The Impact of Physical Distancing and Associated Factors Towards Internet Addiction Among Adults in Indonesia During COVID-19 Pandemic: A Nationwide Web-Based Study

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.

Understanding the pubertal, psychosocial, and cognitive developmental trajectories of stunted and non-stunted adolescents: protocol of a multi-site Indonesian cohort study

Background

The prevalence of stunting among Indonesian children aged 5-12 years decreased from 30.7% in 2013 to 23.6% in 2018 but has remained among the highest rates worldwide. Furthermore, Indonesian children were shorter than the standard reported by the World Health Organization and experienced obesity. The Indonesian government has created many programs to reduce stunting in children under the age of 5 years. An early preventive strategy is necessary because stunting can manifest within the initial 1,000 days of life, including during pregnancy. Therefore, a newer perspective, such as that achieved by addressing stunting in adolescents, has been deemed useful, given that adolescents are in their pubertal stage and are undergoing lifestyle changes. This cohort study was designed to measure these factors comprehensively in stunted and non-stunted children as they pass through adolescence.

Methods

For the prospective cohort, 560 individuals will be recruited from DKI Jakarta, DI Yogyakarta, and East Java. The participants will be categorized into stunted and non-stunted groups, then undergo annual examinations in which key objectives, such as weight, height, and body mass index ,will be assessed for the growth profile; waist circumference, middle-upper arm circumference, hand-grip strength, body fat percentage, and food intake will be evaluated in a nutritional assessment; psychosocial and mental issues will be evaluated according to behavioral problems, symptoms of depression, quality of life, sleep patterns, anxiety disorders, and parenting style through the use of specific questionnaires; and pubertal stage will be assessed using a self-report questionnaire. Some cross-sectional data, such as cognitive performance, hair zinc levels, vitamin D levels, bone mineral density, and bone age, will also be included. All the outcomes will be analyzed in accordance with the variable types.

Discussion

This study provides a thorough dataset of Indonesian adolescents encompassing several elements, such as growth, nutrition, psychosocial wellbeing, mental health, and pubertal development, for both stunted and non-stunted individuals. The data acquired from this study can be used to formulate policies to prevent stunting through targeted interventions for adolescents. Finally, a better understanding of adolescent health could lead to improved strategies to decrease the number of stunted individuals in the next Indonesian generation.

Internet addiction and its relationship with food choice motives and the risk of eating disorders among young adults in Malaysia

The COVID-19 lockdown measures have dramatically altered the daily routines of young adults. Therefore, this study aims to elucidate the relationships between internet addiction, food choice motives and the risk of eating disorders in young adults during the transition to the endemic phase of COVID-19. The Internet Addiction Test was utilised to evaluate the presence and severity of internet addiction among young adults. The Food Choice Questionnaire was employed to assess the food choice motives of young adults, while the risk of eating disorders was determined using the Eating Attitude Test-26. The relationships between internet addiction, food choice motives, and the risk of eating disorders were assessed using model 4 of the PROCESS macro for SPSS. The findings indicated that 29.0% of young adults experienced moderate-to-severe internet addiction, whereas 32.6% were at risk of eating disorders. Young adults were highly valued for the price, sensory appeal, and mood when deciding food choices. The relationship between internet addiction and the risk of eating disorders was partially mediated by convenience (b = - 0.211, SE = 0.140, - 0.548 to - 0.016) and familiarity (b = 0.219, SE = 0.122, 0.019 to 0.494). A significant direct effect was also observed between internet addiction and the risk of eating disorders (B = 0.793, p = 0.017). There is an urgent need to implement intervention strategies aimed at reducing problematic internet use, promoting healthier food choices, and fostering healthy eating habits among young adults.

Internet Use and Effects on Mental Well-being During the Lockdown Phase of the COVID-19 Pandemic in Younger Versus Older Adults: Observational Cross-Sectional Study

BACKGROUND

Majority of individuals, including both younger and older adults, had to adapt to digital means to cope with lockdown measures and pandemic-induced lifestyle changes during the COVID-19 pandemic. While internet accessibility was beneficial during the pandemic, existing literature suggests that excessive use could lead to the rise of problematic internet use in adolescents and younger adults. However, the effects on older adults remain unclear.

OBJECTIVE

This study aimed to examine differences in internet use during the lockdown phase of the COVID-19 pandemic and explore how age differences in mental health could be explained by time spent on the internet.

METHODS

A door-to-door survey of a nationally representative sample of 602 adults in Singapore was carried out using computer-assisted personal interviewing during the early phase of the COVID-19 pandemic (October to November 2020). Participants were categorized into younger (21-59 years old) and older (60 years or above) age groups. We assessed self-reported measures of depression, anxiety, and stress; psychosocial adaptability; ability to perform essential activities; social support; health status; digital media use patterns, and time spent on the internet. Procedures complied with existing safe distancing measures.

RESULTS

Older adults reported being less able to use digital platforms to meet needs and acquire information updates compared with younger adults during the lockdown period of the pandemic. Older adults spent significantly less time on the internet for both work and personal uses per day (mean 146.00 min, SD 9.18 min) compared with younger adults (mean 433.27 min, SD 14.32 min). Significant age differences in depression, anxiety, and stress were found, with younger adults showing poorer mental health. Mediation analysis showed that age differences in depression, anxiety, and stress were partially explained by time spent on the internet. These variables together explained 43%, 40%, and 40% of the variances in depression, anxiety, and stress scores, respectively.

CONCLUSIONS

The findings showed that younger adults spent significantly more time on the internet compared with older adults during the lockdown phase of the pandemic. They were also ahead in their ability to use digital resources to meet needs and engage socially compared with older adults. Despite this, the mental health of younger adults was poor, and this was partially accounted for by the amount of time spent on the internet. Since past research suggests that excessive time spent on the internet could lead to disordered use, the benefits brought by digital technologies could have been attenuated during the lockdown phase of the pandemic. Considering this potential negative effect, it is imperative to educate both young and old adults in the appropriate use of information and communication technology.

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

AIM

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

COVID-19 Pandemic and Internet Addiction in Young Adults: A Pilot Study on Positive and Negative Psychosocial Correlates

Objective

During and after the lockdowns of the COVID-19 pandemic period, a strain was put on young adults who have taken refuge in the problematic use of internet, social media, gaming, and gambling. This paper aims to investigate possible correlates of Internet Addiction Disorder (IAD), hypothesizing anxiety, depression and perceived stress would promote addiction, while mindfulness skills, resilience and socialization would, conversely, hamper IAD, and promote, consequently, a more functional internet use.

Method

A pilot study was carried out with a sample of 31 young adults, recruited through a snowball sampling using social networks. Participants filled out an online questionnaire including the following measures: Internet Use, Abuse and Addiction (UADI), Beck Depression Inventory (BDI-II); State-Trait Anxiety Inventory (STAI-Y); Perceived Stress Scale (PSS); Five Facet Mindfulness Questionnaire (FFMQ); Mindfulness Attention and Awareness Scale (MAAS); Resilience Scale (RS-14). It was also administered an ad hoc questionnaire for the assessment of socialization behaviour (6 items) and gambling (2 items).

Results

All the measures, but socialization, showed adequate reliability. Our sample showed high levels of anxiety, stress, IA and gambling, while presenting low levels of resilience, the mindful skill of no-reactivity and socialization. The first hypothesis was confirmed, finding positive and significant correlations between Internet Addiction on one side and PSS, STAI-Y1, STAY-2, and BDI II on the other side. We also partially confirmed the second hypothesis about UADI negatively correlated with both RS-14 and Mindful Acting. Finally, no correlations were found between Gambling and IA.

