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Ma Y, Li Y, Xie X, Zhang Y, Ammerman BA, Lewis SP, Chen R, Yu Y, Li F, Tang J. The role of depressive symptoms and social support in the association of internet addiction with non-suicidal self-injury among adolescents: a cohort study in China. BMC Psychiatry 2023; 23:322. [PMID: 37161436 PMCID: PMC10169141 DOI: 10.1186/s12888-023-04754-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 04/05/2023] [Indexed: 05/11/2023] Open
Abstract
BACKGROUND Both internet addiction (IA) and non-suicidal self-injury (NSSI) are major public health concerns among adolescents, however, the association between IA and NSSI was not well understood. We aimed to investigate the association between IA and NSSI within a cohort study, and explore the mediated effect of depressive symptoms and the moderating effect of social support in the association. METHODS A total of 1530 adolescents aged 11-14 years who completed both the baseline (T1) and 14-month follow-up (T2) survey of the Chinese Adolescent Health Growth Cohort were included for the current analysis. IA, NSSI, depressive symptoms and social support were measured at T1; depressive symptoms and NSSI were measured again at T2. Structural equation models were employed to estimate the mediated effect of depressive symptoms and the moderating effect of social support in the association between IA and NSSI at T2. RESULTS IA was independently associated with an increased risk of NSSI at T2, with the total effect of 0.113 (95%CI 0.055-0.174). Depressive symptoms mediated the association between IA and NSSI at T2, and social support moderated the indirect but not the direct effect of IA on NSSI at T2. Sex differences were found on the mediated effect of depressive symptoms and the moderated mediation effect of social support. CONCLUSIONS Interventions that target adolescents' NSSI who also struggle with IA may need to focus on reducing depressive symptoms and elevating social support.
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Affiliation(s)
- Ying Ma
- Department of Child Healthcare, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, P.R. China
| | - Yanqi Li
- Department of Preventive Medicine, School of Public Health, Guangzhou Medical University, Room 507, Block 2, Jinxiu Road, Xinzao, Panyu District, Guangzhou, 511436, P.R. China
| | - Xinyi Xie
- Department of Preventive Medicine, School of Public Health, Guangzhou Medical University, Room 507, Block 2, Jinxiu Road, Xinzao, Panyu District, Guangzhou, 511436, P.R. China
| | - Yi Zhang
- Department of Preventive Medicine, School of Public Health, Guangzhou Medical University, Room 507, Block 2, Jinxiu Road, Xinzao, Panyu District, Guangzhou, 511436, P.R. China
| | - Brooke A Ammerman
- Department of Psychology, University of Notre Dame, Notre Dame, IN, USA
| | - Stephen P Lewis
- Department of Psychology, University of Guelph, Guelph, ON, Canada
| | - Ruoling Chen
- Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton, UK
| | - Yizhen Yu
- Department of Maternal and Child Healthcare, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China
| | - Fenghua Li
- Zhongshan Health Care Center for Primary and Secondary Schools, Zhongshan City, P.R. China
| | - Jie Tang
- Department of Preventive Medicine, School of Public Health, Guangzhou Medical University, Room 507, Block 2, Jinxiu Road, Xinzao, Panyu District, Guangzhou, 511436, P.R. China.
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Greenberg NR, Zhai ZW, Hoff RA, Krishnan-Sarin S, Potenza MN. Difficulties in impulse control in adolescents with problematic use of the internet and self-injurious behaviors. Psychiatry Res 2022; 317:114919. [PMID: 37732862 DOI: 10.1016/j.psychres.2022.114919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 10/14/2022] [Accepted: 10/19/2022] [Indexed: 12/24/2022]
Abstract
Problematic use of the internet (PUI) and self-injurious behaviors (SIB) associate in adolescents and both relate to impulsivity. However, studies have not examined whether difficulties in impulse control are shared in adolescents with PUI and SIB, and how PUI relates to SIB frequency and impairment. Here, exploratory factor analysis was performed on a PUI questionnaire based on the Minnesota Impulse Disorder Interview, using survey data from 2,912 Connecticut high-school students. Regression analyses evaluated relationships between PUI factor scores and correlates of SIB. Moderation analyses examined impulsivity and sensation-seeking in relationship to PUI factors and SIB. Two PUI factors were extracted. The first PUI factor was associated with lifetime SIB, frequency, severity, urges, rising tension, and self-perceived problems with SIB. The second factor was associated with lifetime SIB and attempts to reduce SIB. Impulsivity and sensation-seeking associated with PUI factors and SIB, but did not moderate relationships between PUI and SIB. Findings suggest that PUI and SIB are related by difficulties in impulse control, and poor control over internet use is associated with more impairing SIB in adolescents who self-injure. Further research should investigate possible interventions targeting impulsivity and sensation-seeking to prevent PUI and SIB in youth.
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Affiliation(s)
| | - Zu Wei Zhai
- Program in Neuroscience, Middlebury College, Middlebury, VT, USA
| | - Rani A Hoff
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | | | - Marc N Potenza
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; Connecticut Mental Health Center, New Haven, CT, USA; Connecticut Council on Problem Gambling, Wethersfield, CT, USA; Child Study Center, Yale School of Medicine, New Haven, CT, USA; Department of Neuroscience, Yale University, New Haven, CT, USA; Wu Tsai Institute, Yale University, New Haven, CT, USA.
