Internet addiction and child physical and mental health: Evidence from panel dataset in China

IS THERE A CORRELATION BETWEEN OBJECTIVE AND SUBJECTIVE METHODS TO ASSESS DENTAL ANXIETY? A SYSTEMATIC REVIEW AND META-ANALYSIS

OBJECTIVE

To assess the evidence about the correlation between objective and subjective methods for evaluating dental anxiety.

METHODS

Eligibility criteria were defined as follows: Patients (P): individuals in the dental care context; Index test (I): subjective methods; Reference test (R): objective methods; Outcome (O): correlation between methods to dental anxiety evaluation. Searches were conducted in 7 databases and grey literature up to November 2023, without language or date restrictions. The QUADAS-2 tool was employed to evaluate Risk of bias. A random-effects meta-analysis was performed to calculate pooled correlation coefficients between methods on the basis of the objective method analyzed. The GRADE approach was utilized to assess evidence certainty.

RESULTS

A total of 29 studies, with 1891 participants aged 3 to 82 years, were included, with 22 studies participating in the meta-analysis. The Risk of bias was mostly "unclear" due to inadequate methodology detail. Weak correlations were observed between subjective methods and heart rate (r 0.15 [0.08, 0.21], P < .001, I2 = 56%) and alpha-amylase (r 0.25 [0.11, 0.38], P < .001, I2 = 43%. Subjective methods showed a moderate correlation with cortisol analysis (r 0.40 [0.33, 0.47] P < .001, I2 = 72%). No other objective method displayed a significant correlation with subjective methods. The certainty of evidence was very low.

CONCLUSION

The findings can suggest a correlation between the following subjective and objective methods: ACDAS, DAS, MCDAS, MDAS and Cortisol; CFSS-DS, DAS, MCDAS, MDAS and Alpha-amylase; and DAS, DAS-R, MDAS, S-DAI, Venham Picture Anxiety, Venham Picture Test and Heart rate. Nonetheless, these results lack conclusiveness due to their very low certainty of evidence.

REGISTRATION

PROSPERO database registration number CRD42022298589.

Effects of rural-to-urban migration on healthcare utilization of middle-aged and older adults: evidence from the China health and retirement longitudinal study

Background

An increasing number of middle-aged and older adults are migrating from rural to urban areas for employment, to care for their younger generation and due to old age. As these age groups move into urban areas, their healthcare service utilization are directly related to their health status and basic rights to survival. It also places higher demands on China's healthcare service provision.

Objectives

This study aims to examine effects of rural-to-urban migration on healthcare utilization among middle-aged and older adults in China.

Methods

Panel data from Waves 3, 4, and 5 of the China Health and Retirement Longitudinal Study were used. We included 318 participants in the exposure group and 7,525 participants in the control group. The study employed propensity score matching (PSM) and Difference in Difference (DID) analysis.

Results

Difference in difference regression results showed that middle-aged and older adults reduced number of hospitalizations when they moved to a city with DID values of -0.092 (p < 0.10) for the period 2015-2018 and - 0.135 (p < 0.05) for the period 2015-2020. No significant effects were observed regarding the number of outpatient visits (p > 0.05).

Conclusion

Middle-aged and older migrants who migrated to cities reduced inpatient healthcare utilization, possibly due to lower hospitalization reimbursement rates, financial burden, and lower social integration. Policies enhancing health insurance reimbursement rates for migrants, integrated community support programs, and strengthening health education to promote health equity may provide remedy.

Mediating effect of social anxiety on the association between self-esteem and internet addiction among Chinese vocational school students

Introduction

In today's digital age, concerns about internet addiction among adolescents have escalated alongside the widespread use of the internet. Simultaneously, research has spotlighted the influence of psychological factors like self-esteem and social anxiety on addictive behaviors. The aim of this study was to verify the hypothesis regarding social anxiety as a mediator in the association between self-esteem and internet addiction.

Methods

A total of 10,158 participants were randomly selected from five vocational schools in Anhui Province, China, with a mean age of 18.5 years. They completed a series of self-administered questionnaires, including the Young Internet Addiction Test (IATS), the Liebowitz Social Anxiety Scale (LSAS), and the Self-Esteem Scale (SES). Structural equation modeling (SEM) was employed to examine the mediating role of social anxiety between self-esteem and internet addiction, adjusting for demographic variables such as age, gender, and parental education.

Results

The correlation analysis revealed that self-esteem was significantly negatively correlated with internet addiction, while social anxiety was significantly positively correlated with internet addiction. The indirect effect of self-esteem on internet addiction through social anxiety was 0.11 (p < 0.01), constituting 28.35% of the total effect. Additionally, the total impact of self-esteem on internet addiction was 0.278 (p < 0.01). Subgroup analyses by age and gender confirmed the robustness of these findings, with significant total effects observed across different age groups (14-18 years: total effects = 0.637; 18-24 years: total effects = 0.744; p < 0.01) and genders (male: total effects = 0.385; female: total effects = 0.744; p < 0.01).

Discussion

The results indicate that social anxiety plays a significant mediating role in the relationship between self-esteem and internet addiction, affecting both directly and indirectly this association. These findings underscore the importance of addressing self-esteem and social anxiety in interventions aimed at reducing internet addiction among adolescents, suggesting that targeted psychological support could be pivotal in mitigating the risk of developing addictive behaviors online.

Excessive screen time and problem behaviours among school-age children in Fujian, China: a cross-sectional study

BACKGROUND

Screen time encompasses activities conducted on digital devices, including traditional devices such as televisions and computers, as well as modern devices like smartphones, tablets, and other digital screens. Excessive screen time among children has been linked to a heightened likelihood of engaging in high-risk problem behaviours. This study aimed to quantify the prevalence of excessive screen time and delve into its correlation with problem behaviours among school-aged children in Fujian, thereby gaining insight into the prevalence and trends within this region.

METHODS

From October to November 2022, we used cluster sampling and invited 891 school-age children from Fujian as participants. Parents recorded children's screen time for a week, taking the average value of seven days, and the unit is minutes. The Child Behaviour Checklist was used to assess their problem behaviours. Correlation analysis, Propensity Score Matching, Single-factor analysis, and Multi-factor analysis were used to explore the influencing factors and correlation.