Conclusions

In conclusion, the more one perceives an emotional overload with less stress-control, high anxiety, and depression, and the less one can leverage on the skills of mindful acting and resilience, the more one uses the internet as a strategy to escape from a threatening reality.

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.

Impact of COVID-19 on adolescent sexual life and attitudes: have we considered all the possible secondary effects of the pandemic?

A significant increase in pornography use has been reported in the adolescent population worldwide over the past few years, with intensification of the phenomenon during the COVID-19 pandemic. The aim of the present review is to provide data on the frequency of pornography consumption among adolescents during the pandemic and raise awareness about its potential impact on personal beliefs and sexual attitudes in the long term. A comprehensive literature review was performed in two scientific databases using the crossmatch of the terms "pornography", "adolescents" and "COVID-19". A significant increase in pornography consumption in adolescents was documented during the COVID-19 pandemic as a result of social detachment. Fulfilment of sexual desires in the context of social distancing, alleviation of COVID-19-related boredom and psychological strain, and coping with negative emotions are some of the reported reasons for increased pornography use during the pandemic. However, concerns have been raised in the literature regarding potentially negative effects of excessive pornography use from an early age, including the development of pornography addiction, sexual dissatisfaction and aggressive sexual attitudes reinforced by gender preoccupations and sexual inequality beliefs.

CONCLUSION

The extent to which increased pornography consumption from an early age during the COVID-19 pandemic may have affected adolescents' mental well-being, personality construction and sexual behaviour is yet to be seen. Vigilance from the society as a whole is required so that potential negative adverse effects of adolescent pornography use and potential social implications are recognized early and managed. Further research is needed so that the full impact of the COVID-19-related pornography use in the adolescent population is revealed.

WHAT IS KNOWN

•A significant increase in pornography consumption has been documented in the adolescent population worldwide over the past decades due to its quick, affordable and easy access from electronic devices and the possibility of anonymous and private participation. •During the COVID-19 pandemic, this phenomenon was intensified as a coping mechanism to social isolation and increased psychosocial strain.

WHAT IS NEW

•Concerns have been raised regarding the risk of pornography addiction in adolescents during the COVID-19 pandemic, making the post-pandemic adaptation challenging. •Awareness is raised in parents, health care providers and policy makers about the potential negative impacts of pornography consumption from an early, vulnerable age, such as sexual dissatisfaction and development of aggressive sexual attitudes and sex inequality beliefs.

Internet Addiction and Online Gaming Disorder in Children and Adolescents During COVID-19 Pandemic: A Systematic Review

The Indonesian government has enforced several social restrictions to prevent the spread of the coronavirus disease-2019 (COVID-19) virus, such as closures of in-person schools, public areas, and playgrounds as well as reduced outdoor activities. These restrictions will affect mental health of school-age children and adolescents. The internet is chosen as one of the media to keep academic activities running, but excessive internet use will increase internet addiction and online gaming disorder. This study aimed to understand the prevalence and psychological impacts of internet addiction and online gaming disorder on children and adolescents globally during the pandemic. Systematic searches were carried out on the PubMed, ProQuest, and Google Scholar search engines. All studies were assessed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 criteria and the Newcastle Ottawa Scale. Five studies met the criteria for assessing internet addiction and online gaming disorder cases in children and adolescents. Four studies discussed internet addiction, and one study addressed the negative impacts of online gaming on children and adolescents during the COVID-19 pandemic. There has been an increase in internet use and online gaming disruption in children and adolescents in almost all parts of Asian and Australian countries during the COVID-19 pandemic period.

The Role of Internet Use and Offline Social Engagement in the Health of Chinese Older Adults: Evidence from Nationally Representative Samples

This study investigated the association between internet use as a novel type of social engagement and the health of older adults, and evaluated the role of online versus offline social activities through nationally representative samples. Participants aged ≥ 60 in the datasets from the Chinese sample of the World Value Survey (N_{Sample 1} = 598) and the China Health and Retirement Longitudinal Study (CHARLS, N_{Sample 2} = 9434) were selected. Correlation analysis presented the positive relationships between internet use and self-reported health in both Sample 1 (r = 0.17, p < 0.001) and Sample 2 (r = 0.09, p < 0.001). In addition, the relationships between internet use and both self-reported health and depression (r = -0.14, p < 0.001) were stronger than the correlation between offline social activities and health outcomes in Sample 2. After accounting for the frequency of traditional social activities, regression analysis revealed the relationship between internet use and higher self-reported health (β_{Sample 1} = 0.16, p < 0.001; β_{Sample 2} = 0.04, p < 0.001) and lower depressive symptom scores (β = -0.05, p < 0.001) This research contributes to the existing body of literature on the favorable relationship between social engagement and health outcomes among Chinese older adults. Additionally, it identifies the social benefits of internet use for health promotion among older adults.

Mediating and moderating effects of cognitive flexibility in the relationship between social media addiction and phubbing

Presently, social media is widely used worldwide among different populations. Therefore, phubbing rapidly became a popular phenomenon in our daily life. However, little is known about the underlying mechanism and interaction between social media use and phubbing. Therefore, this research examines the mediating and moderating role of cognitive flexibility in the association between social media addiction and phubbing. Participants were 385 university students (280 females) studying at a state university in eastern Turkey and completed the self-reported measures of cognitive flexibility, social media addiction, and phubbing. The results showed that cognitive flexibility mediated and moderated the effect of social media addiction on phubbing. These findings may contribute to the discussion around the psychological consequences of using social media alongside increasing awareness about factors affecting and explaining the association between social media use and phubbing, which have important implications for research and practice.

Relationship Quality and Mental Health Implications for Adolescents during the COVID-19 Pandemic: a Longitudinal Study

Although parent-adolescent and peer-adolescent relationship quality are critical for adolescent wellbeing during typical stressful life events, the unique features of the COVID-19 pandemic put into question whether strong parent-adolescent and peer-adolescent relationship quality functioned as protective factors of adolescent mental health in this context. The current longitudinal study examined a community sample of adolescents across 3 time points, each 6 months apart (Time 1: Fall, 2019; n = 163, 50.9% male; mean age = 15.75 years, SD = 1.02). Results showed that increases in depression symptoms, perceived stress, and emotion dysregulation from Fall 2019 to Fall 2020 were predicted by changes in parent, but not peer relationship quality. The current study demonstrates that adolescent-parent relationship quality may be protective against mental health difficulties during the COVID-19 pandemic, while adolescent-peer relationship quality may not. Identifying protective factors that may play a role in mitigating the impact of the pandemic, and other such widespread health crises, on youth mental health is critical in reducing the long-term psychological harm of the viral outbreak, as well as promoting adolescent wellbeing and resilience.

The longitudinal association between internet addiction and depressive and anxiety symptoms among Chinese adolescents before and during the COVID-19 pandemic

Background

The COVID-19 pandemic and related prevention policies, such as home quarantine or online courses, could increase the risks of experiencing internet addiction and mental health problems among Chinese adolescents. There is a lack of longitudinal evidence to show the association between internet addiction symptoms and psychological consequences (e.g., depressive and anxiety symptoms).

Objective

This study aimed to explore the association between internet addiction and depressive and anxiety symptoms before and during the coronavirus disease 2019 (COVID-19) pandemic.

Methods

An effective sample of 7,958 Chinese adolescents was recruited for this two-wave longitudinal survey conducted over a six-month interval. All participants completed two-wave surveys before and during the COVID-19 pandemic. A longitudinal cross-lagged path model was used to analyze the associations between internet addiction and depressive and anxiety symptoms after controlling for four covariates (i.e., age, sex, minority, and COVID-19 influence).

