The Impact of Adverse Childhood Experiences on Mobile Phone Addiction in Chinese College Students: A Serial Multiple Mediator Model

The Association Between Child Abuse and Internet Addiction: A Three-Level Meta-Analysis

Child abuse is an important factor for Internet addiction. Despite numerous researches had observed there was a positive correlation between child abuse and Internet addiction, the strength of this association differed considerably in the previous studies. This study aims to obtain reliable estimates for effect sizes and investigate the potential moderator of the association between child abuse and Internet addiction. Thirty-one studies reported the association between child abuse and Internet addiction (273 effect sizes and 55,585 participants) through a systematic literature search. Based on Preferred Reporting Items for Systematic Review and Meta-Analysis approach, a three-level model was employed to conduct a three-level meta-analysis. The current meta-analysis found that child abuse was significantly positively correlated with Internet addiction. Besides, the study found that the type of child abuse and publication year had significant moderating effects on the association between child abuse and Internet addiction. This study suggested child abuse was a risk factor for Internet addiction. Moreover, child abuse is an essential factor should be considered when strengthening interventions for individuals' Internet addiction.

Changes in Chinese college students' mobile phone addiction over recent decade: The perspective of cross-temporal meta-analysis

In recent years, with the rapid advancement of Internet technology and the impact of the COVID-19 pandemic, mobile phones have been used more frequently, the development trend of mobile phone addiction among Chinese college students is a concern to society. This cross-temporal meta-analysis provides compelling evidence of the rising trend of mobile phone addiction in Chinese college students based on data from 42 independent studies (Sample Size = 49,544) over the past decade (2013-2022), and discuss the three important rising periods. Furthermore, extended research has revealed correlated factors of mobile phone addiction among Chinese college students, including gender, anxiety, depression, loneliness, stress, well-being, social support, and resilience. Additionally, the study identified the National internet penetration rate and the National GDP index as significant predictors of mobile phone addiction in Chinese college students. These findings not only reveal the changing trends of mobile phone addiction among Chinese college students, but also enrich the understanding of mobile phone addiction among this population and provide a reference for improving mobile phone addiction among in the future.

Adverse childhood experience and young adult's problematic Internet use: The role of hostility and loneliness

BACKGROUND

Few studies have explored the relationship between adverse childhood experiences (ACEs) and problematic Internet use (PIU) during young adulthood. Moreover, even fewer studies have explored the roles of loneliness (social and emotional) and hostility in this relationship.

METHODS

This study used data from the Taiwan Youth Project (2011-2017). The analytical sample included 1885 participants (mean age = 31.3 years). PIU was measured using the short form of Chen's Internet Addiction Scale (2017). ACEs were assessed at the baseline of the adolescent phase (mean age = 14.3 years); this indicator has undergone recent revision. Hostility (three items from the Symptom Checklist-90-Revised) and loneliness (six items from the De Jong Gierveld scale) were measured in 2011 and 2014, respectively.

RESULTS

ACEs were associated with hostility and loneliness (emotional and social). Additionally, hostility (β = 0.62, p < .01) and emotional loneliness (β = 0.44, p < .01) were significantly associated with PIU. Most mediating paths (e.g., ACE → hostility → PIU) were significant, based on the bootstrapping results.

CONCLUSIONS

This study suggests that ACEs have a long-term shadow effect on PIU in young adults. ACEs show an indirect association with PIU through both hostility and loneliness, as well as involving the relationship between them.

Leisure experience and mobile phone addiction: Evidence from Chinese adolescents

Background

During the Covid-19 pandemic, online learning became the mainstream because of many restrictions on interpersonal relationships. Children spent more and more time using mobile phones, which also aroused public concern.In past research on the prevention of problematic mobile phone use, it was easy to neglect meaningful part of leisure. Hence, based on Davis's cognitive-behavioral model, this study was designed to verify how leisure experience influences mobile phone addiction through maladaptive cognition, which received little attention before.

Methods

By convenient sampling method, it involved a sample of 1007 middle school students recruited from Northern China. We used adolescent leisure experience questionnaire, maladaptive cognition scale and mobile phone addiction scale to measure adolescents' leisure experience, maladaptive cognition and mobile phone addiction respectively.

