Evaluation of Internet addiction and the quality of life of Brazilian adolescents from public and private schools

Internet addiction and health-related quality of life in adolescents: The mediating role of sleep disturbance

BACKGROUND

Internet addiction (IA) has emerged as a recognized risk factor associated with impaired health-related quality of life (HRQOL) in adolescents. However, the role of sleep disturbance in this association remains unclear. This study aimed to investigate the association of IA with HRQOL in Chinese adolescents and to evaluate the potential mediating role of sleep disturbance.

METHODS

A cross-sectional study was conducted among adolescents attending six randomly selected middle schools in Guangzhou, China. Adolescents self-reported their internet use using the Young Diagnostic Questionnaire. HRQOL and sleep disturbance were assessed by the Pediatric Quality of Life Inventory version 4.0 and the Pittsburgh Sleep Quality Index, respectively. Multivariate linear regression analysis was employed to assess the association between IA and HRQOL. Baron and Kenny's causal steps method was used to examine the possible mediating role of sleep disturbance.

RESULTS

Of the 6473 adolescents included, 23.5% had maladaptive internet use (MIU) and 16.6% had pathological internet use (PIU). Compared to adolescents with adaptive internet use (AIU), those with IA had significantly lower scores across all HRQOL dimensions and summary scales. Mediation analysis revealed that sleep disturbance was a significant mediator. Specifically, sleep disturbance mediated 34.55% of the effects of MIU and 34.06% of the effects of PIU on the HRQOL total scale score , respectively.

CONCLUSIONS

IA was associated with poorer HRQOL, indicating the needs of preventing IA in Chinese adolescents. Additionally, our findings underscored the importance of enhancing sleep quality to mitigate the adverse impact of IA on adolescents' well-being.

Internet Addiction, Sleep Habits and Family Communication: The Perspectives of a Sample of Adolescents

BACKGROUND

With the increase in communication technologies, the internet has become an indispensable tool in the life of the individual. Several studies report on the advantages of this resource; however, there is still a group of individuals who use the internet excessively. The aim of this study was to explore the relationships between internet addiction, daytime sleepiness, and family communication in adolescents.

METHODS

A total of 340 adolescents aged between 12 and 17 years participated in this study. All completed the sociodemographic questionnaire, the internet addiction test, the pediatric daytime sleepiness scale, and the family communication scale.

RESULTS

The results indicate that 64.1% of the adolescents had mild to moderate addiction to the internet. The main results suggest that internet addiction in adolescents is negatively associated with family communication and positively associated with excessive daytime sleepiness. It was also observed that gender had a significant effect on daytime sleepiness, with female participants having more excessive daytime sleepiness. Regarding age, the results indicate higher values of internet addiction among younger adolescents.

CONCLUSIONS

In view of the above, it is considered important to develop preventive actions with a view to healthy family communication, with the adoption of sleep hygiene habits and the promotion of healthy use of the internet.

Psychometric Evidence of the Online Version of the Coping Scale of Hospitalization, Illness and Treatment − Parents Version (COPHAT-P)

Hospitalizations can be stressful for children, adolescents, and their parents, thus requires assessment and proper management. This study’s objective was to provide psychometric validation of the online version of the Escala Coping da Hospitalização, Adoecimento e Tratamento − Versão para Pais (COPHAT-P) [Coping Scale of Hospitalization, Illness and Treatment – parents version (COPHAT-P)]. A total of 98 Brazilian parents/legal guardians of hospitalized or previously hospitalized children participated. Participants completed a sociodemographic questionnaire along with the COPHAT-P and the Escala de Coping da Hospitalização − versão para cuidadores (COPE-H-Cuidador) [Hospitalization Coping Scale – caregiver version (COPE-H-Caregiver)]. Confirmatory Factor Analysis did not indicate a good fit. Three factors were extracted from the Exploratory Factor Analysis, which were further supported by network analyses. Convergent validity of the online version of the COPHAT-P was supported by its associations with the COPE-H-Caregiver, except for the “maladaptive coping” dimension. The online version of the COPHAT-P had high internal consistency (α=0.94). In sum, the online version of the COPHAT-P demonstrates satisfactory validity evidence.

