUND

Internet Addiction (IA) refers to excessive or uncontrolled behaviors related to Internet access, causing impairment or distress. Similarly, Smartphone Addiction (SPA) involves the excessive use of smartphones, disrupting users' daily lives. Cognitive control plays a relevant role in the development of IA and SPA, with executive functions and rewards processing being particularly important.

OBJECTIVE

This study aims to provide a synthesis of scientific evidence on the differential effects of IA and SPA on cognition in young adults and adolescents, using fMRI.

METHODS

Relevant articles published between 2013 and May 2023 were identified following the PRISMA protocol.

RESULTS

Included studies (n = 21) revealed that both behavioral addictions were associated with impairments in cognitive control related to reward processing (ACC, insula, amygdala) and executive function (DLPFC, frontal, parietal lobes) in adolescents and young adults.

CONCLUSION

These findings provide evidence for neuroanatomical similarities between IA and SPA in young adults and adolescents related to executive functions and rewards processing. However, differential effects of SPA and IA on cognitive control were not found in this study. Future research should explore the relationship between these addictions with other cognitive domains to further expand our understanding within this field. While both IA and SPA involve the excessive use of online technology, SPA could involve a higher risk, given that smartphones allow internet connectivity anytime.

A study on the influencing factors of mental health of Chinese garden workers: a cross-sectional study

BACKGROUND

Occupational hazards occur in all walks of life. China's horticulture industry is undergoing rapid development. However, the mental health of garden workers has not received much attention. This study investigates the mental health status and influencing factors of Chinese garden workers and provides a basis for promoting their mental health and ensuring the healthy development of Chinese horticulture.

METHODS

A cross-sectional survey of garden workers in Beijing was conducted from 10 July 2021 to 10 October 2021. A total of 3349 valid questionnaires were recovered, with an effective response rate of 95.69%. Descriptive statistical analysis was carried out on the demographic characteristics, job satisfaction, stress, anxiety, and depression of garden workers, and the influencing factors affecting the mental health of Chinese garden workers were found through a t-test, variance analysis, and ordinal multi-class logistic regression analysis.

RESULTS

Survey respondents were mostly male (54.4%) and under the age of 40 (64.1%). The anxiety and depression symptoms of the garden workers were moderate. Among staff members, 40.2% were in a normal state of stress. Gender, three meals on time, monthly income, and job satisfaction were the factors influencing stress, anxiety, and depression symptoms among garden workers.

CONCLUSION

Compared to medical staff and other groups, the stress, anxiety, and depression symptoms of Chinese garden workers are severe. Gender, monthly income, and job satisfaction are important factors affecting their mental health. Managers should continuously improve the working environment of garden workers, provide salaries that match their positions, and improve their job recognition and satisfaction to reduce the impact of negative emotions on personal health.

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

Introduction

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

Method

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

Results

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

Conclusion

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

Validation of the Amharic version of Internet Addiction Test-20: a cross-sectional study

Background

Internet Addiction is defined as excessive internet use or poorly controlled preoccupations, impulses, or behaviors related to computer use and internet access that cause impairment or suffering. It had devastating effect on people lives, families, productivity, academic performance and rarely engaging in criminal acts like alcohol use, drug addiction, or compulsive gambling. This study aimed to investigate the psychometric properties of the Amharic version of Internet Addiction Test-20 among Addis Ababa University, College of Health Sciences medical students, Addis Ababa, Ethiopia.

Methods

A cross sectional study was carried out among 410 medical students using a convenience sampling method after stratifying them based on their year level. SPSS Version 23 was used to do Pearson's correlation coefficient to determine the convergent validity of Amharic version of IAT. We computed correlation coefficient between the aggregate scores of IAT-20 and the scores for depressive symptoms, problematic substance use, and other characteristics of participants which was assessed using Patient health questionnaire-9 (PHQ-9), Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) and questionnaire developed to assess demographic and internet use related characteristics, respectively. AMOS 23 software was used to conduct confirmatory factor analysis (CFA) to evaluate the construct validity of Amharic version of IAT. Test-retest reliability was also determined with 2 weeks interval (n = 51).

Results

The data confirmed a two-factor structure. Normed Fit Index (NFI) = 0.89, Tucker Lewis Index (TLI) = 0.91 and Comparative Fit Index (CFI) = 0.92, Root Mean Square Error Approximation (RMSEA) = 0.07, and Standardized Root Mean Residual (SRMR) =0.05 indicated a good fit model structure. There was moderate positive correlation between the aggregate scores of IAT-20 and PHQ-9 scores (r = 0.55, p < 0.00), but weak positive correlation between IAT-20 and ASSIST scores (r = 0.14, p < 0.00). IAT-20 was also found to have good internal consistency (Cronbach's alpha = 0.89 for each factor). The test-retest reliability was also good for all items (Intra Class Correlation Coefficient (ICC) > 0.30) except item 16.

Conclusion

We found that the IAT-20 is psychometrically sound and a simple screening test for Internet Addiction. However, it is important to acknowledge that further studies are necessary to replicate these findings on diverse population.

Prevalence of internet addiction and its relationship with insomnia, depression, anxiety, and stress among medical students of a tertiary care medical institute of Eastern India

Background

Internet has become an integral part of our daily lives but as the use of internet is increasing, it is important to be aware of the prevalence, context, and impact of its addiction on sleep and the presence of anxiety, depression, and stress in our lives.

Aim

To assess the prevalence of internet addiction and its association with insomnia, depression, anxiety, and stress among medical students in a tertiary care medical institute in Eastern India.

Materials and Methods

A descriptive cross-sectional questionnaire-based study with a purposive sampling method was conducted among 420 undergraduate medical students of different professional years. Out of 420 medical students, 413 students who gave consent and returned complete performa were taken in the study using a semi-structured performa for sociodemographic details, Young's Internet Addiction Test, Insomnia Severity Index, and Depression Anxiety Stress Scale.