Results

The findings revealed that leisure experience was negatively correlated with maladaptive cognition (r = -0.21, p < 0.01) and mobile phone addiction (r = -0.20, p < 0.01) respectively. Maladaptive cognition was positively correlated with mobile phone addiction (r = 0.51, p < 0.01). Given gender, age and family economic conditions, the negative predictive effect of leisure experience on mobile phone addiction was significant (β = -0.18，p < 0.001). Besides, the process by which leisure experience predicted mobile phone addiction through maladaptive cognition was significant, indirect effect = -0.10, SE = 0.02, 95 % CI = [-0.13, -0.07].

Conclusions

Adolescents' great leisure experience has a positive impact on mobile phone addiction, which can be achieved by reducing maladaptive cognition. Therefore，it is significant to improve their leisure experience and guide them to perceive their irrational beliefs in leisure and rethink offline leisure and real life from more positive views.

Brief Mindfulness Training Mitigates College Students' Mobile Phone Addiction: The Mediating Effect of the Sense of Meaning in Life

Objective

To explore the impact of brief mindfulness training on college students' mobile phone addiction and the mediating effect of the sense of meaning in life between them.

Methods

This study has employed the mixed experimental design of 2 (experimental conditions) × 2 (time points), randomly assigned 44 college students into a mindfulness training group and a control group (22 college students in each group), and selected the Freiburg Mindfulness Inventory (FMI), Mobile Phone Addiction Tendency Scale (MPATS), and Chinese Meaning in Life Questionnaire (C-MLQ) to conduct separate tests before and after mindfulness training.

Results

The results show that: (1) in the pretest, the differences between the mindfulness training group and the control group in the level of mindfulness, the level of mobile phone addiction, and the sense of meaning in life are not statistically significant; (2) in the posttest, compared with those of the control group, both the FMI score (p=0.013) and the C-MLQ score (p<0.001) of the mindfulness training group improve significantly, while the MPATS score (p=0.008) of the mindfulness training group declines significantly; and (3) the Bootstrap analysis of the mediating effect shows that after the change in C-MLQ (95% CI [0.537, 11.630]) enters the equation, the direct effect of mindfulness training is not significant (95% CI [-3.254, 5.861]).

Conclusion

The results of this study reveal the impact and mechanism of brief mindfulness training on college students' mobile phone addiction, and provide an empirical basis for intervening on mobile phone addiction.

The Factors Affecting Longitudinal Course of Posttraumatic Stress Disorder Symptoms in Sexual Assault Victims

OBJECTIVE

This study aimed to identify the factors affecting posttraumatic stress disorder (PTSD) symptom remission prospectively through a 1-year follow-up of sexual assault (SA) victims.

METHODS

A total 65 female SA victims who visited the crisis intervention center were included. Self-administered questionnaires regarding PTSD symptoms and PTSD related prognostic factors were conducted at both recruitment (T1) and 1 year after recruitment (T2). The multivariate analyses were used to determine the significant predictors of PTSD remission/non-remission state 1 year after SA.

RESULTS

In logistic regression analysis, both anxiety and secondary victimization were identified as significant factors explaining the results on PTSD remission/non-remission state at T2 (Beck's Anxiety Inventory [BAI], p=0.003; Secondary Victimization Questionnaire, p=0.024). In a linear mixed analysis, both depression and anxiety were found to be significant variables leading to changes in Posttraumatic Diagnostic Scale for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition from T1 to T2 (BAI, p<0.001; Center for Epidemiological Studies Depression Scale, p<0.001).

CONCLUSION

Depression, anxiety symptoms, and secondary victimization after SA were associated with PTSD symptom non-remission 1 year after SA.

Attention, Externalizing and Internalizing Problems Mediated Differently on Internet Gaming Disorder Among Children and Adolescents With a Family History of Addiction as an Adverse Childhood Experience

BACKGROUND

This study aimed to examine the factors associated with internet gaming disorder (IGD) and the mediating role of pediatric symptoms (attention, externalizing problems and internalizing problems) in children and adolescents with a family history of addiction as an adverse childhood experience (ACE).