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3
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Wei C, Wang Y, Ma T, Zou Q, Xu Q, Lu H, Li Z, Yu C. Gratitude buffers the effects of stressful life events and deviant peer affiliation on adolescents’ non-suicidal self-injury. Front Psychol 2022; 13:939974. [PMID: 36248536 PMCID: PMC9561820 DOI: 10.3389/fpsyg.2022.939974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 09/06/2022] [Indexed: 11/13/2022] Open
Abstract
Although stressful life events have been shown to be a key risk factor for adolescent NSSI, the potential mediators and moderators of this relationship are unclear. Based on the social development theory and the organism-environment interaction model, we tested whether the link between stressful life events and adolescent NSSI was explained in part by deviant peer affiliation, and whether this process was buffered by gratitude. Chinese adolescents (N = 854; Mage = 16.35; 68.50% female) anonymously completed questionnaires to assess the study variables. The present study demonstrated that stressful life events was linked to NSSI in part because of deviant peer affiliation, and high gratitude was a key protective factor to buffer this indirect effect. Teaching gratitude may be a helpful component of prevention and intervention programs to reduce adolescent NSSI.
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Affiliation(s)
- Chang Wei
- Research Center for Rural Educational and Cultural Development of Key Research Base of Humanities and Social Sciences in Hubei Province, School of Education, Hubei University of Science and Technology, Xianning, China
- School of Psychology, South China Normal University, Guangzhou, China
| | - Yu Wang
- Research Center for Rural Educational and Cultural Development of Key Research Base of Humanities and Social Sciences in Hubei Province, School of Education, Hubei University of Science and Technology, Xianning, China
- *Correspondence: Yu Wang,
| | - Tao Ma
- Liuxiang Junior High School, Zhuhai, China
| | - Qiang Zou
- Research Center for Rural Educational and Cultural Development of Key Research Base of Humanities and Social Sciences in Hubei Province, School of Education, Hubei University of Science and Technology, Xianning, China
| | - Qian Xu
- Research Center for Rural Educational and Cultural Development of Key Research Base of Humanities and Social Sciences in Hubei Province, School of Education, Hubei University of Science and Technology, Xianning, China
| | - Huixing Lu
- Research Center for Rural Educational and Cultural Development of Key Research Base of Humanities and Social Sciences in Hubei Province, School of Education, Hubei University of Science and Technology, Xianning, China
| | - Zhiyong Li
- College of Education Science, Hubei Normal University, Huangshi, China
| | - Chengfu Yu
- School of Education, Guangzhou University, Guangzhou, China
- Chengfu Yu,
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Sarour EO, El Keshky MES. Deviant peer affiliation as a mediating variable in the relationship between family cohesion and adaptability and internet addiction among adolescents. Curr Psychol 2022; 42:1-9. [PMID: 35693840 PMCID: PMC9168353 DOI: 10.1007/s12144-022-03270-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2022] [Indexed: 11/03/2022]
Abstract
The aim of this study was to investigate the mediating role of deviant peer affiliation in the relationship between family functioning, specifically family cohesion and family adaptability, and internet addiction among Saudi adolescents. A sample of 946 Saudi Arabian adolescents with a mean age of 18.5 years (SD = 3.06) was obtained using snowball sampling. Path analysis using structural equation modeling was conducted. The results indicated significant negative relationships between family cohesion and internet addiction and between deviant peer affiliation and family cohesion, and a significant positive relationship between family adaptability and internet addiction. In accordance with prior research, we found a significant positive relationship between deviant peer affiliation and internet addiction, but in terms of mediation, deviant peer affiliation mediated only the relationship between family cohesion and internet addiction. In conclusion, it is important for the effectiveness of interventions and preventive programs that aim to address deviant peer affiliation and internet addiction in adolescents to enhance the well-being of their family systems.
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Affiliation(s)
- Enas ObaidAllah Sarour
- Human Sciences and Design, Family Sciences Department, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mogeda El Sayed El Keshky
- Department of Psychology, Faculty of Arts and Humanities, King Abdulaziz University, P.O. Box 42803, Jeddah, 21551 Saudi Arabia
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Liu P, Cao J, Nie W, Wang X, Tian Y, Ma C. The Influence of Internet Usage Frequency on Women's Fertility Intentions-The Mediating Effects of Gender Role Attitudes. Int J Environ Res Public Health 2021; 18:4784. [PMID: 33946141 PMCID: PMC8124929 DOI: 10.3390/ijerph18094784] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 04/23/2021] [Accepted: 04/27/2021] [Indexed: 11/17/2022]
Abstract
The purpose of this study is to verify the influence of internet usage frequency on women's fertility intentions and to examine the mediating effects of gender role attitudes, under the influence of internet usage frequency that affects women's fertility intentions, combined with the specific Chinese cultural context. A cross-sectional secondary data analysis was conducted using a sample of 3113 women of childbearing age in the Chinese General Social Survey in 2017 (CGSS2017). The results of the negative binomial regression model showed that, under the premise of controlling individual characteristic variables, the higher the frequency of internet usage, the lower the fertility intention (p < 0.01). The results of the mediating effect model show that the more frequently women use the internet, the lower their fertility intentions, and the less they agree with Chinese traditional gender roles, which are "men work outside to support the family while women stay at home to take care of the family". These findings have implications in formulating public policies aimed at increasing the fertility rate; that is, it is not enough to increase women's fertility intentions under China's universal two-child policy. Moreover, public policy formulators need to consider gender role attitudes and the influence of the internet as a method for dissemination of information.
