Internet Addiction and Depression in Chinese Adolescents: A Moderated Mediation Model

Prevalence of internet addiction among Chinese adolescents: A comprehensive meta-analysis of 164 epidemiological studies

BACKGROUND

Internet Addiction (IA) among Chinese adolescents is a growing concern that is associated with considerable psychological, social, and academic problems. Although numerous past studies on IA prevalence in China have been conducted, the findings have been mixed. This meta-analysis aimed to examine the pooled IA prevalence among adolescents in China and its associated factors.

METHODS

Both English (PubMed, Web of Science, PsycINFO) and Chinese (Wan Fang, CNKI) databases were systematically searched. Pooled prevalence and study heterogeneity were analyzed using the random effects model, while the factors contributing to prevalence variation were identified using subgroup and meta-regression analyses.

RESULTS

A total of 164 studies involving 737,384 adolescents were included in the meta-analysis. The overall pooled IA prevalence was 10.3 % (95 % CI: 9.1 %-11.7 %). In the subgroup analyses, differences in IA prevalence were significantly associated with the assessment tools (Q = 32.8, p < 0.001) and publication years (Q = 20.6, p < 0.001). In the meta-regression analyses, rural residence (β = 1.82, p = 0.030) and junior student level (β = 0.26, p = 0.002) were positively associated with the prevalence of IA, while only child status (β = -1.28, p = 0.033) was negatively associated with the prevalence of IA.

CONCLUSION

In this meta-analysis, IA among adolescents in China was common and associated with rural residence, junior student level, and only-child status. Given the detrimental impacts of IA, the development of effective prevention and treatment strategies for this population is critical.

Association of Internet addiction with psychiatric symptom levels and sleep disorders: a systematic review and meta-analysis

Background

Maladaptive Internet use is defined as Internet addiction disorders (IAD), which can lead to psychological problems and sleep disorders. Although many studies on the correlation between Internet addiction, psychiatric symptom levels, and sleep disorders have been conducted in recent years, there is no meta-analysis to substantiate the connection between these variables.

Methods

We systematically searched databases including Web of Science, PubMed, Embase, and the Cochrane Library to collect relevant studies using keywords associated with Internet addiction, psychological problems, and sleep disorders. All comparable studies that provided sufficient data (e.g., correlation coefficients) were included in our analysis.

Results

41 studies were included, and the results indicated that IAD was associated with psychological problems and sleep quality at moderate to low levels (depression: r = 0.39, 95%CI = 0.34-0.45; SMD = 1.34, 95%CI = 0.81-1.86; OR = 0.86, 95%CI = 0.46-1.26; anxiety: r = 0.30, 95%CI = 0.23-0.37; OR = 0.90, 95%CI = 0.29-1.52; stress: r = 0.34, 95%CI = 0.29-0.38; OR = 1.76, 95%CI = 0.37-3.16; sleep problems: r = 0.26, 95%CI = 0.19-0.33).

Conclusion

This meta-analysis reveals that IAD is positively associated with depression, anxiety, and sleep problems, which indicates that individuals with IAD have an increased risk of depression, anxiety, and sleep problems. Hence, high attention should be paid to Internet addictive behaviors, and preventive and treatment measures should be adopted timely.

Systematic review registration

The publicly accessible registration record can be found at: https://www.crd.york.ac.uk/prospero/.

Exploring the relationship between social media dependence and internet addiction among college students from a bibliometric perspective

Background

Social media use among college students often leads to psychological dependence, resulting in a rising number of internet addictions. The link between social media dependence and addiction is garnering increasing attention.

Objective

The aim of this study was to analyze and discuss the research trends and hotspots on social media dependence and internet disorder among college students by bibliometric methods.

Methods

Relevant studies on social media dependence and online addiction among college students were retrieved from the Web of Science (WoS) database spanning the years 2013 to 2024. We delineated the distribution of publications to identify the core productivity within the field. VOSviewer software was employed to conduct network visualization analyses of countries, authors, journals, and keywords, aiding in a comprehensive understanding of the research trends and hotspots in this domain.

Results

From the WoS database, we retrieved 302 publications, and 167 publications were included after screening. The findings revealed: (1) a steady increase in publications and citations, particularly accelerating after 2019. (2) The most productive journal is Computers in human behavior, the most productive research area is Psychology, and the most productive author, institution, and country are Professor Griffiths MD, Nottingham Trent University and China, respectively. (3) Collaborative network analysis indicated that there were multiple research groups in this field, yet the connections among countries and authors remain relatively limited. (4) Co-citation analysis of journals revealed that this field was interdisciplinary, primarily integrating psychology, psychiatry, and behavioral science. (5) Keyword analysis identified two major research hotspots: the relationship between college students' social media dependence and internet addiction, and the mediating factors influencing college students' social media dependence and internet addiction. The mechanism of internet addiction is an emerging research frontier.

Conclusion

This analysis outlines the progress and directions of research on college students' social media dependence and internet addiction. It offers a comprehensive examination of the latest frontiers and trends, providing theoretical support for regulating the use of electronic products and implementing mental health interventions in college students.

Resilience as a predictor of internet addictive behaviours: a study among Ghanaian and Saudi samples using structural equation modelling approach

This study aimed to examine the relationship between resilience and internet addictive behaviours, focusing on cross-cultural contexts involving tertiary education students in Ghana and Saudi Arabia. Using a cross-sectional survey design, data were collected from 738 students across selected universities in both countries. Structural equation modeling (SEM) techniques were employed to analyse the data. The findings indicated that most respondents exhibited low resilience levels alongside a high prevalence of internet addictive behaviours. A significant positive relationship was identified between resilience levels and various dimensions of internet addiction, as well as the overall composite of internet addictive behaviours. Interestingly, while low resilience levels were found to increase the risk of internet addiction, higher resilience levels also appeared to heighten susceptibility to addictive behaviours. These results suggest the need for targeted interventions to address internet addiction. Programs should focus on enhancing resilience through resilience-building initiatives, promoting digital well-being, and integrating mental health support services. These approaches can help mitigate the risks associated with internet addiction while fostering healthier coping mechanisms in students across diverse cultural settings.

The Association Between Internet Addiction and Adolescents' Mental Health: A Meta-Analytic Review

This study examines the association between problematic internet use, or internet addiction, and adolescent mental health, focusing on key psychological variables, assessing the strength of these associations, and identifying potential moderating factors.

METHODS

A search of the Web of Science databases over the past five years identified 830 articles. Of these, 33 met the inclusion criteria, involving 303,243 participants (average age 14.57; 49.44% female). The selection process was verified by two researchers.

