Association Between Internet Addiction and the Risk of Musculoskeletal Pain in Chinese College Freshmen - A Cross-Sectional Study

Association between internet addiction and musculoskeletal disorders in Iranian medical sciences students

BACKGROUND

The utilization of the Internet can lead to adverse outcomes in students' lives. Prolonged Internet usage may result in academic failure, an elevated risk of musculoskeletal problems, and the emergence of issues impacting the lives of students and their peers. This study aimed to explore the relationship between Internet addiction and musculoskeletal disorders (MSDs) among students in the field of medical sciences.

METHODS

In this cross-sectional study, 314 medical sciences students in Semnan, Iran, were assessed using the census sampling method. The participants' Internet addiction status and the presence of MSDs were determined through Young's Internet Addiction questionnaire and the Nordic self-report questionnaire, respectively. Data underwent analysis employing logistic regression test to ascertain the relationship between Internet addiction and MSDs.

RESULTS

Among the 314 participating students in this research, about 21% and 1.6% of the participants were lay open to and suffered from Internet addiction, respectively. Internet addiction was associated with the presence of pain, discomfort, burning, or numbness in the neck, wrist, upper back, hips, and thighs. For each unit increase in the Internet addiction score, the chance of neck and wrist pain rises by 3% compared to a 2% increase in upper back and hip/thigh pain.

CONCLUSION

The findings of this study indicate that excessive Internet use is linked to a heightened risk of MSDs in medical sciences students. Consequently, it is imperative to raise awareness about these complications and promote the adoption of proper posture when using the Internet. Further research is also warranted among diverse student populations to investigate the impact of Internet addiction.

Prevalence of Thumb and Wrist Pain Among Smartphone Users in the Saudi Arabian General Population: A Cross-Sectional Study

Background This study aims to investigate the prevalence of thumb and wrist pain among smartphone users in the general population of Saudi Arabia, examining the potential links between the duration and frequency of smartphone usage, specific smartphone activities, and the occurrence of discomfort in the thumb and wrist. Methodology This descriptive cross-sectional study was conducted at Jazan University, Saudi Arabia, between July 2022 and June 2023. The questionnaire developed following an extensive literature review, covered demographic information, smartphone usage patterns, assessment of thumb or wrist pain, and evaluation of the impact of this discomfort. Descriptive statistical methods were employed, and relationships between thumb or wrist pain and demographic variables were analyzed using chi-square and Wilcoxon rank-sum tests. Results In total, 811 participants were included in this study. Approximately 322 (39.7%) study participants reported wrist or thumb pain. Notably, female sex (P = 0.001) and prolonged daily smartphone usage exceeding five hours (P = 0.045) were linked to thumb or wrist pain. Additionally, emailing on smartphones was linked to thumb or wrist pain (P = 0.04). Concerning smartphone ergonomics, the majority of respondents reported holding their phones with one hand (215, 66.77%), in a downward position (290, 90.06%), and with their wrists bent downward (136, 42.24%). Conclusions Our study highlights a relatively high prevalence of wrist and thumb pain among smartphone users in the general Saudi Arabian population. Furthermore, we identified a connection between prolonged smartphone use and wrist and thumb pain, with a more pronounced prevalence observed among females.

Problematic smartphone use and two types of problematic use of the internet and self-stigma among people with substance use disorders

BACKGROUND AND AIMS

Guided by the Interaction of Person-Affect-Cognition-Execution (I-PACE) model and a self-stigma framework, this study aimed to investigate relationships between cognitive and affective self-stigma and behavioral self-stigma, problematic use of internet (PUI), and problematic smartphone use (PSU) among people with substance use disorders (SUDs). It also examined mediating roles for affective self-stigma in the relationships between cognitive self-stigma and behavioral self-stigma/PUI/PSU.

METHODS

Using a cross-sectional design, 530 participants diagnosed with SUDs in Taiwan were recruited from a psychiatric center in Taiwan. Mediation models were investigated using the Hayes' Process Macro Model 4.

