Problematic Smartphone Use and Mental Health in Chinese Adults: A Population-Based Study

The Effects of a Complex Interactive Multimodal Intervention on Personalized Stress Management Among Health Care Workers in China: Nonrandomized Controlled Study

BACKGROUND

Health care workers (HCWs) frequently face multiple stressors at work, particularly those working night shifts. HCWs who have experienced distress may find it difficult to adopt stress management approaches, even if they are aware of the effects of stress and coping processes. Therefore, an individualized intervention may be required to assist distressed HCWs in bridging the "knowledge-practice" gap in stress management and effectively alleviating stress symptoms.

OBJECTIVE

The main objective of this research was to compare the effects of a complex interactive multimodal intervention (CIMI) to self-guided stress management interventions on stress symptoms of distressed HCWs, as measured by physiological (heart rate variability), psychological (perceived stress, mental distress, and subjective happiness), and sleep disorder (fatigue and sleepiness) indicators.

METHODS

We conducted a nonrandomized, controlled study in 2 Chinese general hospitals. The participants in this study were 245 HCWs who fulfilled at least 1 of the 3 dimensions on the Depression, Anxiety, and Stress Scale. All eligible individuals were required to complete a questionnaire and wear a 24-hour Holter device to determine the physiological signs of stress as indexed by heart rate variability at both baseline and after the intervention. The CIMI group received a 12-week online intervention with 4 components-mobile stress management instruction, a web-based WeChat social network, personalized feedback, and a nurse coach, whereas the control group simply received a self-guided intervention.

RESULTS

After a 12-week intervention, the Perceived Stress Scale (PSS) scores reduced significantly in the CIMI group (mean difference [MD] -5.31, 95% CI -6.26 to -4.37; P<.001) compared to the baseline levels. The changes in PSS scores before and after the intervention exhibited a significant difference between the CIMI and control groups (d=-0.64; MD -4.03, 95% CI -5.91 to -2.14; P<.001), and the effect was medium. In terms of physiological measures, both the control group (MD -9.56, 95% CI -16.9 to -2.2; P=.01) and the CIMI group (MD -8.45, 95% CI -12.68 to -4.22; P<.001) demonstrated a significant decrease in the standard deviation of normal-to-normal intervals (SDNN) within the normal clinical range; however, there were no significant differences between the 2 groups (d=0.03; MD 1.11, 95% CI -7.38 to 9.59; P=.80).

CONCLUSIONS

The CIMI was an effective intervention for improving sleep disorders, as well as parts of the psychological stress measures in distressed HCWs. The findings provide objective evidence for developing a mobile stress management intervention that is adaptable and accessible to distressed HCWs, but its long-term effects should be investigated in future research.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05239065; https://clinicaltrials.gov/ct2/show/NCT05239065.

Absolute and relative preferences for mobile phone internet content, mobile phone dependence, and depressive symptoms: a study of Chinese university students in the post-pandemic era

Background

Due to the COVID-19 pandemic, Chinese university students may have increased mobile phone dependence, a habitual behavior in the student population and a risk factor for depressive symptoms. Therefore, this study explored the association between mobile phone dependence and depressive symptoms in Chinese university students in the post-pandemic era. It also investigated the effects of different types and categories of mobile phone Internet content preferences. In particular, this study examined whether mobile phone dependence mediates the relationship between absolute preference (AP) for mobile phone Internet content and depressive symptoms, and whether relative preference (RP) for mobile phone Internet content moderates the association between mobile phone dependence and depressive symptoms.

Methods

A cross-sectional study of Chinese university students recruited through Credamo was conducted in February-March, 2023. Participants completed the Mobile Phone Internet Content Preference Questionnaire, Self-rating Questionnaire for Adolescent Problematic Mobile Phone Use, and Center for Epidemiological Survey, Depression Scale. Statistical analyses included descriptive statistics, correlation, regression, and analyses of mediation and moderation effects. The final sample comprised 1,602 students (709 males).

Results

We found a positive association between mobile phone dependence and depressive symptoms. The mediating role of mobile phone dependence between AP for mobile phone Internet content and depressive symptoms differed according to the type and category of content. Meanwhile, different types and categories of RP for mobile phone Internet content moderated the association between mobile phone dependence and depressive symptoms in opposite directions.

