Assessing the Association Between Internet Addiction Disorder and Health Risk Behaviors Among Adolescents and Young Adults: A Systematic Review and Meta-Analysis

Association Between Excessive Internet Use Time, Internet Addiction, and Physical-Mental Multimorbidity Among Chinese Adolescents: Cross-Sectional Study

BACKGROUND

In contemporary society, the lives of adolescents are profoundly influenced by the internet. While irrational internet use may have an impact on the physical and mental well-being of teenagers, the relationship between excessive internet use and physical-mental multimorbidity in adolescents remains unclear.

OBJECTIVE

The aim of this study was to examine the relationship between excessive internet use and physical-mental multimorbidity among adolescents in China.

METHODS

A total of 5842 students aged 13 to 18 years from Suzhou city in Eastern China were recruited. Four specific physical disorders and a mental disorder were considered to assess the physical-mental multimorbidity, that is, obesity, hypertension, myopia, dental caries, and depressive symptoms. Logistic regression models were used to evaluate the odds ratios (ORs) and 95% CIs between internet use time, internet addiction (IA) behaviors, and physical-mental multimorbidity. Mediation analyses were performed to explore the mediating effect of sleep duration, diet scores, and tobacco or alcohol consumption on the association between excessive internet use and physical-mental multimorbidity.

RESULTS

A total of 973 (16.7%) students exhibited physical-mental multimorbidity. Students with excessive internet use time (≥2 hours per day) were associated with 45% higher odds of physical-mental multimorbidity compared to their peers who reported internet use for <1 hour per day. Among children and adolescents, a significant J-shaped association was observed between internet use time and physical-mental multimorbidity (nonlinear P<.001). Diet score (16.3%) and tobacco or alcohol consumption (12.7%) partially mediated the relationship. Students who met 1 IA behavior (OR 2.44, 95% CI 2.00-2.98) or ≥2 IA behaviors (OR 5.80, 95% CI 4.90-6.86) were associated with higher odds of physical-mental multimorbidity. In the total population, a positive nonlinear correlation was identified between the number of IA behaviors and physical-mental multimorbidity (nonlinear P<.001). Sleep duration (2.3%), dietary scores (6.1%), and tobacco or alcohol consumption (6.2%) partially mediated the association.

CONCLUSIONS

Excessive internet use is associated with increased odds of physical-mental multimorbidity among adolescents. Sleep duration, dietary quality, and tobacco or alcohol consumption may partially mediate this relationship. These findings highlight the need for monitoring and promoting healthy internet habits as well as addressing lifestyle factors in order to prevent and control physical-mental multimorbidity among adolescents. This research will also provide references for managing internet use and physical-mental health as well as for future longitudinal studies.

Application of machine learning in predicting adolescent Internet behavioral addiction

Objective

To explore the risk factors affecting adolescents' Internet addiction behavior and build a prediction model for adolescents' Internet addiction behavior based on machine learning algorithms.

Methods

A total of 4461 high school students in Chongqing were selected using stratified cluster sampling, and questionnaires were administered. Based on the presence of Internet addiction behavior, students were categorized into an Internet addiction group (n=1210) and a non-Internet addiction group (n=3115). Gender, age, residence type, and other data were compared between the groups, and independent risk factors for adolescent Internet addiction were analyzed using a logistic regression model. Six methods-multi-level perceptron, random forest, K-nearest neighbor, support vector machine, logistic regression, and extreme gradient boosting-were used to construct the model. The model's indicators under each algorithm were compared, evaluated with a confusion matrix, and the optimal model was selected.

Result

The proportion of male adolescents, urban household registration, and scores on the family function, planning, action, and cognitive subscales, along with psychoticism, introversion-extroversion, neuroticism, somatization, obsessive-compulsiveness, interpersonal sensitivity, depression, anxiety, hostility, paranoia, and psychosis, were significantly higher in the Internet addiction group than in the non-Internet addiction group (P < 0.05). No significant differences were found in age or only-child status (P > 0.05). Statistically significant variables were analyzed using a logistic regression model, revealing that gender, household registration type, and scores on planning, action, introversion-extroversion, psychoticism, neuroticism, cognitive, obsessive-compulsive, depression, and hostility scales are independent risk factors for adolescent Internet addiction. The area under the curve (AUC) for multi-level perceptron, random forest, K-nearest neighbor, support vector machine, logistic regression, and extreme gradient boosting models were 0.843, 0.817, 0.778, 0.846, 0.847, and 0.836, respectively, with extreme gradient boosting showing the best predictive performance among these models.