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Affiliation(s)
- Pengcheng Liu
- School of Economics, Qingdao University, Qingdao 266061, China;
| | - Jingjing Cao
- School of Business, Qingdao University, Qingdao 266061, China; (J.C.); (C.M.)
| | - Wenjie Nie
- School of Management, Ocean University of China, Qingdao 266100, China;
| | - Xiaojie Wang
- School of Management, Ocean University of China, Qingdao 266100, China;
| | - Yani Tian
- Business School, The University of Sydney, Sydney, NSW 2006, Australia;
| | - Cheng Ma
- School of Business, Qingdao University, Qingdao 266061, China; (J.C.); (C.M.)
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Karki K, Singh DR, Maharjan D, K. C. S, Shrestha S, Thapa DK. Internet addiction and sleep quality among adolescents in a peri-urban setting in Nepal: A cross-sectional school-based survey. PLoS One 2021; 16:e0246940. [PMID: 33600410 PMCID: PMC7891762 DOI: 10.1371/journal.pone.0246940] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 01/29/2021] [Indexed: 11/18/2022] Open
Abstract
Background Excessive use of the internet among adolescents often led to later bedtimes and poor sleep quality. This study assessed the relationship between internet addiction and sleep quality among adolescents in a peri-urban setting in Nepal. Method This cross-sectional study employed a questionnaire survey among 390 adolescent students recruited from two schools in Kirtipur Municipality in Nepal. The Internet Addiction Test and the Pittsburgh Sleep Quality Index were used to assess internet addiction and poor sleep quality respectively. The association between internet addiction and sleep quality was analysed by logistic regression. Results One-fifth (21.5%) of the participants were identified with borderline internet addiction and 13.3% with possible internet addiction. Poor sleep quality was found among 31% of the participants. Internet addiction was significantly associated with poor sleep quality (OR = 1.85, p = 0.022 for borderline, and OR = 3.98, p = <0.001 for possible internet addiction compared to no internet addiction). Conclusion Adolescents with internet addiction were more vulnerable to suffer from poor sleep quality. It is recommended that municipalities and schools should aware the adolescent students on the adverse effects of excessive internet use including poor sleep quality. The findings have implications for adolescents, parents, school authorities and researchers.
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Affiliation(s)
- Kshitij Karki
- Department of Public Health, Asian College for Advance Studies, Purbanchal University, Lalitpur, Nepal
- Group for Technical Assistance, Program and Research, Lalitpur, Nepal
- * E-mail:
| | - Devendra Raj Singh
- Department of Public Health, Asian College for Advance Studies, Purbanchal University, Lalitpur, Nepal
- Southeast Asia Development Actions Network (SADAN), Innovation, Research and Program, Lalitpur, Nepal
| | - Dikshya Maharjan
- Department of Public Health, Asian College for Advance Studies, Purbanchal University, Lalitpur, Nepal
| | - Sushmita K. C.
- Faculty of Humanities and Social Sciences, Tribhuvan University, Kathmandu, Nepal
| | - Shreesha Shrestha
- Department of Public Health, Asian College for Advance Studies, Purbanchal University, Lalitpur, Nepal
| | - Deependra Kaji Thapa
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Sydney, NSW, Australia
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Dou D, Shek DTL. Concurrent and Longitudinal Relationships between Positive Youth Development Attributes and Adolescent Internet Addiction Symptoms in Chinese Mainland High School Students. Int J Environ Res Public Health 2021; 18:ijerph18041937. [PMID: 33671277 PMCID: PMC7922687 DOI: 10.3390/ijerph18041937] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 02/08/2021] [Accepted: 02/09/2021] [Indexed: 12/19/2022]
Abstract
In view of growing adolescent Internet addiction (IA) in the global context, there is a great need to understand the predictors of IA and design related evidence-based intervention and prevention programs. This longitudinal study investigated the relationships between Positive Youth Development (PYD) attributes and IA problems and the mediating role of life satisfaction using a large sample of Chinese high school students (N = 2648). Separated by one academic year, students completed a questionnaire evaluating their adolescent psychosocial adjustment, including validated PYD and IA measures. Multiple regression and structural equation modeling analyses were used. Consistent with the theoretical predictions of PYD models, results revealed a significant negative influence of PYD attributes on IA symptoms concurrently and longitudinally. In particular, general PYD attributes, such as emotional competence, spirituality, and resilience, showed strong and stable protective effects against IA. Life satisfaction also served as a mediator of the influence of all measures of PYD attributes on IA symptoms. The study underlines the importance of PYD attributes in promoting adolescents’ life satisfaction and preventing IA, and thus contributes to the design and implementation of evidence-based intervention and prevention programs.
