Bidirectional associations between family factors and Internet addiction among adolescents in a prospective investigation

Family functioning and problematic usage of the internet in youth: A cross-sectional investigation

BACKGROUND

Problematic usage of the internet (PUI) refers to maladaptive use of the Internet linked to functional impairment as a growing concern in many countries. Youths are often considered more vulnerable to PUI than other age groups. The relationship between PUI and family dynamics is likely bidirectional and complex, warranting further research. Using a cross-sectional study design, we aimed to determine the rate of PUI and the association between PUI and family functioning in a South African sample between the ages of 18 and 30 years.

METHODS

South African youths were recruited via email and social media. Respondents completed an online survey as part of a cross-sectional study to assess the extent and the types of activities for which they use the internet, as well as the quality of their family relationships and functioning, employing standardised questionnaires (including the IAT-10) and the General Functioning Scale of the Family Assessment Device (GF-FAD). The sample included 814 participants (65% female; aged 21 years; SD 3 years).

RESULTS

15.5% of our sample presented with PUI. There was a significant, moderate positive correlation between totals on the IAT-10 and GF-FAD (r = 0.33, p < .001). An independent samples t-test found that individuals with self-reported PUI (GF-FAD: M = 2.57, SD = 0.51) had significantly poorer quality family functioning than individuals without PUI (GF-FAD: M = 2.13, SD = 0.61; t (812) = -7.52, p < .001; Cohen's d = -0.73, 95% CI [-0.92, -0.54]). Correlations were found between increased time spent on various online activities, including pornography (r = 0.20, p < 0.001), cyberbullying (r = 0.17, p < 0.001), social networking (r = 0.11, p = 0.003), and streaming media (r = 0.11, p = 0.003), and poorer quality family functioning.

CONCLUSION

PUI is common in South African youth. Presence of PUI and increased PUI severity were associated with worse family functioning in this sample. We recommend using family-based approaches in promoting a healthy family environment, and in the prevention of PUI and mitigation of its effects, with the goal of striking a balance between the benefits of the internet and its potential role in compromising aspects of family relationships.

Risks and protection: a qualitative study on the factors for internet addiction among elderly residents in Southwest China communities

BACKGROUND

In the global trend of actively promoting the participation of older adults in the digital age, the relevant negative issues featuring potential Internet Addiction (IA) among them has risen to be a new challenge facing the global public health. However, there is a severe lack of related research. This study aimed to gain a comprehensive understanding of the phenomenon and process of IA among the elderly. The purpose of this paper is to introduce factors that may influence IA in the demographic.

METHODS

This study employed qualitative descriptive research methods to investigate older adults' perceptions and experiences of IA. Semi-structured in-depth personal interviews were conducted between March and June 2023 with 36 senior citizens from urban communities in Chongqing, Southwest China. Data were analyzed via inductive content analysis methods.

RESULTS

Through data analysis, 2 main categories concerning IA in older adults were identified: risk factors and protective factors. The risk factor categories include 5 individual factors (e.g., Internet as the major avenue for pursuing personal hobbies and interests, etc.), 3 family factors (e.g., household WIFI increasing the risk of prolonged Internet use indoors, etc.), 2 peer factors (e.g., peer recommendation and guidance as catalysts for intensified Internet engagement, etc.), 2 socio-environmental factors (e.g., the widespread daily Internet use spurs offline intolerance, etc.), and 3 Internet platform factors (e.g., the plenitude of online content triggers endless viewing/browsing behaviors, etc.). The category of protective factors encompasses 2 individual factors (e.g., a higher level of perceived risk regarding internet health hazards, etc.) and 2 family factors (e.g., more family commitment, etc.).

CONCLUSIONS

Older adults' Internet addictive behaviors are shaped by multiple and complex internal and external factors. A higher level of online health risk perception is a key protective factor to effectively avoid the occurrence and deterioration of IA among the aged, a distinct finding from this study. It is believed that the "individual-family-peer-community" synergy strategy is expected to become an essential direction for IA intervention for older adults, in order to promote healthy Internet use among older adults.

Psychological distress and aggression among adolescents with internet gaming disorder symptoms

The present study aimed to investigate the current situation of internet gaming disorder (IGD) in Chinese adolescents and explore the impact of IGD-related factors on adolescent aggression. We hypothesized that IGD symptoms in adolescents would be associated with aggressive behavior and that risk factors for IGD symptoms could increase the aggressive tendencies of adolescents. To verify the above hypothesis, a cross-sectional survey of junior and senior high school students from southern, southwestern, central, and eastern China was conducted. A total of 9306 valid questionnaires were collected. The results showed that the prevalence of IGD symptoms was 1.78 % among Chinese adolescents. The adolescents in the disordered gamer group had the most severe IGD symptoms, with the highest levels of psychological distress and aggression. Interestingly, adolescents in the casual gamer group had the lowest psychological distress and aggression scores. Linear regression analysis further showed that higher levels of aggression were significantly associated with male sex, younger age, more severe psychological distress and IGD symptoms, and more violent game exposure. Our results suggested that excessive online gaming not only contributes to psychological distress in adolescents but also increases their levels of aggressive behavior. Apart from male sex and younger age, severe IGD symptoms and psychological distress are the most important predictors of the development of aggressive behavior.

Understanding older adults' smartphone addiction in the digital age: empirical evidence from China

Background

Despite the fact that an increasing number of older adults are addicted to smartphones, the existing addiction literature still focuses primarily on adolescents. To address this issue, this study draws from the perspectives of subjective cognitive decline and family relationship conflict to examine older adults' smartphone addiction based on their key characteristics.

Methods

This study investigates the effects of subjective cognitive decline and family relationship conflict on older adults' smartphone addiction through a survey of 371 subjects in China.

Results

The results show that subjective cognitive decline and family relationship conflict affect older adults' smartphone addiction through a sense of alienation. In addition, older adults' perceived power moderates the relationship between alienation and smartphone addiction.

Discussion

This study offers new perspectives on the study of smartphone addiction from the perspective of older adults, and sheds light on how to improve the older adults' quality of life in their later years.

Social Media Addiction and Poor Mental Health: Examining the Mediating Roles of Internet Addiction and Phubbing

Many researchers have examined the potential detrimental role of problematic social media use (often referred as 'social media addiction') on mental health. The present study investigated how social media addiction is associated with three components of mental health: depression, anxiety, and stress. In addition, structural equation modeling was used to test the mediating roles of internet addiction and phubbing among a sample of young adults (N = 603). Results showed that social media addiction was associated with poorer mental health via internet addiction and phubbing. More specifically, associations between social media addiction and stress, and social media addiction and anxiety were explained by both internet addiction and phubbing. The association between social media addiction and depression was explained by internet addiction only. These results remained consistent after controlling for gender, age, frequency of internet use, frequency of social media use, and frequency of smartphone use. These findings extend the extant literature by providing evidence for the dual roles of internet addiction and phubbing in explaining the relationship between social media addiction and poor mental health. Social media addiction did not directly influence poorer mental health but did via internet addiction and phubbing. Therefore, greater awareness of the inter-relationships between technology-based behaviors and their impact on mental health is needed among a wide range of stakeholders, and these inter-relationships need considering in the prevention and treatment of technology-based disorders.