Conclusion

The detection rate of Internet addiction is higher in males than in females, and adolescents with impulsive, extroverted, psychotic, neurotic, obsessive, depressive, and hostile traits are more prone to developing Internet addiction. While the overall performance of the machine learning models for predicting adolescent Internet addiction is moderate, the extreme gradient boosting method outperforms others, effectively identifying risk factors and enabling targeted interventions.

[Association of Physical Activity, Mental Health and Contextual Factors with Problematic Internet Use in Adolescents from Barcelona: A Cross-sectional Study]

OBJECTIVE

Physical activity (PA) may be key to reducing problematic Internet use (PIU) among adolescents. Given that Internet usage patterns and PA participation can vary significantly across genders and different age groups, this study aims to analyze the association between PIU and PA, mental health and other contextual factors, in students aged thirteen to nineteen in Barcelona, by sex and age.

METHODS

A cross-sectional study using data from the 2021 FRESC Survey was carried out, which included 3,256 students in the city of Barcelona. The dependent variable was PIU, measured with the validated CIUS scale. Poisson regression was used to estimate crude and adjusted prevalence ratios (PRa) with 95% confidence intervals (IC95%).

RESULTS

In the group over sixteen years old, lower PIU was associated with regular PA in girls (PRa=0.62, IC95%=0.39-0.97) and in boys (PRa=0.51, IC95%=0.35-0.74). Lower PIU in girls under sixteen was associated with higher frequency of sports activities (PRa=0.53, IC95%=0.31-0.88). Poor mental health was associated with higher PIU across all groups (boys under sixteen, PRa=3.31, IC95%=2.42-4.51).

CONCLUSIONS

PA is associated with lower PIU in all groups except boys under sixteen years old. Other factors associated with higher PIU includes poor mental health and poor family relationships. PA promotion programs with a gender perspective could be key to addressing PIU in adolescents.

Factors related to risky alcohol consumption and binge drinking in Spanish college students: a cross-sectional study

OBJECTIVES

The aim of this study was to determine the prevalence of risky alcohol consumption and regular binge drinking, and their associated factors, in Spanish college students.

DESIGN

A cross-sectional study was conducted.

SETTING

This study took place at a private university in a northern region of Spain.

PARTICIPANTS

A total of 330 Spanish undergraduate university students enrolled in the 2022-2023 academic year voluntarily agreed to participate in this investigation.

PRIMARY AND SECONDARY OUTCOME MEASURES

Data collection included sociodemographic information and health-related behaviours. The Alcohol Use Disorders Identification Test was used to assess alcohol consumption. Logistic regression models were used to identify independent predictors for risky alcohol consumption and regular binge drinking.

RESULTS

40.0% of participants reported risky alcohol consumption, and 26.7% were classified as regular binge drinkers. Factors associated with risky alcohol consumption included smoking (OR=3.54, 95% CI 2.03 to 6.14) and problematic internet use (OR=2.10, 95% CI 1.24 to 3.53). Conversely, being older than 30 years was associated with a lower likelihood (OR=0.22, 95% CI 0.08 to 0.60). Regular binge drinking was associated with living outside the family home (OR=2.78, 95% CI 1.56 to 4.95), smoking (OR=3.53, 95% CI 1.94 to 6.40) and problematic internet use (OR=2.19, 95% CI 1.23 to 3.89). In contrast, being female (OR=0.50, 95% CI 0.27 to 0.94) and being over 30 years old (OR=0.28, 95% CI 0.10 to 0.86) were inversely associated.

CONCLUSIONS

Risky alcohol consumption and binge drinking are relatively common among Spanish university students. Interventions to promote responsible alcohol consumption among this population should be implemented in collaboration with other stakeholders.