RESULTS

Screen exposure time of school-age children was 34.29 (17.14, 55.71) min/day. Then, 17.06% were exposed to excessive video. The total CBCL score of school-age children was 10.00 (3.00, 22.00), and 10.00% had problem behaviours. After matching the propensity score, the total score of problem behaviours in the daily over-exposure group was higher than that in the non-over-exposure group (Z = 5.466, p < 0.001). Generalized linear model analysis showed that after controlling confounding variables, daily video exposure time or daily excessive screening could affect problem behaviours (p < 0.05).

CONCLUSIONS

The incidence of problem behaviours among school-age children is low in Fujina. The daily screen time, weekday screen time, and weekend screen time were positively associated with problem behaviours. We suggested family members shift to more serious and cautious attitudes toward children's screen exposure and adopt appropriate digital-related parenting practices, such as accompanying children when they inevitably need to watch electronic devices, to better understand and manage their screen time.

Problematic internet use profiles and their associated factors among adolescents

The cognitive-behavioral model of generalized Problematic Internet Use (PIU) is the theoretical approach that has obtained the most evidence on the study of this problem, which includes four components: Online Social Preference, Mood Regulation, Deficient Self-Regulation, and Negative Outcomes. This study aimed to identify PIU profiles using Latent Profile Analysis, and to analyze the differences in them attending to some of the principal PIU risk and protective factors. A total of 675 Spanish adolescents completed questionnaires assessing PIU, Internet usage, mental health problems, personality, psychological strengths, and family relationships. Four profiles were obtained: Nonproblematic use (68.30% of the sample), Slightly problematic use (17.90% of the sample), Problematic use (8.50% of the sample), and Severe problematic use (5.40% of the sample). Results showed differences between them, with the profile with more PIU having more risk factors and less protective factors. Results showed that many different personal and social variables included in the study play a role in PIU. Knowing the different PIU profiles can help in the design of more specific and precise procedures and instruments for risk assessment, as well as aiding in prevention and in the design of more individualized treatments.

Investigating the mediating role of emotional intelligence in the relationship between internet addiction and mental health among university students

INTRODUCTION

The widespread use of the internet has brought numerous benefits, but it has also raised concerns about its potential negative impact on mental health, particularly among university students. This study aims to investigate the relationship between internet addiction and mental health in university students, as well as explore the mediating effects of emotional intelligence in this relationship.

OBJECTIVE

The main objective of this study was to examine whether internet addiction (dimensions and total) negatively predicts the mental health of university students, with emotional intelligence acting as a mediator.

METHODS

To address this objective, a cross-sectional design with an inferential approach was employed. Data were collected using the Wong Law Emotional Intelligence Scale (WLEIS-S), Internet Addiction Scale (IAS), and Keyes' Mental Health Continuum-Short Form (MHC-SF). The total sample consisted of 850 students from two large public higher education institutions in Ethiopia, of which 334 (39.3%) were females and 516 (60.7%) were males, with a mean age of 22.32 (SD = 4.04). For the purpose of the study, the data were split into two randomly selected groups: sample 1 with 300 participants for psychometric testing purposes, and sample 2 with 550 participants for complex mediation purposes. Various analyses were conducted to achieve the stated objectives, including Cronbach's alpha and composite reliabilities, bivariate correlation, discriminant validity, common method biases, measurement invariance, and structural equation modeling (confirmatory factor analysis, path analysis, and mediation analysis). Confirmatory factor analysis was performed to assess the construct validity of the WLEIS-S, IAS, and MHC-SF. Additionally, a mediating model was examined using structural equation modeling with the corrected biased bootstrap method.

RESULTS

The results revealed that internet addiction had a negative and direct effect on emotional intelligence (β = -0.180, 95%CI [-0.257, -0.103], p = 0.001) and mental health (β = -0.204, 95%CI [-0.273, -0.134], p = 0.001). Also, Internet Craving and Internet obsession negatively predicted EI (β = -0.324, 95%CI [-0.423, -0.224], p = 0.002) and MH (β = -0.167, 95%CI [-0.260, -0.069], p = 0.009), respectively. However, EI had a significant and positive direct effect on mental health (β = 0.494, 95%CI [0.390, 0.589], p = 0.001). Finally, EI fully mediated the relationship between internet addiction and mental health (β = -0.089, 95%CI [-0.136, -0.049], p = 0.001). Besides The study also confirmed that all the scales had strong internal consistency and good psychometric properties.

CONCLUSION

This study contributes to a better understanding of the complex interplay between internet addiction, emotional intelligence, and mental health among university students. The findings highlight the detrimental effects of internet addiction on mental health, and the crucial mediating role of emotional intelligence.

RECOMMENDATIONS

The findings discussed in relation to recent literature have practical implications for practitioners and researchers aiming to enhance mental health and reduce internet addiction among university students. Emotional intelligence can be utilized as a positive resource in interventions and programs targeting these issues.

The relationship between childhood trauma and mental health status among Chinese vocational high school adolescents: the mediating effect of poor self-control and internet addiction

BACKGROUND

Mental health problems among adolescents are a common concern globally. However, its relationship with childhood trauma is not clearly understood from the existing studies. Therefore, this study aims to explore the relationships among childhood trauma, mental health, self-control, and internet addiction in Chinese vocational high school students.

METHODS

A cross-sectional survey was conducted among vocational high school students in China from October 2020 to December 2020. Standardized questionnaires were used to collect basic information regarding childhood trauma, self-control, psychological state, and social demographics. A structural equation model was used to study the relationships among internet addiction, self-control, childhood trauma, and mental health.

RESULTS

A total of 3368 individuals participated in the study. The results revealed the mediating effects of poor self-control and internet addiction on the association between childhood trauma and mental health.

CONCLUSIONS

Internet addiction and low self-control play mediating roles in childhood trauma and mental health. Clarifying these relationships will help formulate better-targeted interventions to improve the mental health of Chinese vocational high school students and aid in interventions to treat and prevent mental health problems.

