Prevalence of Smartphone Addiction in Patients with Depression and Its Association with Depression Severity: a Cross-sectional Study

Predictors of smartphone addiction in adolescents with depression: combing the machine learning and moderated mediation model approach

Smartphone addiction (SA) significantly impacts the physical and mental health of adolescents, and can further exacerbate existing mental health issues in those with depression. However, fewer studies have focused on the predictors of SA in adolescents with depression. This study employs machine learning methods to identify key risk factors for SA, using the interpretable SHapley Additive exPlanations (SHAP) method to enhance interpretability. Additionally, by constructing a mediation moderation model, the interactions between significant risk factors are analyzed. The study included 2203 adolescents with depression. Machine learning results from four models (Random Forest, Support Vector Machine, Logistic Regression, XGBoost) consistently identified emotion-focused coping, rumination, and school bullying as the strongest predictors of SA. Further mediation moderation analyses based on the Interaction of Person-Affect-Cognition-Execution (I-PACE) model revealed that rumination significantly mediated the relationship between school bullying and SA, and emotion-focused coping significantly moderated the relationships between school bullying and both rumination and SA. This is the first study to use machine learning to explore the predictors of SA in depressive adolescents and further analyze the interactions among these predictors. Future interventions for SA in adolescents with depression may benefit from psychotherapy that addresses emotion-focused coping and rumination.

Online Captive: The Impact of Social Media Addiction on Depression and Anxiety-An SEM Approach to the Mediating Role of Self-Esteem and the Moderating Effects of Age and Professional Status

In the "era" in which social networks have become an integral part of everyday life, this study aims to analyze the impact of social network addiction on mental health, with a focus on the manifestation of anxiety and depression symptoms. The relationship analyzed on a batch of a Romanian adult population, explained by self-esteem and influenced by factors such as age and professional status, highlights the fact that all age categories and professional status can be affected by addiction to the online environment but with different degrees of intensity. The analyses carried out using Structural Equation Modeling (SEM) suggest that young people and professionally inactive people are the categories with the highest degree of self-esteem impairment and with a high potential to manifest symptoms associated with depression and anxiety disorders, as a result of the intense use of social networks. The current study makes a significant contribution to the specialized literature, given the small volume of similar studies conducted on the adult population of Romania.

The relationship between childhood trauma and internet addiction in adolescents with depression: the mediating role of insomnia and alexithymia

BACKGROUND

The correlation between depressive symptoms and internet addiction in adolescents is strengthened, and childhood trauma is an important predictor of internet addiction. However, the mechanism of childhood trauma on internet addiction in adolescents with depression remains unclear. This study investigates the current status and factors influencing internet addiction in adolescents with depression and further examines whether insomnia and alexithymia mediate childhood trauma and internet addiction in adolescents with depression.

METHODS

This study investigated 300 adolescent patients in 7 hospitals in Anhui province. General demographic characteristics such as age and gender were collected. The clinical characteristics of the patients were measured using the Childhood Trauma Questionnaire Short Form (CTQ-SF), Internet Addiction Test (IAT), Insomnia Severity Index (ISI) and 20-item Toronto Alexithymia Scale (TAS-20). PROCESS (Model 4) was used to examine the mediating effects of insomnia and alexithymia.

RESULTS

The prevalence of internet addiction among adolescents with depression was 50.2%. There were statistically significant differences between the internet addiction group and the non-internet addiction group in terms of relationships with classmates, relationships with teachers, family relations, and economic status. The total score of CTQ and its five subscale scores were significantly and positively correlated with the total score of IAT. Insomnia and externally oriented thinking (EOT) played a significant mediating role in the effect of physical neglect (PN) on internet addiction.

CONCLUSION

Insomnia and alexithymia play a significant mediating role between childhood trauma and internet addiction in adolescents with depression, which expand the existing understanding of internet addiction in adolescents with depression, and provide some theoretical references to address the problem of internet addiction in adolescents with depression and prevent the development of adolescent depression.

The mediation and interaction effects of Internet addiction in the association between family functioning and depressive symptoms among adolescents: A four-way decomposition

INTRODUCTION

Previous studies have demonstrated that both family dysfunction and internet addiction (IA) are associated with a higher risk of adolescent depression. However, no study has yet investigated the mechanisms involved. This study aims to explore the mediation and interaction roles of internet addiction (IA) between family functioning and depressive symptoms among adolescents in rural China.