The Relationship Between Empirical Avoidance, Anxiety, Difficulty Describing Feelings and Internet Addiction Among College Students: A Moderated Mediation Model

With the increasing detection rate of Internet addiction in college students, the correlation between Internet addiction and emotional problems is further strengthened. Therefore, it is crucial to actively investigate the emotional mechanisms underlying college students' internet addiction to foster their healthy development. This study establishes a moderated mediation model based on the relationships among experiential avoidance, internet addiction, anxiety, and difficulty describing feelings to explore the link between experiential avoidance and internet addiction, the mediating role of anxiety, and the moderating effect of difficulty describing feelings. The study collected data from 1,591 Chinese college students across seven provinces (municipalities), utilizing measures such as the Experiential Avoidance Questionnaire, the Internet Addiction Scale, the Anxiety Subscale, and the Difficulty Describing Feelings Scale. A cross-sectional analysis was conducted to further investigate the potential emotional mechanisms behind college students' internet addiction. The results indicated that experiential avoidance significantly predicts internet addiction among college students, with anxiety mediating the relationship between experiential avoidance and internet addiction. Additionally, difficulty describing feelings moderate the relationship between experiential avoidance and anxiety. These findings further suggest that emotional disorders such as experiential avoidance, anxiety, and difficulty describing feelings are potential risk factors behind college students' internet addiction. The study recommends enhancing psychological counseling and other intervention measures in interventions for college students' internet addiction.

The Association Between Internet Addiction and the Risk of Suicide Attempts in Chinese Adolescents Aged 11-17 Years: Prospective Cohort Study

BACKGROUND

Suicide is a critical public health issue in adolescents worldwide. Internet addiction may play a role in the increased rate of suicide attempts in this population. However, few studies have explored the relationship between pathological internet use and suicide attempts among adolescents.

OBJECTIVE

This study aimed to conduct a prospective cohort study to examine whether higher severity of pathological internet use was associated with an increased risk of suicide attempts among Chinese adolescents.

METHODS

A total of 782 adolescents were recruited from a middle school from November 2020 to December 2020 and followed up for 6 months. An online self-reported questionnaire was used to collect the participants' demographic data and assess their mental health. The Depression, Anxiety, and Stress Scale-21 items (DASS-21) was used to evaluate depression, anxiety, and stress. The Chen Internet Addiction Scale-Revised (CIAS-R) was used to assess the symptoms and severity of pathological internet use. χ2 test and ANOVA were used for intergroup comparison, and logistic regression analysis was used to examine the relationship between the severity of pathological internet use and suicide attempts. We also used a restricted cubic splines model to investigate the pattern of the association.

RESULTS

The participants had an average age of 12.59 (SD 0.64) years, with the majority being of Han ethnicity (743/782, 95.01%) and more than half being male (426/782, 54.48%). Most participants had no previous history of depression (541/782, 69.18%), anxiety (415/782, 53.07%), or stress (618/782, 79.03%). The rate of newly reported suicide attempts was 4.6% (36/782). A significant positive association was observed between internet addiction and suicide attempts (odds ratio 3.88, 95% CI 1.70-8.82), which remained significant after adjusting for age, sex, ethnicity, anxiety, depression, and stress (odds ratio 2.65, 95% CI 1.07-6.55). In addition, this association exhibited a linear pattern in the restricted cubic spline regression model.

CONCLUSIONS

This study suggested that internet addiction, rather than internet overuse, was associated with a higher likelihood of suicide attempts, which highlighted the importance of addressing internet addiction symptoms among Chinese adolescents for suicide prevention.

The association between internet addiction and sleep quality among medical students in Saudi Arabia

BACKGROUND

Sleep is one of the fundamental human needs, essential for maintaining a high quality of life and mental and physical well-being across all age groups. Poor sleep quality often stems from negative lifestyle habits, including excessive internet usage. Therefore, it is important to determine the prevalence of internet gaming disorder among youth in Saudi Arabia and to examine the relationship between internet addiction levels and sleep quality.

METHODS

Data were collected from 338 medical students in the southern region of Saudi Arabia (mean age = 21.2 years, standard deviation = 3.29 years). Participants completed an online questionnaire comprising the Internet Addiction Test (IAT) and the Pittsburgh Sleep Quality Index (PSQI). Data analysis employed iterations, chi-square tests, Pearson correlation coefficients, and ANOVA.

RESULTS

The results revealed that 21% of the participants exhibited severe internet addiction, while 31% displayed moderate internet addiction. Furthermore, the findings indicated a positive correlation between sleep quality and the severity of internet addiction. Sleep quality symptoms explained 75% of the variance in Internet addiction scores, even after controlling for demographic variables. Additional bivariate analyses revealed that individuals who spent six or more hours online daily were more likely to experience symptoms of poor sleep quality and exhibit a higher severity of internet addiction. Additionally, Men were more susceptible to developing internet addiction compared to women. Moreover, students with internet addiction tended to have lower academic achievements.

