Association of Internet Addiction with Adolescents' Lifestyle: A National School-Based Survey

The relationship between internet addiction and lifestyle among high school students: A cross sectional in the west of Iran

Excessive internet usage can precipitate internet addiction (IA), negatively impacting lifestyle behaviors, especially during adolescence. These warrants investigating associations between IA and lifestyle factors. To examine the relationship between IA and health-promoting lifestyle dimensions among Iranian high school students. A cross-sectional study was conducted among 407 students from Sanandaj, Iran selected via cluster sampling. IA was assessed using the Young IA Test. Lifestyle was measured via the Health-Promoting Lifestyle Profile questionnaire. Regression analyses evaluated associations while adjusting for covariates. Approximately 25% of participants were at risk of internet addiction. Prevalence variations across groups lacked significance. Non-addicted students had significantly higher overall healthy lifestyle scores (p<0.05). Spiritual growth, health responsibility and nutrition scores significantly differed between addicted and non-addicted students. Regression analyses revealed a statistically significant negative correlation between IA and lifestyle even after adjustment (p<0.001). Nutrition and physical activity scores particularly declined for those at risk of addiction. IA was significantly associated with unhealthy dietary habits, sedentary behavior, and a lower healthy lifestyle. It may also hinder stress management and spiritual well-being. With rising internet integration, collaborative awareness programs between educational institutions, families, and communities are warranted to curb addiction risks and promote healthy lifestyles in youth. This study provides valuable insights, though longitudinal research is needed to establish causality.

Understanding the relationships among adolescents' internet dependence, reward, cognitive control processing, and learning burnout: a network perspective in China

Alterations in the reward and cognitive control systems are commonly observed among adolescents with internet dependence (ID), and this impairment is often accompanied by social dysfunctions, such as academic burnout. However, the intercorrelations among ID, reward, cognitive control processing, and learning burnout remain unclear. We recruited 1074 Chinese adolescents to investigate the complex interrelationships among these variables using network analysis. The resulting network revealed patterns that connected ID to the behavioral inhibition/activation system (BIS/BAS), self-control, and learning burnout; these results exhibited reasonable stability and test-retest consistency. Throughout the network, the node of BAS-drive was the critical influencing factor, and the node of self-control was the protection factor. In addition, several symptoms of learning burnout and ID were positively associated with sensitivity to punishment. As revealed by the network comparison test, the network constructed among internet dependent (ID) group differed from the network constructed among internet nondependent (IND) group not only in the edges between BIS and learning burnout but also in terms of the edges associated with learning burnout. In conclusion, this study provides insights into the complex mechanisms underlying ID among adolescents from the perspective of the network relationships between core influencing factors and negative consequences. It validates the dual-system model of risky behavior among adolescents and offers a foundation for early warning and interventions for ID in this context.

Association Between Internet Addiction and Dietary Habits Among Omani Junior College Students

Objectives

This study aimed to investigate the association between internet addiction and dietary habits among Omani junior college students.

Methods

This cross-sectional study was conducted at Sultan Qaboos University, Muscat, Oman, among junior college students surveyed in November 2020. The Compulsive Internet Use Scale and a dietary habits questionnaire were used. Chi-square cross-tabulation analyses were used to explore the relationship between internet addiction and dietary habits.

Results

A total of 377 students were included in this study. Overall, 59.9% of the junior college students were identified as having an internet addiction. Within this group, 62.8% reported reduced meal sizes and 54.4% reported a decrease in appetite. There was a statistically significant difference in both meal size (X2 = 30.528; P <0.001) and appetite changes (X2 = 28.731; P <0.001) among students with different levels of internet addiction.

Conclusion

The results of this study suggest a possible link between internet addiction and altered dietary habits among this population. This study highlights the need for strategies that encourage healthy living behaviours and raise awareness about the adverse effects of internet addiction.

Lifestyle factors associated with symptoms suggestive of restless legs syndrome in Korean adolescents

OBJECTIVE

Restless legs syndrome (RLS) is a common sleep disorder among adolescents. This study aimed to investigate the lifestyle factors and sleep disturbances associated with the symptoms suggestive of RLS in Korean adolescents.