Family socioeconomic status and young children digital addiction: a moderated mediation model

Background

Presently, the problem of digital addiction in young children is becoming more and more prominent, and digital addiction can cause significant harm to the healthy physical and mental development of young children. A growing body of research suggests that family socioeconomic status and parenting styles are associated with digital addiction. However, little is known about the mediating and moderating mechanisms behind this relationship, and few studies have explored whether this relationship holds in young children populations. Therefore, the present study aimed to investigate whether parenting styles mediate the relationship between family socioeconomic status and young children's digital addiction and whether young children's gender moderates this mediation process.

Methods

A cross-sectional study design was used. 403 parents of young children were asked to complete online questionnaires, including the Internet Addiction Test-10 (IAT-10) the Chinese version of the Parenting Style Questionnaire (C-EMBU). The mediation model with moderation was tested using the PROCESS plug-in for SPSS.

Results

(1) Family socioeconomic status is significantly and negatively associated with digital addiction in young children. (2) Parenting styles (emotional warmth and understanding, punishment and harshness) mediate the relationship between family socioeconomic status and young children's digital addiction. (3) Young children's gender moderates the relationship between family socioeconomic status and punishment and severity parenting styles, emotional warmth and understanding parenting styles and young children's digital addiction.

Conclusion

The results indicate that family socioeconomic status can prevent digital addiction in young children through the path of improving parenting styles. However, there is still an overall negative effect of family socioeconomic status on young children's digital addiction.

Influence of Internet Use on Happiness in China: Mediating Effects of Environmental Quality Perception and Moderating Role of Sense of Environmental Security

This study aims to comprehensively examine the effects of different types of Internet use and happiness while considering the mediating role of environmental quality perception and the moderating role of a sense of environmental security. Drawing on the uses and gratifications theory, negativity bias, and social cognitive theory, the study investigates the mediating role of environmental quality perception and the moderating role of environmental security in the above relationship. Using data from 3162 respondents in the 2021 Chinese Social Survey (CSS) and Structural Equation Modeling (SEM), the study finds that Internet use for information and educational purposes significantly enhances happiness, with environmental quality perception acting as a mediator. Moreover, a moderating effect of environmental security was observed in the relationship between Internet use for educational purposes and national environmental quality perception. Specifically, the interaction between study-related Internet use and the sense of environmental security significantly and positively predicted national environmental quality perception. These findings highlight the complex interaction between Internet use, environmental factors, and happiness, offering insights into policy interventions aimed at improving Internet access and environmental awareness to enhance public mental health outcomes in China.

Dose-Response Associations of Internet Use Time and Internet Addiction With Depressive Symptoms Among Chinese Children and Adolescents: Cross-Sectional Study

Background

Children's lives are increasingly mediated by digital technologies, yet evidence regarding the associations between internet use and depression is far from comprehensive and remains unclear.

Objective

This study aimed to investigate the dose-response association between internet use, including use time and addiction behaviors, and depressive symptoms among children and adolescents in Zhejiang Province.

Methods

Data were collected from a school-based health survey China Common Disease and Risk Factor Surveillance Among Students, encompassing 21,336 students in Zhejiang Province. The daily internet use time, internet addiction (IA) behaviors, and depressive symptoms were assessed with questionnaires. Logistic regression models were used to explore the associations of internet use time and IA behaviors with depressive symptoms among children and adolescents. Restricted cubic spline curves were used to determine the dose-response associations.

Results

A total of 6225 (29.2%) students had depressive symptoms. Compared to those reporting no internet use, boys using the internet for >2 hours/day (odds ratio [OR] 1.53, 95% CI 1.34-1.74) and girls using internet for 1.1-2 hours/day (OR 1.22, 95% CI 1.06-1.39) and >2 hours/day (OR 1.70, 95% CI 1.50-1.93) were at higher risks of depressive symptoms. A significant J-shaped association was identified between internet use time and depressive symptoms among children and adolescents, especially in boys and primary school students (nonlinear P values were .006, .003, and <.001, respectively). Increased IA behaviors were associated with a higher odd of depressive symptoms (1 IA behavior: OR 2.01, 95% CI 1.83-2.21; 2 IA behaviors: 2.91, 95% CI 2.57-3.29; and ≥3 IA behaviors: 4.72, 95% CI 4.26-5.22). A positive nonlinear association between the number of IA behaviors and depressive symptoms was found in total population, girls, and primary school students (nonlinear P values were .02, .002, .007, respectively).

Conclusions

Findings suggested that excessive internet use time and IA behaviors were significantly associated with an increased risk of depressive symptoms, highlighting the importance of interventions to regulate and educate about adequate internet use during childhood and adolescence.

Internet use and adolescent development in rural China: A scoping review protocol of research landscape and gaps

INTRODUCTION

In the digital era, the Internet has become a necessity in adolescents' daily lives. Many studies globally are exploring the influences of Internet use on adolescent development, but they focus on the negative impacts of simplistic "screen time" on adolescents' physical and mental health, rather than both positive and negative influences of multifaceted Internet use on multidimensional adolescent development. Specifically in rural China, adolescents live in disadvantageous and marginalizing contexts, and Internet use is widespread among this population. However, knowledge on Internet use and adolescent development in rural China is fragmented. It is still unclear in what ways Internet use would bring benefits or risks for Chinese rural adolescents' healthy growth. Therefore, the objective of this scoping review is to identify the current research landscape, gaps, and future directions in rural China contexts. It aims to provide a comprehensive overview of elements, findings, and limitations in existing empirical studies on the influences of Internet use on adolescent development in rural China.

MATERIALS AND METHODS

The standard for conducting this scoping review is the five-stage model proposed by Arksey and O'Malley, and the reporting standard is the Preferred Reporting Items for Systematic Reviews and Meta-Analyses: Extension for Scoping Reviews (PRISMA-ScR). The overall research question is: What are the influences of Internet use on adolescent development in rural China? In consultation with librarians, to locate articles, subject headings (controlled vocabularies) and textwords (keywords) in article titles, abstracts, and author-assigned keywords will be searched in APA PsycInfo (psychology), China National Knowledge Infrastructure (interdisciplinary), Communication Abstracts (media and communication), Education Source (education), MEDLINE (public health), Social Services Abstracts (social work), Social Work Abstracts (social work), and Sociological Abstracts (sociology). The review process via Covidence will consist of two sequential steps based on inclusion/exclusion criteria: the title and abstract review and the full-text review. Then study characteristics and research findings will be charted, and the results will be analyzed and synthesized quantitatively and qualitatively via visualizations and narratives, guided by the typological frameworks of Internet use and adolescent development.