RESULTS

Nine psychological variables were analyzed: depression, anxiety, stress, suicidal behaviour, psychological well-being, self-esteem, externalizing problems, aggressiveness, and impulsiveness. Internet addiction showed positive correlations with aggressiveness (r+ = 0.391), depression (r+ = 0.318), anxiety (r+ = 0.252), and suicidal behaviour (r+ = 0.264). Negative correlations were observed with psychological well-being (r+ = -0.312) and self-esteem (r+ = -0.306). No significant associations were found for externalizing problems, impulsiveness, or stress. None of the moderators showed a significant correlation with internet addiction and depression.

CONCLUSIONS

Although limited by small sample sizes for some variables and the cross-sectional design of most studies, the findings confirm that there is a negative relationship between internet addiction and adolescent mental health. It is related to poorer self-perceived health, greater psychological distress, and greater aggression.

A Multi- Mediation Analysis on the Impact of Social Media and Internet Addiction on University and High School Students' Mental Health Through Social Capital and Mindfulness

INTRODUCTION

Social media addiction (SMA) and internet addiction (IA) are increasingly prevalent, impacting mental health (MH) globally. This study investigates the mediating roles of mindfulness and social capital (SC) in the relationship between SMA, IA, and MH among Ethiopian high school and university students, contributing to the Sustainable Development Goal (SDG) 3 of good health and well-being.

METHODS

A cross-sectional study was conducted with 1160 university and 1473 high school students in Dessie, Ethiopia. Participants completed validated questionnaires assessing SMA, IA, mindfulness, SC, and MH. Structural Equation Modeling (SEM) with a multi- mediation Model (SMM) was used to examine the hypothesized relationships.

RESULTS

SEM revealed that both SMA and IA had a direct negative effect on mindfulness, SC, and MH in in both high school and university students. Notably, mindfulness and SC significantly and positively predicted MH, indicating their protective role against the negative effects of SMA and IA. Furthermore, both mindfulness or SC fully or partially mediated the relationship between SMA, IA, and MH, highlighting their crucial role in explaining the association.

CONCLUSIONS

This study provides evidence for the crucial roles of mindfulness and SC in buffering the negative effects of SMA and IA on MH among Ethiopian students. The findings highlight the need for educational and health interventions that foster mindfulness and SC to enhance student mental health and promote a healthy digital environment. These results offer valuable insights for educators, health professionals, and policymakers in Ethiopia and other developing countries facing similar challenges.

Do Boys and Girls Display Different Levels of Depression in Response to Mobile Phone Addiction? Examining the Longitudinal Effects of Four Types of Mobile Phone Addiction

Purpose

Prior research has indicated that mobile phone addiction (MPA) significantly contributes to depression. However, there is a research gap in exploring the distinct impacts of various types of MPA on depression, along with the potential moderating effect of gender. The current study investigated whether the relationship between MPA and depression varies depending on the types of MPA and gender.

Methods

A one-year longitudinal study was undertaken at two high schools in Central China. Data was gathered at two time points (Time 1/T1 and Time 2/T2) with a one-year gap between assessments. A total of 480 adolescents, aged 12 to 19 years old, completed all questionnaires assessing four types of mobile phone addiction at T1, as well as depression at T1 and T2.

Results

The findings demonstrated significant positive associations between all four types of MPA at T1 and depression at T2. Additionally, gender was found to moderate the associations between three types of MPA and depression. Specifically, among girls, T1 social media addiction had a stronger predictive effect on T2 depression compared to boys. Conversely, among boys, T1 game addiction had a more pronounced predictive effect on T2 depression, which was less significant among girls. Moreover, in boys, T1 short-form video addiction had a noteworthy predictive effect on T2 depression, but this effect was not significant in girls. However, it is worth noting that T1 information acquisition addiction had a significant predictive effect on T2 depression in both boys and girls, with no noticeable gender difference.

Conclusion

The current study has enhanced our understanding of the impact of MPA on mental health by examining the correlation between different types of MPA and depression across genders. The findings provide valuable insights for reducing depression among adolescents of different genders by considering their mobile phone usage patterns.

Correlations between problematic internet use and suicidal behavior among Chinese adolescents: a systematic review and meta-analysis

Background

Problematic Internet Use (PIU) has been increasingly linked to suicidal behavior among adolescents, raising significant public health concerns, particularly in Chinese youth. This study aimed to systematically review and meta-analyze the correlation between PIU and suicidal behavior in Chinese adolescents to provide a clearer understanding of this association.

Methods

A comprehensive search was conducted across seven databases up to July 1, 2024. Studies investigating the relationship between PIU and suicidal behavior among Chinese adolescents were included. A random-effects meta-analysis was employed to assess pooled effect sizes, with subgroup analyses conducted to explore potential moderators, such as geographic region, age, gender, assessment tools for PIU and suicidal ideation, and the presence of depression. Data analysis was performed using STATA software (version 16).

Results

This meta-analysis, comprising 23 studies with 353,904 participants, identified significant associations between PIU and suicidal behavior among Chinese adolescents. PIU was associated with increased risks of suicidal ideation (OR = 1.72, 95% CI: 1.45, 2.03), suicidal plans (OR = 1.50, 95% CI: 1.02, 2.20), and suicidal attempts (OR = 1.48, 95% CI: 1.16, 1.89). Subgroup analyses indicated higher risks in specific groups: adolescents from Central China (OR = 1.84, 95% CI: 1.46, 2.32), college students (OR = 2.09, 95% CI: 1.66, 2.62). The risk of suicidal ideation was particularly elevated when depression was not controlled (OR = 1.86, 95% CI: 1.53, 2.25). These findings underscore the need for targeted interventions in vulnerable populations.

Conclusion

This meta-analysis demonstrated significant associations between PIU and suicidal behaviors among Chinese adolescents. The findings emphasize the need for targeted interventions, particularly for adolescents from Central and Western China, college students, and those with untreated depression. Focused strategies are required to mitigate the risks associated with PIU and to effectively address suicidal behaviors in these high-risk populations.

Systematic review registration

https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024577593, identifier CRD42024577593.

Technology Addiction and Social Connectedness in Psychiatric Illness: A Multicenter Study

OBJECTIVE

Technology addiction is an increasingly important public health problem all over the world that negatively affects people's mental and physical health. In this study, we examined technology addiction and social connectedness levels of psychiatric patients who admitted to clinics in different geographical regions of Turkey.