METHODS

In this cross-sectional study, we investigated a total of 25,789 adolescents (mean age, 15.8 ± 1.7 years; male, 48.5 %). The presence of symptoms suggestive of RLS was assessed with a single question about RLS in the Global Sleep Assessment Questionnaire. We performed multiple logistic regression analysis to estimate the odds ratios (ORs) and 95 % confidence intervals (CIs) of lifestyle factors and sleep disturbances that were independently associated with adolescent RLS.

RESULTS

The prevalence of RLS-suggestive symptoms was 5.1 % among adolescents. After adjustment, lifestyle factors associated with symptoms suggestive of RLS were occasional alcohol consumption (OR, 1.245; 95 % CI, 1.006-1.540) and proneness to Internet addiction (OR, 1.027; 95 % CI, 1.021-1.033). Bedtime behaviors associated with RLS-suggestive symptoms were sleeping with a doll or pet (OR, 1.194; 95 % CI, 1.032-1.381) and sleeping with a TV or radio on (OR, 1.366; 95 % CI, 1.156-1.614). Male sex, frequent snoring and witnessed apnea, perceived sleep insufficiency, excessive daytime sleepiness were also associated with RLS-suggestive symptoms in adolescents.

CONCLUSIONS

Adolescents with symptoms suggestive of RLS were associated with different lifestyle factors compared to adults with RLS. Further research is needed to determine the clinical implications of lifestyle factors in adolescent RLS.

Associations of vegetable and fruit intake, physical activity, and school bullying with depressive symptoms in secondary school students: the mediating role of internet addiction

BACKGROUND

Few studies have simultaneously focused on the associations of vegetable and fruit intake, physical activity, school bullying, and Internet addiction (IA) with depressive symptoms. This study aimed to explore the direct and indirect effects of the above factors on depressive symptoms in adolescents by constructing a structural equation model (SEM).

METHODS

This study was conducted in Qingdao from September to November 2021. A total of 6195 secondary school students aged 10-19 years were included in the analysis. Information on all variables was assessed using a self-administered questionnaire. An SEM was constructed with depressive symptoms as the endogenous latent variable, IA as the mediating variable, and vegetable and fruit intake, physical activity, and school bullying as the exogenous latent variables. The standardized path coefficients (β) were the direct effects between the latent variables, and the indirect effects were obtained by the product of direct effects between relevant latent variables.

RESULTS

The median value with the interquartile range of depressive symptom scores was 7 (3,12). Vegetable and fruit intake (β=-0.100, P<0.001) and physical activity (β=-0.140, P<0.001) were directly negatively related to depressive symptoms. While school bullying (β=0.138, P<0.001) and IA (β=0.452, P<0.001) were directly positively related to depressive symptoms. IA had the greatest impact on depressive symptoms. Vegetable and fruit intake, physical activity, and school bullying could not only directly affect depressive symptoms, but also indirectly affect depressive symptoms through the mediating effect of IA, the indirect effects and 95% confidence intervals (CIs) were -0.028 (-0.051, -0.007), -0.114 (-0.148, -0.089) and 0.095 (0.060, 0.157), respectively. The results of the multi-group analysis showed that the SEM we constructed still fit in boy and girl groups.

CONCLUSIONS

The results indicated that vegetable and fruit intake, physical activity, school bullying, and IA had a significant direct impact on depressive symptoms, among which IA had the greatest impact. In addition, both vegetable and fruit intake, school bullying, and physical activity indirectly affected depressive symptoms through the mediating effect of IA. The impact of IA on depressive symptoms should be given extra attention by schools and parents. This study provides a scientific and effective basis for the prevention and control of adolescent depressive symptoms.

Is problematic use of the Internet and smartphone predictor of unhealthy eating behaviors and abnormal body weight in Turkish young adults?

With technological progress, the use of the internet and smartphones has become an inseparable part of our lives and their use is increasing. The uncontrolled use of both the internet and smartphones is defined as problematic use. This study examined the effects of problematic internet and smartphone use on dietary behaviors and abnormal body weight status in young adults. Participants were 560 university students. Participants completed measures of demographics, dietary behaviors, internet and smartphone usage habits, Young's Internet Addiction Test and Smartphone Addiction Scale. Negative associations were found between dietary behaviors and problematic internet and smartphone use. Significant inverse associations were also found between these uses and recommended consumption levels of several food groups. For a healthy future generation, it is recommended that policies be developed to prevent or manage these problematic uses, especially in young adults with negative dietary behaviors and abnormal body weight.