RESULTS

Mediation analyses indicated that cognitive self-stigma was directly associated with behavioral self-stigma (p < 0.001), but not with either types of PUI or PSU (p-values ranging from 0.41 to 0.76). Affective self-stigma was directly related to behavioral self-stigma (p < 0.001), two types of PUI, and PSU (β = 0.24-0.30; all p < 0.001); cognitive self-stigma was indirectly associated with behavioral self-stigma (β = 0.53; 95  % bootstrapping CI = 0.46, 0.60), two types of PUI, and PSU (β = 0.20-0.25; 95  % bootstrapping CI = 0.08-0.14, 0.31-0.37) via a mediating effect of affective self-stigma.

DISCUSSION AND CONCLUSION

Findings support the I-PACE model in a self-stigma context. The findings also suggest that addressing affective self-stigma may help prevent or reduce behavioral self-stigma, PUI, and PSU among people with SUDs. Longitudinal studies are warranted to investigate over time relationships between self-stigma and PUI/PSU in people with SUDs.

Internet addiction and its relationship with attention deficit hyperactivity disorder (ADHD) symptoms, anxiety and stress among university students in Malaysia

BACKGROUND AND AIMS

There is growing evidence on the contribution of psychological factors to internet addiction; yet it remains inconsistent and deserves further exploration. The aim of this study was to determine the relationship between the psychological symptoms (Attention Deficit Hyperactivity Disorder (ADHD) symptoms, stress, depression, anxiety and loneliness) and internet addiction (IA) among the university students in Malaysia.

MATERIALS AND METHODS

A total of 480 students from different faculties in a Malaysian public university participated in this study. They were selected by simple random sampling method. They completed self-administered questionnaires including the Malay Version of Internet Addiction Test (MVIAT)) to measure internet addiction and Adult Self-Report Scale (ASRS) Symptom Checklist, Depression Anxiety Stress Scales (DASS) and UCLA Loneliness Scale (Version 3) to assess for ADHD symptoms, depression, anxiety, stress, and loneliness respectively.

RESULTS

The prevalence of IA among university students was 33.33% (n = 160). The respondents' mean age was 21.01 ± 1.29 years old and they were predominantly females (73.1%) and Malays (59.4%). Binary logistic regression showed that gender (p = 0.002; OR = 0.463, CI = 0.284-0.754), ADHD inattention (p = 0.003; OR = 2.063, CI = 1.273-3.345), ADHD hyperactivity (p<0.0001; OR = 2.427, CI = 1.495-3.939), stress (p = 0.048; OR = 1.795, CI = 1.004-3.210) and loneliness (p = 0.022; OR = 1.741, CI = 1.084-2.794) were significantly associated with IA.

CONCLUSION

A third of university students had IA. In addition, we found that those who were at risk of IA were males, with ADHD symptoms of inattention and hyperactivity, who reported stress and loneliness. Preventive strategy to curb internet addiction and its negative sequelae may consider these factors in its development and implementation.

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.

Short version of the smartphone addiction scale: Measurement invariance across gender

The Smartphone Addiction Scale Short Version (SAS-SV) has been widely used in research, but little is known about the measurement invariance across gender. The current study measured SAS-SV invariance between male and female college students in a sample of 1112 participants. Single- and multiple-group confirmatory factor analyses (CFAs) of smartphone addiction symptom ratings were conducted using R program with RStudio. SAS-SV was psychometrically robust in measuring the severity of smartphone addiction among college students, as well as the gender-based invariance. The differences in SAS-SV between male and female participants were likely to represent true gender differences, and meaningful comparisons could be made.

Sex differences in factors associated with neck pain among undergraduate healthcare students: a cross-sectional survey

Background

Neck pain is widespread among students in healthcare-related fields. Although neck pain is more prevalent in females, since most research involves mixed-sex samples we know very little about sex differences in contributors to neck pain. Thus, this study sought to explore sex differences in the risk factors for neck pain in this high-risk population.