Results

Higher depressive and anxiety symptoms before COVID-19 significantly predicted severe internet addiction during COVID-19. Results showed a significant bidirectional relationship between internet addiction and depressive symptoms. Furthermore, the prevalence of internet addiction displayed an increasing trend over the two waves. Conversely, a reduced prevalence of anxiety and depressive symptoms was observed over the two waves.

Conclusion

This current study provided valuable evidence that psychological problems and internet addiction significantly influenced each other before and during the COVID-19 outbreak. Consequently, the presence of psychological problems before and during the COVID-19 outbreak could indicate internet addiction. Thus, depression- and anxiety-related psychotherapies should be developed to prevent internet addiction among Chinese adolescents.

The effect of mindfulness on social media addiction among Chinese college students: A serial mediation model

Introduction

The COVID-19 pandemic has exacerbated social media addiction (SMA), making it urgent to find effective interventions for social media addiction. Evidence has shown that mindfulness might be an effective intervention for social media addiction. However, psychological mechanisms by which mindfulness reduce social media use remain unclear. Here, we further addressed this issue to examine whether attentional control and fear of missing out (FOMO) mediate the relationship between mindfulness and SMA.

Methods

We recruited 446 college students from two universities in China and analyzed the data.

Results

The results suggest that there are mediation effects of attentional control and FOMO between mindfulness and SMA through 3 paths: path 1, mindfulness → attention control → SMA (-0.04); path 2, mindfulness → FOMO → SMA (-0.22); and path 3, mindfulness → attention control → FOMO → SMA (-0.05).

Discussion

Therefore, mindfulness-based interventions may be an effective way to alleviate social media addiction, especially mindfulness-based interventions targeting FOMO. At the end of the article, we also discussed the limitations of this study.

Problematic use of the Internet in low- and middle-income countries before and during the COVID-19 pandemic: a scoping review

People from low- and middle-income countries (LMICs) represent large portions of the world population, often occupy less favorable living conditions, and typically suffer greater health risks, yet frequently receive little research and global health attention. The present study reviews emerging evidence on problematic use of the Internet (PUI) in LMICs prior/during the COVID-19 pandemic. Analyzed studies mainly focused on general properties of PUI in university students, problematic gaming in youth, or problematic use of social media in adults, registering higher prevalence estimates, as compared with earlier reports. Research mainly focused on initially affected regions and COVID-exposed populations. Overall, unfavorable circumstances, including poor social support, family relationships, and lifestyle tendencies/habits, may present potential risk for PUI in LMICs, likely exacerbated during the pandemic.

An Evaluation of the Factors Related to Internet Gaming Disorder in Young Adults

BACKGROUND

Game addiction is a growing problem all over the world. The present study aimed to evaluate the prevalence and psychological, social, and behavioral effects of internet gaming disorder (IGD) on young adults.

METHODS

A preliminary study was conducted and the game types most commonly played on the internet were determined. Then, approximately 60 gaming site managers were contacted. After obtaining consent, the questionnaires were sent to gaming site members and they were asked to complete the questionnaires. Data were collected through a sociodemographic form, Internet Gaming Disorder Scale-Short Form (IGDS9-SF), Strengths and Difficulties Questionnaire (SDQ), and State-Trait Anxiety Inventory (STAI).

FINDINGS

The study was conducted with 613 participants. The age of the participants ranged from 15 to 30 years, with a mean age of 20.80±4.63 years. The prevalence of IGD was 10% (n=67). Those with low-income families and low academic performance were identified as more likely to develop IGD. Moreover, IGD was revealed to be more likely in individuals with fewer close friends, playing games from an early age, and those with a habit of devoting extensive time to watching online game videos on Twitch or YouTube. In addition, the risk of gaming disorder was approximately two times higher in individuals who preferred First Person Shooter (FPS) games and Massively Multiplayer Online Role-Playing Games (MMORPG).

CONCLUSION

The results of this study could be useful for estimating the level of IGD and carrying out more comprehensive studies to possibly be able to control IGD.

Estimation of Behavioral Addiction Prevalence During COVID-19 Pandemic: A Systematic Review and Meta-analysis

Purpose of Review

The COVID-19 pandemic changed people’s lifestyles and such changed lifestyles included the potential of increasing addictive behaviors. The present systematic review and meta-analysis aimed to estimate the prevalence of different behavioral addictions (i.e., internet addiction, smartphone addiction, gaming addiction, social media addiction, food addiction, exercise addiction, gambling addiction, and shopping addiction) both overall and separately.

Recent Findings

Four databases (PubMed, Scopus, ISI Web of Knowledge, and ProQuest) were searched. Peer-reviewed papers published in English between December 2019 and July 2022 were reviewed and analyzed. Search terms were selected using PECO-S criteria: population (no limitation in participants’ characteristics), exposure (COVID-19 pandemic), comparison (healthy populations), outcome (frequency or prevalence of behavioral addiction), and study design (observational study). A total of 94 studies with 237,657 participants from 40 different countries (mean age 25.02 years; 57.41% females). The overall prevalence of behavioral addiction irrespective of addiction type (after correcting for publication bias) was 11.1% (95% CI: 5.4 to 16.8%). The prevalence rates for each separate behavioral addiction (after correcting for publication bias) were 10.6% for internet addiction, 30.7% for smartphone addiction, 5.3% for gaming addiction, 15.1% for social media addiction, 21% for food addiction, 9.4% for sex addiction, 7% for exercise addiction, 7.2% for gambling addiction, and 7.2% for shopping addiction. In the lockdown periods, prevalence of food addiction, gaming addiction, and social media addiction was higher compared to non-lockdown periods. Smartphone and social media addiction was associated with methodological quality of studies (i.e., the higher the risk of boas, the higher the prevalence rate). Other associated factors of social media addiction were the percentage of female participants, mean age of participants, percentage of individuals using the internet in country, and developing status of country. The percentage of individuals in the population using the internet was associated with all the prevalence of behavioral addiction overall and the prevalence of sex addiction and gambling addiction. Gaming addiction prevalence was associated with data collection method (online vs. other methods) that is gaming addiction prevalence was much lower using online methods to collect the data.

Summary

Behavioral addictions appeared to be potential health issues during the COVID-19 pandemic. Healthcare providers and government authorities should foster some campaigns that assist people in coping with stress during COVID-19 pandemics to prevent them from developing behavioral addictions during COVID-19 and subsequent pandemics.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40429-022-00435-6.

Experiences of parents of children with psychiatric disorder from Covid-19 pandemic and its related quarantine: A qualitative study

Introduction

Owing to the considerable mortality caused by Covid-19, different countries have made some decisions for dealing with this virus, one of which was quarantine. It was shown that a range of behavioral and emotional changes may exacerbate in children while staying more at home, and parents may then experience these positive or negative behavioral changes. The present study was conducted to examine the experiences of families with children with psychiatric disorders in a psychiatric outpatient clinic in Iran.

Method

The phenomenological method, which is a qualitative approach, was used in this study. The population was the parents of children with psychiatric disorders referred to the pediatric psychiatric clinic of Imam Hossein Hospital. Sampling was purposeful, which continued until data saturation. Finally, the number of included participants reached 14. As well, the Colaizzi method was used for data analysis.

Results

The results of this study included 12 secondary codes and 10 tertiary codes, which were divided into three main thematic groups as follows: effective factors for improving behavior, effective factors for worsening behavior, and affective factors on creating a new behavior during quarantine.

Conclusion

In conclusion, quarantine, social restrictions, closure of schools, and online classes can affect the mental health status of children and adolescents in different ways, especially in children with a history of psychiatric disorders.