Conclusion

Our results highlight the interrelationships among mobile phone Internet content preferences, mobile phone dependence, and depressive symptoms in Chinese university students. For different types and categories of mobile phone Internet content preferences, we propose distinct preventive measures to alleviate students' depressive symptoms.

Impact of smart device use on objective and subjective health of older adults: findings from four provinces in China

Background

The digital divide has grown because of the deepening digitalization of the Chinese society and the intersection between high-end technology and the age structure. Older adults show an increasing level of weakness in digital life integration. What digital development can bring to older adults is a pressing concern.

Objective

This study aims to investigate how smart device use affects older adults' health status and offers an empirical reference for improving their digital literacy and health.

Methods

The data in this study were collected from an offline survey conducted from December 2021 to April 2022, which obtained 1110 valid samples of older adults This study used a multivariate ordered logit model, mediating effect model, and heterogeneity test to analyze the impact of smart device use on the health status of older adults.

Results

Smart device use has a significant positive effect on the self-rated, physical, and psychological health of older adults, and this positive effect is more pronounced among older adults living in urban areas or with a higher age. The average net effect of smart devices on each health status of older adults is 0.161 for self-rated health, 0.155 for physical health, and 0.071 for psychological health. In-depth research found that older adults' attitudes toward smart devices played a mediating role in the influence of smart device use on self-rated and psychological health respectively.

Conclusions

The study found that smart device use had a positive effect on the health status of older adults and that the performance expectations and individualized needs of older adults exhibited an effective linkage between smart devices and health status. Smart device use could improve the overall health of older adults, especially the urban and low-age older adults. Promoting the understanding of the practicality of smart devices for older adults and the aging-oriented transformation of smart devices is an effective way to improve the health status of older adults. The findings provide theoretical support for the wide application of smart devices in older adults, and can effectively help eHealth practitioners implement accurate geriatric health support strategies.

How does social media use impact subjective well-being? Examining the suppressing role of Internet addiction and the moderating effect of digital skills

Introduction

Previous studies have explored the impact of social media use on people's subjective well-being, but there is a lack of discussion on the relationship between social media use, Internet addiction, and subjective well-being, and the research on the influence of digital skills on this relationship is not sufficient. This paper aims to fill these gaps. Based on the flow theory, this paper takes Chinese residents as the research object and uses CGSS 2017 data to analyze the impact of social media use on people's subjective well-being.

Methods

Our study used multiple linear regression models for analysis. To test the hypotheses and the moderated mediation model, we adopted PROCESS models with 5000 bias-corrected bootstrap samples and 95% confidence intervals. All analyses were conducted using SPSS 25.0.

Results

The empirical analysis shows that social media use has a positive direct effect on subjective well-being, and Internet addiction plays a suppressing role in the relationship between social media use and subjective well-being. In addition, we found that digital skills moderated the positive effect of social media use on Internet addiction and the indirect effect of social media use on subjective well-being through Internet addiction.

Discussion

The conclusion of this paper supports our previous hypothesis. Besides, the theoretical contribution, practical significance, and limitations of this study are discussed based on the results of previous studies.

Distinct patterns of problematic smartphone use and related factors in Chinese college students

BACKGROUND

This study aimed to categorize different subgroups of problematic smartphone use in Chinese college students. Differences in gender and psychosocial characteristics of the categorized groups were also examined.

METHODS

A total of 1123 participants completed the Mobile Phone Addiction Index Scale, the Center for Epidemiologic Studies Depression Scale, the Perceived Social Support Scale, and the Perceived Stress Scale. Using latent profile analysis, we identified different subgroups of problematic smartphone use in college students. Multivariate logistic regression analysis was implemented to examine the relationship between latent classes and demographic and psychosocial covariates.

RESULTS

The four following latent classes were identified: a low-risk group, a moderate-risk with no evasiveness group, a moderate-risk with evasiveness group, and high-risk group that accounted for 11%, 24.1%, 35.5%, and 29.4% of the total sample, respectively. Further analysis revealed that female participants were more likely to be in the moderate-risk with evasiveness and high-risk groups, and individuals with depressed mood were more likely to be in the moderate-risk and high-risk groups.

CONCLUSIONS

Classifying college students according to the features of problematic smartphone use is potentially useful for understanding risk factors and developing targeted prevention and intervention programs.