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Tóth-Király I, Morin AJS, Hietajärvi L, Salmela-Aro K. Longitudinal Trajectories, Social and Individual Antecedents, and Outcomes of Problematic Internet Use Among Late Adolescents. Child Dev 2021; 92:e653-e673. [PMID: 33511643 DOI: 10.1111/cdev.13525] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Given the detrimental effects associated with problematic internet use (PIU) and the need to better understand its nature and evolution, the present study examined the development of PIU in a sample of 1,750 adolescents (aged 16-19) from Finland over a 3-year period. We documented the social (loneliness, perceived maternal and paternal behaviors) and individual (sex) antecedents, as well as the outcome implications (depressive symptoms, substance use, academic achievement) of PIU trajectories. Outcomes also predicted PIU trajectories. Latent curve modeling revealed an initially moderate, and subsequently decreasing trajectory of PIU. PIU was predicted by loneliness, paternal neglect, maternal care, depressive symptoms, and being male. In turn, PIU trajectories predicted increases in depressive symptoms and substance use, but decreases in academic achievement.
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Kruzan KP, Whitlock J, Bazarova NN. Examining the Relationship Between the Use of a Mobile Peer-Support App and Self-Injury Outcomes: Longitudinal Mixed Methods Study. JMIR Ment Health 2021; 8:e21854. [PMID: 33507154 PMCID: PMC7878111 DOI: 10.2196/21854] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 11/16/2020] [Accepted: 12/15/2020] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Many individuals who self-injure seek support and information through online communities and mobile peer-support apps. Although researchers have identified risks and benefits of participation, empirical work linking participation in these web-based spaces to self-injury behaviors and thoughts is limited. OBJECTIVE This study aims to investigate the relationship between behavioral and linguistic traces on a mobile peer support app and self-injury outcomes. METHODS Natural use data and web-based surveys (N=697) assessing self-injury outcomes were collected from 268 users (aged 13-38 years; median 19; 149/268, 55.6% female) of a mobile peer-support app for 4 months. Participants were identified as having posted self-injury content using an internal classifier. Natural log data was used to predict self-injury outcomes in a series of multilevel logistic and linear regressions. RESULTS Greater engagement on a mobile peer-support app was associated with a decreased likelihood of self-injury thoughts (odds ratio [OR] 0.25, 95% CI 0.09-0.73) and fewer intentions to self-injure (b=-0.37, SE 0.09), whereas posting triggering content was associated with an increased likelihood of engaging in behaviors (OR 5.37, 95% CI 1.25-23.05) and having self-injury thoughts (OR 17.87, 95% CI 1.64-194.15). Moreover, viewing triggering content was related to both a greater ability to resist (b=1.39, SE 0.66) and a greater intention to self-injure (b=1.50, SE 0.06). CONCLUSIONS To our knowledge, this is the first study to connect naturally occurring log data to survey data assessing self-injury outcomes over time. This work provides empirical support for the relationship between participation in online forums and self-injury outcomes, and it articulates mechanisms contributing to this relationship.
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Affiliation(s)
- Kaylee Payne Kruzan
- Center for Behavioral Intervention Technologies, Northwestern University, Chicago, IL, United States
| | - Janis Whitlock
- Bronfenbrenner Center for Translational Research, Cornell University, Ithaca, NY, United States
| | - Natalya N Bazarova
- Department of Communication, Cornell University, Ithaca, NY, United States
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Wang L, Liu X, Liu ZZ, Jia CX. Digital media use and subsequent self-harm during a 1-year follow-up of Chinese adolescents. J Affect Disord 2020; 277:279-286. [PMID: 32841829 DOI: 10.1016/j.jad.2020.05.066] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 04/02/2020] [Accepted: 05/13/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Excessive digital media use is prevalent and has a negative impact on sleep, daytime functioning, and mental health in adolescents. We examined the prospective associations between digital media use and subsequent suicidal and non-suicidal self-harm. METHODS Shandong Adolescent Behavior & Health Cohort (SABHC) is a longitudinal study of adolescent behavior and health in Shandong, China. Participants included for the analysis were 7,072 SABHC adolescents who were initially assessed in 2015 and were reassessed in 2016. A self-administered structured questionnaire was used to measure digital media use (i.e., television watching, internet use, and mobile phone use) on weekdays and at the weekend, mental health, and self-harm. RESULTS Multivariable logistic regression analyses showed that daily internet use ≥2 h on weekdays (odd ratio (OR) = 1.86, 95% confidence interval(CI) = 1.25-2.76) and ≥3 h at the weekend (OR = 1.46, 95%CI = 1.06-2.00) and daily mobile phone use 2-3 h (OR = 1.46, 95%CI = 1.02-2.10) and ≥4 h (OR = 1.74, 95%CI = 1.20-2.51) at the weekend were significantly associated with increased risk of recurrent self-harm. Daily internet use ≥ 2 h on weekdays (OR = 1.81, 95%CI = 1.20-2.74) and ≥3 h at the weekend (OR = 1.55, 95%CI = 1.12-2.15), daily mobile phone use 1-2 h on weekdays (OR = 1.47, 95%CI = 1.02-2.12) and 2-3 h (OR = 1.49, 95%CI = 1.01-2.19) and ≥4 h (OR = 1.93, 95%CI = 1.31-2.85) at the weekend were significantly associated with increased risk of recurrent non-suicidal self-injury. Daily internet use 1-2 h on weekdays and 2-3 h at the weekend were significantly associated with increased risk of new suicide attempt (OR = 1.80, 95%CI = 1.07- 3.03) and recurrent suicide attempt (OR = 6.26, 95%CI = 1.31-29.88), respectively. LIMITATIONS All data were self-reported. CONCLUSIONS Excessive use of internet or mobile phone appears to be a significant risk factor of self-harm, suggesting that limiting adolescent use of internet and mobile phone may be beneficial to reduce risk of self-harm.
