Problematic Internet use and physical health

Risk factors for poor progression of addictive internet use across different COVID-19 periods in China

BACKGROUND AND OBJECTIVES

Addictive behaviors are serious factors for mental health and usually increase during public crises. We identified the vulnerable characteristics for bad prognosis of addictive internet use across different periods of the coronavirus disease 2019 (COVID-19) pandemic.

METHODS

Self-reported questionnaires were delivered in three waves through jdh.com during the outbreak (n = 17,960), remission (n = 15,666), and dynamic zero (n = 12,158) periods of COVID-19 pandemic in China. Internet addiction degree was assessed using the Internet Addiction Test. The different progression groups were divided using a latent class growth model among 1679 longitudinal participants. Risk factors for bad progression were identified by two-step logistic regression.

RESULTS

A total of 40.16% of participants reported an increase in the addictive degree of internet use compared with prepandemic. Across different COVID-19 periods, the overall trend of addictive internet use was downward among general Chinese study participants (Mslope = -1.56). Childhood traumatic experiences, deterioration of physical health, depression, and anxiety during remission and dynamic periods were the main risk factors for the bad progression of pandemic-induced addictive internet use.

DISCUSSION AND CONCLUSIONS

Addictive internet use was remitted following relaxed control policies during the COVID-19 pandemic. Negative childhood experiences and bad mental status during the recovery period were harmful to coping with pandemic-related addictive internet use.

SCIENTIFIC SIGNIFICANCE

Our findings profiled the general trend of addictive internet use and the vulnerable characteristics of its bad progression across different periods of the first wave of COVID-19 pandemic in China. Our findings provide valuable insights for preventing the long-term adverse effects of negative public events on Internet addiction.

The effect of solution-focussed education and counselling on problematic internet usage, sleep quality and school achievement: A randomized controlled trial

AIM

The aim of this study was to determine the effects of solution-focussed education and counselling on problematic internet usage, sleep quality and school achievement.

METHODS

This randomized controlled trial was conducted between January - December 2016 with 44 adolescents who participated in a solution-focussed intervention to address their problematic internet usage and poor sleep quality. After the intervention, the teens were followed up for 6 months to measure problematic Internet usage, sleep quality and school achievement using the Internet Addiction Test, Pittsburg Sleep Quality Index, Parent-Child Internet Addiction Scale and the students' end-of-term school grades. Data were analysed in Statistical Package for the Social Sciences programme using Chi-square test, Independent t test, Man-Whitney U test, Friedman test and Spearman correlation analysis.

RESULTS

The median Internet Addiction Test and Pittsburg Sleep Quality Index scores of the adolescents in the intervention group were significantly lower than those of the controls (P < 0.05), and there was a positive and moderate association between problematic Internet usage and sleep quality in both groups after the follow-up (r = 0.537, P = 0.010; r = 0.576 P = 0.005).

CONCLUSION

The education and counselling intervention decreased problematic Internet usage and increased sleep quality. There was also an improvement in school achievement, but the difference was not significant.

Internet Risk Perception: Development and Validation of a Scale for Adults

Despite the importance of Internet risk perception, no instrument currently exists that measures this awareness in the Spanish population. The goal of this study was to provide information on studies of the validity and reliability of the Internet Risk Perception (IRP) Scale for adult Spanish citizens. We began with a literature review and validation using a mixed panel with 20 participants. We analyzed the degree to which the subjects agreed or disagreed with the criteria evaluated, including contributions for improving the instrument, and performed a pilot test with 517 adults aged 18 to 77. Construct reliability and validity were analyzed using various statistical analyses. The results from the confirmatory factor analysis showed a sufficient accuracy of the data with parameters that indicated an excellent fit for all items. The Spanish version of the scale for adults is a reliable and valid instrument for use in studies that investigate Internet risk perception in people over 18 years of age.

Internet addiction and child physical and mental health: Evidence from panel dataset in China

BACKGROUND

The number of internet users has increased substantially in the last decade and these increasing rates of internet use also apply to children. Children usually have poorer self-control and poorer cognition than college-age populations or adults, the impact of Internet addiction on the health of this group has important implications not only for their individual economic and social outcomes but also the future human capital development in China.

METHODS

We use data from the 2016 and 2018 China Family Panel Survey, a survey that collected data from a large and nationally representative sample of the Chinese population, to construct a sample of children from 25 provinces, and then use DID and PSM-DID methods to investigate whether Internet addiction (increased screen time in this article) impacts the physical and mental health of children (ages 10-15) in China.