A latent profile transition analysis and influencing factors of internet addiction for adolescents: A short-term longitudinal study

Internet addiction for adolescent, which is widely concerned by the whole society, has become a public health problem. Internet addiction not only had a negative impact on physical and mental development of adolescents, but also was harmful to their study, life, interpersonal communication and personality formation, and so on. In recent years, the data analysis methods of longitudinal research have developed rapidly. It not only focused on the overall average growth trend, but also considered the differences in the individual trends. Latent profile transition analysis (LPTA) is an extension of latent profile analysis (LPA) and latent transition analysis (LTA), and is a longitudinal data analysis method. LPTA can simultaneously estimate group membership in multiple time points and their latent transition tendency among these subgroups between each two time points. This study used LPTA to explore the development trend of adolescent internet addiction over time and its influencing factors. 1033 adolescents participated in a short-term 6-month longitudinal study with a total of three tests. Participants completed internet addiction test, self-rating anxiety scale and self-rating depression scale. The results showed that: (1) There are three categories of adolescent internet addiction, namely non-internet addiction group, low-internet addiction group and high-internet addiction group. (2) Non-internet addiction group has a strong stability. Low-internet addiction group has a high probability to become non-internet addiction group or high-internet addiction group. (3) Boys are more likely than girls to develop into high-internet addiction group. Anxiety and depression both affect the development of adolescent internet addiction.

Vicious circle of family dysfunction and adolescent internet addiction: Do only child and non-only child exhibit differences?

The primary aim of the current study was to probe the longitudinal relationships between family dysfunction (FD) and adolescent Internet addiction (IA), as well as the group difference between only child and non-only child. Data were from a three-wave longitudinal data of 1301 Chinese adolescents, collected when adolescents were at Grade 7, Grade 8, and Grade 9. FD and IA were assessed via adolescent self-reported questionaries of Chinese Family Assessment Instrument and Internet Addiction Test. Cross-lagged panel model was constructed to estimate possible associations between FD and adolescent IA after controlling for demographic variables. Our results suggest that adolescents might get stuck in a vicious cycle of dysfunctional family and addictive Internet use: adolescents who lived in a dysfunctional family showed increased risk in IA in the subsequent year; in turn, adolescent IA further increased the possibility of FD. Moreover, multigroup comparison analysis revealed that the vicious cycle between FD and adolescent IA could be applied to both the only child and the non-only child. The findings may enrich the application of the Developmental Contextualism Theory and contribute to the identification of the starting points for intervention strategies of adolescent IA.

Children's excessive digital media use, mental health problems and the protective role of parenting during COVID-19

COVID-19's outbreak in March 2020 and the social distancing measures that followed it changed the lives of children worldwide. Studies assessing the pandemic's implications for children have reported an alarming increase in the use of digital media (DM) and warned of its adverse impacts on children's functioning and development. The current study aimed to assess the relationship between excessive and problematic DM use and emotional, behavioral, and academic functioning among Israeli adolescents during COVID-19 and to identify adolescents at elevated risk of developing problematic DM use. Three hundred forty-seven Israeli parent-child dyads (M age = 11.81, SD = 1.41) separately completed measures assessing children's DM use (time and addiction), functioning (academic, social, emotional, and behavioral), behavioral dysregulation, and the parents' parenting practices. The results showed that DM addiction, but not DM use, was related to children's emotional, behavioral, and academic difficulties. Moreover, the results indicated that negative parenting and behavioral dysregulation increased the risk of DM addiction, which in turn increased emotional, behavioral, and academic difficulties. The results underscored parents' role in preventing problematic DM use and highlighted the need to treat DM use and problematic DM use as distinct constructs.

Public Health Approach to Problems Related to Excessive and Addictive Use of the Internet and Digital Media

Purpose of Review

Advances in digital technology and media have provided convenience and advantages in all areas of our daily lives. However, there is a risk of excessive and addictive use, which increases the risk of addiction as a disease and other related mental and physical problems. This article reviews the public health approach to problems related to excessive and addictive use of the Internet and digital media.

Recent Findings

The public health model views addiction as the result of interactions among individuals, digital media, and the environment; therefore, interventions should aim to reduce risk factors and increase protective factors in these three areas. This includes developing and providing evidence-based services according to each individual's problem type and severity. Regarding interventions for digital media and the environment, restricting accessibility and regulating content may be necessary. This calls for an integrative, comprehensive, and continuous intervention strategy, and to achieve such a framework, we need to establish an information system to monitor the magnitude and patterns of related problems.

Summary

This review suggests a surveillance system that provides a list of evidence-based policies from the public health perspective. Suggestions for an advanced international information, policy, and monitoring system are discussed.

Changes of internet behavior of adolescents across the period of COVID-19 pandemic in China

During the COVID-19 pandemic, internet use and gaming of adolescents had been elevated. On the one hand, internet use and gaming in the period was a good approach to killing quarantined time. However, the increased use of the internet and game of adolescents may also increase the risk of internet addiction. This study aimed to describe the internet behavior changes of adolescents and to understand the impact of clinical features on internet addiction after the adolescents back to school in COVID-19 period. We conducted a cross-sectional cohort study using data collected through online investigation in China. Six hundred and twenty-five adolescents completed the online survey. Results indicated that internet addiction, having gaming use behaviors, Strengths and Difficulties Questionnaire (SDQ) Conduct subscale scores and the SDQ Prosocial subscale scores before the COVID-19 outbreak were significant in predicting the internet addiction after the adolescents back to school. The proportion of internet addiction and gaming behaviors among adolescents in China was changed across the COVID-19 pandemic. Clinical features before the COVID-19 pandemic could predict Internet addiction risk after the adolescents back to school.

Rejection sensitivity mediates the interparental conflict and adolescent Internet addiction: School connectedness as a moderator

Internet addiction (IA) is a growing social problem with negative mental and social outcomes; the present study examined whether rejection sensitivity mediates the relationship between interparental conflict and adolescent IA and the moderating role of school connectedness. One thousand and seven adolescents (51.84% females; Mean_age = 13.17; SD = 0.69) anonymously completed questionnaires to assess interparental conflict, school connectedness, rejection sensitivity, IA, and demographic information. The model results showed that: (1) the positive association between interparental conflict and adolescent IA was partially mediated by rejection sensitivity; (2) this indirect link was moderated by the school connectedness and was stronger for adolescents with high school connectedness. The results provide support for the attachment theory that high interparental conflict could increase adolescents’ rejection sensitivity, and high school connectedness plays a double-edged role that adolescents show more rejection sensitivity while reporting high interparental conflict and high school connectedness.

Associations Between Adolescent Problematic Internet Use and Relationship Problems in Chinese Families: Findings from a Large-scale Survey

BACKGROUND

Problematic internet use (PIU) is prevalent among Chinese adolescents. There is a need to better understand how the quality of parent-adolescent relationship is associated with adolescent PIU to guide the development of effective prevention and early intervention programs.

OBJECTIVE

This study aims to evaluate parent-adolescent conflict and parenting styles as potential risk factors associated with adolescent PIU.

METHODS

A sample of 6552 students (aged 10-19 years) from 22 schools in Guangdong, China, was recruited. The participants completed self-report questionnaires measuring their perceptions of conflict with their parents (involving verbal conflict, emotional abuse, and physical abuse) as well as their perceptions of their parents' parenting styles (including parental care and parental control as measured by the Parental Bonding Inventory), and PIU using the Adolescent Pathological Internet Use Scale. Grade level and gender were examined as moderators of these associations.