Results

We found 31.2% of students had internet addiction, 24.2% had clinical insomnia, 58.1% had stress, 68.8% had anxiety, and 64.6% had depression. Potential internet addiction was significantly related to average screen time, insomnia, stress, anxiety, and depression.

Conclusions

Internet addiction is prevalent among medical students affecting sleep, anxiety, depression, and stress, which needs urgent preventive strategies.

Neural basis underlying the relation between internet addiction tendency and sleep quality: The intrinsic default-mode network connectivity pathways

Internet addiction (IA) tendency is considered an addictive behavior that results from excessive Internet use, and severely affecting an individual's physical health, emotion, and sleep. Although previous studies indicated that IA tendency was negatively correlated with sleep quality, the underlying neural basis of this relationship remained unclear. To address this issue, we utilized resting-state functional connectivity (RSFC) analysis to identify the neural pathways of the relationship between IA tendency and sleep quality. The behavioral results indicated a positive correlation between these two factors. And RSFC results revealed that IA tendency was positively related to the strength of functional connectivity within the default-mode network (DMN), including the right precuneus-left middle temporal gyrus (rPrcu-lMTG), the left anterior cingulate-left superior frontal gyrus (lAC-lSFG), and the left inferior parietal lobe-left medial superior frontal gyrus (lIPL-lMSFG). More importantly, mediation analysis demonstrated that IA tendency could mediate the relationship between these functional couplings and sleep quality. In conclusion, our findings suggest that intrinsic DMN connectivity may be an important neural pathways underlying the effects of IA tendency on sleep quality, and provide neural evidence for understanding the relationship between IA tendency and sleep quality.

Associations of academic environment, lifestyle, sense of coherence and social support with self-reported mental health status among dental students at a university in Brazil: a cross-sectional study

OBJECTIVES

The study evaluated the association of academic environment, lifestyle, sense of coherence (SOC) and social support with self-reported mental health status among dental students.

DESIGN

Secondary analysis of data from a cross-sectional, questionnaire-based survey conducted from August to October 2018.

SETTING

Dental school of a public-funded university in the south-eastern region of Brazil.

PARTICIPANTS

233 undergraduate dental students recruited across all years of the course.

OUTCOME MEASURES

Socioeconomic and demographic characteristics, city of origin and student's academic semester were obtained through self-completed questionnaires. Perception of the academic environment (Dundee Ready Education Environment Measure (DREEM)), individual lifestyle (Individual Lifestyle Profile Questionnaire (ILPQ)), SOC (SOC Scale (SOC-13)), social support (Medical Outcomes Study Scale (MOS)), and depression, anxiety and stress (Depression, Anxiety and Stress Scale-21 (DASS-21)) were assessed using validated instruments. The relationships between variables were investigated through multivariable negative binomial regression to obtain the rate ratios (RRs) and 95% CIs.

RESULTS

Female sex was associated with greater scores of anxiety (RR 1.74, 95% CI 1.10 to 1.97) and stress (RR 1.52, 95% CI 1.12 to 2.06). Students who perceived a better academic environment and those reporting a greater SOC had a lower probability of depression, anxiety and stress. Furthermore, a favourable lifestyle was associated with lower depression scores (RR 0.99, 95% CI 0.97 to 0.99). Social support did not remain associated with depression, anxiety and stress after adjustment.

CONCLUSIONS

The present findings suggest that self-reported mental health status is associated with students' sex, academic environment, SOC and lifestyle. Enhancing the educational environment and SOC, and promoting a healthy lifestyle may improve the psychological health of dental students.

Prevalence and causes of social media usage and addiction status of pregnant women

BACKGROUND

This study was conducted to determine the prevalence and causes of social media usage and the addiction status of pregnant.

MATERIALS AND METHODS

This cross-sectional study, which was conducted in the Gynecology and Obstetrics Clinics of a university and state hospital between December 2019 and February 2020 in a city in the west of Turkey, aims to determine the prevalence and causes of social media usage and the addiction status of pregnant women. 500 people were included in the study. The data were collected with the face-to-face interview technique in the outpatient clinics.

RESULTS

The prevalence of the pregnant women's social media usage was found to be 100%. The average daily social media usage was 3.5 h, whereas the social media addiction index was X̅ = 65.58. There were 358 pregnant women (71.6%) with high social media addiction scores.

CONCLUSIONS

In the study, it was concluded that all the pregnant women used social media and that most of them had a high level of social media addiction. Healthcare professionals should promote the conscious and balanced use of social media by organizing educational programs related to the accessibility of accurate and reliable online content for pregnant women at every stage of healthcare, and the dangers and addiction of social media.

Caught in a Dangerous World: Problematic News Consumption and Its Relationship to Mental and Physical Ill-Being

This study adds to the growing body of literature on problematic media behavior by introducing and explicating the concept of problematic news consumption, which we define as involving transportation, preoccupation, misregulation, underregulation, and interference. Using survey data from a national sample of U.S. adults, we examine the factor structure of a problematic news consumption measure, the existence of latent classes derived from the expected factors, and differences in mental and physical health across the emerging classes. Results show support for the proposed factor structure as well as the existence of four latent classes, which appear to be stratified according to severity of problematic news consumption. Results also show greater mental and physical ill-being among those with higher levels of problematic news consumption compared to those with lower levels, even after controlling for demographics, personality traits, and overall news use. Implications for designing effective media literacy campaigns to raise awareness of the potential for news consumption to develop into a problematic behavior as well as the development of intervention strategies are discussed.

Frequency of depression and correlates among Chinese children and adolescents living in poor areas under the background of targeted poverty alleviation: results of a survey in Weining county

BACKGROUND

There is a lack of epidemiological data on depressive morbidity in children and adolescents in rural China. This study determines the frequency and correlates of depression among children and adolescents to offer useful insights for family education and government policy-making in rural China.

METHODS

A cross-sectional online survey was conducted between April 20 to May 10, 2022. Depression was assessed using the Center for Epidemiologic Studies Depression Scale (CES-D), and the correlative factors of depression were analyzed.