Relationship between fruit and vegetable consumption and internet addiction with insomnia and depression as multiple mediators during the COVID-19 pandemic: a three-wave longitudinal study in Chinese college students

BACKGROUND

The relationships between fruit and vegetable consumption (FV) and Internet addiction (IA) in college students still remained unknown together with the internal mechanisms. Given the limitations of previous cross-sectional design, longitudinal research was necessary to be conducted to explore more precise correlations. Using the three-wave data in a longitudinal design, this study aimed to explore the association between FV and IA among Chinese college students and potential multiple mediators of insomnia and depression during the COVID-19 pandemic.

METHODS

A total of 579 college students were recruited during three waves (T1: August 2020; T2: November 2020; T3: February 2021). FV (T1), insomnia (T2), depression (T2) and IA (T3) symptoms were reported. The descriptive statistics of the sociodemographic characteristics and correlation analyses of the study variables were calculated. The significance of the mediation effects was measured conducting a bootstrap method with SPSS PROCESS macro.

RESULTS

FV was negatively correlated with IA, and lower FV predicted higher risk of IA. Depression mediated the association between FV and subsequent IA. Insomnia and depression were multiple mediators, which in turn mediated the links between FV and subsequent IA.

CONCLUSIONS

The three-wave longitudinal study has revealed that FV had indirect effects on IA through individual mediating factor of depression and multiple mediating roles of insomnia and depression sequentially. The policy makers, educators and researchers should pay attention to the impact of the interventions from healthy diet, in order to optimize the coping strategies for preventing college students from IA.

Association between internet addiction, brain structure, and social capital in adolescents

Of late, internet addiction among adolescents has become a serious problem, with increased internet use. Previous research suggests that the more people become addicted to the internet, the more they isolate themselves from society. Conversely, it has been suggested that abundant social capital (the networks of relationships among people who live and work in a particular society) protects people from becoming addicted to the internet. This study focused on the brain structure of typical adolescents (10-18 years of age) and hypothesized that the size of the left dorsolateral prefrontal cortex (DLPFC), which is thought to be associated with self-control ability, is associated with both internet addiction and social capital. Voxel-based morphometry analysis indicated that left DLPFC volume was negatively correlated with the severity of internet addiction and positively correlated with social capital. Furthermore, correlation analysis demonstrated that the severity of internet addiction and social capital were negatively correlated. The statistical association between them was no longer significant when left DLPFC volume was used as a control variable. These results suggest that the left DLPFC may mediate the relationship between social capital and internet addiction in adolescents.

The Degree of Problematic Technology Use Negatively Affects Physical Activity Level, Adherence to Mediterranean Diet and Psychological State of Adolescents

The previous scientific literature has shown how detrimental addictive internet and mobile phone use can be for the adolescent population. However, little is known about their influence on the physical activity, kinanthropometry and body composition, nutrition patterns, psychological state, and physical fitness of this population. For this reason, the objectives of this research were (a) to determine the differences in the physical activity level, kinanthropometric and body composition variables, adherence to Mediterranean diet (AMD), psychological state, and physical fitness according to gender and different levels of problematic use of the internet and mobile phones; and (b) to establish the differences in the physical activity level, kinanthropometric and body composition variables, AMD, psychological state, and physical fitness among adolescents when considering problematic use of the internet and mobile phones in combination. The sample consisted of 791 adolescent males and females between 12 and 16 years of age (1st to 4th course) from four compulsory secondary schools (404 males and 387 females; mean age: 14.39 ± 1.26 years-old; mean height: 163.47 ± 8.94 cm; mean body mass: 57.32 ± 13.35 kg; mean BMI: 21.36 ± 3.96 kg/m²). The physical activity level (baseline score: 2.64 ± 0.67), kinanthropometric variables and body composition, AMD (baseline score: 6.48 ± 2.48), psychological state (baseline life satisfaction: 17.73 ± 4.83; competence: 26.48 ± 7.54; autonomy: 25.37 ± 6.73; relatedness: 24.45 ± 6.54), and physical condition variables were measured. The results showed that adolescent males and females with problematic internet and/or mobile phone use presented a worse psychological state, but it is especially relevant to highlight that females also had a lower level of physical activity and AMD, with problematic mobile phone use being especially relevant, mainly in the psychological state of adolescents. In conclusion, problematic use of the internet and mobile phones can have detrimental effects on the level of physical activity, AMD, and psychological state of adolescents, with the differences found in females being particularly relevant.