METHODS

A multi-stage, stratified cluster, and random sampling was conducted among 3343 adolescents in rural China from October 27 to November 6, 2020. Depressive symptoms, IA, and family functioning were assessed using the Epidemiologic Studies Depression Scale (CESD), the Internet Addiction Test (IAT), and the Family Adaptation Partnership Growth Affection and Resolve Index (APGAR), respectively. Correlation analysis was performed by binary logistic regression. The study employed a four-way decomposition method to explore the potential mechanisms of family functioning on depressive symptoms.

RESULTS

The results indicated that family functioning and IA were associated with adolescents' depressive symptoms. The interaction between family functioning and IA accounted for 74 % of the association between family functioning and depression symptoms, while direct effects accounted for 24 %. The "proportion eliminated" (76.11 %) was substantially larger than "proportion mediated" (7.36 %).

LIMITATIONS

The cross-sectional design limited to identify the causal relationship among the variables.

CONCLUSIONS

We found that family dysfunction synergizes with IA to contribute to the high risk of adolescent depression. Prioritizing at preventing IA in adolescence could be an effective way to mitigate the adverse effects of family dysfunction on depression.

Depression and internet addiction among adolescents:A meta-analysis

Depression and Internet addiction (IA) are both prevalent and burdensome in adolescents. Findings on the relationship between depression and IA remain equivocal, and we therefore conducted a meta-analysis to confirm their correlation. We searched for relevant studies, with the last search being conducted on November 10, 2022. Adolescents aged 10 to 24 reported objectively measured depression and IA using scales that have been used worldwide and are valid. Random effect models were used to produce combined odds ratios (OR) and coefficient of regression (β) We included 42 studies presenting data from 102,769 participants. The meta-analysis confirmed that depression is positively correlated with IA and vice versa. Adolescents with depressive disorders were found to have a higher risk of IA. Adolescents with IA were found to have a higher risk of depressive disorders. In addition, IA had a stronger effect on depression risk. Screening for Internet addiction in depressed adolescents is recommended at initial diagnosis and follow-up. Similarly, Internet addicts should be screened regularly for depression.

Internet addiction and residual depressive symptoms among clinically stable adolescents with major psychiatric disorders during the COVID-19 pandemic: a network analysis perspective

To assess the inter-relationships between residual depressive symptoms (RDS) and Internet addiction (IA) using network analysis among clinically stable adolescents with major psychiatric disorders during the COVID-19 pandemic. RDS and IA were assessed using the Patient Health Questionnaire-9 (PHQ-9) and the Internet Addiction Test (IAT), respectively. Central symptoms and bridge symptoms in the network model were examined. A total of 1,454 adolescents met the study criteria and were included in the analyses. The prevalence of IA was 31.2% (95% CI: 28.8%-33.6%). In the network analysis, the nodes IAT15 ("Preoccupation with the Internet"), PHQ2 ("Sad mood"), and PHQ1 ("Anhedonia") were the most central symptoms in the IA-RDS network model. Bridge symptoms included IAT10 ("Sooth disturbing about your Internet use"), PHQ9 ("Suicide ideation"), and IAT3 ("Prefer the excitement online to the time with others"). Additionally, PHQ2 ("Sad mood") was the main node linking "Anhedonia" to other IA clusters. Internet addiction was common among clinically stable adolescents with major psychiatric disorders during the COVID-19 pandemic. Core and bridge symptoms identified in this study could be prioritized as targets for the prevention and treatment of IA in this population.

Relationships between cervical sagittal posture, muscle endurance, joint position sense, range of motion and level of smartphone addiction

BACKGROUND

Frequent smartphone use in a pathological way forces the user to adopt a compromised posture. This gradually results in changes to both the postural and musculoskeletal systems. This study's objectives were evaluation of head posture, muscle endurance, neck range of motion (ROM) and joint position sense in two separate smartphone user groups, one 'Addicted', the other 'Non-Addicted'.

METHODS

A sample of convenience (n = 60) was recruited from medical students (age 24.57 ± 4.38, 53.3% male) with a history of smartphones use > 2 h/day for 1-year. Based on the cut-off values of the smartphone addiction scale-short version (SAS-SV), participants were entered into each group (cut-off for male ≥ 31, female ≥ 33). Neck muscle endurance time, joint position error and cervical ROM, along with forward head posture parameters of craniovertebral angle (CVA), shoulder angle (SA), sagittal head angle (SHA) and forward head distance (FHD)) were evaluated. A Mann-Whitney test and Spearman correlation coefficient were used to determine the difference between groups and the correlations between variables.