RESULTS

Internet addiction has a significant negative impact on child physical and mental health. The mediating effect model shows that Internet addiction impairs child physical and mental health by reducing their sleep and exercise time. The heterogeneity analysis shows that, Internet addiction has a stronger negative effect on urban children than rural children. Additionally, Internet addiction has a significant correlation with the mental health of left-behind children (LBC), but not children living with both parents (CLP).

LIMITATIONS

Our research has several weaknesses. First, this article uses time spent online to measure Internet addiction and this measurement method is not perfect. Also, given that the sample is made up of only Chinese children, conclusions about generalizability remain tentative. Future studies should be conducted in other countries.

CONCLUSION

This study systematically studied the effects of Internet addiction on the physical and mental health of Chinese children. This study can help government leaders make targeted programs to prevent children from Internet addiction in the future, especially to reduce internet dependence among students.

Internet Addiction Effect on Quality of Life: A Systematic Review and Meta-Analysis

PURPOSE

Due to the use of different methodologies, tools, and measurements, the positive or negative impact of Internet use on human life quality is accompanied by a series of ambiguities and uncertainties. Therefore, in this study, a systematic review and meta-analysis are conducted regarding the effect of Internet addiction on the quality of life.

METHODS

A systematic search of resources was conducted to investigate the effect of Internet addiction on the quality of life. The databases of PubMed, Cochrane Library, Scopus, Web of Science, Embase, and Science Direct were searched from January 1980 to July 2020. The articles were screened by two researchers in multiple levels in terms of the title, abstract, and full-text; then, final studies that met the inclusion criteria were retrieved and included in the study.

RESULTS

After searching the previously mentioned international databases, 3863 papers were found, 18 of which we included in the final analysis. Surveys indicated that people who had a high Internet addiction received lower scores of quality of life than those who were normal Internet users (OR = 2.45, 95% CI; 2.31-2.61, p < 0.001; I 2 = 85.23%, p < 0.001). Furthermore, There was a negative significant relationship between Internet addiction and quality of life in the psychological (OR = 0.56, 95% CI: 0.32-0.99, p=0.04, I 2 = 97.47%, p < 0.001), physical (OR = 0.58, 95% CI: 0.39-0.86, p=0.007, I 2 = 95.29%, p=0.001), and overall quality of life score (OR = 0.39, 95% CI: 0.27-0.55, p < 0.001, I 2 = 0.0%, p=0.746).

CONCLUSION

These findings illustrate that Internet addiction should be regarded as a major health concern and incorporated into health education and intervention initiatives.

[An associations of possible genetic risk markers for Internet addiction with childhood trauma experience and personality traits in young adults : preliminary results]

OBJECTIVE

To study was to test an associations of the preliminary genetic risk markers for Internet addiction (IA) with clinical, psychological and personality characteristics, taking into account the childhood traumatic experience, in 44 IA persons compared with 120 healthy individuals.

MATERIAL AND METHODS

The study included 164 participants: 44 individuals with IZ (group IZ), male and female, aged 16 to 30 years in the absence of diagnoses of mental health problems. diseases from rubrics F00-09 and F20-29 (ICD-10) and 120 healthy (control group).

RESULTS AND CONCLUSION

We have found an associations of the preliminary IA genetic risk markers with some personality traits and behavioral characteristics (TCI-125, TIPI) and with the childhood trauma experience (ACE IQ, CTQ), both for healthy individuals and to a greater extent for IA individuals, that may suggests the possible effects of the gene-environment interaction on a risk of developing IA. The data obtained on the structure of associations between IA genetic risk markers and individual psychological characteristics under the significant influence of the childhood trauma experience allow us to proceed with the construction of models for IA risk prediction taking into account the "gene - environment" interactions.