RESULTS

In this study, 23,180 children and adolescents were enrolled (median (range) age: 12 (9-18) years); of them, 8,261 (35.6%) suffered from depression with a CES-D score of > 15. The onset of depression was significantly related to age, grade, gender, parental absence, attending key schools or classes, presence of moderate or severe internet addiction (IA), school record, social relationships, parental occupation, and education status. Furthermore, female gender (OR = 1.175; 95% CI: 1.108-1.247; p < 0.001), junior middle school (OR = 1.487; 95% CI: 1.380-1.601; p < 0.001), parental absence (OR = 1.272; 95% CI: 1.183-1.367; p < 0.001), attending key schools (OR = 1.221; 95% CI: 1.120-1.332; p < 0.001), attending key classes (OR = 1.099; 95% CI: 1.001-1.207; p = 0.048), and presence of moderate or above IA (OR = 13.593; 95% CI: 12.028-15.361; p < 0.001) were the most prominent independent factors for depression.

CONCLUSION

Depression is very common among Chinese children and adolescents living in poor areas of Weining County. Older age, higher school grade, female gender, parental absence, attending key schools or classes, and the presence of moderate to severe IA are some important factors that may dictate the occurrence of depression in these children and adolescents.

Connectivity and Integration of Instagram® Use in the Lives of Dental Students and Professionals: A Country-Wide Cross-Sectional Study Using the InstaAA© Questionnaire

Purpose

This study probed towards the impact of Instagram® on the lives of dental students and professionals and how it affects their learning and professional performance.

Patients and Methods

A 24-item copyrighted and validated questionnaire was employed to examine the affinity and aftermath of Instagram® in the lives of dental students using a cross-sectional survey technique. Part I (6 questions) is the first of three sections included information on the participant's sociodemographic traits, Part II (8 questions) - Screened to determine Instagram® use, and Part III (10 questions) - Was based on attitudes regarding Instagram® to assess their mental, physical, and emotional well-being. It includes a Likert scale with ten questions. The sample was collected by combining convenience and snowball sampling approaches. The difference in proportion was assessed using frequency and percentage. The Chi Square test of proportion was used to the data to examine and a p value <0.05 was considered as the proportional difference.

Results

The study comprised 461 participants, with 155 (33.6%) men and 306 (66.4%) women, having an average age of 23.13 ± 4.95 years. Among the participants, a significant proportion (119, 25.8%) were dental interns. In terms of Instagram® usage, 167 participants (36.2%) reported spending between 30 minutes and 1 hour on the platform (p<0.01). Approximately 52.5% acknowledged the influence of Instagram® on their dressing, behaviour, and usage of other social media platforms (p<0.01). Moreover, 52.1% experienced common distractions while performing important tasks, and 40.6% reported negative effects on their mental and emotional well-being (p<0.05).

Conclusion

This research concludes by emphasizing the huge influence that Instagram® has on dental workers' life. The results underline the necessity of striking a balance between social media use and academic and personal obligations while also emphasizing the need for knowledge and education about Instagram® features and ramifications.

Sleep quality and internet addiction among junior college students; The mediating role of depression: A cross-sectional study

This study investigated the mediating effect of depression on the relationship between sleep quality and internet addiction in Taiwanese junior college students. We recruited 590 (53 males, 537 females) students, aged from 15 to 22 years from a day school of a junior college in northern Taiwan. We used a cross-sectional study design. The Chen Internet Addiction Scale, Chinese Version of the Pittsburgh Sleep Quality Index, and Adolescent Depression Scale were used as measurement instruments. Using the IBM SPSS Statistics 26 software package, descriptive statistics, reliability analysis, correlation analysis, and inferential statistics were used to evaluate the participants' demographics and relationships between the study variables. The mediation model was tested using the Z test. The prevalence of internet addiction in junior college students was 21.2 %. The indirect effects were determined using Sobel's test and bootstrapping confirming that depression completely mediated the relationship between sleep quality and internet addiction. The findings would help to build holistic and comprehensive prevention and intervention programs that should be developed to reduce the addictive behaviors of adolescents.

Internet Addiction and Depression among Syrian College Students: A Cross-Sectional Study

Background: Problematic internet use (PIU) or internet addiction has become increasingly prevalent, and concerns about its impact on mental health and social functioning have grown. This study aimed to investigate the prevalence of PIU among Syrian university students and its relationship with their demographics, internet user behavior, and mental health. Methods: A cross-sectional study was conducted among undergraduate medical students in Syrian government universities between 12 April and 29 May 2022. The survey included the Beck Depression Inventory and the Internet Addiction Scale. Results: Out of 2891 participants, 75.2% were female, with an average age of 21.87. The average Internet Addiction Test (IAT) score was 49.4, and the overall prevalence of PIU was 89%. Furthermore, 93.0% of participants displayed possible signs and symptoms of depression. PIU was significantly linked with physical abuse (p = 0.001) and mental stress (p = 0.0001). Internet addiction is (AOR:1.723, COR:2.289) fold more likely to occur in those with more than 8 h of sleep per night than in those who sleep for less than 6 h (p-value < 0.05). Unadjusted regression analysis showed that 13 predictors of the independent variables were statistically significant in predicting the presence of internet addiction, such as participants who suffered from a breakup (COR:2.039), domestic violence (COR:2.136), physical abuse (COR:2.190), or mental stress (COR:2.621) were more likely to be affected by internet addiction than those who did not (p-value < 0.05). Conclusions: The study found a high rate of internet addiction among Syrian medical students, with those experiencing mental health problems and depression symptoms more likely to be internet addicts. To prevent PIU, students should be encouraged to participate in extracurricular activities, such as sports, and awareness programs should be enhanced to highlight the negative effects of internet addiction.