Relationship between smartphone addiction and eating disorders and lifestyle among Chinese college students

Purpose

Smartphone addiction has been a matter of serious concern among society and parents because of its high incidence and serious negative effects. This study aimed to determine the association between smartphone addiction and eating disorders and lifestyle changes among college students.

Methods

The present article is a descriptive, cross-sectional study involving 1,112 college students from several universities in Chengdu, China. The data were collected by using the Chinese version of the Mobile Phone Addiction Index (MPAI) and the Eating Attitudes Test-26 (EAT-26). In addition, the information on sociodemographic, lifestyle, and smartphone use were obtained through a self-administered questionnaire.

Results

The prevalence of smartphone addiction among the students involved in the study was 22.6%, of which 10.4% were at risk for eating disorders. Female students had higher MPAI scores and EAT-26 scores than male students (p < 0.001). The proportion of male students with a risk of eating disorders was significantly higher than that of female students (p < 0.05). The total EAT-26 scores of students with smartphone addiction were higher than that of others (p < 0.001). The correlation analysis indicated that the MPAI scores were significantly positively correlated with the EAT-26 scores, depression and anxiety, difficulty in falling asleep at night, the frequency of eating fast food and drinking carbonated soft drink (p < 0.01). In addition, the MPAI scores were significantly negatively correlated with skipping breakfast and the frequency of physical activity (p < 0.05).

Conclusion

Smartphone addiction is significantly associated with eating disorders, eating habits, and lifestyle. The influence of dietary habits and lifestyle needs to be considered for the prevention and development of an intervention for smartphone addiction among college students.

The effect of time spent sitting and excessive gaming on the weight status, and perceived weight stigma among Taiwanese young adults

Background

During the COVID-19 pandemic, physical inactivity and sedentary behaviors (i.e., longer sitting time and excessive gaming) increased because governments across the globe adopted stringent mitigation strategies such as social distancing and lockdowns to curb the spread of the virus. Excessive gaming was one of the coping mechanisms used to deal with the pressure associated with the pandemic. Moreover, perceived weight stigma (PWS) and weight status became more salient concerns among young adults during the COVID-19 pandemic. The current study sought to investigate the relationship between time spent sitting, excessive gaming, weight status, and PWS of Taiwanese Young adults. Additionally, weight status and PWS were examined as mediators between both sedentary behaviors.

Methods

This cross-sectional study involved 600 participants who were recruited through Taiwan universities. All participants completed a demographic questionnaire (including weight and height) and self-report measures including the International Physical Activity Questionnaire short form (IPAQ-SF), the Perceived Weight Stigma Scale (PWSS), and the Internet Gaming Disorder Scale-short form (IGDS9-SF). PROCESS model was performed to test the potential mediation roles of weight status and PWS. Moreover, we categorized participants into two groups based on the sitting-time item in the IPAQ-SF: students whose sitting time was less than 8 h daily, and those more than 8 h daily.

Results

The group that had less than 8 h had significantly higher PWS and IGDS9-SF scores than the other group. Sitting time was negatively associated with weight status, PWS, and IGDS9-SF. Additionally, we found a significantly direct effect between time spent sitting and excessive gaming. Both weight status and PWS were significant mediators in the association between time spent sitting and excessive gaming.Conclusions: The present study demonstrated important negative correlates of excessive sedentary behaviors. Prevention efforts should focus on promoting physical activity and providing information to decrease sedentary behavior among university students.