RESULTS

Using multiple regression analyses, we found that greater mother-adolescent conflict, father-adolescent conflict, and parental control, and lower levels of parental care, were associated with higher levels of adolescent PIU (P<.001). The association between mother-adolescent conflict and PIU was stronger in older students than in younger students (P=.04), whereas the association between father-adolescent conflict and PIU was stronger in male students than in female students (P=.02). Compared with those who reported no mother-adolescent conflict, participants who experienced verbal conflict and emotional abuse, but not physical abuse from their mothers, reported higher levels of PIU (P<.001). Compared with those who reported no father-adolescent conflict, participants who experienced verbal conflict, emotional abuse, and physical abuse from their fathers had significantly higher levels of PIU (P<.001, P<.001, and P=.02, respectively).

CONCLUSIONS

These findings point to the value of interventions to reduce parental verbal conflict, emotional abuse, and physical abuse, and to increase positive parenting styles, to lower the risk of PIU in Chinese adolescents.

Family Factors Associated with Problematic Use of the Internet in Children: A Scoping Review

BACKGROUND

Problematic use of the internet (PUI) is a growing concern, particularly in the young population. Family factors influence internet use among children in negative ways. This study examined the existing literature on familial or parental factors related to PUI in children.

METHODS

A scoping review was conducted in EBSCOhost, PubMed, ScienceDirect, JSTOR, Biomed Central, VHL Regional Portal, Cochrane Library, Emerald Insight, and Oxford Academic Journal databases. Studies reporting data on family factors associated with PUI in children, published in English in the 10 years to July 2020 were included. The following data were extracted from each paper by two independent reviewers: methodology and demographic, familial, psychiatric, and behavioral correlates of PUI in children.

RESULTS

Sixty-nine studies fulfilled the eligibility criteria. Three themes emerged: parenting, parental mental health, and intrafamilial demographic correlates of PUI in children. Parenting styles, parental mediation, and parent-child attachment were the major parenting correlates.

CONCLUSION

Literature on significant familial and parental factors associated with PUI in children is scarce. More research is required to identify the interactions of familial and parental factors with PUI in children, to develop informed management strategies to address this issue.

How Does the Parent–Adolescent Relationship Affect Adolescent Internet Addiction? Parents’ Distinctive Influences

Although previous research has demonstrated that parent–adolescent relationships have a significant effect on adolescent Internet Addiction (IA), the mechanisms underlying these associations and parental differences in these effects have received insufficient attention. We investigated the mediating role of Perceived Social Support and Dual System of Self-Control (DSSC) in the relationship between Father-Adolescent Relationships/Mother-Adolescent Relationships (FAR/MAR) and adolescent IA, as well as the differences in the effects of FAR and MAR. A cross-sectional survey of 732 Chinese adolescents was conducted using the Adolescent Pathological Internet Use Scale, Parent–Adolescent Relationship Scale, Multidimensional Scale of Perceived Social Support, and Dual System of Self-Control Scale. Multiple linear regression analysis, Pearson correlation analysis and structural equation modeling were used. The results of structural modeling analysis showed that neither FAR nor MAR directly predicted adolescent IA. In contrast, FAR/MAR had an impact on adolescent IA mainly through the mediating effects of Perceived Social Support and Impulsive System. Furthermore, in the relationship between FAR/MAR and adolescent IA, the Impulsive System and Perceived Social Support both served as chain mediators, as did Perceived Social Support and the Reflective System. And more importantly, unlike FAR, MAR affects adolescent IA through the mediating effect of the Reflective System. Multiple linear regression showed that the regression coefficient of MAR on adolescent IA had stronger significance compared to FAR, MAR is deserving of more attention than FAR. These findings contribute to our understanding of the mechanisms underlying the association between FAR/MAR and adolescent IA and suggest that family relationship-focused training approaches are critical for suppressing adolescent IA. These interventions should be tailored to the unique circumstances of each family.

Internet behavior patterns of adolescents before, during, and after COVID-19 pandemic

BACKGROUND

The outbreak of COVID-19 has affected the mental health of adolescents. To describe the Internet behavior-changing patterns of adolescents and to understand the impact of clinical features on changing patterns during the COVID-19 pandemic.

MATERIALS AND METHODS

We conducted a cross-sectional cohort study using data collected through online investigation in China. A total of 625 adolescents completed the online survey from May 15 to June 7, 2020. The adolescents were asked to retrospect to the Internet behaviors and game behaviors of three time periods as follows: before the COVID-19 outbreak in China, during the COVID-19 outbreak in China, and back to school. The clinical variables of the demographic data, family functionality, and emotional and behavioral symptoms were also collected. According to the Internet behaviors and game behaviors patterns across the three time periods, the subjects will be sub-grouped.

RESULTS

Four Internet behavior-changing patterns during the COVID-19 was identified: (1) Continuous Normal Group (55.52%); (2) Normal to Internet Addiction Group (5.28%); (3) Internet Addiction to Normal Group (14.56%); and (4) Continuous Internet Addiction Group (24.64%). Years of education, academic score ranking, family functionality, and emotional and behavioral symptoms were different across the four groups. Proportions of game behaviors, scores of Strengths and Difficulties Questionnaire (SDQ), and SDQ subscale during the period before the COVID-19 outbreak were significant in predicting changing patterns.

CONCLUSION

The Internet behavior patterns of adolescents during the COVID-19 period were various. Clinical features before the COVID-19 pandemic may predict changing patterns. The heterogeneity in characteristics between different changing patterns should be considered when intervening in adolescents' problematic Internet behavior.

Individual and Interpersonal Factors Associated with the Incidence, Persistence, and Remission of Internet Gaming Disorders Symptoms in an Adolescents Sample

Video game playing behavior has serious consequences for adolescents on a personal, family, social, and academic level. This research aimed to examine risk and protective factors involving incidence, persistence, and remission of gaming disorders symptoms (IGDs) in Spanish adolescents after nine months of follow-up. Data were drawn from self-administered questionnaires completed on two occasions: at the beginning (T1) and end of the academic year (T2). A total of 950 adolescents aged from 11 to 20 years (M = 14, SD = 1.52, 48.5% female) completed the questionnaire at T1, while 550 adolescents aged from 11 to 18 years (M = 13.43, SD = 1.23, 48.9% female) took part in the follow-up study (T2). The incidence, persistence, and remission rates were 6%, 2.7%, and 4.2%, respectively. Significant relationships with IGDs were found between the male gender and studying at a private school in T1 and T2. The findings show that the time spent playing video games during T1 was positively associated with IGDs in T1 and T2. The incidence of IGDs was associated with emotional problems and low family affection. The persistence of IGDs was linked to higher motor impulsivity, agreeableness, and lower family resolve. Remission was related to a decrease in anxiety and hostility as well as an increase in the emotional stability of adolescents. These findings imply that emotional well-being and family adjustment could be relevant for the effective management of gaming behaviors.