Psychometric Properties of the Nine-Item Problematic Internet Use Questionnaire in a Brazilian General Population Sample

Objective: The goal of the study is to adapt and examine the psychometric properties of the Brazilian version of the nine-item Problematic Internet Use Questionnaire (PIUQ-SF-9). Methods: A convenience sample of Brazilian internet users aged between 18 and 89 years (72.7% female, mean age 38.7 years ± 13.5) was recruited online from September 2018 to July 2019 (test sample = 1,525; retest sample = 237). Participants responded to the adapted version of the PIUQ-SF-9, as well as the Center for Epidemiologic Studies-Depression Scale (CES-D-10) and sociodemographic questions. Results: A bifactor model with one general factor and three specific dimensions (obsession, neglect and control disorder) yielded the best fit indices [χ² = 67.66, df = 15, CFI = 0.99, TLI = 0.99, RMSEA = 0.048 (0.037-0.060), RMSEA p close = 0.587 and SRMR = 0.01]. McDonald's hierarchical omega coefficient was 0.76 for the general factor and varied between 0.16 and 0.33 for the specific dimensions. The intraclass correlation coefficient was 0.73 for the general factor and varied between 0.64 and 0.72 for the specific dimensions. The MIMIC model supported the scale's construct validity as the relationship of the predictors (age, time spent online, self-perception of problematic internet use, and depression symptoms) with the PIUQ-SF-9 factors was in line with the assumptions based on the literature. Conclusion: PIUQ-SF-9 seems to be a brief and culturally validated instrument with sound psychometric properties to be used in future studies on problematic internet use in the Brazilian population.

The reliability and validity of the 18-item long form and two short forms of the Problematic Internet Use Questionnaire in three Japanese samples

This study aimed to provide evidence for the reliability and validity of the Japanese version of the Problematic Internet Use Questionnaire (PIUQ). The PIUQ is an 18-item scale that includes three subscales (Obsession, Neglect, Control Disorder). There are also two short forms, a 9-item and a 6-item version. The PIUQ was administered to 587 adults, 360 adolescents, and 222 undergraduate students in Japan. In all three samples, Cronbach's alpha coefficients of the total scores were high, and the majority of the subscale scores also demonstrated adequate internal consistency. One-month test-retest correlations were lower than in the original PIUQ research, and construct validity was demonstrated by correlations between the PIUQ and the Internet Addiction Test (IAT), psychological distress, participant's time spent on Internet use, sleep, exercise, and time spent on various online activities. Both the full version and the short forms of the PIUQ demonstrated adequate construct validity. The short forms will be useful for convenient screening and the assessment of problematic Internet use.

The Relationship Between Sleep Quality and Internet Addiction Among Female College Students

BACKGROUND

Over 40% of Taiwanese College students experience sleep problems that not only impair their quality of life but also contribute to psychosomatic disorders. Of all the factors affecting the sleep quality, internet surfing is among one of the most prevalent. Female college students are more vulnerable to internet-associated sleep disorders than their male counterparts. Therefore, this study aims to investigate (1) the relationship between internet addiction and sleep quality, and (2) whether significant variations in sleep quality exist among students with different degrees of internet use.

METHODS

This structured questionnaire-based cross-sectional study enrolled students from a technical institute in southern Taiwan. The questionnaire collected information on the following three aspects: (1) demography, (2) sleep quality with Pittsburgh Sleep Quality Index (PSQI), and (3) severity of internet addiction using a 20-item Internet Addiction Test (IAT). Multiple regression analysis was performed to examine the correlation between PSQI and IAT scores among the participants. Logistic analysis was used to determine the significance of association between PSQI and IAT scores.

RESULTS

In total, 503 female students were recruited (mean age 17.05 ± 1.34). After controlling for age, body mass index, smoking and drinking habits, religion, and habitual use of smartphone before sleep, internet addiction was found to be significantly associated with subjective sleep quality, sleep latency, sleep duration, sleep disturbance, use of sleep medication, and daytime dysfunction. Worse quality of sleep as reflected by PSQI was noted in students with moderate and severe degrees of internet addiction compared to those with mild or no internet addiction. Logistic regression analysis of the association between scores on IAT and sleep quality, demonstrated significant correlations between quality of sleep and total IAT scores (odds ratio = 1.05:1.03 ∼ 1.06, p < 0.01).

CONCLUSION

The results of this study demonstrated significant negative association between the degree of internet addiction and sleep quality, providing reference for educational institutes to minimize adverse effects associated with internet use and improve students' sleep quality.