METHODS

A total of 642 people with a diagnosis of psychiatric illness who applied to psychiatry clinics in İstanbul, Elaziğ, Malatya, Yozgat, Adıyaman, and Bingöl provinces were included. Sociodemographic data form, Technology Addiction Scale (TAS), and Social Connectedness Scale (SCS) were applied to all participants.

RESULTS

The total score of the TAS in patients diagnosed with anxiety disorder and somatoform disorder was significantly higher than the other patient groups (p<0.001). Patients diagnosed with anxiety disorder showed a significant difference from other patient groups in terms of SCS score (p<0.001). Anxiety disorder was found to be the highest in TAS total score and sub-dimensions and the lowest in SCS score, while major depressive disorder was found to be the lowest in TAS total score and sub-dimensions and the highest in SCS score. The multiple linear regression analysis showed that the total score of the TAS was predicted by the SCS score (β=-1.857, p<0.001) and the SCS score was predicted by age (β=0.046, p=0.049) and the total score of the TAS (β=-0.316, p<0.001).

CONCLUSION

As a result of this study, we can say that psychiatric patients have a moderate level of technology addiction, these people have high levels of social connectedness, and psychiatric patients with technology addiction have a high level of social belonging.

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.

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Parent-adolescent conflict and problematic internet use among Chinese adolescents: the mediating role of depression and the moderating role of school climate

BACKGROUND

Problematic Internet use (PIU) may lead adolescents to physical, emotional, social, or functional impairment due to the risky, excessive, or impulsive internet use manner. How do the experiences of adolescents influence them using the internet in a problematic manner? The answer to this question is the key to preventing and intervening PIU of adolescents. To address this question, we focus on the interactions among family (parent-adolescent conflict), school (school climate), and individual factors (PIU, depression), exploring the influence factors of PIU.

METHODS

A moderated mediation model was constructed to explore the relationship between variables. Using a two-wave longitudinal design with a six-month interval between timepoints, this study collected data from 801 Chinese adolescents (411 boys, Mage = 14.68) by questionnaires. Path analysis was employed to test the model and participants' age, sex and baseline were controlled.

RESULTS

Parent-adolescent conflict at Time 1 (T1) was positively related to PIU at Time 2 (T2) in adolescents. Depression at T2 mediated the relationship between parent-adolescent conflict at T1 and PIU at T2. School climate at T2 significantly moderated the mediation effect of depression on the relationship between parent-adolescent conflict at T1 and PIU at T2. Specifically, positive school climate could significantly weaken the negative effect of depression on PIU for adolescents with low level of depression.

CONCLUSIONS

The present study reveals that parent-adolescent conflict leads to PIU in adolescents through depression whilst the school climate moderates the impacts of depression on PIU. This adds further evidence regarding the significance of systematically and consistently incorporating family and school in the alleviating of problem behaviors displayed by teens.

Connectome-based predictive modeling of Internet addiction symptomatology

Internet addiction symptomatology (IAS) is characterized by persistent and involuntary patterns of compulsive Internet use, leading to significant impairments in both physical and mental well-being. Here, a connectome-based predictive modeling approach was applied to decode IAS from whole-brain resting-state functional connectivity in healthy population. The findings showed that IAS could be predicted by the functional connectivity between prefrontal cortex with the cerebellum and limbic lobe and connections of the occipital lobe with the limbic lobe and insula lobe. The identified edges associated with IAS exhibit generalizability in predicting IAS within an independent sample. Furthermore, we found that the unique contributing network, which predicted IAS in contrast to the prediction networks of alcohol use disorder symptomatology (the range of symptoms and behaviors associated with alcohol use disorder), prominently comprised connections involving the occipital lobe and other lobes. The current data-driven approach provides the first evidence of the predictive brain features of IAS based on the organization of intrinsic brain networks, thus advancing our understanding of the neurobiological basis of Internet addiction disorder (IAD) susceptibility, and may have implications for the timely intervention of people potentially at risk of IAD.

Network analysis of suicidality and internet addiction symptoms among Chinese primary and secondary school students

BACKGROUND

The COVID-19 pandemic has increased the risk of both Internet addiction and suicide across various populations, especially among children and adolescents. This study aimed to assess the inter-relationships between Internet addiction symptoms and suicidality among primary and secondary school students from the perspective of network analysis.

METHODS

This was a cross-sectional, multicenter study. The Internet Addiction Test (IAT) was used to assess internet addiction symptoms. Participants were also asked about having any suicidal ideation and suicide plan. Univariate analyses and network analysis were subsequently conducted.

RESULTS

Altogether, 5380 primary and secondary school students participated in the study. Among them, 3161 (58.8 %, 95 % CI = 57.4 %-60.1 %) students reported having Internet addiction symptoms and 798 (14.8 %, 95 % CI = 13.9 %-15.8 %) reported having suicidal ideation or suicide plan in the past two weeks. Network analysis revealed that IAT16 ('Request an extension for longer time spent online'; node strength = 1.223) was the most central symptom in the Suicidality-Internet addiction network model, while the edge suicidality-IAT4 ('Form new relationship with online users'; edge weight = 0.055) was the strongest edge linking both communities.

CONCLUSIONS

Internet addiction symptoms were common among primary and secondary school students during the COVID-19 school closure period in China and were significantly associated with suicidality. Targeted strategies such as strengthening self-control, sense of belonging and connectedness may be important in reducing the risk of both suicidality and Internet addiction among primary and secondary school students.

Exploring internet addiction and its associated factors among college students in Western Rajasthan, India: A mixed-methods study

Background

With near universal use of internet by college students, there is propensity for internet addiction (IA) among them. This study aimed to estimate the prevalence and predict the factors for internet addiction among college students in Jodhpur, Rajasthan, India, and qualitatively explore the factors associated with internet addiction.

Materials and Methods

Explanatory sequential (QUAN-QUAL) mixed-methods design was used. A cross-sectional questionnaire-based survey was conducted among three streams of undergraduate colleges (health, engineering, and others). Survey instruments included Young's internet addiction test (IAT), Pittsburgh Sleep Quality Index (PSQI), and Depression, Anxiety, and Stress Scale-21 (DASS-21) Items. Focus group discussions (FGDs) and in-depth interviews (IDIs) among the students with mild-to-moderate levels of addiction were conducted to understand the reasons for excessive internet use.

Results

The prevalence of internet addiction (IA) among the college students was 51% and the rates for mild, moderate, and severe addiction were 31.8%, 18.5%, and 0.7%, respectively. Predictors of IA were male gender, age in years, age of first internet use in years, urban origin, accessing internet at college, mobile internet use, using internet to make online friendship, sleep disturbance, depression, anxiety, and stress. Qualitative study identified five major themes related to situations initiating internet use for nonacademic purpose, content of internet use, triggers for internet overuse/addiction (IA), perceived impact of IA, and measures to overcome IA.