The Impact of Online Learning among Adolescents during the COVID-19 Pandemic: A Qualitative Study of Mothers' Perspectives

BACKGROUND

The COVID-19 pandemic changed the educational system from conventional learning in schools to online learning. The use of the internet as a learning medium can have positive and negative impacts on adolescents and cause concern for mothers. In this study, mothers' perspectives were explored with the phenomenological approach to assess their experience of the effect on line learning during the COVID-19 pandemic among adolescents.

MATERIALS AND METHODS

The qualitative study design: phenomenology was conducted on mothers with children at senior high school education levels. The data were collected using in-depth interviews from June to November 2020 in West Java, Indonesia. A total of 13 mothers were recruited using the purposive sampling technique. Data analysis was performed using the Colaizzi method and NVIVO software for managing the coding process.

RESULTS

We obtained four themes, namely (1) formation of adolescent behavior with the internet, (2) prevention of internet addiction, (3) disturbance of cognitive development, and (4) negative effect of online learning.

CONCLUSIONS

The usage of the internet cannot be avoided. By guiding adolescents, the negative effects of the internet could be prevented. Developing learning programs, media, and online learning strategies according to students' needs should be promoted.

Online dialectical behavioral therapy for adults with internet addiction: A quasi-experimental trial during the COVID-19 pandemic

The pathological use of the Internet has surged during the pandemic, even though service provisions were negatively impacted. Telepsychiatry can be used as a solution to maintain psychiatric addiction services. This study examined the efficacy of online group dialectical behavioral therapy (DBT) for Internet addiction (IA), compared to cognitive behavioral therapy (CBT). Participants were divided into two arms for 8 weeks: the experimental arm received eight sessions of online DBT skill group training (n = 20), and the control arm received four sessions of online individual CBT (n = 20). All participants were required to complete a sociodemographic and Internet use survey, the Internet Addiction Test (IAT), and the University of Rhode Island Change Assessment (URICA). All participants completed the therapy. Of the 40 participants, six (15%) perceived the need for therapy and one (2.5%) participant had a history of seeking IA therapy. In the pre-post comparison, significant improvements were noted in the IAT and URICA scores as well as Internet use duration for both arms. No significant differences were observed across the arms and in the time-by-arm interaction. Online group DBT is a viable alternative to online CBT in an acute constrained setting, although further studies are required to scrutinize its long-term efficacy. Trial Registration: ISRCTN17273762.

Factors associated with Facebook addiction among university students amid the COVID-19 pandemic: Findings from an online cross-sectional survey

Background

Facebook addiction (FA) has been suggested as a potential behavioral addiction. There is a severe lack of research evidence regarding the Facebook addiction behavior among university students during the ongoing COVID-19 pandemic. The aim of this study was to determine factors associated with Facebook addiction among Bangladeshi university students.

Methods

A cross-sectional online survey was conducted among 2,161 Bangladeshi university students during the COVID-19 pandemic from June 2021 to September 2021. A well fitted regression model in R programming language was used for this study.

Results

Female respondents and those whose family monthly income was <25,000 BDT were more addicted to Facebook than other respondents. Respondents who lost a family member or a relative to COVID-19, engaged in physical activities (exercise) during the pandemic, used Facebook for work purposes or used Facebook to relieve daily stress were more addicted to Facebook.

Conclusion

Overuse of social media is problematic as it can trigger several mental health symptoms, especially among students. Adequate and effective interventions are required to educate students about the dangers of Facebook addiction and to provide an alternative, healthy options.

Online Behaviours during the COVID-19 Pandemic and Their Associations with Psychological Factors: An International Exploratory Study

This cross-sectional study aimed to explore specific online behaviours and their association with a range of underlying psychological and other behavioural factors during the COVID-19 pandemic. Eight countries (Italy, Spain, the United Kingdom, Lithuania, Portugal, Japan, Hungary, and Brazil) participated in an international investigation involving 2223 participants (M = 33 years old; SD = 11), 70% of whom were females. Participants were surveyed for specific type of Internet use severity, appearance anxiety, self-compassion, and image and use of performance-enhancing drugs (IPEDs). Results were compared cross-culturally. The mean time spent online was 5 h (SD = ±3) of daily browsing during the pandemic. The most commonly performed activities included social networking, streaming, and general surfing. A strong association between these online behaviours and appearance anxiety, self-compassion, and IPEDs use was found after adjustment for possible confounders, with higher scores being associated with specific online activities. Significant cross-cultural differences also emerged in terms of the amount of time spent online during the initial stages of the COVID-19 pandemic.

Cross-Addiction Risk Profile Associations with COVID-19 Anxiety: a Preliminary Exploratory Study

"Cross-addiction" involves a person substituting one form of addictive behaviour for another. Indeed, cross-additive presentations have been frequently described (e.g. from drugs to alcohol, gambling to sex), and risk profiles have been assumed. Nevertheless, there has been a dearth of evidence considering the occurrence of cross-addiction risk profiles in the community. This research is imperative for informing effective prevention/intervention policies, especially under anxiety-provoking conditions, such as the current coronavirus pandemic. To address this need, a cross-sectional exploratory research design was utilized, with quantitative survey data obtained from 968 respondents (18-64; M age  = 29.5 years, SD = 9.36), who completed an online survey regarding a range of addictive behaviours (i.e. abuse of alcohol, drug, smoking, online gaming, shopping, internet, exercise, online gambling, sex, and social media) and their anxiety about the coronavirus. Latent class/profiling analyses were implemented to (a) explore profiles of cross-addiction risk, (b) describe the characteristics and the proportions of these profiles, and (c) identify their differential associations with the pandemic precipitated anxiety. Findings revealed two distinct profiles/types, the "cross-addiction low risk" (57.4%) and the "cross-addiction high risk" (42.6%). Those in the latter scored consistently higher across all behaviours assessed, were more likely to suffer from concurrent addictive problems, and reported significantly higher levels of pandemic-related anxiety. Implications for prevention, assessment, and treatment and future research are discussed.

[The role of the Internet as a source of medical information for orthopedic patients]

INTRODUCTION

The advance of the digital revolution in medicine and health is called "e-health". The Internet serves as a digital health information platform and is indispensable as a source of medical information. The aim of this work was to examine the behavior of orthopedic patients with respect to finding information on their illnesses. The role and the importance of the Internet as an informative health application for these patients are highlighted.

MATERIALS AND METHODS

The basis of this prospective cross-sectional study was a patient survey in Germany of orthopedic patients from July 2019 to July 2020. Descriptive statistics were calculated, and regression analyses were carried out to show coherent results.

RESULTS

We analyzed the responses of 1262 orthopedic patients. Most of them used the Internet as a digital health information platform. Patients rated their Internet skills as good to very good, regardless of age or educational level. Most respondents said that they currently use the Internet at least once a week to find out about their orthopedic illnesses. Patients reported a positive change in attitude towards the Internet as a digital source of medical information, and its use has increased in the past 12 months.

CONCLUSION

The Internet as an informative digital health application in orthopedics is used intensively and is widely accepted by patients. While mistrust of orthopedic health information from the Internet has decreased, patient confidence in meaningful digital health information platforms has increased. The Internet is seen as a useful health information platform alongside medical advice.

Prevalence and determinants of internet addiction among adults during the COVID-19 pandemic in Bangladesh: An online cross-sectional study

Background

Globally, internet use has increased significantly during the COVID-19 pandemic, and internet addiction (IA) has become a severe public health issue. Therefore, this study aimed to assess IA prevalence among adults and identify its determinants during the COVID-19 pandemic in Bangladesh.