The relationship between internet addiction and risk of suboptimal health status among Chinese college students

Internet addiction (IA) is a prevalent trend among college students, and the relationship between severe IA and poor health status among college students has been well established. However, whether IA is associated with suboptimal health status (SHS) in college students is unclear. This study aimed to investigate the association between IA and SHS risk in Chinese college students. We conducted a cross-sectional study to assess whether IA was related to SHS risk in 2265 college students in Shenyang, China. SHS was assessed using the Suboptimal Health Status Questionnaire with a cutoff score of ≥35 to document SHS. IA was assessed using the validated 20-item Young's Internet Addiction Test with cutoff scores of 31-49 and 50-100 for mile and moderate-to-severe cases, respectively. The prevalence rate of SHS was 54.0%. After adjusting for potential confounding factors, the IA categories were positively related to a higher risk of SHS. The odds ratios (95% confidence intervals) for SHS across IA categories were 1.00, 7.66 (6.00, 9.78), and 27.93 (20.95, 37.24) (P for trend: <.001) after adjusting for multiple confounding factors. This is the first cross-sectional study to demonstrate that IA is independently associated with SHS. This finding suggests that IA is a negative risk factor for SHS.

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

AIM

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

The relationship between depression, healthy lifestyle behaviors and internet addiction: a cross-sectional study of the athlete university students in Turkey

Introduction

Mental health research exists for university students in the areas of prevalence and association of depression, internet addiction and healthy lifestyle behaviors. However, the studies examining prevalence rates and these relationships in athlete university students are needed. This study aimed to evaluate the relationship between depression, healthy lifestyle behaviors and internet addiction among athlete university students in Turkey.

Methods

A cross-sectional design was conducted, measuring depression using the Center for Epidemiologic Studies Depression Scale, healthy lifestyle behaviors (HPLP-II), and internet addiction (YIAT-SF). Predictive factors associated with depressive symptoms were estimated using binary logistic regression.

Results

Of the 501 participants, 61.3% were male, with a mean age of 21.45 years (SD: 3.19). Student-athletes were at risk of depressive symptoms (76.4%), internet addiction (34.4%) and had moderate healthy lifestyle behaviors (130.41 ± 22.93). No significant differences were found for age, smoking, time spent on social network, number of sports days, number of social networks use for depressive symptoms (p > 0.05), however significant differences were found for depressive symptoms by sex and living with family status (p < 0.05). Pathological internet addiction (OR: 12.74, 95% CI: 2.91-55.77) and low spiritual growth (OR: 0.854, 95% CI: 0.79-0.92) were found to be predictors of depressive symptoms within the athlete university students (p < 0.001).

Conclusion

The athlete university students are at increased risk for depressive symptoms and internet addiction and decreased healthy lifestyle behaviors. It is essential to establish programs to improve the mental health of students in universities and to strengthen the psychological counseling services offered to students. These findings can assist universities in establishing effective measures to improve mental health outcomes.

Depressive and Anxious Symptoms Increase with Problematic Technologies Use Among Adults: The Effects of Personal Factors Related to Health Behavior

Background

Depression and anxiety disorders are a significant and growing health problem that has a significant impact on psychosocial functioning and quality of life. The onset and severity of mental health problems have been related to various biological, psychosocial, and behavioral variables.

Purpose

The purpose of this study was to explore the association among the severity of depression and anxiety, problematic information and communications technology (ICT) use, and some related personal factors with health behavior among adults. It also analyzes the moderating role of personal factors in the relationship between the problematic use of ICT and anxiety and depression.

Patients and Methods

Descriptive, bivariate, multivariate and moderation analyzes of data from 391 participants of 35-74 years old in primary health care centers located in Aragón (Spain) were performed between July 2021 and July 2022. The primary outcome was the severity of depressive and anxious symptoms as continuous variable.

Results

Low sense of coherence (β = -0.058; p = 0.043), low self-esteem (β = -0.171; p=0.002), and low self-efficacy (β = -0.122; p= 0.001), are predictors of having more severe depressive symptoms. Furthermore, low self-esteem (β = -0.120; p= 0.012), low self-efficacy (β = -0.092; p=0.004), and high problematic use of ICT (β = 0.169; p = 0.001), are predictors of having more severe anxiety symptoms. Moderation analyzes were significant in the effect of self-efficacy (b = -0.040, p=0.001) and resilience (b = -0.024, p=0.033) on the relationship between problematic ICT use and anxiety.

Conclusion

The problematic use of ICT and personal factors are related to depressive and anxiety symptoms. The interrelationship between problematic ICT use, personal factors, and depression needs to be further explored.

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

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

Sluggish cognitive tempo (Cognitive Disengagement Syndrome) symptoms are more associated with a higher risk of internet addiction and internet gaming disorder than ADHD symptoms: A study with medical students and resident doctors

BACKGROUND & AIMS

The purpose of this study was to examine the relationships between Attention Deficit Hyperactivity Disorder (ADHD), Sluggish Cognitive Tempo (SCT), demographic factors, and Internet Addiction (IA) and internet gaming disorder (IGD) among medical students and resident doctors.

METHODS

The study included 274 medical students and resident doctors. (Ages:18-35, 70.4% female). Fisher exact test, Contingency Table analyses, Mann Whithey-U Test and structural equation model-path analysis were used for analysis. The Sociodemographic Information Form, ASRS Scale, Barkley SCT Scale, Young Internet Addiction Test-Short Form and The Digital Game Addiction Scale were utilized to collect data.

RESULTS

In the sample, 48 participants (17.51%, 22 female, 26 male) were classified as having a high-risk internet gaming disorder (IGD+), while 53 participants (19.3%, 37 female, 16 male) were classified as having a high-risk internet addiction (IA+). SCT Scale Daydreaming and Sluggishness scores, as well as ASRS Scale Inattention and Hyperactivity/Impulsivity ratings, were all substantially higher in high-risk groups (for all, p < 0.05). Instead of age, there was no difference between high and low-risk groups, but men had a significantly greater rate of high risk- IGD (%32.1 vs. 11.4; p = 0.001). Path analysis revealed that while older age has a substantial negative effect (β = -0.37, p = 0.001) on increased risk of IA, Inattention (β = 0.19, p = 0.028), Daydreaming (β = 0.62, p0.001), and Sluggishness ( β = 1.12, p0.001) had significant positive effects. On the other hand, results revealed that male gender (β = 5.08, p0.001), IA scores (β = 0.21, p0.001), and only Sluggishness ( = 0.52, p = 0.002), but not Inattention, Hyperactivity/impulsivity, or Daydreaming, have positive effects on greater risk of internet gaming disorder (IGD).