Methods

This cross-sectional study was conducted in China in 2021 and included a sample of 1921 undergraduate healthcare students (693 males, 1228 females) from 7 health professional schools at Fujian Medical University. We collected data on neck pain symptoms, demographics, behavioral and psychological factors. Multiple regression analysis was conducted to examine sex differences in the risk factors of neck pain.

Results

The overall prevalence of neck pain was 41.6% with female students having a higher prevalence than male students (44.4% vs. 36.7%, respectively). The adjusted analyses showed that self-study time ≥ 6 h/day (OR = 1.44, 95% CI:1.13-1.83), flexed neck posture >20 degrees (OR = 2.19, 95% CI: 1.28-3.74), static duration posture >2 h (OR = 1.42, 95% CI: 1.02-1.97), and psychological distress (high: OR = 2.04, 95% CI:1.42-2.94; very high: OR = 2.50, 95% CI:1.57-3.74; respectively) were independent factors for neck pain in females. Among males, self-study time ≥ 6 h/day (OR = 1.43, 95% CI: 1.02-2.01) and psychological distress (moderate: OR = 2.04, 95% CI:1.28-3.25; high: OR = 2.37, 95% CI:1.49-3.79; very high: OR = 2.97, 95% CI:1.75-5.02; respectively) were significant risk factors for neck pain.

Conclusions

These findings suggest that the risk profiles of neck pain differ between females and males. The modifiable risk factors for neck pain, such as prolonged self-study time and elevated psychological distress, as well as poor posture among females, could be targeted through health promotion interventions in university settings.

Cross-sectional and prospective association between internet addiction and risk of fatigue among Chinese college students

Severe internet addiction (IA) is associated with a higher risk of musculoskeletal pain, but whether there is a significant prospective association between IA and fatigue is unclear. This study aimed to examine the association between IA and fatigue level among Chinese college students. A cross-sectional (n = 1011) and prospective study (n = 653) was conducted to examine the association between IA and risk of fatigue. IA was measured using Young internet addiction test. Fatigue level was evaluated using the Chalder fatigue scale. Multivariate logistic regression analyses showed a cross-sectional association between IA and the risk of fatigue. The odds ratios (95% CIs) of fatigue for normal, mild, and moderate to severe groups were 1.00 (reference), 1.88 (1.20, 2.95), and 5.60 (3.33, 9.42), respectively (P for trend: <0.001). Similarly, multivariate logistic regression analyses also revealed a significant prospective relationship between IA and the risk of fatigue during the 1-year follow-up period. The odds ratios (95% CIs) of fatigue for normal, mild, and moderate to severe groups were 1.00 (reference), 1.56 (0.67, 3.67), and 3.29 (1.08, 10.04), respectively (P for trend: 0.046). Our findings indicate that IA is positively related to risk of fatigue among Chinese college students. Further interventional studies are needed to explore the causality underlying the effects of IA on fatigue.

Exploring the relationship between social exclusion and smartphone addiction: The mediating roles of loneliness and self-control

Previous studies have identified many antecedents of smartphone addiction. However, social exclusion as a risk factor for smartphone addiction has not been widely studied, and little is known concerning the psychological mechanism underlying this association. The present study tested the influence of social exclusion on smartphone addiction as well as the mediating roles of loneliness and self-control in this relationship. An online survey was conducted, and the sample consisted of 573 university students (323 females). The results revealed that (1) social exclusion was a positive predictor of smartphone addiction; (2) loneliness and self-control separately mediated the association between social exclusion and smartphone addiction; and (3) loneliness and self-control sequentially mediated the relation between social exclusion and smartphone addiction. Possible explanations were discussed. The findings of the current study would contribute to understanding the relationships between these study variables as well as the psychological mechanisms underlying these associations.