Methods

Using a cross-sectional design, this study recruited 608 participants through a self-administered online-based e-questionnaire. Young's internet addiction test (YIAT) of 20 items was used to assess the prevalence of IA among adults in Bangladesh. Bivariate and binary logistic regression analyses explored the factors influencing IA.

Results

The overall prevalence of IA was 29.4% among adults during the COVID-19 pandemic. However, the addiction rate was 34.7% among participants under 20 years old. Tobacco smoking (AOR = 1.88, 95% CI 1.15-3.07) and spending more time on the internet during the COVID-19 pandemic (AOR = 2.06, 95% CI 1.08-3.94) were likely the reasons for IA among Bangladeshi adults. Participants aged over 24 years (AOR = 0.39, 95% CI 0.17-0.91), living in rural areas (AOR = 0.51, 95% CI 0.32-0.81), living away from family (AOR = 0.45, 95% CI 0.26-0.79), attached to physical activity (AOR = 0.35, 95% CI 0.24-0.52), and sleeping less than or equal 6 hours (AOR = 0.63, 95% CI 0.42-0.93) had a lower chance of IA during the COVID-19 pandemic.

Conclusion

This study has shown that the prevalence of IA was comparatively higher among younger participants during the COVID-19 pandemic. Smoking, long-time use of the internet, physical activity status, and sleeping duration were the most significant determinants of IA. Thus, raising awareness among the younger generation is the most important strategy to reduce IA. The findings of this study can be used to support health and educational organizations to design their programs, which will help prevent IA in Bangladesh during the COVID-19 pandemic.

Distinguishing the Effect of Time Spent at Home during COVID-19 Pandemic on the Mental Health of Urban and Suburban College Students Using Cell Phone Geolocation

The aim of this study was to assess the correlation of depression and anxiety with time spent at home among students at two universities-one urban and the other suburban-during the COVID-19 pandemic.

METHODS

Geolocation data from the smartphones of 124 participants were collected between February 2021 and May 2021. The level of depression was estimated by the PHQ-9 and PHQ-2 screening tools, and anxiety scores were estimated by the GAD-2 and GAD-7 screening tools.

RESULTS

51% of participants in the PHQ-9 surveys indicated mild to severe depression. Participants spent on average 75% of their time at home during COVID. Time spent at home had a positive correlation with the mental health of urban students but a negative correlation with suburban students. The relation between the time at home with mental health was stronger among female participants than among male participants. Correlations between female depression, anxiety, and time at home were significant.

CONCLUSIONS

Lockdown and distance learning contributed to the high levels of depression in university students. This research highlights the importance of time spent at home for mental health being during the pandemic and the importance of distinguishing between urban and suburban settings when formulating public health recommendations. Quality of time spent at home versus time spent outside differentiated the mental well-being of students located in different environments. Staying at home may be recommended for students without access to safe outdoor places as it is associated with lower levels of depression.

Impact of internet addiction during COVID-19 on anxiety and sleep quality among college students of Bhubaneswar city

BACKGROUND

COVID-19 initiated in December 2019 in Wuhan, China, and over a period of time, the infection outspread across the world in a rapid pace. To protect the people and to further limit the spread of infection, lockdown was declared in most parts of the world including India. As all people were forced to stay indoors during this pandemic, internet was the only source of entertainment whose overuse has side effects on anxiety and sleep quality. This study is aimed to know the impact of Internet addiction during COVID-19 on anxiety and sleep quality among college students of Bhubaneswar city.

MATERIALS AND METHODS

This was a web-based cross-sectional, questionnaire study. It administered 475 students from six colleges. The students were assessed by a proforma containing demographic details, patterns of internet use, Youngs Internet Addiction Test, Generalised Anxiety disorder score, and the Pittsburgh Sleep Quality Index. Statistical analysis was done using SPSS version 21.0 using Chi-square test and Wilcoxon signed-rank test.

RESULTS

The mean age of the study group was 18.81 ± 1.189. Out of 475 students, 60.6% were female and 39.4% were male. 23.6% and 13.4% of recruited students had severe internet addiction and anxiety disorder, respectively. The mean global PSQI score in the study was 6.356 ± 1.88. About 84.6% of the students had poor global sleep quality score. All components of sleep quality were significantly associated (P = 0.000) with different degrees of internet addiction except sleep duration (P = 0.589) and efficiency (P = 0.767).

CONCLUSION

Females were highly addicted than males. The study findings specified that students' excessive internet usage leads to anxiety, and affects mental health. Monitoring and controlling students' internet addiction through informative sessions on how to use the Internet adequately is useful.

Relationship between adolescents' perceptions of social support and their psychological well-being during COVID-19 Pandemic: A case study from Turkey

The aim of this research was to establish the relationship between the perceptions of social support and the psychological well-being among adolescents during the coronavirus disease 2019 (COVID-19) pandemic. This research, which includes descriptive and relative features, was conducted from December 15, 2020 to January 31, 2021. There were 378 participants, all of whom were adolescents aged from 13 to 18 years who were living in Turkey. Either the adolescents themselves or their parents used social media tools or sites such as Facebook, Whatsapp, Instagram, etc., and they had all agreed to participate voluntarily. The adolescents had given their permission to the ethics committee through oral or written statements before the data were collected. The data collection process involved completing a questionnaire form, the Multidimensional Scale of Perceived Social Support (MSPSS) and the Psychological Well-being Scale for Adolescents (PVSA). The Analysis of the data included numbers, percentages, means, the independent samples t test, analysis of variance (ANOVA), the Kruskal-Wallis H test, multiple regression analysis and correlations between these. Of the 378 participants who were admitted to the study, the mean age was 14.66 ± 1.65, and 52.1% were female. The total mean for the perceived social support among adolescents was established as being 54.39 ± 17.13. The mean level for psychological well-being was determined as being 91.13 ± 12.34. A significant difference was detected between gender and levels of social support and psychological well-being of adolescents (p < 0.05). As a result of multiple regression analysis, the overall score of gender and PVSA has been found to have a statistically meaningful effect on the MSPSS overall score (p < 0.05). However, the difference in relation to the classes, the parents' jobs, the income levels, the family types and the places of residence of the adolescents in terms of social support and psychological well-being was not statistically significant. There was a statistically positive and strong correlation between the scores for social support and psychological well-being. The present study, which occurred during the outbreak of COVID-19, found that the levels of social support perceived by the adolescents and their psychological well-being were decent. In addition, the study showed that as the levels of perceived social support among the adolescents rose, their psychological well-being also increased positively.

Associations between Fear of COVID-19, Depression, and Internet Addiction in South Korean Adults

This study investigates the associations between Internet addiction and psychological distress, including fear of coronavirus disease 2019 (COVID-19), and depression in South Korean adults during the COVID-19 pandemic. A population-based cross-sectional online survey was conducted from 14 to 18 May 2021. Potential adult survey respondents aged 20 years or older were randomly extracted from one of the largest online survey panels in South Korea, matching the South Korean national demographic proportions (i.e., region, gender, and age). Subsequently, 1155 participants were included in the study. Descriptive and logistic regression analyses were performed to investigate the participants’ characteristics and analyze the adjusted odds ratios (aORs). Of the South Korean adults, 11.17%, 15.15%, and 37.23% were at risk of Internet addiction, COVID-19 fear, and depression, respectively. Internet addiction was positively associated with COVID-19 fear (aOR = 3.25, 95% CI [2.10, 5.04]) and depressive symptoms (aOR = 6.40, 95% CI [4.15, 9.86]). Addictive Internet use was significantly associated with psychological distress during the COVID-19 pandemic. The development of public health strategies that mitigate addictive Internet use and increase eHealth literacy will be useful for securing the public’s psychological well-being.