Problematic smartphone use is associated with differences in static and dynamic brain functional connectivity in young adults

Introduction

This study aimed to investigate the possible associations between problematic smartphone use and brain functions in terms of both static and dynamic functional connectivity patterns.

Materials and methods

Resting-state functional magnetic resonance imaging data were scanned from 53 young healthy adults, all of whom completed the Short Version of the Smartphone Addiction Scale (SAS-SV) to assess their problematic smartphone use severity. Both static and dynamic functional brain network measures were evaluated for each participant. The brain network measures were correlated the SAS-SV scores, and compared between participants with and without a problematic smartphone use after adjusting for sex, age, education, and head motion.

Results

Two participants were excluded because of excessive head motion, and 56.9% (29/51) of the final analyzed participants were found to have a problematic smartphone use (SAS-SV scores ≥ 31 for males and ≥ 33 for females, as proposed in prior research). At the global network level, the SAS-SV score was found to be significantly positively correlated with the global efficiency and local efficiency of static brain networks, and negatively correlated with the temporal variability using the dynamic brain network model. Large-scale subnetwork analyses indicated that a higher SAS-SV score was significantly associated with higher strengths of static functional connectivity within the frontoparietal and cinguloopercular subnetworks, as well as a lower temporal variability of dynamic functional connectivity patterns within the attention subnetwork. However, no significant differences were found when directly comparing between the groups of participants with and without a problematic smartphone use.

Conclusion

Our results suggested that problematic smartphone use is associated with differences in both the static and dynamic brain network organizations in young adults. These findings may help to identify at-risk population for smartphone addiction and guide targeted interventions for further research. Nevertheless, it might be necessary to confirm our findings in a larger sample, and to investigate if a more applicable SAS-SV cutoff point is required for defining problematic smartphone use in young Chinese adults nowadays.

Smartphone Use, Digital Addiction and Physical and Mental Health in Community-dwelling Older Adults: a Population-based Survey

This study aims to assess mobile technology use (cell phones and smartphones), level of digital addiction, and the association of these factors with physical, mental and social health and quality of life (QOL) in community-dwelling older adults. A population-based study of a city with a low-income population in Brazil was carried out. Sociodemographics, cognition(MMSE), mental health(DASS-21), QOL(WHOQOL-bref), sleep quality(Pittsburgh Index), instrumental activities of daily living(Lawton), loneliness(UCLA), digital addiction(Internet Addiction Test) and cell phone/smartphone use were investigated. A total of 668 older adults (93.6% of total) were included; 175(26.2%) owned cell phones, 172(25.7%) smartphones and 321(48.1%) no mobile device. Smartphones owners were predominantly younger, white, had higher income, MMSE scores and social support, and were less dependent. However, no group differences were observed for depression, anxiety or stress symptoms, QOL, sleep disturbances or loneliness. Among 172 smartphone users, Structural Equation Models revealed that the degree of digital addiction was correlated with better physical and environmental conditions, in detriment of a poorer sleep quality. Hours of use were not correlated with health outcomes, whereas greater importance of the smartphone in life correlated with less depressive symptoms and lower loneliness. Different from previous studies in adults or adolescents, older adults who were smartphones users had similar health outcomes than those without Internet access. These findings serve to further our understanding on technology use in this age group.

Multidimensional Profiles of Addictive Smartphone Use: A Latent Profile Analysis

Given that crucial psychological attributes of smartphone addiction have been studied in isolation from each other, we examined latent profiles of emotional distress (depression, stress, loneliness, and fear of missing out; i.e., FoMO); protective traits (self-control, mindfulness, grit); the behavioral inhibition system (BIS) and approach system (BAS; drive, reward responsiveness, and fun seeking) in relation to addictive smartphone use. We identified three distinctive profiles, using five fit statistics: AIC, BIC, adjusted BIC, an entropy, and LRT. The self-controlled, gritty, and mindful profile (22.7%) was characterized by heightened levels of self-control, grit, and mindfulness but lower levels of emotional distress, BIS, and BAS. The emotionally distressed profile (29.8%) was distinguished by elevated levels of depression, stress, loneliness, FoMO, and BIS, but relatively lower protective traits and BAS. Lastly, the approach sensitive profile (47.5%) corresponded to the normative group characterized by relatively higher BAS but mostly average levels of emotional distress and protective traits. When both global and pairwise comparisons between profiles were performed using Wald tests, we found that the self-controlled, gritty, and mindful profile was associated with significantly lower smartphone addiction tendencies than emotionally distressed or approach sensitive profiles, while the latter two did not differ from each other. These results still held when multiple covariates (age, sex, and income) were controlled for. Using a sophisticated person-centered approach, our findings underscore multidimensional psychological profiles that have different associations with smartphone addiction.