Relationship Between Parental Marital Conflict and Social Anxiety Symptoms of Chinese College Students: Mediation Effect of Attachment

Social anxiety has been a common problem among college students and has an adverse impact on their adaptation outcomes. Among influential factors, parental marital conflict and attachment (parental and peer attachment) have been found to be related to social anxiety symptoms of college students; however, little is known how parental marital conflict and attachment jointly contribute to social anxiety symptoms of college students. The current study explored this issue. Self-reported questionnaires of perception of children of interparental conflict scale, inventory of parent and peer attachment, and the social interaction anxiety scale were administered to 707 undergraduate students (Mean age = 19.27, SD = 0.97). Results indicated that perceived parental marital conflict was positively correlated with social anxiety symptoms and was negatively associated with parental and peer attachment. Parental and peer attachments were negatively correlated with social anxiety symptoms. Mediation analyses indicated that perceived parental marital conflict exerted its indirect effect on social anxiety symptoms through a serial multiple mediation role of parental and peer attachment. The present findings highlight the serial multiple mediation role of parental and peer attachment in the relationship between perceived parental marital conflict and social anxiety symptoms of college students.

The Relationship between Family Functioning and Pathological Internet Use among Chinese Adolescents: The Mediating Role of Hope and the Moderating Role of Social Withdrawal

This study constructed a moderated mediation model based on problem behavior theory to explore the psychological mechanism of family functioning interaction with pathological internet use. We used the Adolescent Pathological Internet Use Scale, General Functioning Scale, Trait Hope Scale, and Social Withdrawal Scale to measure internet use in 1223 middle school students. The results showed that (1) pathological internet use was negatively correlated with family functioning and hope, and positively correlated with social withdrawal; family functioning was positively correlated with hope, and negatively correlated with social withdrawal; hope was negatively correlated with social withdrawal; (2) family functioning could not only directly predict pathological internet use, but also indirectly predict pathological internet use through hope; and (3) the mediating effect of family functioning on pathological internet use was moderated by social withdrawal, which was stronger for individuals with low social withdrawal but not significant for individuals with high social withdrawal. This study revealed the internal mechanism of the relation between family functioning and adolescents’ pathological internet use, which has theoretical significance for improving adolescents’ hope and reducing their pathological internet use.

Prevalence and Factors Associated with Problematic Internet Use in a Population of Spanish University Students

(1) Background: To examine the prevalence, and associated factors of, problematic Internet use in a sample of Spanish university students. (2) Methods: Cross-sectional descriptive study of a convenience sample of 698 university students. Self-esteem, alcohol consumption, perceived social support, depression, anxiety, stress and problematic Internet use were evaluated using the Rosenberg, CAGE, DUKE-UNC-11, DASS-21 and Young's Internet Addiction Test, respectively. (3) Results: Problematic internet use was reported by 21% of respondents. Risk of problematic Internet use was independently associated with the preferred use of the smartphone, time of exposure to the Internet, less perceived social support, problematic alcohol consumption and symptoms of stress and anxiety. We found significant association between problematic internet use and time of exposure to the Internet, residential status, alcohol consumption, self-esteem, perceived social support and psychological distress, after bivariate analysis. (4) Conclusions: A considerable prevalence of problematic Internet use was found; in our sample problematic Internet use was associated with stress, alcohol consumption, anxiety and perceived social support. Strategies aimed at the early identification of problematic Internet use may lead to an improvement in the psychosocial health of the university student population.

Development and Validation of the Gaming Disorder Scale-Family Form

The aim of the current methodological study was to develop a psychometric measurement tool for determining internet gaming disorder (IGD) based on family members' responses. The sample comprised 173 adolescents and their families. For reliability, the scale was created using item-total correlation, internal consistency coefficient, and test-retest correlation methods. The validity of the scale was evaluated using content validity index (CVI), construct validity, explanatory factor analysis (EFA), and confirmatory factor analysis (CFA). CVI for the scale was 0.92, Cronbach's alpha coefficient was 0.963, and item-total correlation ranged between 0.67 and 0.81. In the EFA, 61.7% of the total variance on the one-dimensional scale was explained and item factor loads ranged between 0.71 and 0.84. CFA showed good fit of the model. Thus, the Gaming Disorder Scale-Family Form, which was proven to be a valid and reliable measurement tool, is recommended for use by health care providers and community partners in the evaluation of potential IGD in adolescents. [Journal of Psychosocial Nursing and Mental Health Services, xx(x), xx-xx.].

Internet addiction among Czech adolescents

Our study estimates the prevalence of Internet addiction in Czech adolescents as well as differences by gender and school type. A total of 3,950 adolescents (n = 1,940 boys, n = 2,010 girls) from 11 to 19 years of age (M = 15.73, SD = 1.99) participated in the research. They completed the Internet Addiction Test, which consists of subscales for Salience, Excessive Use, Neglect Work, Anticipation, Lack of Control, and Neglect Social Life. The results indicate that adolescent girls have higher levels of internet addiction. In boys, unlike girls, internet addiction was associated with a reduction in social relationships and interactions. Our findings show interesting differences between adolescent girls and boys and the type of school attended in the Czech population in terms of Internet addiction.

Problematic Internet Use in Adolescents from Divorced Families: The Role of Family Factors and Adolescents' Self-Esteem

Family functioning is salient in explaining adolescents’ problematic internet use (PIU), and precisely this family functioning is under pressure after parental divorce. Moreover, growing up with divorced parents is identified as a risk factor for PIU. Therefore, examining which factors are associated with adolescents’ PIU after divorce is particularly important. Based on self-report data from N = 244 adolescents of divorced families (49.6% boys, M = 13.42), structural equation modeling (SEM) was used to examine the associations of PIU with interparental conflict, triangulation, maternal and paternal warmth, and adolescents’ self-esteem. Potential buffering effects of self-esteem were tested, as well as gender differences in associations. The results showed that more triangulation and less maternal warmth were related to higher levels of PIU, but these effects disappeared after adding self-esteem to the models. Adolescent self-esteem did not significantly buffer the effects of the different family factors on PIU, nor were there any significant gender differences in association. Hence, especially adolescents’ self-esteem seems to be a key aspect for PIU in adolescents from divorced families.

Social Networking Addiction Among Hong Kong University Students: Its Health Consequences and Relationships With Parenting Behaviors

The use of social networking sites (SNSs) has been growing at a staggering rate, especially among university students. The present study investigated the prevalence of social networking addiction (SNA), its health consequences, and its relationships with parents' Internet-specific parenting behaviors in a sample of Hong Kong university students (N = 390). Adopting the 9-item social media disorder scale, 21.5% of the participating students met the criteria for SNA. Students with SNA showed longer sleeping latency, more sleep disturbance, poorer academic performance, lower levels of life satisfaction, and higher levels of depression than did students without SNA. Parental reactive restriction and limiting online behaviors of the participants were associated with higher risk of SNA. The findings suggest the severity of SNA and its negative consequences among Hong Kong university students. While parental behaviors limiting children's use of SNSs were found to increase the occurrence rate of SNA among university students, longitudinal studies are needed to further examine this causal relationship.