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Affiliation(s)
- Liang Wang
- Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, TX, 76798, USA
| | - Xianchen Liu
- Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, PA, 19104, USA.
| | - Zhen-Zhen Liu
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University and Shandong University Center for Suicide Prevention Research, Jinan, Shandong, 250012, China
| | - Cun-Xian Jia
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University and Shandong University Center for Suicide Prevention Research, Jinan, Shandong, 250012, China.
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Arrivillaga C, Rey L, Extremera N. Adolescents’ problematic internet and smartphone use is related to suicide ideation: Does emotional intelligence make a difference? Computers in Human Behavior 2020. [DOI: 10.1016/j.chb.2020.106375] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Pan YC, Chiu YC, Lin YH. Systematic review and meta-analysis of epidemiology of internet addiction. Neurosci Biobehav Rev 2020; 118:612-622. [PMID: 32853626 DOI: 10.1016/j.neubiorev.2020.08.013] [Citation(s) in RCA: 145] [Impact Index Per Article: 36.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 07/31/2020] [Accepted: 08/14/2020] [Indexed: 01/17/2023]
Abstract
BACKGROUND The field of internet addiction has experienced significant debates on conflicting epidemiology. This meta-analysis investigated the prevalence rates of generalized internet addiction (GIA) and internet gaming disorder (IGD). METHODS We included 113 epidemiologic studies covering 693,306 subjects published from 1996 to 2018 (for 31 nations) that reported prevalence rates for GIA or IGD. We examined pooled prevalence of GIA and IGD and the hypothesized moderators including year, geographic regions, types of scales, and sample representativeness. RESULTS All 133 effect sizes included 53,184 subjects with GIA or IGD. Weighted average prevalence for GIA and IGD were 7.02 % (95 % CI, 6.09 %-8.08 %) and 2.47 % (95 % CI, 1.46 %-4.16 %) respectively. For GIA, prevalence was increased over time and prevalence rates variated among different scales. IGD prevalence was neither moderated by year, regions, nor sample representativeness. CONCLUSIONS The prevalence of GIA was higher than the prevalence of IGD. The GIA prevalence was increasing over time and variated with different assessments. Our results reveal that GIA may reflect a pattern of increasing human-machine interaction.
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Affiliation(s)
- Yuan-Chien Pan
- Department of Psychology, National Taiwan University, Taipei, Taiwan.
| | - Yu-Chuan Chiu
- Department of Psychiatry, MacKay Memorial Hospital, Taipei, Taiwan.
| | - Yu-Hsuan Lin
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan; Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan; Institute of Health Behaviors and Community Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan.
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13
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Mészáros G, Győri D, Horváth LO, Szentiványi D, Balázs J. Nonsuicidal Self-Injury: Its Associations With Pathological Internet Use and Psychopathology Among Adolescents. Front Psychiatry 2020; 11:814. [PMID: 32922320 PMCID: PMC7456921 DOI: 10.3389/fpsyt.2020.00814] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 07/29/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND/HYPOTHESES As risk factors for nonsuicidal self-injury (NSSI), most studies highlight the importance of internalising disorders, while only a few researches show the connection between externalising disorders and NSSI. Although some papers have introduced the idea that increasing prevalence rates of NSSI are connected to the broader use of the internet, associations between NSSI and pathological internet use (PIU) are understudied. According to our hypothesis, there is a connection between PIU and NSSI, but this is mediated by psychopathological factors from both internalising and externalising dimensions. METHODS In line with the dimensional approach of psychiatric disorders, participants (N = 363) were recruited from both clinical (N = 202 psychiatric inpatient) and nonclinical (N = 161 adolescents from secondary schools) settings. Measurements: Demographic Questionnaire; Strengths and Difficulties Questionnaire (SDQ); Deliberate Self-Harm Inventory (DSHI); Young Diagnostic Questionnaire for Internet Addiction (YDQ), Mini International Neuropsychiatric Interview Kid (M.I.N.I. Kid). RESULTS There was high NSSI frequency (39.9%-71% of them were girls) in our sample. NSSI was significantly more frequent among those who showed threshold symptoms on SDQ than in the subthreshold group [H(3) = 53.293, p <.001]. In the NSSI frequency, there was also a significant difference between 'normal' internet users and both 'maladaptive' and 'pathological' internet users [H(2) = 10.039, p <.05 p = .007]. According to the mediator models, the relationship between PIU and NSSI is not a direct association; it is mediated by all examined psychopathological factors (M.I.N.I. kid diagnoses) except for obsessive-compulsive disorder (OCD), alcohol abuse and dependence, and adjustment disorder. CONCLUSIONS We found a high frequency of NSSI. According to our results, PIU in itself is not a risk factor for NSSI but might become a risk factor in the presence of comorbid psychiatric disorders. All of these findings draw the attention of clinicians to the importance of careful screening of comorbid disorders with PIU.