CONCLUSION & IMPLICATIONS

Our study is the first to show that SCT symptoms increase the risk of Internet addiction and Internet Gaming Disorder even when ADHD symptoms are controlled. To date, many research have highlighted the necessity of ADHD treatment when evaluating IA and IGD. However, SCT symptoms have a greater impact on people who are predisposed to these behavioral addictions, and despite high comorbidity rates, various treatment approaches for ADHD and SCT are effective. SCT should be kept in mind when assessing treatment-resistant individuals with IA and IGD.

Internet addiction and mental health disorders in high school students in a Peruvian region: a cross-sectional study

OBJECTIVES

To determine the association between internet addiction disorder (IAD) and anxiety and depressive symptomatology in high school students in two private schools in Chiclayo, Peru, during the COVID-19 pandemic.

MATERIALS AND METHODS

Analytical cross-sectional investigation of 505 adolescents from two private schools. The dependent variables were anxiety and depressive symptomatology, measured with the Beck Adapted Depression Questionnaire (BDI-IIA) and the Beck Anxiety Inventory (BAI), respectively. The main independent variable was IAD, measured with the Internet Addiction Test instrument(IATI). Prevalence ratios (PR) and 95% confidence intervals (95%CI) were estimated.

RESULTS

The average age was 14.16 years and 54.9% were women. 22.2% and 3.2% presented mild and moderate IAD; respectively. 9.3% presented severe anxiety and 34.3% severe depressive symptomatology. In the simple regression, adolescents with mild, moderate and severe IAD presented 19% (PR = 1.19; 95%CI: 1.05-1.35), 25% (PR = 1.25; 95%CI: 1.02-1.53) and 53% (PR = 1.47; 95% CI: 1.47-1.60) higher prevalence of depressive symptomatology; however, this association was not maintained in the multiple model. Anxiety increased 196% in adolescents with severe IAD (PR = 2.96; 95%CI: 1.86-4.71).

CONCLUSION

 We found that 2, 1, and 3 out of 10 students presented IAD, depressive symptomatology, and anxiety, respectively. We did not find an association between IAD and depressive symptomatology, but we did find an association with anxiety. Among the factors associated with the development of depressive symptomatology were the male sex, the presence of eating disorders, subclinical insomnia, using devices for more than 2 h, and using the Internet for academic activities. About anxiety, the associated factors are the female sex, the presence of eating disorders, subclinical insomnia, and the use of the Internet as social interaction. We recommend implementing counseling programs in view of the imminent introduction of the Internet as a pillar in education.

Stress and Internet Addiction: Mediated by Anxiety and Moderated by Self-Control

Background

The link between stress and Internet addiction (IA) has been confirmed. However, the mechanism underlying the correlation is poorly understood. Thus, the current study proposed a moderated mediation model to test the mediating role of anxiety and the moderating role of self-control (SC) in the link between stress and IA.

Methods

Eight hundred and sixty-one Chinese college students (M_age = 20.62 years; SD = 1.58; male = 47.7%) were required to complete an online questionnaire package, including a depression-anxiety-stress scale, a self-control scale, and an Internet addiction test. The PROCESS macro developed based on SPSS was used to test the moderated mediation model.

Results

When controlling for gender and age, the results revealed that anxiety partially mediated the link between stress and IA. Specifically, the more stressed college students are, the higher their anxiety level is, and the more likely they are to become addicted to the Internet. Additionally, the direct and indirect links between stress and IA were all moderated by SC. SC buffered the effect of stress on anxiety and anxiety on IA but enhanced stress on IA.

Conclusion

These findings emphasized the predictor role of stress on IA and provided insights on intervening in college students' excessive Internet use behaviors for educators, such as reducing anxiety levels and improving self-control abilities.

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

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

Pattern and predictors of internet addiction among secondary school adolescents in Enugu, Nigeria

Background

Internet addiction has negative effects on adolescents. These range from psychological and social impediments to school absenteeism.

Aim

To ascertain the pattern of Internet addiction and the factors that predict Internet addiction among secondary school adolescents in southeast Nigeria.

Subjects and Methods

This was a cross-sectional study that involved 796 secondary school adolescents drawn from six secondary schools in Enugu, Nigeria. The data were analyzed using IBM Statistical Package for Social Sciences (SPSS) software.

Results

The highest proportion of the respondents (36.3%) had a moderate level of Internet addiction, while the least proportion (2.1%) had severe dependence on the Internet. Adolescents who were less than 15 years of age have 1.1 odds of having Internet addiction when compared to those who were 20 years and above (AOR = 1.1; 95% CI: 0.4-2.8). The respondents who were of the low socioeconomic class were 1.2 times more likely to have Internet addiction when compared with those in the high socioeconomic class (AOR = 1.2; 95% CI: 0.9-1.7). About 20.1% of adolescents were always depressed when they are not using the Internet, while 16.3% of adolescents who were addicted to the Internet developed insomnia.

Conclusion

There is a rising prevalence of Internet addiction among secondary school adolescents. Younger adolescents tend to be more addicted to the Internet than their older counterparts. A small number of them had severe Internet addiction. A subpopulation of adolescents who were addicted to the Internet presents with depression and sleep disorders.

Internet use, loneliness, and mental health in Greek students

Background

Problematic internet use among university students is a rising phenomenon with repercussions worldwide. We aimed to determine the association between time spent online, loneliness, and mental health.

Methods

We conducted an online cross-sectional study using self-administered questionnaires on demographics, frequency of internet use as assessed by the Internet Addiction Inventory (IAT), depressive symptoms as reported by answering the Beck Depression Inventory (BDI), loneliness as depicted by the UCLA Loneliness scale, and general psychopathology on the self-reported General Health Questionnaire-28 (GHQ-28) scale. We performed statistical analysis using the IBM SPSS for Windows, Version 25.0.