Effect of Parental Perception on the Prevalence of Adolescent Internet Gaming Disorder During the COVID-19 Pandemic

OBJECTIVE

During the coronavirus disease (COVID-19) pandemic, several studies have found that Internet usage and gaming times have increased among adolescents. Parents' Internet literacy and attitudes toward Internet gaming have been reported to affect children's Internet gaming disorder (IGD). We hypothesized that parents' attitudes toward Internet use and gaming would affect the prevalence of IGD among adolescents.

METHODS

A total of 199 mothers of children who played Internet games were surveyed online to gather information regarding their demographic characteristics, children's Internet use patterns, psychological factors, and Internet gaming literacy.

RESULTS

Among adolescents, increased Internet usage or gaming time was not associated with IGD, but the presence of attention deficit hyperactivity disorder (ADHD) was. Among parents, anxiety, depression, and family togetherness were not related to IGD, but a positive perception of gaming protected against the development of IGD, whereas a negative perception was a risk factor for IGD.

CONCLUSION

Increased gaming time neither causes nor correlates with IGD in adolescents, even though ADHD may be a risk factor for IGD. Parents' positive or negative perceptions of gaming can be protective or present a risk factor, respectively, for their children's development of IGD.

Internet addiction and its association with depression, anxiety, and stress symptoms among allied health students in Malaysia

BACKGROUND Internet addiction (IA) is prone to be experienced by students and has become a major health concern. However, data on IA among allied health students are limited. This study aimed to describe the prevalence of IA and the association between mental health problems and IA among allied health students in Malaysia. METHODS A cross-sectional study was conducted from July to December 2021 in three government-funded allied health training institutes in Malaysia. A total of 265 allied health students undertaking a diploma in nursing, medical assistant training, physiotherapy, occupational therapy, and diagnostic imaging were recruited using stratified random sampling. The Malay version of the IA test was used to measure IA, while depression, anxiety and stress scale-21 items were used to assess their mental health problems. A general linear model was used to analyze the association between IA scores and mental health problems. RESULTS The prevalence of IA among allied health students was more than 80%, with 16.2% and 2.3% of them reporting moderate and severe IA, respectively. Higher depression (p<0.001), anxiety (p<0.001), and stress scores (p = 0.002) were associated with higher IA scores. CONCLUSIONS There were significant associations between mental health problems and IA scores among allied health students. Future studies with rigorous scientific methods are necessary to explore mental health effects on IA. Early intervention is also needed to prevent mental health problems among allied health students to overcome the problem of IA.

Internet gaming disorder in an adolescent during the COVID-19 pandemic: a case report

The internet has become an indispensable tool in people´s daily lives during the COVID-19 pandemic. Internet and video game use are experiencing rapid growth in the youth and adult populations as a major source of entertainment. However, excessive gaming may cause addiction and negatively impact mental health, entailing low psychosocial well-being, poor social skills, and decreased academic achievement. We report the case of a 16-year-old student with a "typical" pattern of internet gaming disorder (IGD) developed during the pandemic, which improved after weeks of treatment with pharmacotherapy and psychosocial interventions. This case highlights that it is essential for the mental health professionals to know the psychopathology of IGD and multimodal approaches to treat it.

Coping with the COVID-19 Pandemic: Perceived Changes in Psychological Vulnerability, Resilience and Social Cohesion before, during and after Lockdown

The COVID-19 pandemic and associated lockdowns have posed unique and severe challenges to our global society. To gain an integrative understanding of pervasive social and mental health impacts in 3522 Berlin residents aged 18 to 65, we systematically investigated the structural and temporal relationship between a variety of psychological indicators of vulnerability, resilience and social cohesion before, during and after the first lockdown in Germany using a retrospective longitudinal study design. Factor analyses revealed that (a) vulnerability and resilience indicators converged on one general bipolar factor, (b) residual variance of resilience indicators formed a distinct factor of adaptive coping capacities and (c) social cohesion could be reliably measured with a hierarchical model including four first-order dimensions of trust, a sense of belonging, social interactions and social engagement, and one second-order social cohesion factor. In the second step, latent change score models revealed that overall psychological vulnerability increased during the first lockdown and decreased again during re-opening, although not to baseline levels. Levels of social cohesion, in contrast, first decreased and then increased again during re-opening. Furthermore, participants who increased in vulnerability simultaneously decreased in social cohesion and adaptive coping during lockdown. While higher pre-lockdown levels of social cohesion predicted a stronger lockdown effect on mental health, individuals with higher social cohesion during the lockdown and positive change in coping abilities and social cohesion during re-opening showed better mental health recovery, highlighting the important role of social capacities in both amplifying but also overcoming the multiple challenges of this collective crisis.

COVID-19-Related Social Isolation Predispose to Problematic Internet and Online Video Gaming Use in Italy

COVID-19 pandemic and its related containment measures have been associated with increased levels of stress, anxiety and depression in the general population. While the use of digital media has been greatly promoted by national governments and international authorities to maintain social contacts and healthy lifestyle behaviors, its increased access may also bear the risk of inappropriate or excessive use of internet-related resources. The present study, part of the COVID Mental hEalth Trial (COMET) study, aims at investigating the possible relationship between social isolation, the use of digital resources and the development of their problematic use. A cross sectional survey was carried out to explore the prevalence of internet addiction, excessive use of social media, problematic video gaming and binge watching, during Italian phase II (May-June 2020) and III (June-September 2020) of the pandemic in 1385 individuals (62.5% female, mean age 32.5 ± 12.9) mainly living in Central Italy (52.4%). Data were stratified according to phase II/III and three groups of Italian regions (northern, central and southern). Compared to the larger COMET study, most participants exhibited significant higher levels of severe-to-extremely-severe depressive symptoms (46.3% vs. 12.4%; p < 0.01) and extremely severe anxiety symptoms (77.8% vs. 7.5%; p < 0.01). We also observed a rise in problematic internet use and excessive gaming over time. Mediation analyses revealed that COVID-19-related general psychopathology, stress, anxiety, depression and social isolation play a significant role in the emergence of problematic internet use, social media addiction and problematic video gaming. Professional gamers and younger subjects emerged as sub-populations particularly at risk of developing digital addictions. If confirmed in larger and more homogenous samples, our findings may help in shedding light on possible preventive and treatment strategies for digital addictions.

COVID-19-Related Psychological Trauma and Psychological Distress Among Community-Dwelling Psychiatric Patients: People Struck by Depression and Sleep Disorders Endure the Greatest Burden

COVID-19 has created a general state of worry and distress, especially among vulnerable groups such as those with psychiatric diagnoses. Worldwide, psychiatric care provision has drastically suffered during the pandemic, with many patients unable to access proper care, which may have implications for increased mental health consequences in patients with psychiatric disorders (e.g., relapse and suicide). This cross-sectional study used structural equation modeling to investigate COVID-19-related trauma and distress among Arab psychiatric population during COVID-19 quarantine. Patients with pre-existing psychiatric disorders (N = 168) completed an online survey that comprised the Depression Anxiety Stress Scale 21 (DASS-21), the Impact of Event Scale-Revised (IES-R), and a questionnaire on COVID-19-related attitudes/perceptions, sources of information, used protective measures, and socio-demographic information. Respondents commonly reported feeling down-hearted/blue, trouble concentrating, along with symptoms of avoidance and rumination related to the pandemic. Patients with depression and sleep disorders expressed higher COVID-19-related trauma than patients with other disorders. Perceived physical health mediated the effect of co-morbid chronic physical disorders on COVID-19 trauma, psychological distress, perceived vulnerability to COVID-19, and perceived likelihood of recovery in case of contracting COVID-19. Perceived physical health and perceived vulnerability to COVID-19 were strong direct predictors of COVID-19-related trauma and psychological distress. Staying at home negatively predicted COVID-19 trauma and exerted an indirect negative effect on psychological distress via COVID-19 trauma. COVID-19 trauma, age, and marital status directly predicted psychological distress, with COVID-19 trauma being the strongest predictor. Educational level, income, having family members working in the medical field, keeping up to date with the news on deaths/infected cases or the development of COVID-19 drugs or vaccines, satisfaction with available information on COVID-19, and using different protective measures were not associated with significant differences in COVID-19 trauma and psychological distress scores. Immuno-psychiatric interventions should be designed to target COVID-19-trauma and distress among younger single patients with perceived poor physical health, especially those diagnosed with depression and sleep disorders.