Unpacking the relation between children's use of digital technologies and children's well-being: A scoping review

Over the last decade, a substantial number of studies have addressed children's use of technologies and their impact on well-being. Nonetheless, there is still a lack of clarity on the operationalisation of technology use, well-being, and the relation between the two. This scoping review intended to shed lights on Digital Technologies Use, its operationalisation, and the relation between Digital Technologies Negative Use (DTNU) and children's well-being. For the scope of the special issue we focused on negative use. Results showed two conceptualisations of DTNU: compulsive/addictive use of devices and the Internet (e.g., Internet addiction) and negative online experiences/risky behaviours (e.g., cyberbullying). Well-being in relation to DTNU was mainly studied in terms of psycho/social dimensions (e.g., depression), and a gap in cognitive well-being studies was identified. Study designs were largely quantitative, and, in most studies, well-being was considered as a predictor of DTNU. Also, research with children under 12 years was lacking. Future research on DTNU should look at: how dimensions of addiction and negative online experiences relate; provide more evidence on cognitive well-being; explore the interplay of well-being multiple components relying on integrative conceptual frameworks. The recent notion of digital well-being should also be explored considering the results of this review.

Cascading bidirectional influences of digital media use and mental health in adolescence

A substantial portion of critical adolescent development is occurring within digital environments. However, certain individual differences may lead adolescents to use digital media in diverse ways. In this chapter we suggest that the way teens use digital media influences how digital media affects their mental health. Further, we propose a model in which these influences, in the context of ongoing development, may have feedback effects on how digital media is subsequently used, thus resulting in a self-perpetuating cycle. Our model suggests that certain developmental risk/protective factors and maladaptive/adaptive digital media behaviors likely perpetuate each other in a cyclical manner each serving to maintain and/or escalate the other. We discuss existing evidence of these processes in psychosocial, identity, incentive processing, and physical health development. Future research focusing on individual differences and self-reinforcing digital media behaviors that manifest these feedback loops may portray a more complete picture of cascading digital media influences across adolescent development.

The Association of Internet Use Intensity and Lifestyle Behaviors During the COVID-19 Pandemic: A Cross-Sectional Study in Chinese Adults

The COVID-19 pandemic substantially increased the intensity of internet use in humans, which has made public opinion around health and public perceptions of it more vital, and this phenomenon has had a significant impact on human lifestyle behavior. This study used cross-sectional data during the COVID-19 pandemic to explore how internet use intensity influenced lifestyle behaviors among adults, and compared the differences between samples of different ages. The findings showed that the internet use intensity among adults increased the probability of physical activity, staying up late, and high-quality eating behaviors, and that they had a statistically significant positive association. Such associations were also found in independent younger, middle-aged, and older samples. However, the internet use intensity elevated the probability of body weight gain only in the independent samples of younger, middle-aged, and older adults. Besides, internet use intensity was able to increase the probability of smoking & drinking only among the younger sample. Notably, the effect of internet use intensity on lifestyle behaviors, including body weight gain, physical activity, staying up late, and a high-quality diet, was strongest among the elderly, followed by the middle-aged, and weakest among the younger. In the process of rural and urban governance regarding citizens' health, public health agencies should remind citizens to spend a reasonable amount of time on internet use to reduce the probability of unhealthy lifestyle behaviors and improve their physical health.

Association between urbanization and Internet addiction

PURPOSE OF REVIEW

Understanding the association between urbanization and Internet addiction is essential to the design and implementation of Internet addiction prevention measures in urban areas. This epidemiological review explores the urbanization-Internet addiction association and its potential underlying factors.

RECENT FINDINGS

Nine studies have reported that Internet addiction prevalence is higher in urban areas, but three studies have noted the opposite. Psychiatric disorders and stress are the most commonly mentioned factors underlying the association. The effects of urbanization on Internet availability, Internet cafes, online gaming, outdoor or interactive activities, and family regulation and monitoring have been suggested to lead to higher Internet addiction risk. The ongoing COVID-19 pandemic, obesity, sleep problems, and the migration of parents to urban areas in search of work have strengthened the effect of urbanization on Internet addiction.

SUMMARY

Early assessment and treatment provided by mental health services are crucial for mitigating the effect of urbanization on Internet addiction risk. Cities should be designed to provide adequate space for physical and interactive activities. To promote outdoor activities, air pollution, traffic congestion, and crime should be controlled. Prospective face-to-face studies involving analysis of data on pollution, traffic, and Internet addiction could provide evidence to elucidate the urbanization- Internet addiction association.