Internet-Related Instruments (Bergen Social Media Addiction Scale, Smartphone Application-Based Addiction Scale, Internet Gaming Disorder Scale-Short Form, and Nomophobia Questionnaire) and Their Associations with Distress among Malaysian University Students

The present study evaluated the psychometric properties of four instruments related to internet use, namely the Bergen Social Media Addiction Scale (BSMAS), Smartphone Application-Based Addiction Scale (SABAS), (nine-item) Internet Gaming Disorder Scale Short Form (IGDS9-SF), and Nomophobia Questionnaire (NMPQ) as well as their associations with psychological distress among Malaysian university students. A total of 380 Malaysian university students (71.6% females, mean age 24.0 years) were recruited through convenience sampling and completed an online survey including questions concerning socio-demographic background, social media addiction, smartphone addiction, internet gaming disorder, and nomophobia. Confirmatory factor analysis and Rasch analysis were applied to evaluate the psychometric properties of the instruments and Cronbach’s alpha value and McDonald’s omega value were used to confirm the internal consistency reliability of the instruments. The unidimensional structure was confirmed for the BSMAS, SABAS, and IGDS9-SF while the four-factor structure was confirmed for NMPQ. All instruments showed good internal consistency reliability. Promising validity and reliability were confirmed for BSMAS, SABAS, IGDS9-SF, and NMPQ. Therefore, they are useful to assess different types of problematic internet use among university students in Malaysia. Furthermore, a significant association was observed between internet use and psychological distress. The present study is the first to investigate the validity and reliability of BSMAS, SABAS, IGDS9-SF, and NMPQ among Malaysian university students using rigorous psychometric testing methods (i.e., Rasch analysis).

The mediating role of maladaptive cognitive schemas regarding the relationship between parenting styles and chronic pain in adolescents: a structural equation modelling approach

BACKGROUND

Although there is a growing body of evidence linking parenting styles to health outcomes, little emphasis has been dedicated to how parenting styles affect chronic pain in adolescents. Given the high prevalence of chronic pain in adolescents and taking into consideration the complexity of chronic pain and the factors affecting it, further research is needed to better understand the processes through which parenting styles affect adolescents' pain. The purpose of the present study was to explore the mediating role of maladaptive schemas in the association between different parenting styles and chronic pain.

METHOD

1302 adolescents aged 12 to 21 in Shiraz, Iran, were randomly selected to participate in this study. To identify adolescents with chronic pain, screening questions based on the 11th revision of the International Classification of Diseases were used. Buri's Parental Authority Questionnaire (PAQ), and Young's Schema Questionnaire-Short Form (YSQ-SF) were used to assess the parenting styles and maladaptive cognitive schemas, respectively. The structural equation modeling approach was carried out to evaluate the direct, indirect, and total effects of different parenting styles on chronic pain.

RESULTS

The results in the SEM models revealed that disconnection/ rejection (β = - 0.043, 95%CI =  - 0.07 to  - 0.02), impaired autonomy/ performance (β =  - 0.01, 95%CI =  - 0.02 to -0.003), over-vigilance/inhibition (β =  - 0.007, 95%CI =  - 0.01 to  - 0.008), and impaired limits schemas (β =  - 0.004, 95%CI =  - 0.006 to  - 0.002) significantly mediated the protective effects of the authoritative parenting style on chronic pain. It was also found that the mediating effects of disconnection/ rejection (β = 0.01, 95%CI = 0.01 to 0.02), and over-vigilance/ inhibition (β = 0.002, 95%CI = 0.001 to 0.02) existed in the relationship between the authoritarian style and chronic pain. The permissive style may also affect chronic pain through disconnection/ rejection (β = 0.004, 95%CI = 0.001 to 0.01), other-directedness (β = 0.01, 95%CI = 0.005 to 0.015), and impaired limits schemas (β = 0.05, 95%CI = 0.04 to 0.06).

DISCUSSION

The findings of the present study showed that maladaptive cognitive schemas play a mediating role in the relationship between parenting styles and chronic pain in adolescents. It seems that the interventions that target the effective communication between the parents and the adolescents can be considered as an important part in the chronic pain management in adolescents.