Results

The mean age (n =294, 62.9 % female) was 23.19 ± 6.454 years. One-third (33.3 %) and 8.2 % were mildly and moderately addicted to the Internet, respectively. There was no participant with severe dependence. Nearly one-quarter (24.5 %) of participants reported mild, 10.6 % moderate, and 3.3 % severe depression and 44.8 % reported moderate and 11.9 % a moderately high degree of loneliness. Four in ten (41.8 %) of participants self-reported mental health problems. Mean IAT, BDI, UCLA Loneliness, and GHQ-28 score differences were statistically significant between IAT categories across all questionnaires. Correlations between the scales were statistically significant, and a binary logistic regression model revealed that the level of self-reported depressive symptoms, loneliness, and general psychopathology scores could predict internet use.

Conclusions

In our student sample, mental health problems were present in approximately 40 % of participants. They were significantly correlated with problematic internet use, thus complicating the development of essential communication skills in young adults. The higher the internet use, the greater the loneliness felt. Future studies should be more extensive, focusing on the relation of internet use with the type of use, family history of psychopathology, use of substances, and impulsivity. HIPPOKRATIA 2023, 27 (2):31-36.

The mediating role of anxiety and depression between problematic social media use and bulimia nervosa among Lebanese university students

Background

Bulimia nervosa (BN) is a disorder that is characterized by binge eating and inappropriate compensatory behavior to control weight. The aim of this study was to evaluate the mediating role of anxiety and depression between problematic social media use (PSMU) and BN among a sample of Lebanese university students.

Methods

This cross-sectional study was carried out between July and September 2021; a total of 363 university students was recruited through convenience sampling. The PROCESS SPSS Macro version 3.4, model four was used to test the indirect effect and calculate three pathways. Pathway A determined the regression coefficient for the effect of PSMU on mental health issues (depression/anxiety); Pathway B examined the association between mental health issues on BN, and Pathway C’ estimated the direct effect of PSMU on BN. Pathway AB was used to calculate the indirect effect of PSMU on BN via depression/anxiety.

Results

Results showed that depression and anxiety partially mediated the association between PSMU and BN. Higher levels of PSMU were associated with more depression and anxiety; higher depression and anxiety were associated with more BN. PSMU was directly and significantly associated with more BN. When entering anxiety (M1) then depression (M2) as consecutive mediators in a first model, the results showed that only depression mediated the association between PSMU and bulimia. When taking depression (M1) then anxiety (M2) as consecutive mediators in a second model, the results showed that the mediation PSMU → Depression → Anxiety → Bulimia was significant. Higher PSMU was significantly associated with more depression, which was significantly associated with more anxiety, which was significantly associated with more bulimia. Finally, higher PSMU was directly and significantly associated with more bulimia

Conclusion

The current paper highlights the relationship that social media use has on BN and other aspects of mental health such as anxiety and depression in Lebanon. Future studies should replicate the mediation analysis conducted in the current study while taking into account other eating disorders. Additional investigations of BN and its correlates must strive to improve the comprehension of these associations’ pathways through designs that allow to draw temporal frameworks, in order to efficiently treat this eating disorder and prevent its negative outcomes.

Bulimia nervosa, an eating disorder, is characterized by an impulsive consumption of food in a short period of time, followed by behaviors that compensate the eating such as vomiting or excessive exercise in order to avoid weight gain. Individuals with problematic social media use were found to have higher levels of bulimia symptoms. Symptoms of bulimia can also be associated with both depression and anxiety. The aim of the current study was to examine the mediating role of anxiety and depression between problematic social media use and bulimia nervosa. The results of our study found that problematic social media use was directly associated with more bulimia nervosa and also associated with higher depression and anxiety, both of which were associated with bulimia nervosa. Tackling associated disorders may help reduce symptoms of bulimia nervosa. Clinicians should carefully examine these associations while assessing and implementing treatment plans.

The Psychometric Properties of the DASS-21 and Its Association with Problematic Internet Use among Chinese College Freshmen

During transitional periods, college freshmen may experience mental health issues. The Depression, Anxiety, and Stress Scale-21-item version (DASS-21) is commonly used for mental health assessment in China. However, evidence is lacking regarding its applicability with freshmen as a demographic. Debates also exist regarding its factor structure. This study aimed to evaluate the DASS-21's psychometric properties with Chinese college freshmen and investigate its association with three kinds of problematic Internet use. A convenience sampling method was used to recruit two samples of freshmen-one of 364 (female 248; mean age 18.17 years) and the other of 956 (female 499; mean age 18.38 years) participants. McDonald's ω and confirmatory factor analysis were conducted to evaluate both the scale's internal reliability and construct validity. The results indicated acceptable reliability, with a one-factor structure inferior to a three-factor structure in terms of model fit. Furthermore, it was demonstrated that problematic Internet use was significantly and positively associated with depression, anxiety, and stress among Chinese college freshmen. Based on the prerequisite of measurement equivalence across two samples, the study also found that freshmen's problematic Internet use and psychological distress were likely to be affected by the strict measures put in place during the COVID-19 pandemic.

Emotional Exhaustion and Engagement in Higher Education Students during a Crisis, Lessons Learned from COVID-19 Experience in Italian Universities

Italian university students face an uncertain future characterised by a competitive neoliberal academic environment with high demands and a weak labour market that often cannot hire those who are best qualified. The COVID-19 pandemic has exacerbated students’ uncertainty and negatively affected their well-being. The purpose of this study is to explore perceptions of academic life during the pandemic and to examine the relationship between study load, reduced academic performance, internet addiction, academic self-efficacy, and engagement and emotional exhaustion. A sample of university students (N = 10,298) from 11 Italian universities completed a self-report questionnaire about their academic and personal lives between May and June 2021. We performed two multiple linear regressions and one ANOVA to highlight gender differences. Results indicate that female students reported lower levels of engagement and academic self-efficacy, and higher levels of exhaustion and study demands compared to male students, while older students generally appear to exhibit higher levels of well-being. Study load, reduced academic performance, and internet addiction showed a negative association with engagement, particularly the first two, and a positive association with exhaustion, while self-efficacy was positively associated with engagement and negatively associated with exhaustion. The results suggest the need to introduce additional forms of support, such as psychological support, internet addiction awareness courses or counseling services.