Psychometric Evaluation of a Fear of COVID-19 Scale in China: Cross-sectional Study

BACKGROUND

At the very beginning of the COVID-19 pandemic, information about fear of COVID-19 was very limited in Chinese populations, and there was no standardized and validated scale to measure the fear associated with the pandemic.

OBJECTIVE

This cross-sectional study aimed to adapt and validate a fear scale to determine the levels of fear of COVID-19 among the general population in mainland China and Hong Kong.

METHODS

A web-based questionnaire platform was developed for data collection; the study instruments were an adapted version of the 8-item Breast Cancer Fear Scale ("Fear Scale") and the 4-item Patient Health Questionnaire. The internal construct validity, convergent validity, known group validity, and reliability of the adapted Fear Scale were assessed, and descriptive statistics were used to summarize the participants' fear levels.

RESULTS

A total of 2822 study participants aged 18 years or older were included in the analysis. The reliability of the adapted scale was satisfactory, with a Cronbach α coefficient of .93. The item-total correlations corrected for overlap were >0.4, confirming their internal construct validity. Regarding convergent validity, a small-to-moderate correlation between the Fear Scale and the 4-item Patient Health Questionnaire scores was found. Regarding known group validity, we found that the study participants who were recruited from Hong Kong had a higher level of fear than the study participants from mainland China. Older adults had a higher level of fear compared with younger adults. Furthermore, having hypertension, liver disease, heart disease, cancer, anxiety, and insomnia were associated with a higher fear level. The descriptive analysis found that more than 40% of the study participants reported that the thought of COVID-19 scared them. About one-third of the study participants reported that when they thought about COVID-19, they felt nervous, uneasy, and depressed.

CONCLUSIONS

The psychometric properties of the adapted Fear Scale are acceptable to measure the fear of COVID-19 among Chinese people. Our study stresses the need for more psychosocial support and care to help this population cope with their fears during the pandemic.

Gender Difference in the Relationship of Physical Activity and Subjective Happiness Among Chinese University Students

Background: Gender makes a difference in health and physical activity (PA). This research aimed to identify the gender difference in the relationship of PA and subjective happiness among Chinese university students.

Methods: A cross-sectional survey was conducted in Shanghai Jiao Tong University from July 7 to 17 in 2021, using an anonymous online self-report questionnaire. The questionnaire included the Chinese version of the International Physical Activity Questionnaire-Short Form (IPAQ-SF), the Subjective Happiness Scale (SHS), the Depression Anxiety Stress Scale-21(DASS-21). The demographic and health-related factors were also reported. Linear regression was carried out to identify the relationship of PA and subjective happiness.

Findings: In total, 1,512 students (1,108 males and 404 females) from three comprehensive schools completed the survey. The SHS score was 17.20 ± 3.44, and it was 17.00 ± 3.23 in males, and 17.75 ± 3.93 in females, respectively (p < 0.001). There was no gender difference in vigorous, moderate PA, or walk min/week, while female students had longer sedentary behavior hours/day than males. Male students scored higher in each subscale of DASS-21. After controlling for confounders, vigorous PA min/week (β = 0.002, p = 0.002) and sedentary behavior hours/day (β = 0.168, p = 0.005) were significantly positively associated with happiness in male students. In contrast, walk min/week (2= 0.002, p = 0.005) was significantly positively associated with happiness in female students.

Interpretation: This research demonstrated a significant gender difference in the association between PA and happiness. Policymakers and college management should pay more attention to PA programs to promote students’ happiness and mental health status.