Association between Self-Perceived Periodic Limb Movement during Sleep and Excessive Daytime Sleepiness Depend on Restless Leg Symptoms in Korean Adolescents

Although periodic limb movement during sleep (PLMS) and restless legs syndrome (RLS) are common in children and adolescents, they are relatively overlooked as a target of treatment. PLMS has been evaluated as having a lower clinical significance than RLS. This study examined the relationship of socio-behavioral factors of PLMS in Korean adolescents and checked whether PLMS is associated with excessive daytime sleepiness (EDS), depending on whether restless legs symptoms accompany it. In a cross-sectional study, 25,789 adolescents between 12 and 18 years of age (15.76 ± 1.73 years; female 51.49%) were evaluated using an online survey. Various self-report questionnaires were used to assess PLMS and RLS symptoms, EDS, sleep habits, and various socio-behavioral factors. The prevalence of self-perceived PLMS and restless legs symptoms were 903 (3.50%) and 1311 (5.08%), respectively. Of the 1311 participants, 399 had self-perceived PLMS. The odds ratios (ORs) for self-perceived PLMS in participants with restless legs symptoms were: males (OR = 1.528; 95% CI: 1.145–2.040), usually/always experienced apnea apnea (OR, 3.006; 95% CI, 1.954–4.624), increased proneness to Internet addiction (OR = 1.013; 95% CI: 1.001–1.025), sometimes/often consuming coffee (OR = 1.312; 95% CI: 1.015–1.695), EDS (OR = 0.826; 95% CI: 0.488–1.398), and perceived insufficient sleep (OR = 1.143; 95% CI: 0.835–1.565). The male gender, witness apnea, consuming coffee, and being prone to Internet addiction were identified as factors significantly associated with self-perceived PLMS in participants with restless legs symptoms. However, EDS and insufficient sleep were associated with self-perceived PLMS in the absence of restless legs symptoms.

Cingulate circuits are associated with escalation of heroin use and naloxone-induced increases in heroin self-administration

Opioid use disorder (OUD) is defined as a compulsion to seek and take opioids, loss of control over intake and the development of a negative emotional state when access to opioids is denied. Using functional magnetic resonance imaging (fMRI) data in a rat model of OUD, we demonstrate that the escalation of heroin self-administration (SA) and the increased heroin SA following an injection of an opioid receptor antagonist (naloxone) are associated with changes in distinct brain circuits, centered on the cingulate cortex (Cg). Here, SA escalation score was negatively associated with changes in resting state functional connectivity (rsFC) between the Cg and the dorsal striatum. Conversely, increased heroin SA following naloxone injection, was associated with increased connectivity between the Cg and the extended amygdala and hypothalamus. Naloxone-induced increased SA was also positively associated with changes in the amplitude of low frequency fluctuations within the Cg, a measure of spontaneous neuronal activity. Characterizing the distinct brain circuit and behavior changes associated with different facets of addiction increases our understanding of OUD and may provide insight into addiction prevention and treatment.

Children and adolescents' positive youth development qualities and internet addiction during the COVID-19 pandemic: A longitudinal study in China

BACKGROUNDS

Recent studies have shown that the qualities of children and adolescents' positive youth development (PYD) enable them to cope with developmental challenges in an adaptive manner and maintain healthy functioning. During the COVID-19 pandemic, there is still a lack of reporting on changes in children and adolescents' PYD qualities and Internet addiction and their relationship. This study investigated the association between PYD qualities and Internet addiction among the children and adolescents who have experienced the COVID-19 lockdown.

METHODS

A school-based cohort survey was launched in December 2019 (Wave 1, before COVID-19 lockdown) and followed up in June 2020 (Wave 2, after COVID-19 lockdown). The Chinese PYD scale (80 items, scoring 80-480) and Young's Internet addiction test (20 items, scoring 20-100) were used to evaluate the children and adolescents' PYD qualities and the degree of their Internet addiction, respectively. Cross-sectional regressions, longitudinal regressions, and cross-lagged panel model were used to examine the association between PYD qualities and Internet addiction.