Insomnia Status of Middle School Students in Indonesia and Its Association with Playing Games before Sleep: Gender Difference

The excessive use of online gaming before sleep in adolescents could be a risk factor of sleep disorders such as insomnia. This study aimed to assess the association between playing online games before sleep and insomnia based on gender perspective among middle school students in Indonesia. This was a retrospective study and the data came from a cross-sectional survey that included 315 of Grade 8 and 9 students from four middle schools in Jakarta, Indonesia. Self-reported data were collected via a structured questionnaire, which consisted of demographic variables, sleep duration per day, frequency of playing online games before sleep and the Insomnia Severity Index (ISI). Insomnia status was classified into "none or mild" and "moderate to severe" according to ISI score. The proportions of male and female students who often or always played online games before sleep were 50.3% and 21.7%, respectively. Grade 9 students were more likely to have moderate to severe insomnia than Grade 8 students for males (odds ratio-OR = 4.34, p = 0.005) but not for females (OR = 0.69, p = 0.363). However, female students who often or always played online games before sleep were more likely to have moderate to severe insomnia (OR = 4.60, p = 0.001); such an association was relatively smaller for male students (OR = 3.09, p = 0.061). Gender differences should be taken into account when developing health education or interventions.

A Qualitative Study of Practitioners' Views on Family Involvement in Treatment Process of Adolescent Internet Addiction

Despite emerging evidence of the effectiveness of a family-focused approach as an Internet addiction (IA) treatment modality for adolescents, little research has been done to explore family involvement in the treatment process from the clinician's perspective. This study employed a qualitative design to examine practitioners' views pertaining to the roles and challenges of family participation in IA intervention. In total, 10 practitioners working with adolescents with IA were interviewed. Thematic analysis was used to analyze the transcribed interviews. Three overreaching themes were synthesized: That family involvement in IA intervention is challenging yet important; shifting the focus from the adolescent to the relationship; and provision of individualized services and intervention to address the heterogeneous nature of cases. The findings show that family participation in IA treatment is successful in enhancing positive outcomes. The needs of adolescents with IA and family members are addressed through individual counseling and psychoeducation, respectively. Conjoint therapy sessions foster effective communication, improve family interactions and functioning, and restore relationships. However, caution regarding family dynamics is required when considering whether family involvement is appropriate. Practitioners need to establish therapeutic alliances and be flexible when working with family members in terms of the degree and arrangement of participation.

Prevalence of Internet Addiction during the COVID-19 Outbreak and Its Risk Factors among Junior High School Students in Taiwan

The coronavirus disease 2019 (COVID-19) outbreak has significantly disrupted normal activities globally. During this epidemic, people around the world were expected to encounter several mental health challenges. In particular, Internet addiction may become a serious issue among teens. Consequently, this study aimed to examine the prevalence of Internet addiction and identify the psychosocial risk factors during the COVID-19 outbreak. This study was constructed using a cross-sectional design with 1060 participants recruited from among junior high school students around Taiwan using stratified and cluster sampling methods. Taiwan's first COVID-19 case was diagnosed on 28 January 2020. New cases exploded rapidly in February, and as a result, participants were surveyed during March 2 through 27 March 2020. The prevalence of Internet addiction was found to be 24.4% during this period. High impulsivity, high virtual social support, older in age, low subjective well-being, low family function, and high alexithymia was all independently predictive in the forward logistic regression analyses. The prevalence rate of Internet addiction was high among junior high school students during the COVID-19 outbreak. Results from this study can be used to help mental health organizations and educational agencies design programs that will help prevent Internet addiction in adolescents during the COVID-19 pandemic.

Internet Addiction and Attention in Adolescents: A Systematic Review

Internet addiction (IA) has been explored worldwide and involves some features that might harm social, psychological, and functional aspects. The vulnerability of adolescents might result in some addictive behaviors, and the Internet is one of them. The aim of this systematic review was to identify empirical studies that have been done to explore instruments that have been used to assess IA and to verify what variables and comorbidities are related to IA in adolescents, including executive functions, such as attention. To accomplish our aim, a systematic search was conducted in the following databases: PubMed, Web of Science, and PsycINFO. Some inclusion and exclusion criteria were used to select the studies and 44 in total were analyzed independently. The results showed that the most used instrument to assess IA is the Young's Internet Addiction Test. A few studies have been developed in the Western world, and most of them have analyzed attention bias in attention-deficit/hyperactivity disorder (ADHD) and non-ADHD groups. Furthermore, other variables have been widely explored in the studies, such as depression, sleeping patterns, body weight, aggressiveness, and other addictive substances.

Worry and Permissive Parenting in Association with the Development of Internet Addiction in Children

The Internet has experienced a rapid increase in use globally. Specifically, more than 90% of Hong Kong’s citizens use the Internet, and 70% of children in the age group of 6–17 years have daily access to it. However, internet addiction could pose serious social and health issues. Therefore, conducting research to investigate its causes and risk factors is fundamental. The current study examined the relationship between worry and Internet addiction among children in Hong Kong and investigated the moderating effect of the permissive parenting style on such a relationship. The participants consisted of 227 fourth- and fifth-grade students (120 males, 52.9%) with a mean age of 9.55 (standard deviation (SD) = 0.58) in Hong Kong. Each participant was asked to complete the questionnaires, including the Internet Addiction Test for Internet addiction, the Penn State Worry Questionnaire for Children for worry, and the Parental Authority Questionnaire for the permissive parenting style. The results indicated that worry was related to greater Internet addiction among children. Furthermore, there was a moderating effect of the permissive parenting style such that the positive association between worry and Internet addiction was stronger when the permissive parenting style was higher. Our findings imply that parenting styles are influential in the prevention of Internet addiction.

The Psychosocial Factors of Elementary School-Aged Children’s Compulsive Internet Use As Reported by Children and Parents

Children’s electronic media use in the form of Internet has increased over the past decades. The activities that children engage using the Internet can lead to experiencing positive as well as negative outcomes. Recent studies have found that excessive time devoted to the Internet use and behavioral narrowing can lead to Internet addiction (Enagandula et al., 2018) or compulsive Internet use (Meerkerk et al., 2009). This phenomenon can be described as a greater risk of developing excessive online habits, which may result in impairments of individual’s activities of daily living as well as relationships with others. Specific characteristics of these associations, however, have been examined only minimally in young children. The goal of this study was to examine the peculiarities of elementary school-aged children’s Internet use in relation to sociodemographic and relationships with others, as well as possible behavioral and emotional difficulties. The sample consisted of 304 parent-child dyads. All children in the study were second or third grade students (mean age 8.47 years, SD = 0.56), 50.3% were boys. Children and parents completed the Compulsive Internet Use Scale (CIUS; Meerkerk et al., 2009) and provided information about time spent on the Internet. Parents provided sociodemographic information and completed the Strengths and Difficulties Questionnaire (SDQ; Goodman, 1997), and children answered questions about their relationships with their parents and peers. The results of the study revealed significant gender differences in compulsivity of the Internet use, i.e. the estimates of boys CIUS – both provided by children and their parents – were significantly higher than girls. In overall, there was good agreement between parental and children’s reports on child’s CIUS, however parents reported higher CIUS scores and longer Internet use than children themselves. Regression analysis revealed that children’s CIUS is predicted (a) from the child’s perspective – by longer Internet time together with lower scores of child prosocial behavior, male gender, less advantaged financial situation in the family, and poorer parent-child relationships; (b) from the parent’s perspective – by longer Internet time, male gender, lower scores of child prosocial behavior, higher scores of behavioral and emotional difficulties together with less advantaged financial family status. The findings of the study are discussed in light of evidence-based practice and research.