CONCLUSION

These findings, while exploratory, offer valuable insights into potential interventions, strategies, and programs for mitigating internet addiction and enhancing sleep quality among medical college students.

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.

Problematic usage of the internet among Hungarian elementary school children: a cross-sectional study

INTRODUCTION

Problematic usage of the internet (PUI) is perhaps one of the most frequently studied phenomena of the 21st century receiving increasing attention in both scientific literature and the media. Despite intensive research there have been relatively few meaningful studies among elementary school students in Hungary and worldwide, who may be considered as a high-risk population with regard to problematic internet use. The aim of our study was to carry out a complex research focusing on the prevalence and risk factors of PUI among elementary school children aged 10-15 years (Grade 5-8).

METHODS

Demographics included were gender, age, place of stay, type of residence, family type, parental education, start of internet use, used devices, daily internet use, purpose of internet use, internet accounts, ways of keeping in touch with friends and sporting activities. PUI was evaluated using the paper-based version of the Potentially Problematic Use of the Internet Questionnaire.

RESULTS

Overall, 2000 paper-based questionnaires were successfully delivered and the final analysis included 1168 responses (overall response rate 58.4%). Mean age was 12.55 ± 1.24 years. Female gender (OR = 2.760, p = 0,006, CI 95% 0.065 to 0.384), younger age (11-12 years) (OR = 3.812, p < 0.001, 95% CI: 1.747-4.731), early exposure to the internet (OR = 3.466, p = 0.001, 95% CI 1.535-5.446), living in a small village (OR = 1.081, p = 0.002, 95% CI 1.041-1.186) urgency to answer online (OR = 4.677, p < 0.001, 95% CI: 2.714-6.639), decreased frequency of personal contact with friends (OR = 2.897, p = 0.004, 95% CI: 1.037-1.681), spending more than 6 h online (OR = 12.913, p < 0.001, 95% CI: 10.798-14.892), morning and nighttime internet use (OR = 3.846, p < 0.001, CI 95% 1.886-5.810) and never doing any sports (OR = 2.016, p = 0.044, 95% CI: 1.050-3.354) were independently associated with problematic internet use.

CONCLUSIONS

Based on the results of our questionnaire survey more than 10% seemed to be problematic users in our study population, which is a relatively high rate. Early exposure to the internet as well as younger age were strongly related to this phenomenon. Duration of being online as well as daily time interval of internet use are important predisposing factors. Scarcely studied social factors such as being online at the expense of personal relationships and the lack of physical activity should be payed more attention to prevent the development of PUI.

Video games and Facebook addiction among Tunisian adolescents: prevalence and associated factors

OBJECTIVES

As social media and online gaming technology have developed very rapidly over the last two decades, their paired issues are of growing concern worldwide. The aim of our study was to assess the prevalence of video game and Facebook addiction and its predictive factors among Tunisian in school adolescents.

METHODS

We conducted a cross-sectional study among in school adolescents in Sousse, Tunisia, over the first academic term of the 2019-2020 school year using a self-administered questionnaire to a randomly selected representative sample of 1,353 students. The valid Arabic version of the Bergen Facebook Addiction Scale (BFAS), the Video Game Addiction Scale (GAS-7), the Beck Depression Inventory Short Form (13 items) and the Screen for Child Anxiety Related Disorders (SCARED-C) were used to assess facebook addiction disorder (FAD), internet gaming disorder (IGD), depression and anxiety respectively.

RESULTS

More than one in four pupils (26.1 %; CI 95 %: 23.8-28.4 %) were identified as problematic video game users and almost a third of participants (32.5 %; CI 95 %: 30-35 %) reported FAD. IGD was significantly associated with FAD (p<0.001). Likewise, pupils exhibiting depressive symptoms as well as those with anxiety symptoms were significantly more likely to be problematic video games and Facebook users (p<0.001 for each). Being addicted to Facebook (AOR=1.83, 95 % CI: 1.18-2.81), experiencing anxiety disorders (AOR=2.43, 95 % CI: 1.52-3.88), being male (AOR=2.51, 95 % CI: 1.95-3.23) and spending more than 4 h per day surfing the net (AOR=2.55, 95 % CI: 1.65-3.96) were the determinants of IGD in the multivariate analysis. Similarly, being addicted to video games (AOR=1.82, 95 % CI: 1.21-2.73), experiencing anxiety disorders (AOR=1.85, 95 % CI: 1.20-2.86), having experienced academic failure (AOR=1.73, 95 % CI: 1.16-2.56), and spending more than 4 h per day on social media (AOR=3.75, 95 % CI: 2.38-5.90) were the predictors of FAD.