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Affiliation(s)
- Gergely Mészáros
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Semmelweis University, Budapest, Hungary
- Mental Health Sciences School of Ph.D., Semmelweis University, Budapest, Hungary
| | - Dora Győri
- Doctoral School of Psychology, Eötvös Loránd University, Budapest, Hungary
- Institute of Psychology, Eötvös Loránd University, Budapest, Hungary
| | - Lili Olga Horváth
- Doctoral School of Psychology, Eötvös Loránd University, Budapest, Hungary
- Institute of Psychology, Eötvös Loránd University, Budapest, Hungary
| | - Dora Szentiványi
- Doctoral School of Psychology, Eötvös Loránd University, Budapest, Hungary
- Institute of Psychology, Eötvös Loránd University, Budapest, Hungary
- Pedagogical Assistance Services, Budapest, Hungary
| | - Judit Balázs
- Mental Health Sciences School of Ph.D., Semmelweis University, Budapest, Hungary
- Institute of Psychology, Eötvös Loránd University, Budapest, Hungary
- Department of Psychology, Bjørknes University College, Oslo, Norway
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Chahine M, Salameh P, Haddad C, Sacre H, Soufia M, Akel M, Obeid S, Hallit R, Hallit S. Suicidal ideation among Lebanese adolescents: scale validation, prevalence and correlates. BMC Psychiatry 2020; 20:304. [PMID: 32539735 PMCID: PMC7296775 DOI: 10.1186/s12888-020-02726-6] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 06/09/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND In addition to the unstable political situation, Lebanon had experienced a cycle of wars, local armed conflicts, terrorist attacks, and crises (lack of clean water, recurrent power failure, and waste mismanagement, in addition to the growing number of unemployed people, as the number of Syrian refugees has dramatically increased, and led to competition for jobs with locals. All these factors make the Lebanese population prone to mental disorders, particularly suicide, without clear management policies. This study aims to validate the Columbia-Suicide Severity Rating Scale (CSSRS), and determine the prevalence of suicidal ideation and associated factors among a Lebanese nationally representative sample of adolescents from 9th to 12th grades. METHODS Participants were 1810 adolescents who enrolled in this cross-sectional study (January-May 2019), using a proportionate random sample of schools from all Lebanese Mohafazat. The Columbia-Suicide Severity Rating Scale was used to screen for suicidal ideation. RESULTS The results showed that 28.9% had some type of suicidal ideation [95% CI 26.7-31.1%]. The CSSRS items converged on a one-factor solution, accounting for a total of 85.40% of the variance (αCronbach = 0.966). Higher psychological abuse (Beta = 0.041), child physical abuse (Beta = 0.030), alcohol dependence (Beta = 0.062), social fear (Beta = 0.028), victimization/bullying score (Beta = 0.028), impulsivity (Beta = 0.028) and internet addiction (Beta = 0.010) scores were significantly associated with higher suicidal ideation. Same applies to adolescents whose parents are separated compared to living together (Beta = 0.992) and in females compared to males (0.311). On another hand, a higher age (Beta = - 0.182) was significantly associated with lower suicidal ideation. CONCLUSION This study provides insights about suicidal ideation among Lebanese adolescents and related risk factors, such as child psychological and physical abuse, alcohol use disorders, social fear, bullying and victimization, impulsivity, and internet addiction.
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Affiliation(s)
- Melissa Chahine
- grid.444434.70000 0001 2106 3658Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | - Pascale Salameh
- INSPECT-LB: Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie, Beirut, Lebanon ,grid.411324.10000 0001 2324 3572Faculty of Pharmacy, Lebanese University, Hadat, Lebanon ,grid.411324.10000 0001 2324 3572Faculty of Medicine, Lebanese University, Hadat, Lebanon
| | - Chadia Haddad
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon ,grid.497275.aUniversité de Limoges, UMR 1094, Neuroépidémiologie Tropicale, Institut d’Epidémiologie et de Neurologie Tropicale, GEIST, 87000 Limoges, France
| | - Hala Sacre
- INSPECT-LB: Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie, Beirut, Lebanon ,Drug Information Center, Order of Pharmacists of Lebanon, Beirut, Lebanon
| | - Michel Soufia
- grid.444434.70000 0001 2106 3658Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon ,grid.411324.10000 0001 2324 3572Faculty of Medicine, Lebanese University, Hadat, Lebanon
| | - Marwan Akel
- INSPECT-LB: Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie, Beirut, Lebanon ,grid.444421.30000 0004 0417 6142School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Sahar Obeid
- INSPECT-LB: Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie, Beirut, Lebanon ,Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon ,grid.444434.70000 0001 2106 3658Faculty of Arts and Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | - Rabih Hallit
- grid.444434.70000 0001 2106 3658Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | - Souheil Hallit
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon. .,INSPECT-LB: Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie, Beirut, Lebanon.