Impact of Coding Educational Programs (CEP) on Digital Media Problematic Use (DMPU) and on Its Relationship with Psychological Dependence and Emotional Dysregulation

Alongside the positive effects linked to the introduction of digital technologies into our lives, particular dysfunctional behaviors in the use of digital tools have appeared, through which the expression of conditions such as addiction, difficulties in affective and behavioral self-regulation and mental health problems have been channeled. The present study aims to investigate, in a sample of young students aged m = 12.91 (ds = 0.56) years, whether Coding Educational Programs (CEP), deployed to 44.9% of the sample, is effective in psychological dependence, emotional self-regulation and Digital Media Problematic Use (DMPU), as self-assessed through questionnaires (DERS, DSRS, IAT, MPIQ and MPPUS). CEP had no effect on emotional dysregulation or on DMPU. They were effective in the time management of mobile phone use, with students rescheduling from daytime use on working days to daytime use on the weekend. Moreover, people who attended CEP more frequently used smartphones for orienting themselves and for obtaining information. In conclusion, CEP are effective in achieving a more functional and important use of smartphones and better time management. It is possible that CEP effect on metacognition could reduce DMPU if alternative ways to regulate emotions are available.

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.

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.

Sleep characteristics and excessive daytime sleepiness in adolescents and adults: results from the birth cohorts of three Brazilian cities - RPS Consortium

OBJECTIVE

To describe the prevalence of insufficient sleep duration, long sleep latency, terminal or maintenance insomnia, subjective sleep quality, and excessive daytime sleepiness among participants of birth cohorts conducted in three Brazilian cities, and to evaluate differences in prevalence rates within cohorts according to sociodemographic characteristics.

METHODS

Cross-sectional analyses involving adolescents and adults participating in four birth cohorts conducted in Ribeirão Preto (RP78 and RP94), Pelotas (PEL93) and São Luís (SL97/98). Sleep duration, latency, terminal or maintenance insomnia, and subjective sleep quality were obtained through the Pittsburgh Sleep Quality Index; and excessive daytime sleepiness was assessed using the Epworth Sleepiness Scale. Differences in the prevalence of the outcomes were analyzed in each cohort according to sociodemographic characteristics (skin color, marital status, socioeconomic status, study and working at the time of the interview) stratified by sex.

RESULTS

Insufficient sleep duration was the most common outcome at the four cohorts, with higher frequency among men. Long latency was more frequently reported by young adult women in RP94 and PEL93 cohorts, and insomnia by women of the four cohorts, when compared to men of the same age. Women generally suffered more from excessive daytime sleepiness and evaluated the quality of their sleep more negatively than men. In addition to sex, being a student and working were associated with the largest number of outcomes in both sexes.

CONCLUSION

Sleep disorders are more prevalent in women, reinforcing the need for greater investment in sleep health in Brazil, without disregarding gender and socioeconomic determinants.

Internet addiction and its effects on psychological wellbeing: A community-based study

Background

The internet has become an essential part of life, and it has both beneficial and detrimental effects. There is a plethora of evidence relating to the effect of internet addiction on psychological health. There is also an unmet need to lay the foundation for the differences in usage and the effects on mental health in regard to the use of the internet for rural and urban students.

Materials and Methods

The present study was conducted on 200 adolescent subjects belonging to the urban and rural areas around the city of Varanasi to establish the pattern of use of the internet as well as its psychological implications. The participants were evaluated upon the Internet Addiction Test (IAT) and General Health Questionnaire-12 (GHQ-12), and information pertaining to socio-demographics as well as accessory information related to internet usage were captured through semi-structured proforma.

Results

The results indicated no significant differences in the pattern of internet usage (mean IAT score) as well as psychological health (mean GHQ-12) between urban and rural youth. There was a significant positive association between the overall severity of internet use with poor psychological health (GHQ-12 score). There was a significant difference in the overall mean age as well as the mean age of onset of internet use between both groups (rural versus urban). This study highlighted an important issue of the digital divide based on gender-wise differences in the pattern in the overall sample.

Conclusion

This study highlighted the important differences in the pattern of internet use among the rural and urban populations with its clinical implication being a need to educate the youth regarding the healthy use of technology.

Pattern of Facebook use by university students during the COVID-19 pandemic: relations with loneliness and resilience

Considering young adults' extensive use of social media since the outbreak of the COVID-19 pandemic, the present study examined the pattern of Facebook use by university students during the period of hygienic crisis. Specifically, it was investigated students' Facebook intensity use and self-disclosure to unknown online friends, as well as the role of sense of resilience and loneliness in the manifestation of the above Facebook behaviors. Overall, 792 undergraduate and postgraduate university students (48% women) completed online self-report questionnaires regarding the above variables. Undergraduate students, regardless of gender and Department of studies, made more intense Facebook use and self-disclosure to unknown online friends. Sense of loneliness positively predicted students' online self-disclosure not only directly but also indirectly through their Facebook intensity use. Students' resilience negatively moderated the relationship between sense of loneliness and Facebook behaviors. The findings propose a new explanatory model of emotional and behavioral mechanisms, which leads to a less safe pattern of Facebook use. This pattern possibly reflects youth's collective tendency to use this social media platform recklessly as a way out of crisis periods, such as the pandemic period. The emergence of this pattern could be useful for launching or enriching university counselling/prevention actions aimed at strengthening students' psycho-emotional skills, and subsequently their prudent use of social media.