RESULTS

7,985 children and adolescents completed both waves of surveys. Compared with children and adolescents before lockdown (Wave 1), their total PYD quality dropped from 4.99 to 4.96 after COVID-19 lockdown (Wave 2), and the mean score for Internet addiction rose from 35.56 to 36.16. Cross-sectional analysis showed that after controlling for basic characteristics such as age and gender, the total PYD quality of children and adolescents in two waves was negatively correlated with the degree of Internet addiction during the same period, with β of -6.10 and -6.95, respectively. Longitudinal analysis showed that after controlling for basic characteristics, children and adolescents' total PYD quality in Wave 1 was negatively correlated with the Wave 2 of Internet addiction and the change between the two waves of Internet addiction, with β of -3.35 and -0.26, respectively. Cross-lagged panel models showed a negative bilateral relationship between total PYD quality and Internet addiction.

CONCLUSION

During the COVID-19 pandemic, the qualities of children and adolescents' PYD declined, which makes children and adolescents more vulnerable to Internet addiction. Therefore, it is necessary to widely implement programs in China that can comprehensively improve the qualities of children and adolescents' positive development to prevent Internet addiction, especially after the blockade due to public health emergencies.

Nutritional Behaviors, Health Literacy, and Health Locus of Control of Secondary Schoolers in Southern Poland: A Cross-Sectional Study

Nutritional behaviors remain an essential part of a healthy lifestyle. It seems obvious that unfavorable health behaviors adopted in adolescence are maintained late in adulthood and may have a profound effect on health status. The main aim of this study was to assess the association between nutritional behaviors and health literacy (HL), health locus of control (HLC), and socioeconomic variables in secondary school pupils from a voivodship (the main unit of territorial division) in southern Poland. The analysis was based on dataTable from a paper-and-pencil survey taken by 2223 pupils from schools selected as the result of cluster sampling. The survey questionnaire encompassed a set of five items asking about dietary patterns and the consumption of fruit and vegetables as well as fast food, a European Health Literacy Project Questionnaire consisting of 47 items, the Multidimensional Health Locus of Control (MHLC) scale, and items asking about sociodemographic and economic variables. Uni- and multivariate logistic regression models have been developed to assess the predictors of indicator nutrition behaviors. The adjusted models revealed that internal HLC was not significantly associated with any of analyzed nutritional behaviors. “Powerful other HLC” and “Chance HLC” (dimension of external HLC) were significant predictors of the selected dietary patterns. Furthermore, higher HL was associated with higher consumption of fruit and vegetables [odds ratio, 95% confidence interval (OR, 95% CI)]: 1.02 (1.01–1.04) and with lower consumption of fast food (OR, 95% CI, 0.98, 0.95–0.999). There was a significant relationship between gender, the size of the household, self-assessed economic situation, expenditures on mobile phones, and weekly duration of Internet use and selected nutrition behaviors. In conclusion, developed regression models confirmed a significant relationship between HL and the types of consumed food, but not with dieting patterns. Contrary to earlier studies, internal HLC was not associated with nutrition behaviors. In our study, boys showed more favorable nutritional behaviors than girls. More intense use of the Internet was associated with less beneficial nutritional behaviors. This study brings important results that should have an impact on health promotion interventions addressed to adolescents in southern Poland.

Leisure-time and study-time Internet use and dietary risk factors in Korean adolescents

BACKGROUND

Prolonged screen time is associated with an increased risk of obesity in adolescents. However, little is known about whether Internet use is also associated with dietary risk factors including consumption of obesogenic foods.

OBJECTIVES

In this study, we examined the associations of leisure-time and study-time Internet use with dietary risk factors in Korean adolescents using nationally representative survey data.

METHODS

We conducted a cross-sectional analysis among 54,416 middle and high school students in the Korea Youth Risk Behavior Web-based Survey 2015. Participants were asked to report the average duration of leisure-time and study-time Internet use, days of skipping breakfast, and frequency of fruit, vegetable, instant noodle, fast-food, chip/cracker, and sugar-sweetened beverage (SSB) intakes. We performed multivariable logistic regression to estimate ORs and 95% CIs for the relations between duration of Internet use and dietary risk factors, accounting for complex survey sampling and adjusting for potential confounders.