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15
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Tang J, Ma Y, Lewis SP, Chen R, Clifford A, Ammerman BA, Gazimbi MM, Byrne A, Wu Y, Lu X, Chang H, Kang C, Tiemeier H, Yu Y. Association of Internet Addiction With Nonsuicidal Self-injury Among Adolescents in China. JAMA Netw Open 2020; 3:e206863. [PMID: 32496567 PMCID: PMC7273191 DOI: 10.1001/jamanetworkopen.2020.6863] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
IMPORTANCE Both nonsuicidal self-injury (NSSI), defined as the direct, deliberate damage of one's body tissue without suicidal intent, and internet addiction among adolescents are public health concerns. However, the possible association of NSSI with internet addiction is not well understood. OBJECTIVE To examine the occurrence of internet addiction with NSSI and any sex differences among Chinese adolescents. DESIGN, SETTING, AND PARTICIPANTS A multicenter, cross-sectional, survey study was conducted from February 18 to October 15, 2015, among adolescents aged 11 to 20 years from 343 classes in 45 public high schools across 5 provinces of China. Data analysis was performed from August 1, 2018, to March 1, 2019. EXPOSURES Possible internet addiction and internet addiction. MAIN OUTCOMES AND MEASURES Less-frequent (1-4 times) NSSI and more-frequent (≥5 times) NSSI were surveyed using the Chinese version of the Functional Assessment of Self-Mutilation. RESULTS A total of 15 623 students (8043 male [51.5%] and 7580 female [48.5%]) aged 11 to 20 years (mean [SD] age, 15.1 [1.8] years) participated. Of these, 4670 participants (29.9%) met the criteria for possible internet addiction and 509 participants (3.3%) met the criteria for internet addiction. A total of 2667 students (17.1%) engaged in less-frequent NSSI, while 1798 students (11.5%) engaged in more-frequent NSSI in the 12 months preceding the survey. Both possible internet addiction and internet addiction were associated with less-frequent or more-frequent NSSI. The adjusted odds ratios were 1.29 (95% CI, 1.17-1.42) for possible internet addiction and 1.41 (95% CI, 1.11-1.80) for internet addiction for less-frequent NSSI; for more-frequent NSSI, the adjusted odds ratios were 1.75 (95% CI, 1.56-1.96) for possible internet addiction and 2.66 (95% CI, 2.10-3.38) for internet addiction. These associations were similarly observed among age groups of 11 to 14, 15 to 17, and 18 to 20 years. No sex disparities were found in the associations of internet addiction with NSSI, except among adolescents aged 11 to 14 years, where the odds ratios for possible internet addiction with less-frequent NSSI were higher in male adolescents (1.53; 95% CI, 1.25-1.88) than female adolescents (1.13; 95% CI, 0.90-1.47). CONCLUSION AND RELEVANCE Internet addiction appears to be associated with NSSI, and the findings of this study suggest that the association was similar between male adolescents and female adolescents. These data suggest that evaluation of the risk of NSSI for adolescents in association with internet addiction may help health care professionals in developing preventive interventions for NSSI.
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Affiliation(s)
- Jie Tang
- Department of Preventive Medicine, School of Public Health, Guangzhou Medical University, Xinzao, Panyu District, Guangzhou, P. R. China
- Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton, United Kingdom
| | - Ying Ma
- Department of Child Healthcare, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, P. R. China
| | - Stephen P. Lewis
- Department of Psychology, University of Guelph, Guelph, Ontario, Canada
| | - Ruoling Chen
- Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton, United Kingdom
| | - Angela Clifford
- Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton, United Kingdom
| | | | - Marufu Martin Gazimbi
- Global Development Institute, ALB, University of Manchester, Manchester, United Kingdom
| | - Adrian Byrne
- School of Medicine, Queen’s Medical Centre, University of Nottingham, Nottingham, United Kingdom
| | - Yu Wu
- Shenzhen Center for Disease Control and Prevention, Nanshan District, Shenzhen, P. R. China
| | - Xinchuan Lu
- Department of Child and Adolescent Psychiatry, Suzhou Guangji Hospital, Suzhou, P. R. China
| | - Hongjuan Chang
- Department of Maternal and Child Healthcare, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Hankou District, Wuhan, P. R. China
| | - Chun Kang
- Department of Maternal and Child Healthcare, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Hankou District, Wuhan, P. R. China
| | - Henning Tiemeier
- Department of Child and Adolescent Psychiatry, Erasmus University Medical Centre–Sophia Children's Hospital, Rotterdam, the Netherlands
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Yizhen Yu
- Department of Maternal and Child Healthcare, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Hankou District, Wuhan, P. R. China
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Baroni S, Marazziti D, Mucci F, Diadema E, Dell’Osso L. Problematic Internet use in drug addicts under treatment in public rehab centers. World J Psychiatry 2019; 9:55-64. [PMID: 31211113 PMCID: PMC6560498 DOI: 10.5498/wjp.v9.i3.55] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 05/07/2019] [Accepted: 05/14/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Problematic Internet use (PIU) or Internet addiction has been recognized to be a behavioral addiction characterized by excessive or poorly controlled preoccupations, urges, or behaviors regarding computer use and Internet access that leads to impairment or distress resembling substance abuse.