CONCLUSIONS

The prevalence of problematic use of video games and Facebook is alarmingly high. Identifying risk factors can help screen high-risk adolescents. We need additional prevention measures addressing not just adolescents, but all risk factors.

Co-occurrence of habit-forming risk behaviors and their socio-demographic, health status and lifestyle determinants: a population-based cross-sectional study

BACKGROUND

Although habit-forming risk behaviors frequently co-occur, determinants of concurrent risk behaviors have rarely been investigated. The aim of the present study was to investigate socio-demographic, health status, and lifestyle determinants of single versus concurrent risk behaviors in general-population adults.

METHODS

We analyzed data from 32,622 participants (74.5% female; mean age = 57.9 ± 14.2 years) of the NutriNet-Santé cohort who completed the Alcohol Use Disorders Identification Test, the 12-item Cigarette Dependence Scale, the modified Yale Food Addiction Scale 2.0, and the Internet Addiction Test in 2021-2022. Using established cutoffs, participants were first split into 2 groups (presence versus absence) for each risk variable (alcohol use disorders, nicotine dependence, food addiction, Internet addiction) and were then divided into 3 groups (no risk behavior, 1 risk behavior (reference), and ≥ 2 risk behaviors). The association between socio-demographic, health status, and lifestyle exposures and individual/concurrent risk behaviors were investigated with polytomous logistic regression.

RESULTS

Younger age (Odds Ratio (OR) = 2.04; 95% Confidence Interval (CI: 1.62-2.56), current financial difficulties (OR = 1.29; CI: 1.08-1.54), self-perceived poor health (OR = 1.70; CI: 1.32-2.20), overall poor dietary quality (OR = 2.88; CI: 2.06-4.02), being underweight (OR = 1.46; CI: 1.05-2.04), having obesity (OR = 1.62; CI: 1.31-1.99), lack of affection during childhood (OR = 1.41; CI: 1.18-1.69), and a lifetime prevalence or medication use for a mental disorder (OR = 1.46; CI: 1.24-1.73) were positively associated with having ≥ 2 versus 1 risk behavior (all p < 0.05). The comparison of none versus 1 risk behavior revealed the same determinants in addition to having a higher education, being physically active at work, and being overweight.

CONCLUSIONS

We investigated determinants of concurrent habit-forming risk behaviors among adults in a large, population-based study. The findings could serve as impetus for future research in this domain and ultimately help guide addiction prevention efforts.

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

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

Adverse childhood experiences on internet gaming disorder mediated through insomnia in Chinese young people

Background

Adverse childhood experiences (ACEs) have been associated with addictions such as substance use disorders. Few have examined ACEs on internet gaming disorder (IGD) as a newly established behavioral addiction, and the potential mediating role of insomnia remains unclear. We examined the associations between ACE number and types, IGD, and insomnia.

Methods

Participants included 1, 231 Chinese university students (54.5% male; 56.9% aged 18-20 years) who had played internet games at least once in the previous month. ACEs were measured using the 10-item ACE questionnaire (yes/no). Symptoms of insomnia and IGD were measured using the Insomnia Severity Index and the 9-item Internet Gaming Disorder Scale-Short-Form, respectively. Multivariable regressions examined the associations, adjusting for sex, age, maternal and paternal educational attainment, monthly household income, smoking, and alcohol drinking. The mediating role of insomnia symptoms was explored.

Results

The prevalence of ACEs≥1 was 40.0%. Childhood verbal abuse was the most prevalent (17.4%), followed by exposure to domestic violence (17.1%) and childhood physical abuse (15.5%). More ACE numbers showed an association with IGD symptoms (adjusted OR = 1.11, 95% CI 1.04, 1.17). Specifically, IGD symptoms were observed for childhood physical neglect, emotional neglect, sexual abuse, parental divorce or separation, and household substance abuse. Insomnia symptoms mediated the associations of ACE number and types with IGD symptoms (proportion of total effect mediated range 0.23-0.89).

Conclusion

The number and specific types of ACEs showed associations with IGD mediated through insomnia. Screening of ACEs is recommended in future studies on IGD. Longitudinal data are warranted to determine the causality of the observed associations.