Digital Addiction and Sleep

In 2020, the World Health Organization formally recognized addiction to digital technology (connected devices) as a worldwide problem, where excessive online activity and internet use lead to inability to manage time, energy, and attention during daytime and produce disturbed sleep patterns or insomnia during nighttime. Recent studies have shown that the problem has increased in magnitude worldwide during the COVID-19 pandemic. The extent to which dysfunctional sleep is a consequence of altered motivation, memory function, mood, diet, and other lifestyle variables or results from excess of blue-light exposure when looking at digital device screens for long hours at day and night is one of many still unresolved questions. This article offers a narrative overview of some of the most recent literature on this topic. The analysis provided offers a conceptual basis for understanding digital addiction as one of the major reasons why people, and adolescents in particular, sleep less and less well in the digital age. It discusses definitions as well as mechanistic model accounts in context. Digital addiction is identified as functionally equivalent to all addictions, characterized by the compulsive, habitual, and uncontrolled use of digital devices and an excessively repeated engagement in a particular online behavior. Once the urge to be online has become uncontrollable, it is always accompanied by severe sleep loss, emotional distress, depression, and memory dysfunction. In extreme cases, it may lead to suicide. The syndrome has been linked to the known chronic effects of all drugs, producing disturbances in cellular and molecular mechanisms of the GABAergic and glutamatergic neurotransmitter systems. Dopamine and serotonin synaptic plasticity, essential for impulse control, memory, and sleep function, are measurably altered. The full spectrum of behavioral symptoms in digital addicts include eating disorders and withdrawal from outdoor and social life. Evidence pointing towards dysfunctional melatonin and vitamin D metabolism in digital addicts should be taken into account for carving out perspectives for treatment. The conclusions offer a holistic account for digital addiction, where sleep deficit is one of the key factors.

Serial Mediation Roles of Alexithymia and Loneliness in the Association Between Family Function and Internet Addiction Among Chinese College Students

A lot of previous research has highlighted the negative consequences of Internet addiction. However, relatively few is known about the underlying mechanism for Internet addiction among college students in relation to family function. The present study explored the relationship between family function and Internet addiction among college students, as well as the mediating effects of alexithymia and loneliness. A sample of 783 Chinese college students were administered a number of psychometric scales including the “General Function” subscale of the Chinese version of the Family Assessment Device, Toronto Alexithymia Scale, UCLA Loneliness Scale, and Revised Chinese Internet Addiction Scale. The results showed that family function was negatively associated with Internet addiction; the association was significantly mediated by alexithymia; the association was significantly mediated by loneliness; and alexithymia and loneliness sequentially mediated the association. The total mediating effect was 63.96%. The results of the present study are of great significance to the prevention and intervention of Internet addiction among college students.

Prevalence and Clinical Correlates of Internet Addiction Symptoms and Their Association With Quality of Life in Adolescents With Major Depressive Disorder: A Multicenter Cross-Sectional Study

BACKGROUND

Internet addiction (IA) symptoms are common among adolescents and negatively impact their academic performance and development. These symptoms are also associated with lower quality of life (QOL) and increased suicidality. This study aimed to examine the prevalence and the sociodemographic and clinical correlates of IA symptoms in adolescents with major depressive disorder (MDD) and their association with QOL.

METHODS

This cross-sectional study was conducted in three general and four psychiatric hospitals in Anhui Province, China, from January to July 2021. Sociodemographic and clinical data were collected. The Internet Addiction Test (IAT), Center for Epidemiologic Studies of Depression Symptom Scale (CES-D), and World Health Organization Quality of Life Brief version (WHOQOL-BREF) were utilized to examine IA, depressive symptoms, and QOL, respectively.