Conclusions

Internet addiction was found to be highly prevalent in college students across various streams. Qualitative results provide deeper insights into IA among college students. It is imperative to screen for IA among the students and devise suitable preventive interventions, which can be easily implemented at community level.

Internet addiction and depression among Chinese adolescents: anxiety as a mediator and social support as a moderator

This study constructed a moderated mediation model to investigate the mediating effect of anxiety and the moderating effect of social support between Internet addiction and depression. A sample of 17 058 middle school students in one district of Chengdu were selected. The Internet Addiction Test (IAT), Generalized Anxiety Disorder (GAD-7), Patient Health Questionnaire (PHQ-9), and Social Support Scale for adolescents were used to investigate their Internet addiction, anxiety, depression and social support. The descriptive statistics and Spearman correlation analysis were performed with SPSS 25.0. An SPSS macro process was used to analyze the data from complex models that contained mediators and moderators. The results show that adolescents with Internet addiction are more likely to suffer from depression. Anxiety partially mediated the relations between Internet addiction and depression. Social support moderated both direct and indirect pathways leading from Internet addiction to depression, and these two effects were stronger for adolescents with low social support than for those with high social support. It will be possible for researchers to gain a better understanding of the conditions, pathways, and effects of Internet addiction on depression in adolescents through the results of this study.

Depression and internet addiction among adolescents:A meta-analysis

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

Internet addiction and mental health disorders in high school students in a Peruvian region: a cross-sectional study

OBJECTIVES

To determine the association between internet addiction disorder (IAD) and anxiety and depressive symptomatology in high school students in two private schools in Chiclayo, Peru, during the COVID-19 pandemic.

MATERIALS AND METHODS

Analytical cross-sectional investigation of 505 adolescents from two private schools. The dependent variables were anxiety and depressive symptomatology, measured with the Beck Adapted Depression Questionnaire (BDI-IIA) and the Beck Anxiety Inventory (BAI), respectively. The main independent variable was IAD, measured with the Internet Addiction Test instrument(IATI). Prevalence ratios (PR) and 95% confidence intervals (95%CI) were estimated.

RESULTS

The average age was 14.16 years and 54.9% were women. 22.2% and 3.2% presented mild and moderate IAD; respectively. 9.3% presented severe anxiety and 34.3% severe depressive symptomatology. In the simple regression, adolescents with mild, moderate and severe IAD presented 19% (PR = 1.19; 95%CI: 1.05-1.35), 25% (PR = 1.25; 95%CI: 1.02-1.53) and 53% (PR = 1.47; 95% CI: 1.47-1.60) higher prevalence of depressive symptomatology; however, this association was not maintained in the multiple model. Anxiety increased 196% in adolescents with severe IAD (PR = 2.96; 95%CI: 1.86-4.71).

CONCLUSION

 We found that 2, 1, and 3 out of 10 students presented IAD, depressive symptomatology, and anxiety, respectively. We did not find an association between IAD and depressive symptomatology, but we did find an association with anxiety. Among the factors associated with the development of depressive symptomatology were the male sex, the presence of eating disorders, subclinical insomnia, using devices for more than 2 h, and using the Internet for academic activities. About anxiety, the associated factors are the female sex, the presence of eating disorders, subclinical insomnia, and the use of the Internet as social interaction. We recommend implementing counseling programs in view of the imminent introduction of the Internet as a pillar in education.

Pattern and predictors of internet addiction among secondary school adolescents in Enugu, Nigeria

Background

Internet addiction has negative effects on adolescents. These range from psychological and social impediments to school absenteeism.

Aim

To ascertain the pattern of Internet addiction and the factors that predict Internet addiction among secondary school adolescents in southeast Nigeria.

Subjects and Methods

This was a cross-sectional study that involved 796 secondary school adolescents drawn from six secondary schools in Enugu, Nigeria. The data were analyzed using IBM Statistical Package for Social Sciences (SPSS) software.

Results

The highest proportion of the respondents (36.3%) had a moderate level of Internet addiction, while the least proportion (2.1%) had severe dependence on the Internet. Adolescents who were less than 15 years of age have 1.1 odds of having Internet addiction when compared to those who were 20 years and above (AOR = 1.1; 95% CI: 0.4-2.8). The respondents who were of the low socioeconomic class were 1.2 times more likely to have Internet addiction when compared with those in the high socioeconomic class (AOR = 1.2; 95% CI: 0.9-1.7). About 20.1% of adolescents were always depressed when they are not using the Internet, while 16.3% of adolescents who were addicted to the Internet developed insomnia.

Conclusion

There is a rising prevalence of Internet addiction among secondary school adolescents. Younger adolescents tend to be more addicted to the Internet than their older counterparts. A small number of them had severe Internet addiction. A subpopulation of adolescents who were addicted to the Internet presents with depression and sleep disorders.

Depression and Internet Gaming Disorder among Chinese Adolescents: A Longitudinal Moderated Mediation Model

Internet gaming disorder (IGD) is significantly associated with depression across previous studies, and significantly affects the development of mental health among Chinese adolescents. In this two-wave longitudinal research, we tested the mediating role of maladaptive cognition and the moderating role of mindfulness in the linkage between depression and IGD among Chinese adolescents (N = 580, 355 females, average age = 15.76 years, SD = 1.31) who completed questionnaires. Results of regression-based analyses showed that depression was positively related to IGD. Maladaptive cognition significantly mediated the link between depression and IGD. Moreover, mindfulness moderated the second part of the mediation process. Specifically, as the level of mindfulness increased, the influence of depression on the future IGD through maladaptive cognition was weakened. The present study demonstrates the key roles of maladaptive cognition and mindfulness in the link between depression and IGD, and further supports the cognitive-behavioral model of pathological Internet use.

Sleep - the guarantee of health! Does the environmental perception characteristics of urban residential areas affect residents' sleep quality?

A complex urban living environment and residents' sleep quality are intrinsically linked. Nonetheless, there is little evidence that the residential environment affects sleep quality. Based on the results of subjective questionnaires, this study uses the multiple regression combined with mediation analysis to construct a mechanical model of the impact of urban residential environmental perception characteristics on residents' sleep quality. Moreover, the differences among the influence intensities of the significant factors are compared and the results show that (1) in low-density environments (FAR < 2) and lower floors (4-6), residents sleep longer and have better sleep quality; (2) the environmental quality and service facilities of the physical environment and the sense of safety in the social environment have a significant impact on residents' sleep quality; and (3) the mental health of residents play a significant intermediary role in the relationship between social environment and sleep quality, with the highest effect accounting for 33.88%. The influence mechanisms of various environmental factors in a residential area on sleep quality were revealed and a more refined design basis for a healthy urban living environment, community renewal, and renovation was provided.