Mobile phone use addiction, insomnia, and depressive symptoms in adolescents from ethnic minority areas in China: A latent variable mediation model

BACKGROUND AND AIMS

Although previous studies have discussed the association between mobile phone use addiction (MPUA) and depressive symptoms in adolescents, studies on Chinese adolescents are limited, with no studies being reported on adolescents from ethnic minority areas within Yunnan. This study aimed to explore the mediating mechanism of insomnia in the association between MPUA and depressive symptoms among Yunnan college students.

METHODS

A sample survey was conducted among 10,121 college students from four colleges in Yunnan province, China, from November to December 2021 via cluster sampling. Insomnia was assessed using the Insomnia Severity Index Scale, MPUA was assessed using the Self-Rating Questionnaire for Adolescent Problematic Mobile Phone Use, and depressive symptoms were assessed using the Patient Health Questionnaire-9 items. A generalized linear model was used to analyze the association between MPUA, insomnia, and depressive symptoms. The structural equation model was used to analyze the mediating effect of insomnia.

RESULTS

The positive rates of depressive symptoms, MPUA, and insomnia were 39.2 %, 30.8 %, and 22.3 %, respectively. After adjusting for the demographic and confounding variables, MPUA (β = 0.14, 95 % CI: 0.13-0.15, P < 0.01) and insomnia (β = 0.44, 95 % CI: 0.43-0.46, P < 0.01) were associated with depressive symptoms (P < 0.05). The mediating effect of insomnia accounted for 34.7 % of the total effect in the mediating model of MPUA associated with depressive symptoms.

CONCLUSION

Our findings suggest that insomnia partially mediates the association between MPUA and depressive symptoms among Yunnan college students.

The Impact of Mental Health Predictors of Internet Addiction among Pre-Service Teachers in Ghana

This study examined the prevalence of addictive Internet behavior and its links with mental health among pre-service teachers in Ghana. A descriptive, correlational design was employed with 405 pre-service teachers from colleges of education and a public university in Ghana participating in this study. The sample completed a sociodemographic survey about loneliness, life satisfaction, depression, self-esteem, and the Internet addiction scales (abridged form). The results revealed that there was a significant relationship between pre-service teachers' Internet addiction, depression, life satisfaction, and loneliness; however, depression was the least influential factor in addictive Internet use. Additionally, there was a statistically significant nexus between self-esteem, loneliness, depression, and life satisfaction. In addition, all the above-mentioned variables were discovered to explain 56.3% of the absolute variance in addiction to the Internet. Among the variables linked with Internet addiction and its dimensions, loneliness appeared to be the most significant. Institutional coping programs with Internet addiction should be established within the scope of the university administration, supporting pre-service teachers' mental health. Finally, the development of awareness campaigns on the menaces associated with Internet usage and mental health through extracurricular programs is recommended.

College students' anxiety after returning to school during the COVID-19 epidemic: What should we care

The college students' anxiety during the Coronavirus disease 2019 (COVID-19) epidemic remains unclear. We aimed to evaluate the college students' anxiety after returning to school during the COVID-19 epidemic, to provide reference for the management and nursing care of college students. We conducted a survey from September 15, 2021 to September 30, 2021 investigate the anxiety level of college students. The Self-rating Anxiety Scale was used for anxiety assessment. The Spearman correlation analysis was conducted to evaluate the correlation between students' anxiety and characteristics. Logistic regression analysis was used to explore the influencing factors of concurrent anxiety among college students. A total of 2168 college students were included, the incidence of anxiety was 30.07% in college students during the COVID-19 epidemic. Pearson correlation analyses showed that grade (R = 0.715), main use of computer and mobile phone (R = 0.622), daily exercise (R = 0.735), whether relatives or friends are infected with COVID-19 (R = 0.735) are associated with the anxiety level of college students (all P < .05). Logistic regression analysis indicated that senior year (Odds ratio [OR] = 2.064, 95% confidence interval [CI]: 1.355-3.001), online game (OR = 3.122, 95% CI: 2.562-3.899), relatives or friends are infected with COVID-19 (OR = 2.987, 95% CI: 1.901-3.451) are the independent risk factors of anxiety in college students (all P < .05). Daily exercise (OR = 0.514, 95% CI: 0.205-0.814) was the independent protective factors of anxiety in college students (P = .008). During the COVID-19 epidemic, college students have increased anxiety and there are many influencing factors. Administrators and educators should especially pay attention to the mental health of students with those risk factors to maintain students' physical and mental health.

Relationship between Internet Addiction, Personality Factors, and Emotional Distress among Adolescents in Malaysia

COVID-19 has significantly affected the mental health of adolescents, thus increasing the emotional distress among them. Studies have reported that heavy Internet use during COVID-19 was linked with poor mental health among adolescents. Additionally, it was found that personality factors are linked with mental health in general. Although past literature has reported the effect of personality factors on mental health, there are limited studies examining the underlying mechanisms among Malaysian adolescents. Therefore, the current study offers an understanding of the intervening role of personality factors in the relationship between Internet addiction and emotional distress among adolescents in Malaysia. This study also aimed to determine the prevalence of Internet addiction and emotional distress (depression, stress, and anxiety) among adolescents in Malaysia. There are a total of 500 participants from 7 secondary schools who range from 13 to 19 years of age. This was a cross-sectional study, and 3 valid questionnaires were used: The Internet Addiction Test (IAT), the Depression, Anxiety, and Stress Scale (DASS-21), and the Ten-Item Personality Inventory (TIPI). Partial least square structure equation modelling (SmartPLS) was used to analyse the mediation models. The results showed that the prevalence of Internet addiction among adolescents was 29.6% and the prevalence of depression, anxiety, and stress among adolescents were 64.8%, 78%, and 51.4%, respectively. Furthermore, mediation analysis showed only emotional stability mediated the relationship between Internet addiction and emotional distress, but not openness to experience, extraversion, conscientiousness, or agreeableness. It is proposed that mental health providers should focus on providing emotion-related interventions to adolescents confronting COVID-19 challenges, ultimately improving mental health.