DISCUSSION

The scoping review will be a pioneering review to inform the current research landscape and gaps in the Internet use influences on adolescent development in rural China. It will advance the research agenda on this issue conceptually, theoretically, and empirically. In addition, it can provide contextual implications for designing prevention and intervention programs.

Low self-control, perceived social support and internet gaming addiction: findings from an ethnicity minority region in China

Background

Adolescent Internet gaming addiction (IGA) is an pincreasing global concern. Drawing on self-control theory, social support theory, and problem behavior theory, this study aimed to examine the relationships between low self-control, perceived social support, and IGA among Chinese Yi and Non-Yi adolescents, with a focus on the moderating role of perceived social support and ethnic differences.

Methods

A cross-sectional study was conducted among 1,997 adolescents (53.78% female, mean age 14.70 years) in Liangshan Yi Autonomous Prefecture, Sichuan Province, China, using a multi-stage cluster random sampling method. Participants completed questionnaires assessing IGA (Internet Gaming Disorder Scale-Short Form), low self-control (Low Self-Control Scale), and perceived social support (Multidimensional Scale of Perceived Social Support). Data were analyzed using descriptive statistics, t-tests, OLS regression, and the seemingly unrelated estimator (SUE).

Results

Low self-control was positively associated with IGA (β = 0.35, p < 0.001), while perceived social support was negatively associated with IGA (β = -0.27, p < 0.001). Perceived social support, particularly from family (β = -0.43, p < 0.05) and significant others (β = -0.49, p < 0.01), moderated the relationship between low self-control and IGA. These associations were more salient among Yi adolescents compared to non-Yi adolescents.

Conclusions

This study highlights the protective role of perceived social support, especially from family and significant others, in buffering the risk of low self-control on IGA. The findings extend self-control theory and social support theory, and provide empirical support for problem behavior theory in a cross-cultural context. The results underscore the importance of considering cultural contexts in understanding IGA and developing targeted interventions for ethnic minority adolescents.

Preventive Interventions for Internet Addiction in Young Children: Systematic Review

BACKGROUND

In this digital age, children typically start using the internet in early childhood. Studies highlighted that young children are vulnerable to internet addiction due to personal limitations and social influence (eg, family and school). Internet addiction can have long-term harmful effects on children's health and well-being. The high risk of internet addiction for vulnerable populations like young children has raised questions about how best to prevent the problem.

OBJECTIVE

This review study aimed to investigate the existing interventions and explore future directions to prevent or reduce internet addiction risks in children younger than 12 years.

METHODS

The systematic review was conducted following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. We searched for relevant literature from 4 research databases (Scopus, Web of Science, PubMed, and PsycINFO). We included 14 primary studies discussing the interventions to prevent or reduce internet addiction risks in young children and their efficacy outcomes.

RESULTS

The preventive interventions identified were categorized into four approaches as follows: (1) children's education, (2) parenting strategy, (3) strategic physical activity, and (4) counseling. Ten interventions showed promising efficacy in preventing or reducing internet addiction risks with small-to-medium effect sizes. Interventions that enhance children's competencies in having appropriate online behaviors and literacy were more likely to show better efficacy than interventions that force children to reduce screen time. Interventions that shift children's focus from online activities to real-world activities also showed promising efficacy in reducing engagement with the internet, thereby preventing addictive behaviors. We also identified the limitations of each approach (eg, temporariness, accessibility, and implementation) as valuable considerations in developing future interventions.

CONCLUSIONS

The findings suggest the need to develop more sustainable and accessible interventions to encourage healthy online behaviors through education, appropriate parenting strategies, and substitutive activities to prevent children's overdependence on the internet. Developing digital tools and social support systems can be beneficial to improve the capability, efficiency, and accessibility of the interventions. Future interventions also need to consider their appropriateness within familial context or culture and provide adequate implementation training. Last, policy makers and experts can also contribute by making design guidelines to prevent digital product developers from making products that can encourage overuse in children.

School Bullying Victimization and Depression Symptoms in Adolescents: The Mediating Role of Internet Addiction and Moderating Role of Living Areas

School bullying and depression are both serious social and public health problems among adolescents. Prior studies indicated a correlation between bullying and depression. However, the potential moderators remain largely unexplored. This study aimed to identify the mediating effect of Internet addiction and the moderating effect of living in urban or rural areas in the relationship between school bullying victimization and depression symptoms among Chinese adolescents. This cross-sectional study of adolescents was conducted using two-stage random cluster sampling of students in urban and rural public high schools in China. A moderated mediation model was constructed to uncover the underlying mechanism of school bullying victimization and depression symptoms. A total of 2,376 adolescents (52.65% females, mean age ± SD a 14.69 ± 1.76 years) were included in the study. The prevalence of clinical depression symptoms with a cut-off value of 16 on the Center for Epidemiological Studies Depression Scale (CES-D) was 21.76% (95% CI: 20.15, 23.46), and with a cut-off value of 20 on the CES-D was 13.85% (95% CI: 12.51, 15.30) for overall. Our findings indicated a significant positive association between school bullying victimization and depression symptoms (p < 0.01) and a significant mediating effect of Internet addiction in the association between school bullying victimization and depression symptoms (indirect effect = 1.143, 95% CI: 0.677, 1.609; percentage of mediation: 16.7%, 95% CI: 10.3, 23.1). This indirect relationship was partially moderated by the living in urban or rural areas in the mediation process. Specifically, the effect of school bullying victimization on Internet addiction was greater among urban adolescents (simple slope: 0.774, 95% CI: 0.524, 1.024, p < 0.01) than among rural adolescents (simple slope: 0.337, 95% CI: 0.132, 0.543, p < 0.01), but moderating effect of urban-rural areas was not significant on the relationship between Internet addiction and depression symptoms. These findings highlight the mediating role of Internet addiction and the moderating role of living areas in school bullying victimization and adolescents' depression symptoms, which provide evidence for social work, mental health services, and policy interventions for adolescents in China.