METHODS

A total of 2,586 children and adolescents (mean age = 14.04 ± 2.34; age range = 11-19 years; 50.5% boys) completed the Internet Game Use-Elicited Symptom Screen and the Pediatric Symptom Checklist-17. IBM SPSS Statistics 21 was used to calculate descriptive statistics and Pearson correlation coefficients and to conduct multiple regression analyses. Mediation analysis was performed using the Sobel test and the SPSS PROCESS macro. Serial multiple mediation analysis was performed using bootstrapping with 5,000 replications.

RESULTS

The higher levels of Attention problems (β = -0.228, P < 0.001) and externalizing problems (β = -0.213, P < 0.001) were associated with IGD. Furthermore, the indirect effect of the independent variable on the dependent variable through the mediators was significant (Sobel's T: Z = -5.006, P < 0.001). These findings suggest that attention and externalizing problems mediate the effect of family history of addiction on IGD.

CONCLUSION

This study demonstrated the associations among the family history of addiction, IGD, and pediatric symptoms (attention, externalizing problems, and internalizing problems) among Korean children and adolescents. Therefore, we need to pay attention to pediatric symptoms and develop systematic alternatives to improve mental health among Korean children and adolescents with a family history of addiction as ACEs.

Associations between adverse childhood experiences and early adolescent problematic screen use in the United States

BACKGROUND

Problematic screen use, defined as an inability to control use despite private, social, and professional life consequences, is increasingly common among adolescents and can have significant mental and physical health consequences. Adverse Childhood Experiences (ACEs) are important risk factors in the development of addictive behaviors and may play an important role in the development of problematic screen use.

METHODS

Prospective data from the Adolescent Brain Cognitive Development Study (Baseline and Year 2; 2018-2020; N = 9,673, participants who did not use screens were excluded) were analyzed in 2023. Generalized logistic mixed effects models were used to determine associations with ACEs and the presence of problematic use among adolescents who used screens based on cutoff scores. Secondary analyses used generalized linear mixed effects models to determine associations between ACEs and adolescent-reported problematic use scores of video games (Video Game Addiction Questionnaire), social media (Social Media Addiction Questionnaire), and mobile phones (Mobile Phone Involvement Questionnaire). Analyses were adjusted for potential confounders including age, sex, race/ethnicity, highest parent education, household income, adolescent anxiety, depression, and attention-deficit symptoms, study site, and participants who were twins.

RESULTS

The 9,673 screen-using adolescents ages 11-12 years old (mean age 12.0) were racially and ethnically diverse (52.9% White, 17.4% Latino/Hispanic, 19.4% Black, 5.8% Asian, 3.7% Native American, 0.9% Other). Problematic screen use rates among adolescents were identified to be 7.0% (video game), 3.5% (social media), and 21.8% (mobile phone). ACEs were associated with higher problematic video game and mobile phone use in both unadjusted and adjusted models, though problematic social media use was associated with mobile screen use in the unadjusted model only. Adolescents exposed to 4 or more ACEs experienced 3.1 times higher odds of reported problematic video game use and 1.6 times higher odds of problematic mobile phone use compared to peers with no ACEs.

CONCLUSIONS

Given the significant associations between adolescent ACE exposure and rates of problematic video and mobile phone screen use among adolescents who use screens, public health programming for trauma-exposed youth should explore video game, social media, and mobile phone use among this population and implement interventions focused on supporting healthy digital habits.

Problematic Smartphone Use and Social Media Fatigue: The Mediating Role of Self-Control

Background

Excessive social media consumption leads to addiction and affects mental health. It is a phenomenon that is difficult to avoid. Previous research on the effects of excessive Internet use shows that people who engage in social media (SM) without restraint experience over-involvement, over-disclosure, technostress, and social media fatigue (SMF). SMF, conceptualized as an emotional and cognitive feeling of being overwhelmed, manifests itself in mindless browsing of content, limiting the amount of time spent on SM, or quitting SM altogether. Self-control, although present in the technology addiction literature and psychology research, has been rarely described in relation to both excessive SM use and SMF. Therefore, the main goal of the present study was to verify whether there is a direct relationship between problematic smartphone use and SMF, and whether this association is mediated by self-control.