Might insecurity and use of ICT enhance internet addiction and exhaust people? A study in two European countries during emergency remote working

Facing the spread of the SARS-CoV-2 pandemic, we have witnessed a strong recourse to generalised lockdowns and to the deployment of remote working. These emergency measures have also thrown employers and employees into uncertainty regarding the present and future existence of their job. The present study aimed to examine the role of job insecurity and job demands in non-working hours through technologies on emotional exhaustion mediated by Internet addiction. A total of 999 remote workers, 501 of whom live in France and 498 in Italy, completed a self-report questionnaire during the first lockdown. Results suggest that both job insecurity and the requests to use technology for work purposes during non-work time exacerbate emotional exhaustion through the mediation of Internet Addiction. Limitations, future perspectives, and implications for management are discussed.

Demographic and Psychosocial Factors associated with Internet Addiction among the Pakistani Population during COVID-19: A Web-Based Survey

This study aims to determine the burden of COVID19-induced internet addiction and related psychosocial factors among the Pakistani sample. A web-based cross-sectional survey was conducted from January to March 2021. An analytical cross-sectional survey was broadcast on the internet via a Google form completed by 1145 Pakistanis. Individuals aged 13 years and above with competency to comprehend English or Urdu language, currently residing in any province of Pakistan, having access to the questionnaire, and willing to participate were eligible to participate. Overseas Pakistanis were excluded from the study. The outcome is COVID19-induced internet addiction was measured using the validated tool Young’s Internet Addiction Test (IAT). In addition, symptoms of depression, anxiety, stress, and other psychosocial factors were assessed using the validated tool Depression, Anxiety, and Stress Scale-21 (DASS-21). Adjusted odds ratios with a 95% confidence interval were reported using multinomial logistic regression. Most participants were females and youth (between 20 and 24 years). The prevalence of problematic internet users (PIU) and addictive internet users (AIU) was 27.3% and 11.3%, respectively. The odds of extremely severe anxiety among AIU were approximately three times (Adj OR: 2.6 (1.1-7.1), followed by the odds of having extremely severe stress being about five times higher among AIU (Adj OR: 5.4 (1.6-17.6)) as compared to normal internet users (NIU). Amid COVID-19, the burden of internet addiction has surged among the Pakistani populace. This study identified that gender, marital status, depression, stress, anxiety, work situation, and mood changes during the COVID-19 pandemic are significantly correlated with problematic and addictive internet use. Preventative measures against the addictive use of the internet are needed to avoid or mitigate any serious mental health problems.

The Six-Item Version of the Internet Addiction Test: Its Development, Psychometric Properties, and Measurement Invariance among Women with Eating Disorders and Healthy School and University Students

Internet addiction (IA) is widespread, comorbid with other conditions, and commonly undetected, which may impede recovery. The Internet Addiction Test (IAT) is widely used to evaluate IA among healthy respondents, with less agreement on its dimensional structure. This study investigated the factor structure, invariance, predictive validity, criterion validity, and reliability of the IAT among Spanish women with eating disorders (EDs, N = 123), Chinese school children (N = 1072), and Malay/Chinese university students (N = 1119). In school children, four factors with eigen values > 1 explained 50.2% of the variance, with several items cross-loading on more than two factors and three items failing to load on any factor. Among 19 tested models, CFA revealed excellent fit of a unidimensional six-item IAT among ED women and university students (χ2(7) = 8.695, 35.038; p = 0.275, 0.001; CFI = 0.998, 981; TLI = 0.996, 0.960; RMSEA = 0.045, 0.060; SRMR = 0.0096, 0.0241). It was perfectly invariant across genders, academic grades, majors, internet use activities, nationalities (Malay vs. Chinese), and Malay/Chinese female university students vs. Spanish women with anorexia nervosa, albeit it was variant at the scalar level in tests involving other EDs, signifying increased tendency for IA in pathological overeating. The six-item IAT correlated with the effects of internet use on academic performance at a greater level than the original IAT (r = -0.106, p < 0.01 vs. r = -0.78, p < 0.05), indicating superior criterion validity. The six-item IAT is a robust and brief measure of IA in healthy and diseased individuals from different cultures.

The Relationship between Internet Addiction, Internet Gaming and Anxiety among Medical Students in a Malaysian Public University during COVID-19 Pandemic

The internet has become an important medium for learning and communication during the COVID-19 pandemic, particularly for university students. Nevertheless, an increase in internet usage could predispose people to internet addiction (IA) and internet gaming (IG). Equally, there is concern that anxiety levels have increased during the pandemic. The aim of this study is to determine the prevalence of IA and IG, and their associations with anxiety among medical students during the pandemic. Data were collected during the second wave of the “Conditional Movement Control Order” (CMCO) in Malaysia between 12 November and 10 December 2020. A total of 237 students participated through proportionate stratified random sampling in this cross-sectional study. They completed a set of online questionnaires which consisted of a sociodemographic profile, the Malay version of the internet addiction test (MVIAT), the Malay version of the internet gaming disorder-short form (IGDS9-SF) and the Malay version of the depression, anxiety and stress scale (DASS-21). The prevalence of IA and internet gaming disorder (IGD) were 83.5% and 2.5%, respectively. A multiple logistic regression showed that those in pre-clinical years had a greater risk of anxiety than those in clinical years [(AOR) = 2.49, p-value 0.01, 95% CI = 1.22–5.07]. In contrast, those who scored high on IA were protected against anxiety [AOR = 0.100, p-value 0.03, 95% CI = 0.01–0.76)]. In conclusion, IA was highly prevalent during the COVID-19 pandemic and its high usage might serve as a protective factor against anxiety among the medical students in this study sample.

Social Isolation, Loneliness, and Mobile Phone Dependence among Adolescents During the COVID-19 Pandemic: Roles of Parent-Child Communication Patterns

During the COVID-19 pandemic, mobile phone dependence (MPD) became a common addictive behavior among adolescents because of social isolation. To understand the underlying mechanisms of the impact of social isolation on MPD, this study examined the mediating role of loneliness and the moderating role of parent-child communication patterns on social isolation and MPD. Six hundred and eighty-three adolescents from a middle school in Huang'gang city, China, were recruited to complete a self-report questionnaire. Data analysis comprised latent profile analysis and structural equation modelling. The results showed that social isolation had a significant and positive indirect effect on MPD via loneliness. In addition, three types of parent-child communication patterns were observed: complex, adaptive, and maladaptive. For adolescents with complex parent-child communication, the indirect relation of social isolation to MPD via loneliness is weaker than that of adolescents with maladaptive parent-child communication. These findings suggested that the indirect effect of social isolation on MPD via loneliness was moderated by parent-child communication patterns. Psychological intervention for MPD should emphasize relieving adolescents' loneliness and improving the quality of  their communication with parents during the COVID-19 pandemic.