Policy and Prevention Approaches for Disordered and Hazardous Gaming and Internet Use: an International Perspective

Problems related to high levels of gaming and Internet usage are increasingly recognized as a potential public health burden across the developed world. The aim of this review was to present an international perspective on prevention strategies for Internet gaming disorder and related health conditions (e.g., Internet addiction), as well as hazardous gaming and Internet use. A systematic review of quantitative research evidence was conducted, followed by a search of governmental reports, policy and position statements, and health guidelines in the last decade. The regional scope included the USA, UK, Australia, China, Germany, Japan, and South Korea. Prevention studies have mainly involved school-based programs to train healthier Internet use habits in adolescents. The efficacy of selective prevention is promising but warrants further empirical attention. On an international scale, the formal recognition of gaming or Internet use as a disorder or as having quantifiable harms at certain levels of usage has been foundational to developing structured prevention responses. The South Korean model, in particular, is an exemplar of a coordinated response to a public health threat, with extensive government initiatives and long-term strategic plans at all three levels of prevention (i.e., universal, selective, and indicated). Western regions, by comparison, are dominated by prevention approaches led by non-profit organizations and private enterprise. The future of prevention of gaming and Internet problems ultimately relies upon all stakeholders working collaboratively in the public interest, confronting the reality of the evidence base and developing practical, ethical, and sustainable countermeasures.

Relationship between Problematic Internet Use, Sleep Problems, and Oral Health in Korean Adolescents: A National Survey

We examined the relationship between Problematic Internet Use (PIU), sleep (sleep satisfaction, sleep duration), and experience of oral disease symptoms in Korean adolescents by gender. This cross-sectional study utilized the 6th (2010) Korean Youth Risk Behavior Web-based Survey. Participants comprised 74,980 students from 400 middle schools and 400 high schools nationwide. Among these, 73,238 students from 799 schools (38,391 boys, 34,847 girls, aged 13–18 years) were included in the analysis (inclusion rate = 97.7%). Multiple logistic regression and analysis of moment structures (AMOS) analyses were performed to identify meaningful relationships between the three factors. The “high risk group” of problematic internet usage had increased experience of oral disease symptoms (boys: adjusted odds ratio (AOR) = 1.92, 95% confidence interval (CI) = 1.63–2.28, girls: AOR = 1.98, 95% CI = 1.50–2.63) compared to the general group. Boys who used the Internet for “5–6 h” had a higher risk of oral disease symptoms compared to those who used it for “less than 1 h” (OR = 1.24, 95% CI = 1.01–1.53); however, this difference was not significant in Models II and III. For girls, the risk of 5–6 h of use (Model I: OR = 1.69, 95% CI = 1.40–2.04) was higher than that of the boys. In addition, the difference was significant in Models II and III for girl students who used the Internet for 5–6 h. In subgroup analysis, the high-risk group had a higher odds ratio for mild symptoms of bad breath to severe symptoms such as sore and bleeding gums. In addition, in the path analysis, PIU affected sleep and indirectly affected oral health. Direct and indirect causal relationships between the three factors were confirmed. Therefore, it is important to recognize that PIU can have a detrimental effect on mental, physical, and oral health.

Connected to TV series: Quantifying series watching engagement

Background and aims Television series watching stepped into a new golden age with the appearance of online series. Being highly involved in series could potentially lead to negative outcomes, but the distinction between highly engaged and problematic viewers should be distinguished. As no appropriate measure is available for identifying such differences, a short and valid measure was constructed in a multistudy investigation: the Series Watching Engagement Scale (SWES). Methods In Study 1 (N_Sample1 = 740 and N_Sample2 = 740), exploratory structural equation modeling and confirmatory factor analysis were used to identify the most important facets of series watching engagement. In Study 2 (N = 944), measurement invariance of the SWES was investigated between males and females. In Study 3 (N = 1,520), latent profile analysis (LPA) was conducted to identify subgroups of viewers. Results Five factors of engagement were identified in Study 1 that are of major relevance: persistence, identification, social interaction, overuse, and self-development. Study 2 supported the high levels of equivalence between males and females. In Study 3, three groups of viewers (low-, medium-, and high-engagement viewers) were identified. The highly engaged at-risk group can be differentiated from the other two along key variables of watching time and personality. Discussion The present findings support the overall validity, reliability, and usefulness of the SWES and the results of the LPA showed that it might be useful to identify at-risk viewers before the development of problematic use.