Associations of COVID-19 online information sources and information overload with psychological distress symptoms: a population-based study

Using information communication technologies as information sources of COVID-19 was associated with psychological problems, but mechanisms remain uncertain. We examined associations of COVID-19 information sources and information overload with psychological distress symptoms and explored the mediating effect of information overload in Hong Kong. A random sample of Chinese adults (N = 1501; 52.6% females; 55.0% aged 30-59) from dual landline and online surveys in April 2020 reported frequency of using traditional media, internet websites, social networking sites, instant messaging, and online discussion forums as COVID-19 information sources. Psychological distress symptoms were measured using the Patient Health Questionnaire 4-item ([PHQ-4]; 0-12). Information overload defined as a perception of being overwhelmed was measured (1-6). Linear regressions were performed to analyze the associations, and the mediating effect of information overload was examined. Greater PHQ-4 score was observed for frequent use of internet websites (adjusted b = 0.58, 95% CI 0.29, 0.87, adjusted β = 0.12) and online discussion forums (adjusted b = 0.39, 95% CI 0.08, 0.70, adjusted β = 0.08) and information overload (adjusted b = 0.54, 95% CI 0.44, 0.63, adjusted β = 0.28). Information overload mediated 44.9% and 36.9% of associations of frequent use of internet websites and online discussion forums with PHQ-4 score, respectively. Frequent use of social networking sites was associated with lower PHQ-4 score (adjusted b = -0.37, 95% CI -0.69, -0.04, adjusted β = -0.07) partially through lower information overload (37.5%). Psychological distress symptoms were associated with frequent use of internet websites and online discussion forums as COVID-19 information sources, which were mediated through information overload.

Parental Mental Well-Being and Frequency of Adult-Child Nature Visits: The Mediating Roles of Parents' Perceived Barriers

Regular access to green space has been shown to provide several health benefits for children. However, children today spend less time outdoors. Thus, it has become important to understand what drives and limits children's activities in nature. Based on a Finnish online survey of 1463 parents of children aged 2-7 conducted in 2019, the current study examined parents' perceived barriers to visiting nature with their children. It also examined how parental mental well-being is related to families' frequency of nature visits, and whether this association is mediated by different categories of parents' perceived barriers. Eleven out of 12 barriers were largely perceived by parents as reasons that did not prevent them from visiting nature with their children. Next, factor analysis indicated a three-factor solution to the barriers. The results of a multiple mediation analysis showed that better parental mental well-being was associated with more frequent adult-child nature visits, and this relationship was partially mediated by a "lack of competence and logistics" and a "lack of time and interest", but not by "insecurity and fear". The results indicated that parents with poor mental well-being were more likely to perceive barriers to visiting nature, which in turn appeared to be related to a higher likelihood of having children who visited nature less frequently.

Validation of the Hedonic and Eudaimonic Motives for Activities-Revised Scale in Chinese Adults

The Hedonic and Eudaimonic Motives for Activities-Revised scale (HEMA-R) is one of the most extensively used instruments to assess how people pursue well-being. The main aims of the present research were to translate HEMA-R into Chinese and test its construct and predictive validity as well as measurement invariance across gender. In Study 1, we conducted confirmatory factor analysis with data containing 1090 Chinese undergraduates, and replicated the two-factor model which has been found in other studies. Furthermore, the measurement invariance across gender was supported throughout the multi-group confirmatory factor analysis. Study 2 replicated these results and further found the HEMA-R had satisfactory predictive validity in measures of well-being, social support and smartphone addiction. All the findings indicate that the HEMA-R is reliable and valid to measure hedonic and eudaimonic motives, and it could be applied generally across gender in Chinese adults.

The Relationship between Restrained Eating, Body Image, and Dietary Intake among University Students in China: A Cross-Sectional Study

This study aims to explore the association between restrained eating, body image, and dietary intake among Chinese college students. This cross-sectional study included 1301 college students at two universities in Hunan Province. Electronic questionnaires were used to collect information including students’ demographic characteristics, restrained eating, perception of body weight, body satisfaction, and dietary intake. Anthropometric measurements were collected to calculate body mass index (BMI). The prevalence of high restrained eating was 52.8%. Students who were dissatisfied with their bodies or overestimated their body weight showed a higher tendency toward high restrained eating (p < 0.05). Students with high restrained eating tended to eat fruits and eggs more frequently, while the frequency of eating domestic animals and poultry, sugar-sweetened beverages, and fast food were the opposite. Moreover, high restrained eating was a risk factor for low dietary diversity (odds ratio (OR) = 1.384, 95% confidence interval: 1.002~1.912). The high incidence of restrained eating among Chinese college students and its energy-restricted diets that may lead to possible health implications require attention. Further studies are needed to investigate the characteristics of college students’ restrained eating to tailor appropriate interventions for forming positive body images and promoting healthy eating behaviors, thus, improving dietary quality.