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

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

The association between childhood adverse experiences and internet addiction: A meta-analysis

Many studies have explored the association between adverse childhood experiences (ACEs) and Internet addiction (IA), yet the research findings on the association between them are inconclusive. We conducted a systematic search on 7 databases to identify the relevant studies published until January 2023, and analyzed the findings from 37 studies across 12 countries involving 45,364 participants aged 8 to 67 years (51 % women). Results indicated a positive correlation (r = 0.21) was found between ACE and IA around the world, which differed among continents. It was found that all ACE subtypes were significantly associated with IA (range r = 0.16 to 0.25). Meta-regression showed a stronger association among younger individuals without moderating effects of gender or publication year. In conclusion, this study sheds light on the significant association between ACEs and IA, emphasizing the need for targeted interventions and preventive measures. Future research could delve into specific interventions aimed at mitigating the impact of ACEs on IA, such as cognitive-behavioral therapies or metacognitive therapy interventions. Additionally, investigating cultural factors that may influence this association could provide valuable insights into tailored approaches for different populations. Understanding these dynamics is crucial for developing effective strategies to address IA and its underlying factors.

The association between anxiety and internet addiction among left-behind secondary school students: the moderating effect of social support and family types

BACKGROUND

The left-behind children (LBC), children and adolescents aged 0-18 whose parents have migrated for economic purposes for extended periods exceeding three months, present a unique social concern. These children remain in their place of household registration, often under the guardianship of relatives, while receiving compulsory education. LBC with growing Internet addiction (IA) have made it urgent to take a close look at the mechanisms and effective interventions for them. Anxiety has been proven to be correlated with IA in adolescents; however, the mechanisms of addiction in this population are less well-fully grasped. Based on the current theories and empirical results, the study examined whether and how social support (SS) and family types moderated the associations between anxiety and IA among left-behind secondary students.

METHODS

Stratified cluster sampling survey. A questionnaire was administered to 5290 secondary school children (2553 classified as left-behind) to explore the relationships between anxiety, IA, left-behind types, family types, and social support. This cross-sectional study employed a stratified cluster sampling survey of students in the ethnic areas of southeast Chongqing. The study sought to appraise the relationships between anxiety and IA in different types of left-behind children and to assess the potential moderating effect of SS on the relationship among the population and its family types differences.

RESULTS

The relationship between anxiety and IA was moderated significantly by social support and family types. Notably, the impact of social support on the moderating effect between IA and anxiety varied among students from both family types. For students from families where both parents had migrated, social support weakened the association between IA and anxiety. Conversely, for students from single-parent families where the parent had migrated, social support seemed to strengthen the relationships between these two issues.

CONCLUSIONS

The moderating effects of SS on the relationship between anxiety and IA differs based on family type among various groups of left-behind secondary students. Gaining insights into the IA mechanisms can guide the development of targeted intervention strategies aimed at minimizing IA among diverse groups of left-behind students.

Digital Interventions for Combating Internet Addiction in Young Children: Qualitative Study of Parent and Therapist Perspectives

BACKGROUND

Internet addiction is an emerging mental health issue in this digital age. Nowadays, children start using the internet in early childhood, thus making them vulnerable to addictive use. Previous studies have reported that the risk of internet addiction tends to be higher in lower-income regions with lower quality of life, such as Indonesia. Indonesia has high risks and prevalence of internet addiction, including in children. Digital interventions have been developed as an option to combat internet addiction in children. However, little is known about what parents and therapists in Indonesia perceive about these types of interventions.

OBJECTIVE

This study aims to investigate the experiences, perceptions, and considerations of parents and therapists regarding digital interventions for combating internet addiction in young Indonesian children.

METHODS

This study used a qualitative exploratory approach through semistructured interviews. We involved 22 parents of children aged 7 to 11 years and 6 experienced internet addiction therapists for children. The interview data were transcribed and analyzed using thematic analysis.

RESULTS

Participants in this study recognized 3 existing digital interventions to combat internet addiction: Google Family Link, YouTube Kids, and Apple parental control. They perceived that digital interventions could be beneficial in continuously promoting healthy digital behavior in children and supporting parents in supervision. However, the existing interventions were not highly used due to limitations such as the apps' functionality and usability, parental capability, parent-child relationships, cultural incompatibility, and data privacy.

CONCLUSIONS

The findings suggest that digital interventions should focus not only on restricting and monitoring screen time but also on suggesting substitutive activities for children, developing children's competencies to combat addictive behavior, improving digital literacy in children and parents, and supporting parental decision-making to promote healthy digital behavior in their children. Suggestions for future digital interventions are provided, such as making the existing features more usable and relatable, investigating gamification features to enhance parental motivation and capability in managing their children's internet use, providing tailored or personalized content to suit users' characteristics, and considering the provision of training and information about the use of interventions and privacy agreements.

The influence of physical activity on internet addiction among Chinese college students: the mediating role of self-esteem and the moderating role of gender

OBJECTIVES

The significance of self-esteem in the relationship between physical activity and Internet addiction among college students cannot be over, as it lays a solid foundation for the prevention and control of Internet addiction.

METHODS

A total of 950 college students were surveyed using the Physical Activity Rating Scale (PARS-3), Rosenberg Self-Esteem Scale (SES), and Chinese Internet Addiction Scale (CIAS-R) through a cluster random sampling method. Descriptive statistics, independent sample t-test, partial correlation analysis, mediation effect, moderation effect, and Bootstrap testing were conducted on the collected data to analyze and interpret the results.

RESULTS

(1) Significant gender differences were found in the amount of physical activity and the degree of Internet addiction among college students(P&& lt;0.001); (2) Physical activity was significantly and positively correlated with self-esteem (r = 0.26, P < 0.001), but significantly and negatively correlated with Internet addiction (r=-0.23, P < 0.001); Meanwhile, self-esteem and Internet addiction were significantly and negatively related to self-esteem (r=-0.22, P < 0.001). (3) Mediating effect analyses showed that self-esteem played a partial mediating role in physical activity and Internet addiction among college students, accounting for a portion of 78.95%. (4) A moderating effect of gender on the relationship between physical activity and Internet addiction was discovered.