Pathological game use in adults with and without Autism Spectrum Disorder

This study tested whether adults with autism spectrum disorder (ASD) are at higher risk for pathological game use than typically developing (TD) adults. Participants included 119 adults with and without ASD. Participants completed measures assessing daily hours of video game use, percent of free time spent playing video games, and symptoms of pathological game use. The results indicated that adults with ASD endorsed more symptoms of video game pathology than did TD adults. This relationship was strong, enjoying 300,000-to-1 odds in Bayesian model comparison. Results also showed that adults with ASD spent more daily hours playing video games and spent a higher percent of their free time playing video games than did TD adults. Even after adjustment for these differences in daily video game hours and proportion of free time spent on games, model comparisons found evidence for a difference in game pathology scores associated with ASD status. Additionally, escapism motives for playing video games was associated with game pathology scores in both ASD and TD adults, replicating and extending a previous report. In conclusion, the risk for pathological game use appears larger in adults with ASD compared with TD adults. These findings point to pathological game use as a potentially important focus of clinical attention in adults with ASD.

Differential physiological changes following internet exposure in higher and lower problematic internet users

Problematic internet use (PIU) has been suggested as in need of further research with a view to being included as a disorder in future Diagnostic and Statistical Manual (DSM) of the American Psychiatric Association, but lack of knowledge about the impact of internet cessation on physiological function remains a major gap in knowledge and a barrier to PIU classification. One hundred and forty-four participants were assessed for physiological (blood pressure and heart rate) and psychological (mood and state anxiety) function before and after an internet session. Individuals also completed a psychometric examination relating to their usage of the internet, as well as their levels of depression and trait anxiety. Individuals who identified themselves as having PIU displayed increases in heart rate and systolic blood pressure, as well as reduced mood and increased state of anxiety, following cessation of internet session. There were no such changes in individuals with no self-reported PIU. These changes were independent of levels of depression and trait anxiety. These changes after cessation of internet use are similar to those seen in individuals who have ceased using sedative or opiate drugs, and suggest PIU deserves further investigation and serious consideration as a disorder.

Problematic Internet Usage and Immune Function

Problematic internet use has been associated with a variety of psychological comorbidities, but it relationship with physical illness has not received the same degree of investigation. The current study surveyed 505 participants online, and asked about their levels of problematic internet usage (Internet Addiction Test), depression and anxiety (Hospital Anxiety and Depression Scales), social isolation (UCLA Loneliness Questionnaire), sleep problems (Pittsburgh Sleep Quality Index), and their current health – General Health Questionnaire (GHQ-28), and the Immune Function Questionnaire. The results demonstrated that around 30% of the sample displayed mild or worse levels of internet addiction, as measured by the IAT. Although there were differences in the purposes for which males and females used the internet, there were no differences in terms of levels of problematic usage between genders. The internet problems were strongly related to all of the other psychological variables such as depression, anxiety, social-isolation, and sleep problems. Internet addiction was also associated with reduced self-reported immune function, but not with the measure of general health (GHQ-28). This relationship between problematic internet use and reduced immune function was found to be independent of the impact of the co-morbidities. It is suggested that the negative relationship between level of problematic internet use and immune function may be mediated by levels of stress produced by such internet use, and subsequent sympathetic nervous activity, which related to immune-supressants, such as cortisol.

Bipolar spectrum disorders in a clinical sample of patients with Internet addiction: hidden comorbidity or differential diagnosis?

BACKGROUND AND AIMS

Behavioral addictions and bipolar disorders have a certain probability of co-occurrence. While the presence of a manic episode has been defined as an exclusion criterion for gambling disorder, no such exclusion has been formulated for Internet addiction.

METHODS

A clinical sample of 368 treatment seekers presenting with excessive to addictive Internet use was screened for bipolar spectrum disorders using the Mood Disorder Questionnaire. Psychopathology was assessed by the Symptom Checklist 90R and a clinical interview was administered to screen for comorbid disorders.

RESULTS

Comorbid bipolar disorders were more frequent in patients meeting criteria for Internet addiction (30.9%) than among the excessive users (5.6%). This subgroup showed heightened psychopathological symptoms, including substance use disorders, affective disorders and personality disorders. Further differences were found regarding frequency of Internet use regarding social networking sites and online-pornography.

DISCUSSION

Patients with Internet addiction have a heightened probability for meeting criteria of bipolar disorders. It is not possible to draw conclusions regarding the direction of this association but it is recommended to implement screening for bipolar disorders in patients presenting with Internet addiction.

CONCLUSION

Similar to gambling disorder, it might prove necessary to subsume bipolar disorders as an exclusion criterion for the future criteria of Internet addiction.