Internet addiction and sleep quality among medical students during the COVID-19 pandemic: A multinational cross-sectional survey

BACKGROUND

The emergence of the COVID-19 pandemic has affected the lives of many people, including medical students. The present study explored internet addiction and changes in sleep patterns among medical students during the pandemic and assessed the relationship between them.

METHODS

A cross-sectional study was carried out in seven countries, the Dominican Republic, Egypt, Guyana, India, Mexico, Pakistan, and Sudan, using a convenience sampling technique, an online survey comprising demographic details, information regarding COVID-19, the Pittsburgh Sleep Quality Index (PSQI), and the Internet Addiction Test (IAT).

RESULTS

In total, 2749 participants completed the questionnaire. Of the total, 67.6% scored above 30 in the IAT, suggesting the presence of an Internet addiction, and 73.5% scored equal and above 5 in the PSQI, suggesting poor sleep quality. Internet addiction was found to be significant predictors of poor sleep quality, causing 13.2% of the variance in poor sleep quality. Participants who reported COVID-19 related symptoms had disturbed sleep and higher internet addiction levels when compared with those who did not. Participants who reported a diagnosis of COVID-19 reported poor sleep quality. Those living with a COVID-19 diagnosed patient reported higher internet addiction and worse sleep quality compared with those who did not have any COVID-19 patients in their surroundings.

CONCLUSION

The results of this study suggest that internet addiction and poor sleep quality are two issues that require addressing amongst medical students. Medical training institutions should do their best to minimize their negative impact, particularly during the current COVID-19 pandemic.

How Does Psychological Distress Due to the COVID-19 Pandemic Impact on Internet Addiction and Instagram Addiction in Emerging Adults?

International research has underlined a worrying increase in Internet and Instagram addiction among emerging adults during the COVID-19 pandemic. Although the role played by alexithymia and psychological distress due to COVID-19 has been evidenced, no study has explored their complex relationship in predicting emerging adults' Internet and Instagram addiction. The present study aimed to verify whether peritraumatic distress due to the COVID-19 pandemic mediated the relationship between emerging adults' alexithymia and their Internet/Instagram addiction, in a sample composed of n = 400 Italian emerging adults. Results showed that females had higher peritraumatic distress due to COVID-19 than males, whereas males had higher externally oriented thinking and higher levels of Internet addiction than females. Emerging adults' psychological distress due to COVID-19 significantly mediated the effect of alexithymia on Internet and Instagram addiction. Our findings supported the presence of a dynamic relationship between individual vulnerabilities and the co-occurrence of other psychological difficulties in predicting emerging adults' Internet and Instagram addiction during the pandemic, with important clinical implications.

Internet use during COVID-19 lockdown among young people in low- and middle-income countries: Role of psychological wellbeing

Problematic internet use in adolescents has been shown to significantly increase over the past few years, with COVID-19 pandemic lockdowns reinforcing this phenomena globally. We sought to explore whether problematic internet use in specific countries was related to emotional well-being and importantly whether this is predicted by psychological distress. There is a growing number of studies showing that problematic internet use is increasingly prevalent in countries with emerging economies, however we have yet to find out to what extent other factors are influencing this behaviour in adolescents and young people. This study invited young people from countries such India, Mexico, Philippines and Turkey to complete a set of self-reports on their daily internet habits, social media use, alongside questions on psychological distress, self-esteem, loneliness and escapism. A total of 1182 young people aged between 16 and 25 years old completed these questionnaires online. The results showed that there were significant difference in problematic internet use scores among adolescents in the Philippines and Turkey. More specifically, social media use was significantly higher amongst young people from the Philippines whereas gaming addiction was significantly high in the Turkish sample. These findings also revealed that psychological distress, loneliness, and low self-esteem consistently predicted problematic internet use. Taken together these results emphasise that there are several factors underlying growing figures of problematic internet use in young people, these factors include emotional distress, need for escapism, loneliness, and social media use, however, going forward more nuanced cultural differences should also be considered.

Depression as Compared to Level of Physical Activity and Internet Addiction among Polish Physiotherapy Students during the COVID-19 Pandemic

OBJECTIVES

The aim of the survey was to assess the level of depression correlated with physical activity and internet addiction among physiotherapy students of Polish universities during the COVID-19 pandemic.

METHODS

The survey was carried out via the internet among Polish physiotherapy students (141 respondents). The level of depression was assessed by the Beck Depression Inventory, physical activity by the International Physical Activity Questionnaire (IPAQ) in Polish and the level of internet addiction by the Kimberly Young Questionnaire.

RESULTS

It was found that 31% of those surveyed stated that they suffered from moderate or severe depression. The overwhelming majority of the respondents (92%) considered the level of their internet addiction as low. More physical activity had a positive effect on mental health. The overuse of the internet exacerbated depressive symptoms.

CONCLUSIONS

The prevalence of depression observed in students is mainly related to distant learning systems. Therefore, regular physical activity is recommended as it is associated with a lower level of depression. It is also advisable to provide students with necessary psychological care. Excessive use of social media is not recommended to elevate mood as it makes depression symptoms worse.

Internet addiction and psychological distress among Chinese schoolchildren before and during the COVID-19 outbreak: A latent class analysis

BACKGROUND AND AIMS

The present longitudinal study examined the changes in problematic internet use (problematic smartphone use, problematic social media use, and problematic gaming) and changes in COVID-19-related psychological distress (fear of COVID-19 and worry concerning COVID-19) across three time-points (before the COVID-19 outbreak, during the initial stages of the COVID-19 outbreak, and during the COVID-19 outbreak recovery period).

METHODS

A total of 504 Chinese schoolchildren completed measures concerning problematic internet use and psychological distress across three time-points. Latent class analysis (LCA) was used to classify participants into three groups of problematic internet use comprising Group 1 (lowest level), Group 2 (moderate level), and Group 3 (highest level).

RESULTS

Statistical analyses showed that as problematic use of internet-related activities declined among Group 3 participants across the three time points, participants in Group 1 and Group 2 had increased problematic use of internet-related activities. Although there was no between-group difference in relation to worrying concerning COVID-19 infection, Groups 2 and 3 had significantly higher levels of fear of COVID-19 than Group 1 during the COVID-19 recovery period. Regression analysis showed that change in problematic internet use predicted fear of COVID-19 during the recovery period.

CONCLUSION

The varied levels of problematic internet use among schoolchildren reflect different changing trends of additive behaviors during COVID-19 outbreak and recovery periods.

Intolerance of Uncertainty, Anxiety and Depression in the Context of Covid-19 in Indonesia

"This Covid-19 pandemic brings uncertainty and may lead to mental problems. Yet, in this context, no study has examined the relationship between intolerance of uncertainty (IU) and either anxiety or depression during pandemic among Indonesians. This study investigated the pathway between IU, anxiety and depression serially mediated by cognitive appraisals (perceived severity, controllability, and knowledge) and emotional and behavioural responses to COVID-19. Online psychological measures were administered to 406 participants, including the IUS-12, the DASS-21, cognitive appraisal scales, and emotional and behavioural response scale. An indirect pathway was found between IU and depression, and the effect was serially mediated by perceived of severity and emotional and behavioural responses to COVID-19. Perceived knowledge and perceived controllability of COVID-19 did not significantly contribute to the model. A similar pathway was found for IU predicting anxiety. As conclusion, IU represents a risk factor for heightened emotional and behavioural difficulties that eventually, could lead to either anxiety or depression during COVID-19."