CONCLUSION

The physical activity level of male students is significantly higher than that of female students, while the degree of internet addiction among female students is notably higher than that of male students. Physical activity can not only directly improve the issue of internet addiction among college students, but also indirectly improve it through self-esteem, with gender playing a moderating role in this process. This conclusion has practical reference significance for preventing and controlling internet addiction among college students, and provides evidence support for using physical activity as a reference solution in clinical applications. Additionally, it suggests that gender should be taken into account when preventing and intervening in internet addiction among college students, and different strategies and methods should be adopted for male and female students. Male students should be encouraged to participate more in physical activities, gradually increasing the frequency, duration, and intensity of their participation, in order to divert their attention and enhance their sense of achievement in sports, thereby reducing their use of mobile phones. For female students, on the other hand, it is important to strengthen real-life communication, change the form of sports participation, engage in group, collaborative, and different situational sports activities, and enhance their focus and attention in sports, in order to reduce their internet dependency, better guide them to use the internet reasonably, and enable them to achieve emotional release through sports.

Associations between internet addiction and school engagement among Turkish college students: mediating role of psychological distress

Introduction

Internet addiction has become a subject of growing concern with adverse consequences. This study aimed to investigate the mediating effect of psychological distress in the relationship between internet addiction and school engagement.

Methods

Data were obtained from 732 Turkish college students (M = 20.98, SD = 2.58). The data were collected through Young's Internet Addiction Test, Depression, Stress and Anxiety Scale (DASS21)-Short Form, and University Student Engagement Inventory. Mediation analysis was performed to investigate the mediating effects of depression, anxiety, and stress in the association between internet addiction and school engagement.

Results

The results of the study showed that internet addiction was positively associated with psychological distress and negatively associated with school engagement, whereas psychological distress had a negative relationship with school engagement. This study also found that depression, anxiety, and stress acted as mediators in the relationship between internet addiction and behavioral engagement, emotional engagement, and cognitive engagement.

Conclusion

This study has provided evidence that young adults with tendency of internet addiction may experience school engagement problems as well as psychological problems. Our findings underscore the need for special educational intervention programs aimed at encouraging college youth to limit their internet use for their future due to its negative consequences and raising awareness in this vulnerable group and their families.

The cycle of solitude and avoidance: a daily life evaluation of the relationship between internet addiction and symptoms of social anxiety

A consistent association has been observed between internet addiction and symptoms of social anxiety. However, there is a lack of empirical research that delves into potential explanations for this relationship and its directionality, making it difficult to translate findings into development of interventions for social anxiety that account for technology-related behaviors. The present study aimed to evaluate the longitudinal dynamics between internet addiction, symptoms of social anxiety, avoidance of social interactions, and using the internet to cope with loneliness. By means of an ecological momentary assessment study, we evaluated a sample of 122 young adults from Chile using intensive self-report measurements five times a day, for a period of 10 days. Using mixed-effects models, we examined the directionality between internet addiction and symptoms of social anxiety, together with an explanation of their relationship. Results indicate that internet addiction antecedes symptoms of social anxiety; however, the reverse relationship was not observed. Furthermore, instances where individuals avoided social interactions or used the internet to cope with loneliness were predictive of later increases in levels of internet addiction, suggesting a vicious cycle. Significant heterogeneity was observed in these effects, highlighting the need for a more personalized approach when including technology-related behaviors in social anxiety interventions. Theoretical and clinical implications are discussed.

Internet addiction and depressive and anxious symptoms among Chinese rural left-behind adolescents: Mediating roles of resilience and friendship quality

BACKGROUND

Rural left-behind adolescents are more vulnerable to Internet addiction and depressive and anxious symptoms due to the lack of family support and parental supervision. This study was the first to investigate the longitudinal relationships between Internet addiction and depressive and anxious symptoms and to examine the mediating roles of resilience and friendship quality in rural left-behind adolescents.

METHODS

Included in this study, which was from a longitudinal study conducted five times over 2 years, were 1001 rural left-behind adolescents. The internationally used scales for depressive and anxious symptoms, Internet addiction, resilience and friendship quality were administered. A structural equation model was used for analysis.

RESULTS

The prevalence of Internet addiction, depressive and anxious symptoms among rural left-behind adolescents were 17.7%, 35.8% and 27.6%, respectively. Internet addiction predicted the later depressive and anxious symptoms (β = 0.200, 95% confidence interval [CI]: 0.116-0.274 and β = 0.263, 95% CI: 0.188-0.330). Resilience acted as an independent mediator in the relationships between Internet addiction and depressive and anxious symptoms (β = 0.037 and 0.034, P < 0.01). Resilience and friendship quality played a chain-mediating role on the longitudinal relationships between Internet addiction and depressive and anxious symptoms (β = 0.011 and 0.010, P < 0.001). The mediating effects accounted for 24.0% and 16.7% of the total effects, respectively.

CONCLUSION

Resilience and friendship quality play an independent or chain-mediating role in longitudinal relationships between Internet addiction and depressive and anxious symptoms. The findings inform targeted intervention strategies to improve the mental health of left-behind adolescents.

Problematic internet use and suicide ideation among Chinese adolescents: The indirect effects of insomnia, nightmares, and social jetlag

BACKGROUND

Problematic Internet use (PIU) is related to suicide ideation (SI) in adolescents, but little is known about the potential mechanisms between them. This study aimed to examine the mediation roles of insomnia, nightmares, and social jetlag in the association of PIU with SI in adolescents.

METHODS

A total of 39,731 adolescents (mean age = 13.49 ± 0.76 years, 54.4 % males) from Shenzhen, China, participated in a cross-sectional survey. SI was assessed using the ninth item of the Patient Health Questionnaire-9. PIU was measured by the Revised Chinese Internet Addiction Scale. A self-administered questionnaire was used to assess insomnia symptoms, nightmare frequency, social jetlag, sleep duration, psychological distress, and social-demographical characteristics. Logistic regression and path analyses were performed to examine the associations between PIU, insomnia symptoms, nightmares, social jetlag, and SI.

RESULTS

The prevalence of PIU and SI were 14.9 % and 18.6 %, respectively. PIU, insomnia symptoms, frequent nightmares, and social jetlag were significantly associated with SI. Path analyses showed that the indirect effects of PIU on SI through insomnia symptoms, frequent nightmares, and social jetlag were significant. Conversely, social jetlag significantly mediated the pathway from SI to PIU. The mediation effect sizes of these sleep and circadian problems were slightly larger in females than in males.