Problematic internet use: A scoping review – longitudinal research on a contemporary social problem, 2006–2017

Background and aims:

Problematic internet use (PIU), and kindred concepts such as internet addiction (IA), make up a growing research field, partly due to the suggested inclusion of internet gaming disorder in a future DSM-6 as well as the fact that gaming disorder is on its way to being included in the ICD-11. Conclusions from research are far from unified. This study aims to synthesise the research field of problematic internet use/internet addiction/gaming disorder, with a focus on the reporting of prevalence and change.

Methods:

Longitudinal studies of PIU/IA formed the basis for a scoping review. Systematic searches of Web of Science, Scopus and Proquest, for peer-reviewed and published articles based on empirical data collected at a minimum of two time points for studies, and with an end point set at 2017, led to the inclusion of 97 studies. Endnote X7 was used to organise the results and NVivo 11 was used for synthesising the results.

Results:

Analyses focused on prevalence and change. Findings show variation among measures and prevalence as well as in reported outcomes relating to social life and other problems. Most studies reported relations between PIU/IA and other problems in life, but no specific time order could be established. Furthermore, many studies did not present data on prevalence or change even though using a longitudinal survey design.

Discussion and conclusions:

In summary, the research field is plagued by a lack of consensus and common understanding, regarding both measures, perceptions of the problem, and findings.

Interparental conflict, parent–adolescent attachment, and adolescent Internet addiction: The moderating role of adolescent self-control

We explored the extent to which adolescent self-control moderated the relationships among interparental conflict, parent–adolescent attachment, and adolescent Internet addiction. Participants comprised 459 junior high school students, who completed the Adolescents' Perception of Interparental Conflict Scale, the Self-Control Scale, the Inventory of Parent and Peer Attachment, and the Internet Addiction Scale. Results show that adolescents' perceptions of interparental conflict was significantly and positively correlated with their Internet addiction. In addition, the relationship between perceived interparental conflict and Internet addiction was mediated by parent–adolescent attachment. Finally, self-control moderated the relationships among interparental conflict, parent–adolescent attachment, and Internet addiction. Policy implications, limitations, and directions for future research are discussed.

Internet Addiction in India: Its Current Prevalence and Psychological and Complementary Treatment Techniques

Background:

In this technical era, undoubtedly, the internet has brought a great revolution worldwide. Smartphones and technology-mediated social networking sites have caused a drastic increase in internet usage in all age groups of people. This has caused internet captivity leading to its addiction.

Objective:

The paper focussed on the mediators and predictors of internet addiction in India in all age groups of people. Its long-term solutions, i.e. psychological and complementary treatments were focussed that work on personal level rather than disease level.

Methods:

An extensive literature review was done on the prevalence of the internet and its psychological and complementary treatment. The possible non-pharmacological treatment, specifically cognitive behaviour treatment, art and music therapy, internet fasting and cosmic medicine were focussed on its efficient improvement in one’s health.

Conclusion:

As evident from our study, internet addiction is one of the growing challenges of health complications in all age groups of people. The mainly discussed psychological and complementary treatments of internet addiction have ample opportunity of seeking betterment with healthy social and mental well being.

Profiles and sociodemographic correlates of Internet addiction in early adolescents in southern China

Adolescent Internet addiction is currently one of the most common and serious publicly social problems. Understanding Internet addiction in early adolescents has become particularly important for early detection and intervention. This study examines profiles of Internet addiction among Chinese early adolescents and explores both the personal and familial correlates of Internet addiction based on a large random sample. A total of 2059 Chinese seventh-grade students were invited to complete the questionnaire, which included sociodemographic factors, family functions, and Internet addiction. The results reveal that 15.3% of the participating Chinese early adolescents were defined by Young (1998) criteria as expressing Internet addiction, in which boys were more likely to express Internet addiction than girls. Students with poor academic achievements were also more likely to fall into this addiction. Adolescents who did not live with their parents and who experienced more family conflicts and less family communication were more likely to report Internet addiction. These findings suggest that focusing on boys and academic under-performers as well as improving family environments can help early adolescents reduce their propensity to become addicted to the Internet.

Childhood Maltreatment and Mobile Phone Addiction Among Chinese Adolescents: Loneliness as a Mediator and Self-Control as a Moderator

Previous studies have found that childhood maltreatment is an important risk predictor of adolescent mobile phone addiction (MPA). However, little is known about the mediating and moderating mechanisms underlying this association. Grounded in the Basic Psychological Needs Theory and the organism-environment interaction model, this study examined the mediating effect of loneliness and the moderating effect of self-control in the relationship between childhood maltreatment and adolescent MPA. A total of 981 Chinese adolescents (Mage = 13.68 years, SD = 0.92) completed measures regarding childhood maltreatment, MPA, loneliness, and self-control. After controlling for participants’ demographic variables, loneliness partially mediated the relation between childhood maltreatment and adolescent MPA and this indirect path was moderated by self-control. Specifically, the effect of loneliness on MPA was stronger for adolescents with lower self-control than for those with higher self-control. Our research provides additional evidence for the negative association between childhood maltreatment and MPA.

The buffer effect of physical activity: Why does parental marital satisfaction affect adolescents' problematic Internet use

•

Marital satisfaction negatively predicted adolescents' problematic internet use (PIU).

•

Depression mediated the relationship between marital satisfaction and PIU.

•

The mediating effect was significant for individuals with low physical activity.

•

The mediating effect was not significant for individuals with high physical activity.

Introduction

To explore the moderating effect of physical activity and the mediating effect of depression on the relationship between marital satisfaction and adolescents’ problematic internet use (PIU).

Methods

This study adopted a sample of 288 adolescents and their parents, and measured adolescents’ depression, PIU, physical activity, and parents’ marital satisfaction.

Results

These results showed that parental marital satisfaction negatively predicted adolescents' PIU. Adolescents’ depression played a mediating role between parental marital satisfaction and adolescents’ PIU. Further mediated moderation effect analysis showed that the interaction between marital satisfaction and adolescents' physical activity affected the PIU through adolescents’ depression. Specifically, for individuals with lower physical activity, the marital satisfaction affected the PIU through adolescents' depression. However, for the group with higher physical activity, physical activity weakened the effects of marital satisfaction on adolescents' depression, and the mediating effect of depression did not reach a significant level.

Conclusion

These results are of theoretical and practical significance in understanding and intervening to address adolescents' PIU.

When adolescents face both Internet addiction and mood symptoms: A cross-sectional study of comorbidity and its predictors

This study aimed to determine the prevalence of comorbid Internet addiction (IA) and mood symptoms and to identify common and unique risk profiles for individual and comorbid mental health problems among adolescents. A total of 2272 high school students in Changchun, China, were included in a cross-sectional study. Participants were asked to complete paper-based questionnaires on sociodemographic characteristics, lifestyle factors, Internet use, parent-child relationships, IA, and mood symptoms. Multivariate logistic regressions were used to compare the risk profiles for IA, mood symptoms, and their comorbidity. The Bonferroni correction was used for multiple tests. Students who were girls, were current smokers, had more than 1.5 h sleep deprivation per day on weekdays, used the Internet for more than 30 and 240 min per day on weekdays and weekends, respectively, used social networking sites more than 6 times per day, were Internet gamers, and/or reported poor parent-child relationships reported higher rates of comorbid IA and mood symptoms. Adolescents exposed to more of these correlates would have a higher risk of IA, mood symptoms, and their comorbidity. Public strategies for the prevention of mental illnesses should expand their capacity to identify and limit the co-occurrence of IA and mood symptoms.