RESULTS

In a multicenter sample of 278 adolescents with MDD, the prevalence of IA symptoms in adolescents with MDD was 46.8% (95% CI: 40.9-52.7%). Logistic regression analysis showed that patients with more severe depressive symptoms (odds ratio [OR] = 1.05, 95% CI: 1.03-1.08), those living in a rural area (OR = 1.94, 95% CI: 1.15-3.27), and those with poor academic performance (OR = 2.90, 95% CI: 1.42-5.95) were more likely to have IA symptoms. After controlling for confounding factors, patients with IA symptoms had significantly poorer QOL in the physical, psychological, and environmental domains than those without IA symptoms.

CONCLUSION

IA symptoms are common in adolescents with MDD and appear to be associated with clinical symptoms. We could not infer a causal relationship between IA and depression because this was a cross-sectional study. Considering the positive association between IA symptoms and lower QOL, screening for IA symptoms should be conducted, and effective measures should be implemented for adolescents with MDD.

Prevalence and Risk Factors of Internet Addiction among Hungarian High School Students

Introduction: The extensive availability of the internet has led to the recognition of problematic internet use (so-called internet addiction—IA) mostly concerning adolescents. Aim: Here, we present a study focusing on the prevalence and risk factors of internet addiction in Hungarian high school students, using a questionnaire-based survey. Results: Overall, 3000 paper-based questionnaires were successfully delivered and 2540 responses were received (response rate of 84.6%). A total of 1309 males (mean age 17.6 ± 1.43 years) (51.5%) and 1231 females (mean age 17.5 ± 1.4 years) (48.5%) took part in our study. Internet addiction was detected in 486 (19.1%) students (232 males, mean age 17.6 ± 1.35 years, and 254 females, mean age 17.34 ± 1.37 years) based on the Problematic Internet Use Questionnaire. In a multivariate analysis, age (age of 17, OR = 3.688, p < 0.001), family status (living without parents) (OR = 2.091, p = 0.034), the size of the household (more than five people per household) (OR = 2.546, p = 0.026), spending more than 6 h online (OR = 5.457, p < 0.001), and daily time interval (OR = 84.316, p < 0.001) were significantly associated with internet addiction. Alcohol use (OR = 10.341, p = 0.001), drug intake (OR = 6.689, p = 0.001) and musculoskeletal disorders (OR = 3.966, p = 0.047) were also strongly associated with IA. Conclusion: A significant proportion of our students suffered from IA, which is associated with substance intake (possible abuse) and musculoskeletal pain in the multivariate analysis. Our study also draws attention to the preventable risk factors of IA, such as working hours or nighttime internet use, number of hours spent online and family surroundings.

Fear of missing out (FOMO): overview, theoretical underpinnings, and literature review on relations with severity of negative affectivity and problematic technology use

This article discusses the fear of missing out (FOMO) on rewarding experiences, an important psychological construct in contemporary times. We present an overview of the FOMO construct and its operational definition and measurement. Then, we review recent empirical research on FOMO’s relationship with levels of online social engagement, problematic technology and internet communication use, negative affectivity, and sociodemographic variables. Additionally, we discuss theoretical conceptualizations regarding possible causes of FOMO and how FOMO may drive problematic internet technology use. Finally, we discuss future directions for the empirical study of FOMO.

Prevalence and Risk Factors of Internet Addiction among Hungarian High School Teachers

The extensive availability of internet has led to the the recognition of problematic internet use (so called internet addiction, IA) mostly involving adolescents. There is limited data about the prevalence of IA in adults. Here we present a study focusing on the prevalence and risk factors of internet addiction among high school teachers. Overall 2500 paper-based questionnaires were successfully delivered and 1817 responses received (response rate of 72.7%). In our study 1194 females (65.7%) and 623 males (34.3%) participated. In a multivariate analysis including of all factors (demographic data, internet habits, comorbidity etc.) age <35 years (OR: 6.098, CI: 5.09-7.08, p < 0.001), male gender (OR = 5.413, CI: 4.39-6.18, p = 0.002), surfing on the internet > 5 h daily (OR 2.568, CI: 2.03-3.39, p < 0.001), having no children (OR: 1.353, CI: 1.13-1.99, p = 0.0248), and having secondary employment (OR = 11.377, CI: 8.67-13.07, p = 0.001) were significantly associated with internet addiction. This is the first study from Hungary showing the prevalence and risk factors of internet addiction among high school teachers. A small, but significant proportion suffered from IA. Our study also draws attention to the risk factors of IA such as younger age, family status and working type.