Methods

The study included 210 respondents (M = 25.85, SD = 9.84) living in different Polish cities. The survey was conducted online, and the respondents consented to participate in the study. They completed the following measures: the Mobile Phone Problematic Use, the Self-Control Scale, the Social Media Fatigue Scale, and a brief questionnaire with socio-demographic data.

Results

Statistical analysis was performed to verify the relationship between problematic mobile phone use, level of self-control, and SMF. The outcomes indicate that there are significant interrelationships between the three studied variables. The association between problematic smartphone use and SMF is mediated by self-control.

Conclusion

A lack of impulse-inhibition skills, such as compulsive checking of notifications, can be a significant factor in SM exhaustion, fatigue, or frustration. SMF can also be understood as a natural defensive response, triggered in situations where individuals are overwhelmed, when the self-control is insufficient to stop the compulsion to use SM, and the use of a smartphone for this purpose is excessively engaging.

Relationship between adverse childhood experiences and problematic internet use among young adults: The role of the feeling of loneliness trajectory

BACKGROUNDS AND AIMS

Given problematic Internet usage's (PIU) negative impact on individual health, this study evaluates how adverse childhood experiences (ACEs) affect young adults' PIU and the possible underlying mechanism of the "feeling of loneliness" (FOL) trajectory.

METHODS

Analyzing a retrospective cohort sample from the Taiwan Youth Project, 2,393 adolescents were interviewed from the average ages of 14-28. We constructed ACE in 2000 using six categories (e.g., abuse and low family socioeconomic status) and 5-item PIU in 2017 from Chen's Internet Addiction Scale. FOL trajectories measured eight times, at average ages 14, 16, 17, 18, 20, 22, 25, 28 years-old.

RESULTS

Overall, 12.65% of the participants did not have ACEs, and 12.78% exhibited PIU. FOL trajectory analyses yielded three groups: "constant low" (reference group: 53.25%); "moderate decline" (36.81%); and "increasing" (9.94%). Regression models showed a dose-response association between ACE and young adults' PIU (adjusted odds ratio = 1.12; 95% confidence interval [CI] = 1.02-1.23) and the two risky loneliness groups (moderate decline: relative risk ratio [RRR] = 1.42, 95% CI = 1.32-1.54; increasing: RRR = 1.52, 95% CI = 1.37-1.71). Structural equation modeling further found that ACEs increase young adults' risk of being in the increasing group, and consequently, the risk of PIU.

DISCUSSION AND CONCLUSIONS

We demonstrated that ACE may be associated with 1) adults' PIU, 2) FOL from adolescence to emerging adulthood, and 3) young adults' PIU through its association with FOL trajectories.

Correlations between smartphone addiction and alexithymia, attachment style, and subjective well-being: A meta-analysis

Background

Smartphone addiction (SA) has become a social problem that affects peoples’ quality of life and is frequently reported to be correlated with alexithymia, avoidant or anxious attachment styles, and subjective well-being. This study aimed to investigate the relationship between SA and alexithymia, attachment style, and subjective well-being.

Methods

A meta-analysis was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The following electronic databases were searched: PubMed, Web of Science, Embase, PsycINFO, PsycArticles, China National Knowledge Infrastructure (CNKI), WANFANG DATA, and Chongqing VIP Information Co., Ltd. (VIP). Stata 16.0 was used to analyze the overall effect and test the moderating effect.

Results

One hundred and ten studies were included, involving a total of 96,680 participants. SA had a significantly high positive correlation with alexithymia (r = 0.40), attachment anxiety (r = 0.37), and negative emotions (r = 0.31), and a low positive correlation with attachment avoidance (r = 0.17). In addition, there was a high negative correlation between SA and subjective well-being (r = –0.33) and a low negative correlation between SA, life satisfaction (r = –0.17), and positive emotions (r = –0.18). A moderation analysis revealed that age significantly moderated the relationship between SA and positive emotions. The tools for measuring SA significantly moderated the relationship between SA, alexithymia, attachment anxiety, and subjective well-being. Meanwhile, subjective well-being measurement tools significantly moderated the relationships between SA, subjective well-being, and negative emotions.