LIMITATIONS

Cross-sectional design limited the capacity to infer causal relationships.

CONCLUSIONS

The associations between PIU and SI were mediated by sleep and circadian problems. These findings underscore the importance of assessing and intervening in sleep and circadian problems among adolescents with PIU or SI.

Increased Digital Media Use in Preschool Children: Exploring the Links with Parental Stress and Their Problematic Media Use

BACKGROUND

Intense or problematic media use behavior of parents could serve as a role model for their children's media use behavior. So far, knowledge is scarce about increased children's media use (ICMU) and its association with parental stress (PS) and problematic parental media use (PPMU).

METHODS

ICMU was examined using a modified set of the DSM-5 criteria for Internet Gaming Disorder. PS was assessed via the widely used Parenting Stress Index, and PPMU was assessed using the Short Compulsive Internet Use Scale. A multiple linear regression analysis was conducted to evaluate the links between ICMU, PS, and PPMU. A mediation analysis was performed to examine if PPMU mediated the relationship between PS and ICMU.

RESULTS

In sum, 809 parents (M = 36.89 years; SD = 4.87; 81.4% female) of preschool children (average age: 44.75 months, SD = 13.68) participated in the study. ICMU was statistically significantly related to higher age of the parent, greater PPMU, and higher PS. Furthermore, we found that the association between PS and ICMU was partially mediated by PPMU.

CONCLUSIONS

The results indicate that more pronounced PS and PPMU are associated with ICMU, highlighting the necessity of considering these parental variables when developing early prevention strategies for preschool-age children.

Unhealthy Eating Habits and Insomnia Symptoms are Associated with Internet Addiction in Chinese Left-Behind Children: The Gender Difference

Purpose

This study aimed to evaluate the associations between unhealthy eating habits and insomnia symptoms with Internet addiction (IA) among Chinese left-behind children (LBC) based on potential gender difference.

Methods

This cross-sectional study was conducted in junior high schools from an economically disadvantaged area of China in May 2020. Participants were asked to complete the information and scales of socio-demographic characteristics, eating habits (the frequency of eating carbohydrates, fruits, vegetables, protein, and breakfast), insomnia severity and IA. A total of 3156 LBCs (43.9% males and 56.1% females, aged 14.2 years in average) were used for final analyses. Associations between eating habits and insomnia symptoms with IA were analyzed by generalized linear model with binary logistic regression.

Results

The study found that left-behind children (LBCs) had unhealthy eating habits, particularly among females. Females reported more insomnia symptoms than males. The prevalence of IA was similar across genders. Consuming fewer fruits and vegetables and skipping breakfast were linked to increased IA risk, especially in females. Insomnia was significantly associated with higher IA risk in both genders.

Conclusion

In LBCs, unhealthy eating and sleep were notably linked to IA, especially in females. Addressing these factors might reduce the prevalence of IA among LBCs.

Digital economy: an effective path for promoting residents' health in China

The primary prerequisite for socioeconomic growth is good health, hence promoting residents' health is a vital objective of public policies. It is yet up for debate whether or not the digital economy (DE), which will be crucial to future economic growth, will eventually result in improvements in residents' health. Utilizing the China Family Panel Studies (CFPS) data in 2020, we explore how the DE affects residents' health. The findings reveal that residents' health is greatly enhanced by the DE. The eastern region sees a more dramatic improvement in residents' health as a result of the DE. Additionally, the DE can improve residents' health through the promotion of regional green development. The study's findings add to our knowledge of how the DE impacts residents' health while also offering recommendations for achieving universal health.

Parents' Knowledge On, Attitude Toward, and Practice of Screen Time Exposure Regulation of Their Children Under Six Years of Age in Western Region, Saudi Arabia

BACKGROUND

Children and teenagers spend a significant amount of time watching screens, which include cellphones, tablets, gaming consoles, televisions, and computers. Regulation of screen time exposure is a crucial matter to avoid the health drawbacks of prolonged screen exposure.

OBJECTIVES

Assessment of parents' knowledge, attitude, and practice of regulation screen exposure among their children under six years old in the western region of Saudi Arabia.

METHODS

A cross-sectional study was conducted on a convenience sample of 451 parents of under-six-year-old children in the western region of Saudi Arabia. Data were collected by using an online questionnaire, and a link to the survey was distributed to respondents via electronic platforms as well as to primary healthcare visitors. The data were analyzed using SPSS software.

RESULTS

This study included 451 parents from the Saudi western region. Most of the participating parents were female (64.3%), aged 25-34 years (34.8%), married (86.0%), and had completed their university education (56.1%). This study found that 76.4% of parents had adequate knowledge, 73.1% had a positive attitude, and 69.8% had adequate practice of screen time regulation for their children under six years of age. Factors associated with their good knowledge include being married (p = 0.002), having government work (p = 0.020), having children who use mobile phones, and having children attend kindergarten (p <0.001) for each. Furthermore, highly educated parents showed more positive attitudes than others (p-value = 0.004). Finally, better practice of screen time regulation was noted among highly educated parents (p = 0.011), who had government jobs (p = 0.031), and children who went to kindergarten (p = 0.031) for their children.

CONCLUSION

In this study, parents of under-six-year-old children possessed overall good knowledge and a positive attitude, but their actual practice of screen time regulation for their children was low, specifically in terms of parental supervision of the content that children watch, their care of children's regular exercise, and using devices as a method for motivating or punishing their children. Additionally, sociodemographic characteristics like education, occupation, and marital status played a role in this issue. Healthcare professionals such as pediatricians, family doctors, general practitioners, and others can caution parents of young children under six years old about the harmful consequences of excessive screen use. Further longitudinal research is needed to understand the long-term effects of screen time exposure among young children. From this study, further qualitative research would aid in a greater understanding of the impact of parental knowledge, attitude, and practice on their children's use of screen time.

Parental and Child Factors Associated With Internet Addiction in Children

BACKGROUND

Internet addiction has negative effects on psychological development, interpersonal relationships, and social adaptation in 10-year-old elementary school students.

OBJECTIVE

This study aimed to identify parental and child characteristics related to Internet addiction in lower-grade elementary school children.