Internet Addiction and Burnout in A Single Hospital: Is There Any Association?

The extensive availability of the internet has led to the recognition of problematic internet use, the so-called Internet Addiction (IA), mostly involving adolescents. Burnout can lead to substance abuse or addictive behaviour (such as internet addiction) as a coping method. There are insufficient data about internet addiction and its possible association with burnout in adults, especially among healthcare workers. The aim of our present study was to focus on prevalence and the risk factors of internet addiction and its possible association with burnout among healthcare workers in a single hospital applying a questionnaire-based survey. In total, 49 doctors (10.1%), 198 nurses (40.9%), 123 medical assistant (25.4%), 73 other healthcare workers (15.1%), and 42 (1.7%) healthcare associated workers (cleaning, laundry, etc.) have completed our survey. In a multivariate analysis, IA was associated with age between 18 and 25 (OR: 2.6, p = 0.024), surfing on the internet >5 h daily (OR 25.583, p < 0.001), being single (OR: 4.275, p = 0.006), being childless (OR: 3.81, p = 0.011), working less than five years (OR 2.135, p = 0.048) and job type (being healthcare associated worker, OR: 2.907, p = 0.009). Illicit drug intake (OR 52.494, p < 0.001), and diabetes (OR: 4.122, p = 0.043) were also significantly associated with internet addiction. No association of burnout and IA could be found. A small but significant proportion of our healthcare workers suffered from IA, which was associated with substance abuse and diabetes in multivariate analysis. Our study also draws attention to the risk factors of IA such as younger age, family status, working type and working hours internet use. The possible association of burnout and IA merits further investigation.

The association between problematic internet use and neck pain among Japanese schoolteachers

OBJECTIVES

Problematic internet use (PIU) has been suggested in relation to psychological symptoms among schoolteachers, but the relationship with physical symptoms remains unclear. We examined whether PIU or longer Internet usage time is associated with neck pain in schoolteachers.

METHODS

We conducted a cross-sectional study among 2582 teachers aged 20 years or older (35.6% women) in Shimane and Tottori, Japan in 2018. Neck pain was defined as ≥5 points on the Neck Disability Index. The Compulsive Internet Use Scale (CIUS) was used to assess PIU. Internet usage time on weekdays and weekends was divided into five groups: 0, 1-29, 30-59, 60-119, and ≥120 min/day. Logistic regression analysis was conducted to examine the association of the CIUS score and Internet usage time on weekdays or weekends with neck pain, adjusting for sex, age, position at school, insomnia, and psychological distress.

RESULTS

We observed 800 (31.0%) teachers with neck pain. The median (interquartile range) of their CIUS scores was 7 (2, 14). A higher CIUS score was independently associated with a higher prevalence of neck pain (odds ratio of 4th vs. 1st quartiles, 1.41; 95% confidence interval, 1.06-1.87; trend P = .006). Compared with non-Internet users, Internet users on weekdays had almost double the odds of neck pain although the difference did not reach the customary level for designating statistical significance.

CONCLUSIONS

In conclusion, teachers with higher scores in CIUS were associated with a higher prevalence of neck pain in Japan, suggesting adults with PIU being at risk of physical disorders.

Associations between symptoms of problematic smartphone, Facebook, WhatsApp, and Instagram use: An item-level exploratory graph analysis perspective

BACKGROUND AND AIMS

Studies have demonstrated associations between both problematic smartphone and social networks use with everyday life adversities. However, examination of associations between problematic smartphone use (PSU) and problematic use of specific social networking platforms, especially on item-level data, has received relatively little attention. Therefore, the aim of the current study was to explore how items of problematic smartphone, Facebook, WhatsApp, and Instagram use are associated.