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

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

Is Problematic Internet and Smartphone Use Related to Poorer Quality of Life? A Systematic Review of Available Evidence and Assessment Strategies

Purpose of Review

Previous studies have explored the links between problematic Internet use (PIU) or problematic smartphone use (PSU) and quality of life (QOL). In this systematic review, we (i) describe the instruments used to assess QOL or health-related quality of life (HRQOL) in these studies, (ii) critically examine the content validity of the instruments used, and (iii) examine the relationships between PIU, PSU, QOL, and HRQOL.

Recent Findings

We identified 17 PIU and 11 PSU studies in a systematic search. Evidence suggests that PIU and PSU negatively correlate with either QOL or HQOL and most of their domains (especially mental and physical health). Multiple instruments were used to assess QOL or HRQOL in these studies. Our analysis showed an important heterogeneity in the domains covered by these instruments.

Summary

Because of the widespread prevalence of PIU and PSU, which tend to be linked with lower QOL or HRQOL, in particular poor mental and physical health, a more systematic public health campaign is required to target the healthy use of these communication devices. Prevention programs should also target vulnerable individuals, focusing on the most affected domains of QOL and HRQOL (i.e., physical and psychological health). Among the existing instruments, the World Health Organization Quality of Life for adults and the Pediatric Quality of Life Inventory for adolescents (aged 13-18 years) proved to be the most relevant, although new measurement instruments are needed to target domains that are specifically relevant in the context of PIU and PSU (e.g., physical and psychological health domains such as sleep, loneliness, and quality of familial relations).

The Effect of Psychosocial Interventions for Reducing Co-occurring Symptoms of Depression and Anxiety in Individuals with Problematic Internet Use: A Systematic Review and Meta-analysis

The objective of this study is to conduct a systematic review and meta-analysis to assess the effect of psychosocial interventions in reducing problematic Internet use (PIU), anxiety, and depression symptoms in a sample of people. This review was registered on the PROSPERO database (CRD42020181912) and a total of 15 studies were included. Analyses of the effect of the interventions were conducted based on the standardized mean difference of the studied outcomes (PIU, anxiety, and depression). Most studies reported a positive effect of psychosocial interventions on reducing symptoms of PIU, depression, and anxiety among people with PIU. However, only one detected a robust effect in reducing symptoms of anxiety. For depression, this effect was more modest, and there was no difference between the different modalities of psychosocial interventions. The results suggest that psychosocial interventions are effective in reducing both symptoms of PIU and co-occurring symptoms of depression and anxiety in individuals with PIU.

Supplementary Information

The online version contains supplementary material available at 10.1007/s11469-022-00846-6.

Validation of smartphone addiction scale - Short version (SAS-SV) in Brazilian adolescents

The objectives of this study were to analyze the psychometric properties of the Smartphone Addiction Scale - Short Version (SAS-SV) as follows: (i) the factor structure of the SAS-SV using different statistical methods; (ii) the evidence of convergence; (iii) the temporal stability of the SAS-SV; and (iv) predictive SAS-SV validity. A total of 451 adolescents participated in this study (age M = 13.1; SD = 1.22) by completing a sociodemographic questionnaire (including items evaluating the perception of smartphone use), the Internet Addiction Test (IAT), and the SAS-SV. It was found that 53.2% demonstrated problematic smartphone use. The SAS-SV showed good reliability (α = 0.81; ω = 0.78), and all of its items were kept. The network analysis indicated that the items evaluating the withdrawal and preoccupation symptoms had the greatest influence on the network. The intraclass correlation coefficient was 0.846 and indicated good temporal stability of the SAS-SV 20-30 days after the first application. The receiver operating characteristic (ROC) curve analysis indicated 33 points as the best cutoff for the SAS-SV (AUC = 0.739; sensitivity = 65.37%; specificity = 72.26). The instrument also showed a moderate correlation with the variables related to smartphone use (time spent on smartphones, number of messages sent and received, and number of times the smartphone is checked). These data indicate that the SAS-SV may be a reliable instrument for use with Brazilian adolescents.