The effect of mindfulness on social media addiction among Chinese college students: A serial mediation model

Introduction

The COVID-19 pandemic has exacerbated social media addiction (SMA), making it urgent to find effective interventions for social media addiction. Evidence has shown that mindfulness might be an effective intervention for social media addiction. However, psychological mechanisms by which mindfulness reduce social media use remain unclear. Here, we further addressed this issue to examine whether attentional control and fear of missing out (FOMO) mediate the relationship between mindfulness and SMA.

Methods

We recruited 446 college students from two universities in China and analyzed the data.

Results

The results suggest that there are mediation effects of attentional control and FOMO between mindfulness and SMA through 3 paths: path 1, mindfulness → attention control → SMA (-0.04); path 2, mindfulness → FOMO → SMA (-0.22); and path 3, mindfulness → attention control → FOMO → SMA (-0.05).

Discussion

Therefore, mindfulness-based interventions may be an effective way to alleviate social media addiction, especially mindfulness-based interventions targeting FOMO. At the end of the article, we also discussed the limitations of this study.

Childhood trauma and psychological sub-health among Chinese adolescents: the mediating effect of Internet addiction

BACKGROUND

The factors related to psychological sub-health (PSH) have been widely described, but the research on the mechanism behind the complex relationship between childhood trauma and PSH is limited. This study investigated the current situation and risk factors of PSH among Chinese adolescents. And further, explore whether Internet addiction (IA) plays a potential mediating effect in childhood trauma and PSH.

METHODS

The study was conducted in October 2020 in Anhui Province, China. The PSH state of 866 adolescents was investigated, including demographic information such as gender, age, and grade. Childhood trauma, IA, and PSH were measured by the Childhood Trauma Questionnaire Short Form (CTQ-SF), Young's Internet Addiction Test (IAT), and the Multidimensional Sub-health Questionnaire of Adolescents (MSQA). The mediating effect is further verified by the structural equation model (SEM).

RESULTS

In this study, 866 adolescents were selected as subjects, and the proportion of male and female is roughly equal. The prevalence of PSH in adolescents was 25.8%, and left-behind children, boarding, or adolescents who have had non-suicidal self-injury (NSSI) are more likely to have PSH. Through the mediation test, the direct effect of childhood trauma on PSH was 0.23 (95% CI [4.91,9.00],p <0.001), and the mediating effect of IA on childhood trauma and PSH was 0.07 (95% CI [1.42, 3.32],p <0.001). and the proportion of them is 75.14% and 24.86% respectively.

CONCLUSIONS

Childhood trauma has direct and indirect effects on PSH, and IA plays a mediating effect in the indirect effect. Therefore, clarifying these relationships helps formulate and implement effective interventions to improve psychological health (PH) in Chinese adolescents.

Cyberbullying and internet gaming disorder in Chinese youth: The role of positive youth development attributes

Introduction

As digital natives, young people enjoy the convenience and benefits of the internet but also suffer from unique developmental problems of this age, such as cyberbullying and internet gaming disorder (IGD). Research suggests that these online problem behaviors enjoy high prevalence and various negative impacts. To prevent or intervene, this study attempts to explore the association between cyberbullying and IGD and the potential protectors from the positive youth development (PYD) perspective.

Methods

Through the convenience sampling method, a sample of 463 Chinese adolescents was recruited and participated in the survey. They completed a questionnaire regarding PYD attributes, cyberbullying, IGD, and demographic information.

Results

After controlling adolescents' sex and age, results of regression analyses indicated that cyberbullying was positively associated with IGD; PYD attributes had negative cumulative effects on cyberbullying and IGD; and cyberbullying and IGD were negatively related to PYD attributes. Moreover, the mediating effect of PYD attributes was significant in the relationship between cyberbullying and IGD.

Discussion

Specifically, it is very possible for adolescents who have experienced one online problem behavior to suffer from another one. Fortunately, positive personal attributes could effectively buffer this cascading effect. These findings may provide theoretical and practical guidance for practitioners that improving PYD attributes may be a promising approach to prevent or reduce adolescent cyberbullying and IGD.

The relationship between positive youth development and internet gaming disorder in Chinese adolescents: A moderated mediation model

Internet gaming disorder (IGD) is a social problem that cannot be ignored. Considerable research has shown that IGD can impede the healthy physical and mental development of adolescents. Based on positive youth development theory and stage-environment fit theory, the current study explored the mediating effect of depression and the moderating effect of gender to determine the association between positive youth development (PYD) and IGD. A sample of 1970 Chinese adolescents aged 11-18 years (1021 boys, 940 girls, and 10 unidentifiable individuals) completed questionnaires related to PYD, depression, IGD, and their background information. The results revealed that PYD negatively predicted IGD. After controlling for gender and age, this study found that depression mediated the relationship between PYD and IGD. Furthermore, gender moderated the relationship between depression and IGD. Boys with depressive symptoms were more likely to indulge in IGD than girls. This research contributes to a more thorough understanding of how PYD decreases the risk of IGD. These findings suggest that cultivating PYD attributes is a promising approach to prevent or reduce depression and IGD among adolescents in mainland China.

Social networking use, mental health, and quality of life of Hong Kong adolescents during the COVID-19 pandemic

BACKGROUND

During the COVID-19 pandemic, adolescents' use of social networking sites/apps has surged, and their mental health and quality of life have also been significantly affected by the pandemic and its associated social-protection measures. The present study first examined the prevalence of social networking sites/apps use and social networking addiction, the mental health status, and the health-related quality of life among Hong Kong adolescent students. We further investigated the associations of the youths' daily use of social networking sites/apps and their social networking addiction with their mental health and quality of life during the pandemic.

METHODS

A total of 1,147 students (age = 15.20 ± 0.53 years) recruited from 12 randomly selected local secondary schools in Hong Kong participated in a questionnaire survey in classroom settings between January and June, 2020, right after the COVID-19 outbreak. The questionnaire includes demographic characteristics and scales that measure social networking sites/apps use and social networking addiction, mental health, and quality of life.