Conclusion

SA was closely related to alexithymia, attachment style, and subjective well-being. In the future, longitudinal research can be conducted to better investigate the dynamic changes in the relationship between them.

Systematic review registration

[www.crd.york.ac.uk/PROSPERO/], identifier [CRD42022334798].

Attachment anxiety and smartphone addiction among university students during confinement: Teacher–student relationships, student–student relationships and school connectedness as mediators

Learning at home during the COVID-19 confinement might affect students' relationships with their peers, teachers, and schools and increase the possibility of smartphone addiction. We hypothesized that attachment anxiety directly and indirectly affects smartphone addiction, with teacher–student relationships, student–student relationships, and school connectedness as mediators. The participants were 999 university students from different regions of China. The results showed that six of the paths were significant except the one between student–student relationships and smartphone addiction. Also, the association between attachment anxiety and smartphone addiction was mediated by teacher–student relationships and school connectedness not but student–student relationships. The current study highlights the mediating effect of school connectedness and teacher–student relationships in the multiple mediation model, and suggests that universities can alleviate the risk of smartphone addiction in distance teaching by cultivating good teacher–student relationships and strengthening students' sense of belonging to their schools.

Effects of Cell Phone Dependence on Mental Health Among College Students During the Pandemic of COVID-19: A Cross-Sectional Survey of a Medical University in Shanghai

Objective

To investigate the effects of cell phone dependence (CPD) on mental health among undergraduates during the COVID-19 pandemic and further identify the determinants that may affect their mental health in China.

Methods

The data were collected from 602 students at a medical school in Shanghai via an online survey conducted from December 2021 to February 2022. The Mobile Phone Addiction Index (MPAI) and Depression Anxiety Stress Scale (DASS) were applied to evaluate CPD and mental health, respectively. Independent sample t-test and one-way analysis of variance (ANOVA) were employed to compare the means of continuous variables among categorical groups. Correlations between continuous variables were detected using Pearson's correlation analysis. Univariable and multivariable logistic regressions were employed to identify the determinants of mental health.

Results

Among the 402 eligible students, 73.88% were women with an average age of 20.19 ± 2.36 years. On average, the DASS score was 32.20 ± 11.07, the CPD score was 36.23 ± 11.89, and the cell phone use duration was 7.67 ± 3.61 h/day. CPD was found to have a negative effect on mental health among college students in Shanghai. Additionally, cell phone use duration, age, being senior students, faculty-student relationship, insomnia, tobacco use, obesity, and life satisfaction were clarified as contributing factors to mental health among college students.

Conclusion

High degree of CPD could have a negative effect on college students' mental health, which might lead to some psychological problems. Appropriate actions and effective interventions are highly needed to prevent severe psychological injuries among college students in China.

Association between Adverse Childhood Experiences and Time Spent Playing Video Games in Adolescents: Results from A-CHILD Study

Background: Excessive time spent playing video games is associated with adverse health outcomes in adolescents. Although poor child–parent relationship and social relations with peers are considered as possible predictors, little is known as to whether adverse childhood experiences (ACEs) are associated with time spent playing video games. The aim is to examine the association between ACEs and time spent playing video games in adolescents. Methods: We used pooled data from the Adachi Child Health Impact of Living Difficulty (A-CHILD) study in 2016 and 2018, which is a population-based cross-sectional study in Adachi City, Tokyo, Japan (N = 6799, 4th, 6th, and 8th-grade students). Adolescents answered questionnaires examining the time spent playing video games, per day, on weekdays (“less than 1 h”, “less than 3 h”, and “more than 3 h”) and ACEs (eight types). Results: The results of the ordinal logistic regression analysis showed a positive association between ACE total score and time spent playing video games after adjusting for covariates (1 ACE: OR = 1.28, 95% CI = 1.10–1.48; 2 ACEs: OR = 1.25, 95% CI = 1.06–1.48; 3 + ACEs: OR = 1.44, 95% CI = 1.14–1.82, p for trend < 0.001). Regarding each type of ACE, the experiences of single parenthood, parental history of psychiatric disorders, and peer isolation were independently positively associated with time spent playing video games. Conclusions: Health policy to address ACEs might be important to shorten the time spent playing video games.