Emerging Health and Education Issues Related to Internet Technologies and Addictive Problems

This timely editorial paper outlines some of the main emerging research on technological topics on health and education approaches to Internet use-related problems before and during the beginning of coronavirus disease 2019 (COVID-19). Background: The aim is to provide a brief overview to facilitate a rapid comprehensive and practical approach to these new trends to promote research, interventions, education, and prevention. Methods: The rapid review includes an analysis of both health and education technologies studies on Internet use-related addiction problems included in the Special Issue “Internet and Smartphone Use-Related Addiction Health Problems: Treatment, Education and Research” to extract recent findings and a few reflections about the development of the field before and during the first wave of the COVID-19. Results: Main findings highlighted studies which tended to be empirical, with a relational type associating specific addictive problems with individual and a few contextual factors in adult populations. Psychometric studies about scales are prevalent, but predictive and mixed methods ones are starting to emerge, together with reviews about conceptualisation, measure, treatment, and prevention. Conclusions: From the arrival of Internet, our societies have converged in a global culture which has impacted health and educational domains. Internet use-related addiction problems have globally emerged and common knowledge, advances, and strategies exist to overcome challenges which are starting to be tested, and prevention interest has arisen in a pandemic situation with global health problems holistically tackled.

A Survey on Daily Activity Inclination and Health Complaints among Urban Youth in Malaysia

Environmental influence is one of the attributing factors for health status. Chronic interaction with electronic display technology and lack of outdoor activities might lead to health issues. Given the concerns about the digital impact on lifestyle and health challenges, we aimed to investigate the daily activity inclination and health complaints among the Malaysian youth. A self-administered questionnaire covering lifestyle and health challenges was completed by 220 youths aged between 16 and 25. There were a total of 22 questions. Seven questions inspected the patterns of indoor and outdoor activities. Fifteen questions focused on the visual and musculoskeletal symptoms linked to both mental and physical health. The total time spent indoors (15.0 ± 5.4 hours/day) was significantly higher than that spent outdoors (2.5 ± 2.6 hours/day) (t = 39.01, p < 0.05). Total time engrossed in sedentary activities (13.0 ± 4.5 hours/day) was significantly higher than that in nonsedentary activities (4.5 ± 3.8 hours/day) comprised of indoor sports and any outdoor engagements (t = 27.10, p < 0.05). The total time spent on electronic related activities (9.5 ± 3.7 hours/day) was were higher than time spent on printed materials (3.4 ± 1.6 hours/day) (t = 26.01, p < 0.05). The association of sedentary activities was positive in relation to tired eyes (χ² = 17.58, p < 0.05), sensitivity to bright light (χ² = 12.10, p < 0.05), and neck pain (χ² = 17.27, p < 0.05) but negative in relation to lower back pain (χ² = 8.81, p < 0.05). Our youth spent more time in building and engaged in sedentary activities, predominantly electronic usage. The health-related symptoms, both visual and musculoskeletal symptoms, displayed a positive association with a sedentary lifestyle and a negative association with in-building time.

Problematic internet use among young and adult population in Bangladesh: Correlates with lifestyle and online activities during the COVID-19 pandemic

BACKGROUND

Although internet use can boost individuals' quality of life in various aspects, activities on the internet (e.g., gambling, video gaming, social media use, pornography use, etc.) can be used as coping strategy to deal with psychological stressors and mood states (e.g., fear, anxiety, depression) particularly during the global COVID-19 pandemic.

OBJECTIVES

The present study assessed problematic internet use (PIU) among Bangladeshi youth and adults in Bangladesh and examined its correlation with lifestyle and online activities during the COVID-19 pandemic.

METHODS

An online cross-sectional survey was utilized between May and June 2020 comprising 13,525 Bangladeshi individuals (61.3% male; age range 18-50 years; mean age 23.7 years) recruited from various online platforms. The self-report survey included questions concerning socio-demographics, lifestyle, and online activities during the COVID-19 pandemic, as well as psychometric scales such as the nine-item Internet Disorder Scale-Short Form (IDS9-SF).

RESULTS

Utilizing hierarchical regression analysis, problematic internet use was significantly and positively associated with those who were younger, having a higher level of education, living with a nuclear family, engaging in less physical exercise, avoiding household chores, playing online videogames, social media use, and engaging in recreational online activities.