Linking parental mediation practices to adolescents' problematic online screen use: A systematic literature review

BACKGROUND AND AIMS

To remedy problematic Internet use (PIU) and problematic online gaming (POG) in adolescents, much is expected from efforts by parents to help youths to contain their screen use. Such parental mediation can include (a) refraining from acting, (b) co-viewing or co-gaming with the teen, (c) active mediation, and (d) restrictive mediation. We evaluated if parental mediation practices are linked to PIU and POG in adolescents.

METHODS

For a systematic literature review, we searched for publications presenting survey data and relating parental mediation practices to levels of PIU and/or POG in adolescents. The review's selection criteria were met by 18 PIU and 9 POG publications, reporting on 81.002 and 12.915 adolescents, respectively. We extracted data on gaming problems, mediation interventions, study design features, and sample characteristics.

RESULTS

No type of parental mediation was consistently associated with lower or elevated problematic screen use rates in the adolescents. Refraining from parental mediation tended to aggravate screen use problems, whereas active mediation (talking to the teen) may mitigate such problems in PIU, but less clearly in POG. The link of restrictive mediation with problematic screen use varied from positive to negative, possibly depending on type of restriction. In both PIU and POG, family cohesion was related to lower rates of the problem behavior concerned and family conflict to higher rates.

DISCUSSION AND CONCLUSIONS

Parental mediation practices may affect problematic screen use rates for better or worse. However, research of higher quality, including observations of parent-teen interactions, is needed to confirm the trends noted and advance the critical issue of the possible association between PIU, POG, and family interactions.

Functional neural changes and altered cortical-subcortical connectivity associated with recovery from Internet gaming disorder

BACKGROUND AND AIMS

Although studies have suggested that individuals with Internet gaming disorder (IGD) may have impairments in cognitive functioning, the nature of the relationship is unclear given that the information is typically derived from cross-sectional studies.

METHODS

Individuals with active IGD (n = 154) and those individuals no longer meeting criteria (n = 29) after 1 year were examined longitudinally using functional magnetic resonance imaging during performance of cue-craving tasks. Subjective responses and neural correlates were contrasted at study onset and at 1 year.

RESULTS

Subjects' craving responses to gaming cues decreased significantly at 1 year relative to study onset. Decreased brain responses in the anterior cingulate cortex (ACC) and lentiform nucleus were observed at 1 year relative to onset. Significant positive correlations were observed between changes in brain activities in the lentiform nucleus and changes in self-reported cravings. Dynamic causal modeling analysis showed increased ACC-lentiform connectivity at 1 year relative to study onset.

CONCLUSIONS

After recovery from IGD, individuals appear less sensitive to gaming cues. This recovery may involve increased ACC-related control over lentiform-related motivations in the control over cravings. The extent to which cortical control over subcortical motivations may be targeted in treatments for IGD should be examined further.

#StateOfMind: Family Meal Frequency Moderates the Association Between Time on Social Networking Sites and Well-Being Among U.K. Young Adults

Family belonging may influence relationships between the amount of time spent on social networking sites (SNS) and well-being. We examined the SNS and well-being association among young adults and investigated whether different markers of family belonging moderated this association. SNS, well-being, and family data (n = 2,229) were collected from adults aged 16-21 years living with their parent(s) in the United Kingdom. Participants were classed as nonusers (0 hours/weekday spent chatting or interacting with friends through social Web sites), moderate (nonzero to 4 hours/weekday), or heavy users (4+ hours/weekday). Multivariable linear regressions examined the SNS use and well-being associations; interaction terms tested whether these varied by family belonging (family meal frequency, strength of family support, and importance of family to personal identity). Well-being scores were lower for heavy users of SNS compared with moderate users (p = 0.044), and for those sharing few or no family meals (p < 0.001). The SNS use and well-being association was significantly moderated by family meal frequency (p = 0.009). Among those reporting no family meals, well-being scores were lower for heavy users versus nonusers (22.4 vs. 25.3). Well-being scores were similar across the SNS use categories among those having more family meals. Among heavy users of SNS, young adults having no family meals may be particularly vulnerable to the harms of being online. Our findings highlight the importance of minimizing the harms of heavy SNS use, including support for families to enable them to develop and build young adults' resilience to the stresses and anxieties that potentially accompany online social networking.

Personal Factors, Internet Characteristics, and Environmental Factors Contributing to Adolescent Internet Addiction: A Public Health Perspective

Individual characteristics, family- and school-related variables, and environmental variables have equal importance in understanding Internet addiction. Most previous studies on Internet addiction have focused on individual factors; those that considered environmental influence typically only examined the proximal environment. Effective prevention and intervention of Internet addiction require a framework that integrates individual- and environmental-level factors. This study examined the relationships between personal factors, family/school factors, perceived Internet characteristics, and environmental variables as they contribute to Internet addiction among adolescents based on the public health model. A representative sample of 1628 junior high school students from 56 regions in Seoul and Gyeonggi-do participated in the study via questionnaires with the cooperation of the Ministry of Health and Welfare and the district office of education. The study analyzed psychological factors, family cohesion, attitudes toward academic activities, Internet characteristics, accessibility to PC cafés, and exposure to Internet game advertising. About 6% of the adolescents were categorized as being in the severely addicted group. Between-group comparisons showed that the addicted group had started using the Internet earlier; had higher levels of depression, compulsivity, and aggressiveness as well as lower family cohesion; and reported higher accessibility to PC cafés and exposure to Internet game advertising. Multiple logistic regression indicated that for adolescents, environmental factors had a greater influence than family or school-related factors. Policy implications for prevention and intervention are discussed.

The role of depressive symptoms, anxiety symptoms, and school functioning in the association between peer victimization and internet addiction: A moderated mediation model

BACKGROUND

Both peer victimization and internet addiction are common public health problems for children and adolescents. Several studies found an association between peer victimization and internet addiction, but the mechanism underlying this association remained unclear. This study aimed to determine the mechanisms underlying this association.

METHODS

Data was extracted from an epidemiologic study involving middle and high school adolescents, in which 15,415 individuals (14.6 ± 1.7 years) were recruited. The moderated mediation models were examined using SPSS PROCESS macro 2.16 software, in which the mediation variables were depressive symptoms and anxiety symptoms, and the moderation variable was school functioning.

RESULTS

The total indirect effect of verbal victimization on internet addiction through depressive symptoms and anxiety symptoms was found to be 0.4531, which accounted for 63.7% of the total effect of verbal victimization on internet addiction. Depressive symptoms and anxiety symptoms totally mediated the association between relational victimization and internet addiction and the association between the physical victimization and internet addiction. There were gender differences in the mediating effects of depressive and anxiety symptoms on the association between peer victimization and internet addiction. The indirect effect of the three different types of peer victimization (physical, verbal, relational) on internet addiction became stronger as school functioning increased.