Suicide and Non-Suicidal Self-Injury From Internet Addiction Among Korean Adolescents

Objectives

This study examined the associations between Internet addiction and suicide and non-suicidal self-injury (NSSI) among South Korean adolescents.

Methods

We conducted a cross-sectional study of 1694 Korean adolescents. The suicidal Ideation Questionnaire and Deliberate Self- Harm Inventories were used to identify high-risk suicide and NSSI groups, respectively. Internet addiction was assessed using the Internet Addiction Scale. Other questionnaires included sociodemographic data, perceived academic stress, and daily life-related factors. We also performed a logistic regression analysis using the high suicide risk and NSSI groups as dependent variables.

Results

The high suicide risk and NSSI prevalence rates among participants were 11.8% and 28.3%, respectively. A multivariable logistic regression analysis revealed that Internet addiction is associated with higher suicide risk and NSSI. Additionally, being female and academic stress were significant suicide risk factors, while male participants had a higher NSSI prevalence.

Conclusion

Our results suggest that monitoring adolescents' Internet use and providing education to prevent Internet addiction would lower high suicide and NSSI risk. Moreover, suicide and NSSI risk screening in adolescents with Internet addiction and providing suitable interventions will be essential for the preventing suicide and NSSI.

Relationship between behavioral inhibition/activation system and Internet addiction among Chinese college students: The mediating effects of intolerance of uncertainty and self-control and gender differences

Background

Internet addiction is a global public health issue among college students that is associated with a range of negative outcomes. Especially the COVID-19 pandemic has forced them to shift most of their studies and life activities from offline to online, leading to a growing problem of Internet dependence and even Internet addiction. Although previous studies have indicated that the Behavioral Inhibition/Activation System (BIS/BAS) have important effects on college students' Internet addiction, the mechanisms underlying these associations and gender differences are still unclear.

Aims

The present study investigated the mediating roles of intolerance of uncertainty and self-control in the association between BIS/BAS and Internet addiction following the Interaction of Person-Affect-Cognition-Execution model. Gender differences in such associations between variables were also tested.

Method

A total of 747 Chinese college students were surveyed by using Young's Diagnostic Questionnaire for Internet Addiction, BIS/BAS Scales, the Intolerance of Uncertainty Scale and the Brief Self-Control Scale.

Results

The results from the structural equation modeling analysis showed that BIS was positively related to Internet addiction and that BAS had a negative association with Internet addiction. Moreover, intolerance of uncertainty and self-control mediated the relationships between BIS/BAS and Internet addiction. Multi-group analysis further revealed that the associations between BAS and Internet addiction and between intolerance of uncertainty and Internet addiction were stronger among the male students than among female students. The relationship between self-control and Internet addiction was greater in the female sample than in the male sample.

Conclusions

These findings extend our understanding of how BIS/BAS influence Internet addiction among college students and suggest that not only should training approaches based on intolerance of uncertainty and self-control be fully considered, but different intervention programs should be focused on gender sensitivity to maximize the intervention effect.

Adolescent mobile phone addiction during the COVID-19 pandemic predicts subsequent suicide risk: a two-wave longitudinal study

Both the rate of mobile phone addiction and suicidality among adolescents have increased during the pandemic lockdown. However, the relationship between mobile phone addiction and suicide risk and the underlying psychological mechanisms remains unknown. This study examined the associations between mobile phone addiction in adolescents during the first month of lockdown and the suicide risk in the subsequent five months. A two-wave short-term longitudinal web-based survey was conducted on 1609 senior high school students (mean age = 16.53 years, SD = 0.97 years; 63.5% female). At Time 1 (T1), the severity of mobile phone addiction and basic demographic information was collected from Feb 24 to 28, 2020 in Sichuan Province, China (at the pandemic's peak). Five months later, between July 11 and July 23 (Time 2, T2), mobile phone addiction, daytime sleepiness, depression, and suicidality were measured within the past five months. The regression analysis revealed that mobile phone addiction during quarantine directly predicted suicidality within the next five months, even after controlling for the effect of depression and daytime sleepiness. Meanwhile, mobile phone addiction at T1 also indirectly predicted suicidality at T2, with depression and daytime sleepiness mediating this association. Programs targeting improvement of daytime sleepiness and depressive symptoms may be particularly effective in reducing suicide risk among adolescents with mobile phone addiction.