Association between quality of life and risk behaviors in Brazilian adolescents: An exploratory study

We evaluated the association between risk behaviors and quality of life in 1,081 adolescents classified into the risk behavior (RB) or the non-risk behavior (nRB) group. The data were analyzed with logistic regression models, analysis of variance, and network analysis. The nRB group had higher quality-of-life scores, and having a religion (OR = .42) and better quality of life (OR = .95) significantly reduced the odds of risk behaviors. The network analysis identified that religion, gender, and type of school showed the best centrality and connectivity indices. These data showed a negative association between risk behaviors and lower quality-of-life levels.

Findings on the relationship between Internet addiction and psychological symptoms in Brazilian adults

This study evaluated the prevalence of Internet addiction (IA) and its association with negative psychological symptoms in Brazilian adults. A network analysis was conducted to estimate specific variables and their expected influence on IA. In this cross-sectional study, 15,476 adults (M_age  = 37.5, SD = 9.59) completed an open web-based survey. Three questionnaires were used: the Internet Addiction Test (IAT), Depression Anxiety and Stress Scale (DASS-21) and Satisfaction With Life Scale (SWLS). Based on IAT scores, participants were classified as No-Risk user (NRU), Low-Risk user (LRU) or High-Risk user (HRU). We observed that 4.8% of the participants were classified in the HRU group. In addition, their risk for severe symptoms of depression was 10 times higher and, for anxiety, seven times higher than that in the NRU group (p < .001). Time spent using smartphones was also significantly higher in the HRU group (M_hours  = 5.1, p < .001). The main factors associated with IA were depression, gender and anxiety, but the variable "having children" was the most influential in the IA network. These findings suggest that psychiatric symptoms are the main factors associated with IA among the adult population.

Validity and reliability of the Brazilian version of the Smartphone Addiction Scale-Short Version for university students and adult population

Abstract This study sought evidence of the validity of the Smartphone Addiction Scale-Short Version for a Brazilian sample of 718 individuals, amongst university students (n = 387, M age = 22.1 years) and adults (n = 331, M age = 35.2 years), who completed a sociodemographic questionnaire and the scale. The transcultural adaptation was carried out using specific protocols as recommended by expert’s committees. The factorial structure was evaluated by three methods: Confirmatory Factor Analysis, Principal Component Analysis, and Network Analysis. The adjustment parameters were not adequate and Principal Component Analysis explained 39.2% of the variance. The scale showed good reliability (α = 0.81) and a 39.4% prevalence of problematic phone use. The Network Analysis indicated that the correlations between the items were similar in the two populations. This is an unpublished study evaluating the usage pattern of smartphones in a sample of the adult population from all Brazilian states.

Social representation regarding the use of alcoholic beverages by adolescents

Abstract This study evaluated the Social Representations regarding the use of alcoholic beverages by adolescents (N = 386; Mage = 15.6; SD = 1.94) based on the Theory of Social Representations. The following instruments were used: sociodemographic questionnaire, Drug Use Screening Inventory and Word Evocation Questionnaire. The Social Representations was evaluated from prototypical and similarity reviews, based on the Social Representation Theory and on the Central Nucleus Theory, and the other data were analyzed based on descriptive and inferential tests. The results indicated that 45.0% of the adolescents had consumed alcoholic beverages during the month before data collection, 24.5% of them with a certain regularity (more than three times a month). With regard to Social Representations it was observed that the words “beer” and “party” were the most evoked (p < 0.05). Alcohol consumption by adolescents was considered an acceptable social behavior as it is associated with positive thinking and with socializing characteristics among peers (p < 0.01).