LIMITATIONS

We included two mediators in one model, and the data used in this study was self-reported and cross-sectional.

CONCLUSIONS

Depressive symptoms and anxiety symptoms mediate the association between peer victimization and internet addiction. Students who score higher in school functioning were more likely to develop internet addiction when they encounter peer victimization.

The association of problematic smartphone use with family well-being mediated by family communication in Chinese adults: A population-based study

BACKGROUND AND AIMS

Few studies have investigated the effects of problematic smartphone use (PSU) in the family context. We studied the association of PSU as a predictor with family well-being and the potential mediating role of family communication in Hong Kong Chinese adults.

METHODS

We analyzed data of 5,063 randomly selected adults [mean age (SD) = 48.1 (18.2) years; 45.0% men] from a dual landline and mobile telephone survey in 2017. PSU was assessed by the Smartphone Addiction Scale-Short Version with higher scores indicating higher levels. Family well-being was assessed by three questions on perceived family health, harmony, and happiness (3Hs) with higher scores indicating greater well-being. Perceived sufficiency and quality of family communication were rated. Multivariable regression analyses examined (a) associations of PSU with family 3Hs and well-being and (b) mediating role of family communication, adjusting for sociodemographic variables.

RESULTS

PSU was negatively associated with perceived family health (adjusted β = -0.008, 95% CI = -0.016, -0.0004), harmony (adjusted β = -0.009, 95% CI = -0.017, -0.002), happiness (adjusted β = -0.015, 95% CI = -0.022, -0.007), and well-being (adjusted β = -0.011, 95% CI = -0.018, -0.004). Perceived family communication sufficiency (adjusted β = -0.007, 95% CI = -0.010, -0.005) and quality (adjusted β = -0.009, 95% CI = -0.014, -0.005) mediated the association of PSU with family well-being, with 75% and 94% of total effects having mediated, respectively.

DISCUSSION AND CONCLUSIONS

PSU was negatively associated with family well-being, which was partially mediated by family communication. Such findings provide insights for health programs to prevent PSU and improve family well-being.

Young, Bullying, and Connected. Common Pathways to Cyberbullying and Problematic Internet Use in Adolescence

Cyberbullying perpetration (CBP) and problematic Internet use (PIU) are the most studied risky online activities for adolescents in the current generation. However, few studies have investigated the relationship between CBP and PIU. Still lacking is a clear understanding of common or differentiated risk and protective pathways for adolescents interacting in the cyber world. The aim of this study was to understand the role of individual (emotional symptoms) and environmental variables (parental monitoring) underpinning both CBP and PIU, with time spent online as a mediator of these factors. Furthermore, we investigated gender and school level differences in these dynamics. A questionnaire was filled in by 3,602 students from Italian Lower Secondary Schools and Upper Secondary Schools. Structural equation modeling was used to test the effects of emotional symptoms and parental monitoring on CBP and PIU mediated by time spent online, controlling for school level. In addition, the model was implemented for girls and boys, respectively. Negative emotional symptoms and low levels of parental monitoring were risk factors for both CBP and PIU, and their effect was mediated by the time spent online. In addition, parental monitoring highlighted the strongest total effect on both CBP and PIU. Risk and protective pathways were similar in girls and boys across Lower Secondary and Upper Secondary Schools, although there were some slight differences. CBP and PIU are the outcomes of an interplay between risk factors in the individual and environmental systems. The results highlight the need to design interventions to reduce emotional symptoms among adolescents, to support parental monitoring, and to regulate the time spent online by adolescents in order to prevent risky online activities.

Brain response features during forced break could predict subsequent recovery in internet gaming disorder: A longitudinal study

Although internet gaming disorder (IGD) is associated with negative health measures, individuals may recover without professional intervention. Exploring neural features associated with natural recovery may provide insights into how best to promote health among people with IGD. Seventy-nine IGD subjects were scanned when they were performing cue-craving tasks before and after gaming was interrupted with a forced break. After one year, 20 individuals no longer met IGD criteria and were considered recovered. We compared brain responses in cue-craving tasks between these 20 recovered IGD subjects and 20 matched IGD subjects still meeting criteria at one year (persistent IGD). Recovered IGD subjects showed lower dorsolateral prefrontal cortex (DLPFC) activation than persistent IGD subjects to gaming cues at both pre- and post-gaming times. Significant group-by-time interactions were found in the bilateral DLPFC and insula, and these involved relatively decreased DLPFC and increased insula activation in the persistent IGD group during the forced break. Relatively decreased DLPFC activity and increased insula activity in response to gaming cues following recent gaming may underlie persistence of gaming. These findings suggest that executive control and interoceptive processing warrant additional study in understanding recovery from IGD.

Assessment of Family Functioning and Eating Disorders - The Mediating Role of Self-Esteem

The aim of the study was to measure whether people at increased risk for eating disorders (EDs) and people without an increased risk of EDs differ from each other in the assessment of family functioning (FF) and self-esteem (SE) dimensions. Moreover, the correlations between FF, EDs, and SE were verified, looking for the mediating role of SE in the context of the FF and EDs. The research was conducted on the group of 160 people aged from 18 to 47 years, including 74 people at increased risk for EDs. We used: The Family APGAR (Adaptability, Partnership, Growth, Affection, and Resolve); The SCOFF Questionnaire; The Multidimensional Self-Esteem Inventory, MSEI. Analyses indicate that the compared groups differ significantly in terms of EDs, assessment of FF, and all components of SE, in such a way that people without an increased risk of EDs are characterized by a more positive assessment of FF and higher SE in all its dimensions. All SE dimensions, except defensive high SE, are mediators in the relationship of FF with EDs. In therapeutic interactions, it is worth focusing on the SE dimensions, as they are one of the mediation elements in the relationship between the assessment of FF and EDs.

Problematic Internet use and its associations with health-related symptoms and lifestyle habits among rural Japanese adolescents

AIM

There have been concerns about the increase in problematic Internet use (PIU) and its impact on lifestyle habits and health-related symptoms, given the rapid spread of smartphones. This study aimed to clarify PIU prevalence over 3 years in the same area and investigate lifestyle and health-related factors related to PIU among junior high-school students in Japan.

METHODS

Each year during 2014-2016, a survey was conducted with junior high-school students from a rural area of Japan (2014, n = 979; 2015, n = 968; 2016, n = 940). Young's Internet Addiction Test was used to assess participants' PIU. Students scoring 40 or higher on the Internet Addiction Test were classified as showing PIU in this study. The associations between PIU and lifestyle factors (e.g., exercise habits, weekday study time, and sleep time) and health-related symptoms (depressive symptoms and orthostatic dysregulation [OD] symptoms) were studied by logistic regression analyses.

RESULTS

Over the 3 years, the prevalence of PIU was 19.9% in 2014, 15.9% in 2015, and 17.7% in 2016 without significant change. PIU was significantly associated with skipping breakfast, having a late bedtime (after midnight), and having OD symptoms among students from all grades. Sleepiness after awakening in the morning, less studying time, and depressive symptoms had significant positive associations with PIU, except among 1st grade junior high-school students.

CONCLUSION

Our results suggest that PIU is related to decreased time spent sleeping, studying, and exercising and increased symptoms of depression and OD. Further investigations are needed to develop preventive measures for PIU.