RESULTS

The difference between 'Addicted' and 'Non-Addicted' groups was confirmed by the values for SAS-SV scores (25.23 ± 5.5 versus 43.9 ± 6.61) (p < 0.001). There were statistically significant differences between groups for the CVA and FHD parameters (p < 0.001). Further, the neck extensor muscle endurance (97 ± 3.79 versus 74.86 ± 2.23 s), was significantly different between groups (p = 0.010) but not after Bonferroni correction. There was no notable difference in the neck flexor muscle endurance, joint position error, SA, and SHA parameters between groups (p > 0.05).

CONCLUSIONS

There is a positive correlation between smartphone addiction and both decreased extensor muscle endurance and changes in neck postural alignment.

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

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

Internet addiction and its association with quality of life in patients with major depressive disorder: a network perspective

Depressive disorders and internet addiction (IA) are often comorbid. The aims of this study were to examine the network structure of IA in patients with major depressive disorders (MDD) and explore the association between IA and quality of life (QoL) in this population. This was a multicenter, cross-sectional survey. IA and QoL were assessed with the Internet Addiction Test (IAT) and the World Health Organization Quality of Life-brief version, respectively. Node expected influence (EI) was used to identify central symptoms in the network model, while the flow network of QoL was generated to examine its association with IA. A total of 1,657 patients with MDD was included. "Preoccupation with the Internet," "Job performance or productivity suffer because of the Internet," and "Neglect chores to spend more time online" were central symptoms. The symptom "Form new relationships with online users" had the strongest direct positive relation with QoL, while "Spend more time online over going out with others" and "Job performance or productivity suffer because of the Internet" had the strongest direct negative relations with QoL. Neglecting work caused by IA correlated with QoL, while making friends online appropriately was related to better QoL among MDD patients. Appropriate interventions targeting the central symptoms may potentially prevent or reduce the risk of IA in MDD patients.

Mapping network connectivity between internet addiction and residual depressive symptoms in patients with depression

BACKGROUND AND AIMS

Depression often triggers addictive behaviors such as Internet addiction. In this network analysis study, we assessed the association between Internet addiction and residual depressive symptoms in patients suffering from clinically stable recurrent depressive disorder (depression hereafter).

MATERIALS AND METHODS

In total, 1,267 depressed patients were included. Internet addiction and residual depressive symptoms were measured using the Internet Addiction Test (IAT) and the two-item Patient Health Questionnaire (PHQ-2), respectively. Central symptoms and bridge symptoms were identified via centrality indices. Network stability was examined using the case-dropping procedure.

RESULTS

The prevalence of IA within this sample was 27.2% (95% CI: 24.7-29.6%) based on the IAT cutoff of 50. IAT15 ("Preoccupation with the Internet"), IAT13 ("Snap or act annoyed if bothered without being online") and IAT2 ("Neglect chores to spend more time online") were the most central nodes in the network model. Additionally, bridge symptoms included the node PHQ1 ("Anhedonia"), followed by PHQ2 ("Sad mood") and IAT3 ("Prefer the excitement online to the time with others"). There was no gender difference in the network structure.

CONCLUSION

Both key central and bridge symptoms found in the network analysis could be potentially targeted in prevention and treatment for depressed patients with comorbid Internet addiction and residual depressive symptoms.

Are Malaysian Youths Overdependent on the Internet?: A Narrative Review

Overdependence on the internet is a grave concern that has enveloped Malaysian youths which could lead to a variety of sequelae. This narrative review aims to determine the definition of internet overdependence and its associated factors, as well as the potential preventive and treatment strategies for internet overdependence. From the literature, internet overdependence is regarded as a 3-factor model encompassing salience, self-control failure, and serious consequences. Sociodemographic factors such as age, gender, and ethnicity, as well as psychosocial factors such as depression, anxiety, stress, and loneliness, were found to be associated with internet overdependence among Malaysian youths. A multimodal treatment approach is recommended by the implementation of various types of treatments, integrating disciplines such as pharmacology, psychotherapy, and family counseling. Despite various terminologies being used and unclear conceptualization of its nomenclature, overdependence on the internet is prevalent among youths in Malaysia. Future research should go toward establishing a clear definition of its terminology and attaining more robust evidence on treatment strategies.