METHODS

This study used a secondary data analysis. Data from the tenth Panel Study on Korean Children were used. In total, 1224 ten-year-old elementary school students were included in the analysis. The questionnaire included general, parental, and child characteristics.

RESULTS

Of all child participants, 18.5% were in the high-risk group for Internet addiction. Lower paternal and maternal spousal satisfaction, maternal education level of high school graduate or lower, and greater permissive parenting by the mother were associated with higher odds of Internet addiction among their children. Moreover, boys and children who spent more than an hour per day without adults showed higher odds of Internet addiction.

CONCLUSIONS

The results of this study indicate that the implementation of an intervention that improves parenting and family relationships and positively changes the environment in which children are brought up is necessary.

Network Analysis of Health-related Behaviors, Insomnia, and Depression Among Urban Left-behind Adolescents in China

Mental health of urban left-behind adolescents (LBA) is a public issue of growing concern. This study aims to examine the symptom level associations among multiple health-related behaviors, insomnia, and depression in urban LBA. Data on a sample of urban LBA aged 11-19 (N = 3,601) from the Adolescent Mental Health Survey in Shenzhen, China, were used. Health-related behaviors (i.e., Internet use, physical inactivity, social jetlag, smoking, and alcohol consumption), insomnia, and depressive symptoms were assessed using a self-administered questionnaire. Graphical Gaussian Model (GGM) was used to describe key bridging nodes in an undirected network. Directed Acyclic Graph (DAG) was used to construct a directed network and estimate the most likely causal associations among behaviors/symptoms. In the undirected network, Internet use was identified as the key bridging node most strongly associated with insomnia and depression. Two other key bridging nodes include difficulty initiating sleep and appetite change. In the directed network, anhedonia emerged as the most pivotal symptom, which could cause insomnia symptoms and behavioral changes, either directly, or through triggering other depressive symptoms, such as low energy and appetite change. These findings have implications for understanding the occurrence and maintenance process of health-related behaviors, insomnia, and depression in urban LBA. In practice, Internet use should be considered a priority in targeting multiple health behavior interventions. Meanwhile, early screening and treatment for anhedonia are of great significance as well.

Association between Electronic Media Use and Internalizing Problems: The Mediating Effect of Parent-Child Conflict and Moderating Effect of Children's Age

In today's digital world, children are exposed extensively to electronic media, making it an integral part of their daily lives. However, excessive use of electronic media during childhood has been associated with various internalizing problems. Moreover, parent-child conflict and children's age may be closely associated with children's problem behaviors. The current study employed a cross-sectional design and conducted a questionnaire survey of 711 parents to examine the association between children's electronic media use and their internalizing problems. Furthermore, this study probed the mediating role of parent-child conflict within this association and the moderating effect of children's age. The results of structural equation modeling showed a positive correlation between children's use of electronic media and their internalizing difficulties. Parent-child conflict served as a mediating factor in this association. Results also showed that the association between parent-child conflict and internalizing problems becomes more pronounced as children grow older. These findings imply that parents should encourage their children to develop healthy habits in using electronic media while fostering positive relationships. Parents should also be mindful of the psychological changes as children age and provide guidance to help them become proficient digital citizens.

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

AIM

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Internet use time and mental health among rural adolescents in China: A longitudinal study

BACKGROUND

The digital divide between urban and rural adolescents is widening. Many existing studies have found an association between internet use and adolescent mental health, but few use longitudinal data to focus on rural adolescents. We aimed to identify the causal relationships between internet use time and mental health in Chinese rural adolescents.

METHODS

Using a sample of 3694 participants (aged 10-19) from the 2018-2020 China Family Panel Survey (CFPS). Fixed effects model, mediating effect model and instrumental variables method was used to evaluate the causal relationships between internet use time and mental health.

RESULTS

We find that more time spent on the internet has a significant negative effect on participants' mental health. This negative impact is stronger in female and senior students groups. Mediating effects analysis suggests that more time spent on the internet increase risk of mental health problems by reducing sleep duration and parent-adolescent communication. Further analysis find that online learning and online shopping is associated with higher depression scores, while online entertainment with lower depression scores.

LIMITATIONS

The data do not investigate the specific time spent on internet activities (e.g., learning, shopping, and entertainment), and the long-term impacts of internet use time and mental health have not been tested.

CONCLUSIONS

Internet use time has a significant negative impact on mental health by crowding out sleep duration and parent-adolescent communication. The results provide an empirical reference for the prevention and intervention of mental disorders in adolescents.

Treatment Modalities for Internet Addiction in Children and Adolescents: A Systematic Review of Randomized Controlled Trials (RCTs)

BACKGROUND

In recent years, the use of the internet among children and adolescents has dramatically increased, leading to growing concerns regarding the potential risks of excessive internet use and addiction. Addressing these concerns, this systematic review aims to summarize current evidence on the effectiveness of treatment interventions for internet addiction among children and adolescents.

METHOD

We performed a systematic review using PubMed, Web of Science, PsycInfo, and Google Scholar with search terms including "internet addiction", "problematic internet use", "children" or "adolescents", "treatment" and "randomized controlled trial". We found 10 Randomized Controlled Trials (RCTs) meeting the criteria and included them in this systematic review.

RESULTS

This systematic review analyzed 10 randomized controlled trials focused on treatment interventions for internet addiction in adolescents and young adults. The interventions used were diverse, including cognitive-behavioral therapy (CBT), medication, electro-acupuncture (EA), and solution-focused approaches. The measures used to assess the effectiveness of the interventions also varied, but most studies reported moderate to large effect sizes for at least some outcomes. Overall, the studies suggest that interventions such as CBT and EA can be effective in reducing symptoms of internet addiction, internet gaming disorder, and unspecified internet use disorders. School-based programs and brief manualized CBT programs also show promise, though more research is needed to determine their long-term effectiveness.

CONCLUSION

Promising treatment approaches for internet addiction are emerging, but inconsistencies in conceptualization, language, and diagnostic criteria present some challenges. The growing recognition of problematic internet use, as shown by the DSM-5's recognition of Internet Gaming Disorder, highlights the need for a multidisciplinary approach and standardized criteria to facilitate accurate reporting across studies. Continued research is needed to identify effective treatments and diagnostic criteria for internet addiction, with the potential to offer practical insights into effective medications and therapies.

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.