RESULTS

Approximately 46.4% of the participants reported using social networking sites/apps often or very often, and 7.8% met the criteria for social networking addiction using Bergen's Social Media Addiction Scale. The prevalence of mild to extremely severe depression, anxiety, and stress among the adolescents stood at 39.6, 37.5, 48.8%, respectively, and the participants' physical, social, and school functioning were lower than the norms of healthy adolescents before the pandemic. Participants who used social networking sites/apps but for <3 h per day (excluding students who never used social networking sites/apps) showed significantly fewer problems of depression, anxiety, and stress than did those who spent more than 3 h per day on social networking sites/apps. Social networking addiction was found to be consistently associated with poor mental health and health-related quality of life.

CONCLUSION

This study provides important evidence supporting the potential protective effect of guiding adolescents to use social networking sites/apps appropriately in order to mitigate their negative emotions during contexts such as that of the pandemic; it further points to the need to provide extra support to promote the well-being of young people, especially those in disadvantaged situations (e.g., non-intact family) during and after the pandemic.

Internet addiction: Prevalence and relationship with academic burnout among undergraduates during widespread online learning

PURPOSE

We aimed to investigate the prevalence of Internet addiction (IA) and explore its related factors among undergraduates during widespread online learning in China.

DESIGN AND METHODS

The online survey was conducted in April 2020. The Young diagnostic questionnaire and academic burnout scale were respectively used to measure IA and academic burnout.

FINDINGS

A total of 28.4% of 7562 participants developed IA, which correlated with academic burnout. Additionally, positive attitude and practice towards COVID-19 and exercise were protective factors of it.

PRACTICE IMPLICATIONS

IA was associated with academic burnout, and better cognition of COVID-19 and positive lifestyles might reduce its risk.

Depression and Its Association With Self-Esteem and Lifestyle Factors Among School-Going Adolescents in Kuala Lumpur, Malaysia

Introduction

Depression is a prevalent mental health condition worldwide and in Malaysia. Depression among adolescents has been steadily increasing. Self-esteem has been known to be associated with depression. It has been postulated that a poor lifestyle among adolescents is associated with depression. This paper aims to study the correlation of self-esteem, lifestyle (eating behavior, physical activity, and internet usage) with depression among Malaysian youth.

Methodology

This is a cross-sectional study among secondary school children from 5 random schools in an urban city of Kuala Lumpur, Malaysia. Those with intellectual disability and/or difficulty to comprehend Malay language, and without parental consent and assent, were excluded. Students from randomly selected classes aged 13-year-old to 17-year-old were invited to fill in these questionnaires: Socio-demographic Questionnaire, Rosenberg Self-esteem Questionnaire, Physical Activity Questionnaire (PAQ-A), Eating Disorder Examination Questionnaires (EDE-Q), Internet Addiction Test Scale (IAT), and Children's Depression Inventory (CDI).

Result

461 students participated in the study. 21.5% of the participating students were found to have depression (n = 99). Younger age and Chinese race showed significant association with adolescent depression with a p-value of 0.032 and 0.017 respectively. Other significant correlations with depression were self-esteem (p = 0.013), disordered eating (p = 0.000), lower physical activity (p = 0.014) and problematic internet usage (p = 0.000).

Discussion

The prevalence of depression among adolescents in this study (21.5%) is in line with previous prevalence studies in Malaysia. Self-esteem is postulated to be a moderating factor for depression hence explaining the significant association. A sedentary lifestyle may increase the risk of developing depression, The causal relationship between problematic internet usage and depression is complex and difficult to establish. This is similar to the relationship between problematic eating behavior and depression as well.

Conclusion

There is still a need to explore the causal relationship between lifestyle factors and depression among youth. Despite that, the results from this paper have accentuated the gravity of the importance of a healthy lifestyle among adolescents. An appropriate preventive measure is governmental strategies and policies aiming at improving a healthier lifestyle in this age group.

Borderline Pathological Celebrity Worship and Impulsive Buying Intent: Mediating and Moderating Roles of Empathy and Gender

The present study constructed a moderated mediation model to examine whether borderline pathological celebrity worship may be associated with higher levels of impulsive buying intent. The mediating role of empathy and the moderating role of gender were also examined. A total of 1,319 participants recruited from a college through the campus network. The results indicated that (1) borderline pathological celebrity worship could positively predict individuals' impulsive buying intent; (2) the predictive effect of borderline pathological celebrity worship on impulsive buying intent could be mediated by empathy; and (3) gender moderated the predictive effect of borderline pathological celebrity worship on impulsive buying intent. Specifically, relatively higher levels of borderline pathological celebrity worship were found to be associated with higher impulsive buying intent among men. However, this was relatively less significant among women.

Conclusion

The results contribute to previous findings by demonstrating that borderline pathological celebrity worship could affect impulsive buying intent. Moreover, the mediating role of empathy and the moderating role of gender were also revealed.

After-School Extracurricular Activities Participation and Depressive Symptoms in Chinese Early Adolescents: Moderating Effect of Gender and Family Economic Status

Although Western studies showed that participation in extracurricular activities was intimately linked to adolescents’ psychological adjustment, very few studies have addressed this issue among early adolescents in China. Based on a nationally representative sample of 9672 Chinese junior high school students (M_age = 14.54 years, SD = 0.70 years), this study investigated the relationship between participation in different extracurricular activities and depressive symptoms among Chinese early adolescents, and the moderating role of gender and family economic status. Results indicated that time spent completing homework, attending extracurricular tutoring, and playing online games after school was positively related to students’ depressive symptoms, whereas time spent on participating in physical exercise was negatively associated with students’ depressive symptoms. Besides, the relationships between after-school activities participation and student depressive symptoms were moderated by gender and family economic status. The theoretical and practical implications for the arrangement of after-school activities for Chinese early adolescents are discussed.

Prevalence and Associated Factors of Depression in Medical Students in a Northern Thailand University: A Cross-Sectional Study

This study was conducted to investigate the prevalence and associated factors of depression in medical students. This cross-sectional study investigated the prevalence and associated factors of depression in medical students from May 2018 to April 2019. Depression was diagnosed using the nine-item Patient Health Questionnaire. We evaluated the following potential predictors: demographic data, stressors, psychiatric comorbidities, emotional intelligence (EI), and perceived social support. The association between potential factors and depression was analyzed using multiple logistic regression analysis. The prevalence of depression was 149 of 706 students with 12.5% suicidality. Second- and fourth-year medical students were high-risk groups. Risk factors identified were insufficient income, physical illness, and previous psychiatric illness. Depression in medical students likely coincides with anxiety, internet addiction, sleep problems, and loneliness. Highly associated stressors were personal relationships, physical health, mental health, difficulties in social relationships, satisfaction with grades, and boredom with medical education. Protective EI factors included emotional self-control, problem-solving abilities, inner peace, and life satisfaction. Up to 21.1% of medical students had depression. In this study, among multiple known risk factors of depression, we found that EI is the novel protective factor against depression among medical students. EI training might be protective intervention for medical students in the future.