METHODS

949 German-speaking adults participated in a web survey study. The participants were queried about their socio-demographics as well as levels of problematic smartphone, Facebook, WhatsApp, and Instagram use. In addition to bivariate correlation analysis, exploratory graph analysis (EGA), a type of network analysis, was conducted.

RESULTS

The results showed that while problematic Facebook and Instagram use seem to be distinct phenomena, problematic smartphone and WhatsApp use were heavily intertwined. Furthermore, the only cross-platform symptom observed was the extent of reported pain in wrists and neck due to digital technology use. The EGA network models showed very good stability in bootstrap analyses.

DISCUSSION AND CONCLUSIONS

In general, the results of this study suggest that while Instagram and Facebook use may potentially constitute distinct problematic behaviors, problematic smartphone/WhatsApp use scales may be measuring highly similar or even the same construct.

Association between Breakfast Consumption and Depressive Symptoms among Chinese College Students: A Cross-Sectional and Prospective Cohort Study

Skipping breakfast has been suggested to increase the risk of depressive symptoms, but there is no information regarding young adults. We aimed to investigate the relationship between the frequency of breakfast consumption and the risk of depressive symptoms among Chinese college students. We investigated a cross-sectional (n = 1060) and one-year prospective (n = 757) relationship between the frequency of breakfast consumption and the risk of depressive symptoms. The frequency of breakfast consumption was categorized into “≤1 time/week”, “2–5 times/week”, or “≥6 times/week”. Depressive symptoms were assessed using the 20-item Zung self-rating depression scale (SDS) with an SDS score of ≥50 to indicate moderate to severe depressive symptoms. In the cross-sectional analysis, the adjusted odds ratios (ORs) and 95% confidence intervals (CIs) of depressive symptoms related with the breakfast consumption categories were 1.00 (reference) for ≥6 times/week, 1.761 (95% CI: 1.131, 2.742) for 2–5 times/week, and 3.780 (95% CI: 1.719, 8.311) for ≤1 time/week (p for trend: <0.001) after adjusting for these potential confounders. Similarly, in the one-year prospective analysis, we found that 10.2% of participants was classified as having moderate to severe depressive symptoms. Multivariate logistic regressions analysis revealed a significant negative relationship between the frequency of breakfast consumption and the risk of depressive symptoms. The ORs (95% CI) for depressive symptoms with decreasing breakfast consumption frequency were 1.00 (reference) for ≥6 times/week, 2.045 (1.198, 3.491) for 2–5 times/week, and 2.722 (0.941, 7.872) for ≤1 time/week (p for trend: 0.005). This one-year prospective cohort study showed that skipping breakfast is related to increased risk of depressive symptoms among Chinese college students. Future research using interventional or experimental studies is required to explore the causal relationship between the effects of breakfast consumption and depressive symptoms.

Rumination and negative smartphone use expectancies are associated with greater levels of problematic smartphone use: A latent class analysis

Problematic smartphone use (PSU) is related to psychopathology symptoms, such as depression and anxiety. However, less is known about how responses to and coping with psychopathology correlate with PSU. We conducted a web survey of 286 American college students, querying depression and anxiety symptoms, rumination (a coping process to avoid negative emotion), PSU, and expectancies about smartphone use for mood alleviation. We conducted latent class analysis (LCA) of PSU symptom ratings, finding support for two latent subgroups of participants, involving mild and severe PSU, especially distinguished by severity of withdrawal symptoms. Rumination and negative smartphone use expectancies (i.e., to reduce distress) positively related to the more symptomatic PSU class. Results are discussed in context of the I-PACE theoretical model of problematic internet use (PIU). We emphasize the importance of response variables in I-PACE, such as internet-related cognitive bias and coping, over background psychopathology variables in influencing PIU and PSU.