The influence of mobile phone addiction and work procrastination on burnout among newly graduated Chinese nurses

PURPOSE

The study was conducted to explore the relationship between mobile phone addiction, work procrastination, and burnout among newly graduated nurses.

DESIGN AND METHODS

A cross-sectional survey involving 220 newly graduated nurses in China was conducted from June to July 2020.

FINDINGS

Approximately 60.9% of newly graduated nurses experienced occupational burnout; 72.7% of newly graduated nurses were characterized by moderate or greater procrastination and mobile phone addiction was at a moderate level. Mobile phone addiction and work procrastination were significant factors leading to emotional exhaustion and cynicism. Work procrastination was also an independent predictor of reduced professional efficacy.

PRACTICE IMPLICATIONS

Reducing the level of mobile phone addiction and work procrastination among newly graduated nurses might be effective for burnout prevention.

Impulsivity mediates the impact of early life adversity on high risk behaviors among Tunisian adolescents

Adverse childhood experience (ACE) has become an alarming phenomenon exposing youth at a great risk of developing mental health issues. Several studies have examined the mechanism by which ACE affects adolescent's engagement in risky behaviors. However, little is known about these associations in the Tunisian/African context. We investigated the role of impulsivity in the link between ACE and health risk behaviors among schooled adolescents in Tunisia. We performed a cross sectional study among 1940 schooled adolescents in the city of Mahdia (Tunisia) from January to February 2020. To measure ACE, we used the validated Arabic version of the World Health Organization ACE questionnaire. The Barratt Impulsivity Scale and the Internet Addiction Test were used as screening tools for impulsivity and internet addiction. A total of 2520 adolescents were recruited. Of those, 1940 returned the questionnaires with an overall response rate of 77%. The majority (97.5%) reported experiencing at least one ACE. Emotional neglect (83.2%) and witnessing community violence (73.5%) were the most reported intra-familial ACEs. Males had higher rates of exposure to social violence than females. The most common risky behavior was internet addiction (50%, 95%CI = [47.9-52.3%]). Our survey revealed that ACEs score predict problematic behaviors through impulsiveness (% mediated = 16.7%). Specifically, we found a major mediating role of impulsivity between the exposure to ACE and the risk of internet addiction (% mediated = 37.5%). Our results indicate the role of impulsivity in translating the risk associated with ACE leading to engagement in high risk behaviors.

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

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

Adverse Childhood Experiences and Digital Media Use Among U.S. Children

INTRODUCTION

Increasing amounts of time using digital media (i.e., texting, social media, electronic gaming, and general smartphone and computer use) among children and adolescents is becoming a growing concern given its potentially deleterious effects on health. However, little is known about the social and developmental underpinnings of digital media use among children and youth. This study examines the link between adverse childhood experiences and digital media use among a recent, nationally representative sample of children and adolescents.

METHODS

Data pertaining to children/youth aged 6-17 years from the 2018 National Survey of Children's Health were analyzed in 2020 (N=21,954). The association between 9 distinct forms of childhood adversity and time spent on digital media among youth was assessed using multinomial logistic regression. The mediating roles of family-, parent-, and child-level factors were determined using the Karlson-Holm-Breen method.

RESULTS

Net of covariates, the relative risk of heavy digital media use was 3 times higher among youth experiencing ≥4 adverse childhood experiences than among those experiencing none. Both family resilience and connection as well as parenting stress emerged as significant mediators of the association between adverse childhood experiences and heavy digital media use, collectively accounting for approximately 39% of the association.

CONCLUSIONS

In an effort to mitigate heavy digital media use, providers and practitioners who consistently interact with youth should consider screening for adverse childhood experiences and referring high-risk youth and their families for various prevention and treatment programs poised to address these risk factors.