Serial Multiple Mediation of the Correlation Between Internet Addiction and Depression by Social Support and Sleep Quality of College Students During the COVID-19 Epidemic

OBJECTIVE

This cross-sectional study explores the serial multiple mediation of the correlation between internet addiction and depression by social support and sleep quality of college students during the COVID-19 epidemic.

METHODS

We enrolled 2,688 students from a certain university in Wuhu, China. Questionnaire measures of internet addiction, social support, sleep quality, depression and background characteristics were obtained.

RESULTS

The prevalence of depression, among 2,688 college students (median age [IQR]=20.49 [20.0, 21.0] years) was 30.6%. 32.4% of the students had the tendency of internet addiction, among which the proportion of mild, moderate and severe were 29.8%, 2.5% and 0.1%, respectively. In our normal internet users and internet addiction group, the incidence of depression was 22.6% and 47.2%, respectively. The findings indicated that internet addiction was directly related to college students' depression and indirectly predicted students' depression via the mediator of social support and sleep quality. The mediation effect of social support and sleep quality on the pathway from internet addiction to depression was 41.97% (direct effect: standardized estimate=0.177; total indirect effect: standardized estimate=0.128). The proposed model fit the data well.

CONCLUSION

Social support and sleep quality may continuously mediate the link between internet addiction and depression. Therefore, the stronger the degree of internet addiction, the lower the individual's sense of social support and the worse the quality of sleep, which will ultimately the higher the degree of depression. We recommend strengthening monitoring of internet use during the COVID-19 epidemic, increasing social support and improving sleep quality, so as to reduce the risk of depression for college students.

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

BACKGROUNDS

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

METHODS

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

RESULTS

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

CONCLUSION

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

Internet Addiction and Emotional and Behavioral Maladjustment in Mainland Chinese Adolescents: Cross-Lagged Panel Analyses

Adolescence is a developmental stage when adolescents are vulnerable to addictive behaviors, such as Internet addiction (IA), which refers to pathological use of the Internet. Although there are views proposing that the links between IA and adolescent problem behavior may be bidirectional in nature, few studies have examined the reciprocal relationships between IA and other maladjustment indicators, and even fewer studies have simultaneously employed both emotional and behavioral maladjustment indicators in a single study. To address the above research gaps, the present study investigated how IA is associated with both depression and delinquency among Chinese adolescents. Two waves of data were collected at two consecutive years, respectively, with 1year apart, from 3,010 students (Mean age=13.16, SD=0.81; 57.48% boys) in four junior high schools in mainland China. These students completed the same questionnaire containing measures of IA, depression, and delinquency at each wave. The proposed cross-lagged panel model fitted the data very well, and there were significant positive reciprocal effects between IA and depression as well as delinquency after controlling for background socio-demographic factors. Gender differences were also observed in multi-group comparisons. Specifically, IA showed a stronger longitudinal impact on delinquency among boys than among girls. While depression significantly predicted IA in 1year among boys, such a prediction was not significant among girls. These findings delineate the bidirectionality of the associations between IA and emotional and behavioral maladjustment indexed by depression and delinquency, respectively. The findings also suggest that researchers and practitioners have to take gender differences as well as different developmental indicators in understanding the bidirectional influences between IA and adolescent behavioral and emotional development.

Father-Child Conflict and Chinese Adolescent Depression: A Moderated Mediation Model

To investigate the effects of father-child conflict and regulatory emotional self-efficacy (RESE) on Chinese adolescent depression, 654 middle-school students were measured. The results showed that: (1) Father-son conflict was significantly lower than father-daughter conflict, girls’ depression was significantly higher than that of boys, and boys’ RESE and self-efficacy in regulating negative emotions (NEG) were significantly higher than that for girls, but there was no significant difference between boys and girls in self-efficacy in expressing positive emotions (POS). (2) Father-child conflict was significantly positively associated with Chinese adolescent depression. Father-child conflict was negatively correlated with RESE, and its two dimensions. Both POS and NEG played a partial mediating role in the relationship between father-child conflict and adolescent depression. (3) Gender only regulated the relationship between NEG and adolescent depression. Compared to boys, girls are more affected by depression at the low level of NEG.

Perceived stress of the COVID-19 pandemic and adolescents' depression symptoms: The moderating role of character strengths

The outbreak of COVID-19 could increase adolescents' psychological distress and have a detrimental effect on their mental health. However, the negative effect of the COVID-19 pandemic on adolescents' mental health might be moderated by their existing psychological resources. The present study sought to investigate whether the relationship between adolescents' perceived stress of the COVID-19 pandemic and their depression symptoms was alleviated by their character strengths. A total of 617 adolescents were recruited and completed the online survey during the COVID-19 pandemic. The results indicated that adolescents' perceived stress of the COVID-19 pandemic was significantly positively correlated with their depression symptoms. Character strengths were significantly negatively correlated with adolescents' perceived stress of the COVID-19 pandemic and their depression symptoms. Moreover, the moderating effect of character strengths on the relationship between adolescents' perceived stress of the COVID-19 pandemic and their depression symptoms was significant. Therefore, adolescents' character strengths as a protective factor could buffer the effect of perceived stress of the COVID-19 pandemic on their depression symptoms and contribute to maintaining their mental health.

Mindfulness for Sustainable Internet Use in Chinese Junior Secondary School Students: A Dual-Path Mediation Model

Mindfulness training can reduce Internet addiction and promote sustainable development, but the possible mediators of this impact have not been thoroughly explored. This study explored the mediating roles of self-control and maladaptive cognitions in the association between mindfulness and Internet addiction to fill this gap. Altogether, 771 Chinese adolescents (M = 13.87 years, SD = 0.78 years) were surveyed about their mindfulness, self-control, maladaptive cognitions, and Internet addiction. The confirmed model presented a good model fit and revealed that (i) mindfulness, self-control, maladaptive cognitions, and Internet addiction were significantly correlated; (ii) mindfulness had indirect negative effects on Internet addiction, mediated by self-control; (iii) mindfulness had an indirect negative impact on Internet addiction, mediated by the path of self-control to maladaptive cognitions; and (iv) this dual-path mediation model might apply to male and female adolescents. The results of the present study suggest that both self-control and maladaptive cognitions are key factors in the association between mindfulness and Internet addiction.