RESULTS

Prolonged leisure-time Internet use (≥241 compared with 1-60 min/d) was associated with higher prevalence of frequent skipping breakfast (OR: 1.39; 95% CI: 1.29, 1.49), low intakes of fruits (OR: 1.27; 95% CI: 1.18, 1.36) and vegetables (OR: 1.43; 95% CI: 1.33, 1.55), and high intakes of instant noodles (OR: 1.87; 95% CI: 1.74, 2.02), fast-food (OR: 1.63; 95% CI: 1.49, 1.78), chips/crackers (OR: 1.37; 95% CI: 1.24, 1.52), and SSBs (OR: 1.63; 95% CI: 1.52, 1.75). Prolonged study-time Internet use (≥121 compared with 1-60 min/d) was inversely associated with prevalence of low fruit (OR: 0.94; 95% CI: 0.88, 1.00) and vegetable (OR: 0.91; 95% CI: 0.85, 0.98) intakes but was positively associated with high intakes of instant noodles (OR: 1.10; 95% CI: 1.03, 1.19) and chips/crackers (OR: 1.13; 95% CI: 1.04, 1.23). The overall associations remained consistent in analyses stratified by sex, grade, region, parental co-residence, perceived household income, perceived stress level, physical activity, and obesity status.

CONCLUSIONS

Our data suggest that prolonged Internet use, particularly during leisure time, is associated with less healthful dietary behaviors in Korean adolescents.

Depression Mediates the Relationship between Childhood Trauma and Internet Addiction in Female but Not Male Chinese Adolescents and Young Adults

Internet addiction is associated with a range of psychological risk factors such as childhood trauma and depression. Studies have also suggested sex differences in internet and other behavioral addictions. However, it remains unclear how childhood trauma, depression and internet addiction inter-relate differently between the sexes. A total of 1749 adolescents and young adults aged 12–27 participated in a survey of sociodemographic characteristics and standardized assessments to evaluate internet addiction (Internet Addiction Test), childhood trauma (Childhood Trauma Questionnaire) and depression (Beck Depression Inventory). Mediation and path analyses were used to examine the relationship between childhood trauma, depression and internet addiction. Internet-addicted females relative to males showed more severe depression but the control participants showed the opposite. Childhood trauma was associated with depression for both internet-addicted males and females; however, internet-addicted females but not males showed significant associations between depression and the severity of internet addiction as well as between childhood trauma and the severity of internet addiction. Further, in females, depression mediated the correlations between all types of childhood trauma and the severity of internet addiction. A path analysis suggested that sexual abuse and emotional neglect contributed most significantly to internet addiction when all types of childhood trauma were examined in one model. The findings suggest sex differences in the relationship between childhood trauma, depression and internet addiction. Childhood trauma contributes to internet addiction through depression only in females. The findings may guide future prevention and intervention strategies of internet addiction.

Prevalence of Internet Addiction and Its Relationship With Combinations of Physical Activity and Screen-Based Sedentary Behavior Among Adolescents in China

BACKGROUND

Given the widespread prevalence and serious nature of Internet addiction (IA), this study aimed to estimate the prevalence of IA and assess the relationships between IA and combinations of physical activity (PA) and screen-based sedentary behavior (SB) among adolescents in China.

METHODS

This cross-sectional study surveyed 31,954 adolescents in grades 7 to 12 in Beijing. IA, PA, screen-based SB, and other information were obtained from a self-administrated questionnaire. The chi-square test and mixed-effects logistic regression model were applied to estimate the relationship between IA and combinations of PA and screen-based SB.

RESULTS

6.2% of the surveyed adolescents reported IA and the prevalence of low PA/high screen-based SB, high PA/high screen-based SB, low PA/low screen-based SB, and high PA/low screen-based SB were 53.7%, 19.5%, 18.8%, and 8.0%, respectively. Mixed-effects logistic regression analysis showed that adolescents with low PA/high screen-based SB were 1.99 (95% confidence interval, 1.62-2.44, P < .001) times more likely to prefer IA than those with high PA/low screen-based SB.

CONCLUSIONS

The prevalence of IA among Chinese adolescents is still high. Intervention programs like maintaining sufficient PA and reducing screen-based SB might contribute to reducing their IA.