CONCLUSIONS

Excessive internet use appears to have been commonplace during the COVID-19 pandemic period and young adults were most vulnerable to problematic internet use.

The Matthew Effect in Recovery from Smartphone Addiction in a 6-Month Longitudinal Study of Children and Adolescents

The clinical course of problematic smartphone use (PSU) remains largely unknown due to a lack of longitudinal studies. We recruited 193 subjects with smartphone addiction problems for the present study. After providing informed consent, the subjects completed surveys and underwent comprehensive interviews regarding smartphone usage. A total of 56 subjects among the 193 initially recruited subjects were followed up for six months. We compared baseline characteristics between persistent addicted users and recovered users at the end of the 6-month follow-up. Persistent problematic smartphone users displayed higher baseline smartphone addiction severity and were more prone to develop mental health problems at the follow-up. However, baseline depressive or anxiety status did not significantly influence the course of PSU. PSU behaved more like an addictive disorder rather than a secondary psychiatric disorder. Harm avoidance, impulsivity, higher Internet use, and less conversation time with mothers were identified as poor prognostic factors in PSU. Lower quality of life, low perceived happiness, and goal instability also contributed to persistent PSU, while recovery increased these scores as well as measures of self-esteem. These findings suggest that the Matthew effect is found in the recovery of PSU with better premorbid psychosocial adjustment leading to a more successful recovery. Greater clinical resources are required for interventions in vulnerable populations to modify the course of this increasingly prevalent problematic behavior worldwide.

Problematic Internet Use and Perceived Quality of Life: Findings from a Cross-Sectional Study Investigating Work-Time and Leisure-Time Internet Use

Avoiding the potential negative impact brought by problematic internet use is becoming more important. To better understand public health and addiction, this study investigated to what extent work-time and leisure-time internet use relate to problematic internet use and perceived quality of life among college students and highly educated adults. An online cross-sectional survey with 446 individuals was assessed in Germany. Linear regression analyses were used to predict problematic internet use. Ordinal regression analyses were applied to predict perceived quality of life. Results showed that leisure-time internet use, but not work-time internet use, was positively associated with problematic internet use. Participants whose work-time internet use could be considered balanced (5–28 h/week in this study) indicated a higher perceived quality of life compared to individuals with little or large amount of internet use for work. The findings still emerged when taking negative feelings, perceived stress, smoking status and alcohol consumption into account. As both work-time and leisure-time internet use can be risk factors for mental health in terms of problematic internet use and perceived quality of life, well-controlled internet use rather than excessive use is recommended. This should be kept in mind when dealing with the Coronavirus pandemic and its aftermath.

Self-Reported Screen Time on Social Networking Sites Associated With Problematic Smartphone Use in Chinese Adults: A Population-Based Study

Background: Problematic smartphone use (PSU) has been associated with screen time in general, but little is known about the effect of different screen-based activities. We examined the associations of self-reported time spent on overall and specific screen-based activities with PSU and its addictive symptoms in Hong Kong Chinese adults. Methods: We analyzed data from 562 smartphone owners (56.5% female; 82.1% aged 25-64 years) in a population-based telephone survey in 2017. PSU was measured using Smartphone Addiction Scale-Short Version (range 10-60) which includes symptoms of daily-life disturbance, withdrawal, cyberspace-oriented relationship, overuse, and tolerance. Screen time was self-reported as average hours per day spent on the internet, online book/newspaper/magazine, online video, and social networking sites (SNS). Multivariable linear regression analyzed the associations of self-reported screen time with PSU severity and symptoms. Interaction effects of sex, age group, educational attainment, and monthly household income were examined. Results: Self-reported time spent on overall screen-based activities was associated with PSU severity (β = 1.35, 95% CI 0.15, 2.55) and withdrawal and overuse symptoms, after adjusting for sociodemographic and health-related variables. Independent association was observed for self-reported SNS time with PSU severity (β = 1.42, 95% CI 0.35, 2.49) and symptoms of withdrawal and cyberspace-oriented relationship, after mutually adjusting for time on other activities. The strongest association between self-reported SNS time and PSU severity was observed in younger than older adults (β = 4.36, 95% CI 2.58, 6.13; P for interaction = 0.004). Conclusions: The independent association of self-reported SNS time with PSU and core addictive symptoms highlighted the addiction potential of SNS use, particularly in younger users.