Problematic Use of the Internet in Subjects With Bipolar Disorder: Relationship With Posttraumatic Stress Symptoms

Background: Literature shows a high risk for problematic use of the Internet (PUI) in mood disorders, especially in bipolar disorder (BD). In subjects with BD, traumatic events and posttraumatic stress disorder (PTSD) are related to alcohol or substance use disorder, as well as to gambling disorder. However, little is known about the possible association between traumatic exposure and PUI. The present study was aimed at examining the relationship between PUI and trauma exposure, besides PTSD symptoms, in subjects with BD. Methods: A sample of 113 subjects with BD was screened to putative PUI. Furthermore, they completed the Trauma and Loss Spectrum Self-Report (TALS-SR) to assess traumatic events and posttraumatic stress symptoms. Results: Twenty-four subjects (21.2%) reported putative PUI. Subjects with putative PUI presented significantly higher scores in the TALS-SR domains Potentially Traumatic Events, Re-experiencing, Maladaptive coping, and Arousal, as well as in the TALS-SR total score. In a logistic regression model, a positive association emerged between Potentially Traumatic Events and Arousal TALS-SR domains and putative PUI. Conclusion: One in five patients with BD screened positive for PUI. A significant association between PUI and lifetime traumatic events as well as PTSD symptoms emerged, highlighting the relevance of the comorbidity between PTSD and PUI in subjects with BD.

The Mediating Roles of Emotional Regulation on Negative Emotion and Internet Addiction Among Chinese Adolescents From a Development Perspective

Previous researches indicated that emotional regulation can be associated with depression and anxiety, which may be an important mediating factor between emotional regulation and internet addiction. However, the mechanism between these associations has received little attention and it is still unclear. This study has examined 716 Chinese adolescents, 341 were males (47.6%), aged 13 to 18(Mean = 14.58, SD = 1.50), using a cross-sectional survey involving Young's Diagnostic Questionnaire for Internet Addiction, the nine-item Patient Health Questionnaire (PHQ-9), the seven-item Generalized Anxiety (GAD-7) scale, and the Emotion Regulation Questionnaire (ERQ). Correlation analysis, multiple-group analysis and structural equation modeling were carried out in SPSS Statistics version 23 (IBM, Armonk, NY) and AMOS version 21. Cognitive reappraisal had a significantly negative direct effect on Internet addiction (β = -0.118, p < 0.05). Furthermore, negative emotions mediated the relationships between expression suppression and Internet addiction [β = 0.149, 95% CI = (0.099, 0.212)] and the relationship between cognitive reappraisal and Internet addiction [β = -0.101, 95% CI = (-0.147, -0.065)]. The differences in the structure path coefficients for different development stages demonstrated that recognitive reappraisal showed more protective roles for negative emotion (p < 0.01), and negative emotion also predict Internet addiction more effectively in high school students (p < 0.001). However, cognitive reappraisal directly predicted negative Internet addiction in junior high school students. Therefore, the intervention on adolescents for internet addiction should not only focus on emotional regulation and negative emotion, but also development stages of adolescents.

Prevalence of Internet Addiction Disorder and Its Correlates Among Clinically Stable Adolescents With Psychiatric Disorders in China During the COVID-19 Outbreak

Background: Since the Coronavirus disease 2019 (COVID-19) pandemic emerged, Internet usage has increased among adolescents. Due to this trend, the prevalence of Internet addiction disorder (IAD) may have increased within this group. This study examined the prevalence of IAD and its correlates among clinically stable adolescents with psychiatric disorders in China during the COVID-19 outbreak. Method: A multi-center, cross-sectional study was carried out between April 29 and June 9, 2020 in three major tertiary mental health centers in China. IAD and depressive symptoms were assessed using the Internet Addiction Test (IAT) and the 9-item Patient Health Questionnaire (PHQ-9), respectively. Results: A total of 1,454 adolescent psychiatric patients were included in final analyses. The prevalence of IAD was 31.2% (95% CI: 28.8-33.6%) during the COVID-19 pandemic. A multiple logistic regression analysis revealed that poor relationships with parents (P < 0.001, OR = 2.34, 95%CI: 1.49-3.68) and elevated total PHQ-9 scores (P < 0.001, OR = 1.19, 95%CI: 1.16-1.21) were significantly associated with higher risk for IAD while longer daily physical exercise durations (P = 0.04, OR = 0.67, 95%CI: 0.46-0.98) and rural residence (P = 0.003, OR = 0.62, 95%CI: 0.46-0.85) were significant correlates of lower risk for IAD. Conclusions: IAD was common among adolescent patients with clinically stable psychiatric disorders during the COVID-19 pandemic; regular physical exercise, healthy relationships with parents and fewer symptoms of depression were associated with lower risk within this population.

Internet Addiction and Related Psychological Factors Among Children and Adolescents in China During the Coronavirus Disease 2019 (COVID-19) Epidemic

BACKGROUND

The Coronavirus disease 2019 (COVID-19) is an infectious disease presenting a major threat to public health. This study aims to assess Internet use characteristics and objectively examine the potential psychological factors associated with Internet addiction (IA) during the COVID-19 epidemic.

METHODS

A cross-sectional, anonymized, self-reported survey was conducted among Chinese children and adolescents aged 6 to 18 years old. Participants completed questionnaires containing Young's Internet Addiction Test (IAT) and the Depression, Anxiety, and Stress Scale (DASS-21), and questions regarding demographic information and Internet use characteristics.

RESULTS

A total of 2050 participants (mean age:12.34 ± 4.67 years old, female: 48.44%) were enrolled. Fifty-five (2.68%) participants met the criterion for addictive Internet use (IAT≥70), while 684 (33.37%) participants were classified as problematic Internet users (69≥IAT≥40). Internet usage had grown during the COVID-19 epidemic, including the frequency and duration of recreational Internet use, and the frequency of stay-up Internet use. A linear regression analysis showed female gender (β=-0.091, p<0.001), age (β=0.066, p=0.001), depression (β=0.257, p<0.001), and stress (β=0.323, p<0.001) were significantly correlated with the IAT total scores (R=0.539, R^{2 =} 0.291, p<0.001).

CONCLUSIONS

We observed excessive Internet use among Chinese children and adolescents during the outbreak of COVID-19. Age, gender, depression, and stress were the potential key factors affecting IA. Extended family and professional support should be considered for vulnerable individuals during these unprecedented times.