AIM To investigate the prevalence and characteristics of Internet use and abuse in a group of drug addicts from Southern Italy, by means of a specific questionnaire [“Questionario sull’Utilizzo delle Nuove Tecnologie” (QUNT)].
METHODS All subjects (183) were heavy smokers, almost 50% of them used heroin and/or opioid compounds, 30% alcohol, 10% cannabis, 8% cocaine, and 5% were polydrug users. Almost 10% of the individuals were also suffering from gambling disorder.
RESULTS The time spent online was more than 4 hours a day in the total sample, with a slight prevalence in male subjects. Cocaine and cannabis users spent more than 6 hours online, significantly more than opioid and alcohol abusers. Distribution of the QUNT factors was not different in both sexes. Cocaine users showed higher scores at the “loss of control”, “pornography addiction”, and “addiction to social networks” factors, for the stimulant effect of this substance. Moreover, 15 out of the total 17 cocaine users were pathological gamblers. Positive and statistically significant relationships were observed between some QUNT factors and body mass index.
CONCLUSION These findings indicate that PIU is less severe in subjects taking sedative substances, such as heroin/opioids and alcohol, than in subjects taking stimulants. Alternatively, it may be used as a “stimulant” trigger in cocaine and cannabis users. Flattening effect of abuse drugs was noted on possible sex-related differences in QUNT items. We observed a sort of “protective” effect of a love relationship and/or living together with a partner, as those engaged subjects showed lower scores on different items than single subjects or those living alone. The relationship between time spent online (and related sedentary lifestyle) and body mass index would suggest that Internet use might be a contributing factor to increasing weight gain and obesity amongst adolescents and young adults worldwide. Our findings also highlighted the specific vulnerability of drug addicts who use stimulants, rather than sedative compounds, to other kinds of behavioral addictions, such as gambling disorder.
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Affiliation(s)
- Stefano Baroni
- Dipartimento di Medicina Clinica e Sperimentale, Section of Psychiatry, University of Pisa, Pisa 56100, Italy
| | - Donatella Marazziti
- Dipartimento di Medicina Clinica e Sperimentale, Section of Psychiatry, University of Pisa, Pisa 56100, Italy
| | - Federico Mucci
- Dipartimento di Medicina Clinica e Sperimentale, Section of Psychiatry, University of Pisa, Pisa 56100, Italy
| | - Elisa Diadema
- Dipartimento di Medicina Clinica e Sperimentale, Section of Psychiatry, University of Pisa, Pisa 56100, Italy
| | - Liliana Dell’Osso
- Dipartimento di Medicina Clinica e Sperimentale, Section of Psychiatry, University of Pisa, Pisa 56100, Italy
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Choi BY, Huh S, Kim DJ, Suh SW, Lee SK, Potenza MN. Transitions in Problematic Internet Use: A One-Year Longitudinal Study of Boys. Psychiatry Investig 2019; 16:433-442. [PMID: 31247702 PMCID: PMC6603706 DOI: 10.30773/pi.2019.04.02.1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 04/02/2019] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVE Longitudinal studies may help elucidate the factors associated with Problematic Internet Use (PIU); however, little prospective research has been conducted on the subject. The aim of the current study was to prospectively examine PIU in children/adolescents and identify the possible risk factors associated with transitions in PIU severity. METHODS 650 middle-school boys were surveyed at two points one year apart and assessed for PIU using the Internet Addiction Proneness Scale for Youth (KS-II) and on other psychological characteristics. RESULTS We found that 15.3% at baseline and 12.4% at one year met the criteria for at-risk/high-risk PIU (ARHRPIU). Both the persistent-ARHRPIU and emerging-ARHRPIU groups revealed greater depressive, motor impulsive, and smart-phone-addiction tendencies than the remitting-ARHRPIU group or the persistent low-risk group. In addition, we found that individuals exhibiting higher hyperkinetic attention-deficit/hyperactivity disorder (ADHD) scores were less likely to remit from ARHRPIU, and that individuals exhibiting more ADHD-related cognitive dysfunction and reporting fewer Internet-game-free days were more likely to demonstrate an emergence of ARHRPIU. CONCLUSION The present findings support previous studies in that specific negative-health features are linked to transitions in ARHRPIU. Furthermore, these findings suggest that intervention is needed and may be best targeted at specific groups of youths.
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Affiliation(s)
- Bo Young Choi
- Department of Physiology, College of Medicine, Hallym University, Chuncheon, Republic of Korea
| | - Sun Huh
- Department of Parasitology, College of Medicine, Hallym University, Chuncheon, Republic of Korea
| | - Dai-Jin Kim
- Department of Psychiatry, Seoul St. Mary's Hospital, The Catholic University of Korea School of Medicine, Seoul, Republic of Korea
| | - Sang Won Suh
- Department of Physiology, College of Medicine, Hallym University, Chuncheon, Republic of Korea
| | - Sang-Kyu Lee
- Department of Psychiatry, College of Medicine, Hallym University, Chuncheon, Republic of Korea.,Departments of Psychiatry, Neuroscience and Child Study, Yale University School of Medicine, New Haven, CT, USA
| | - Marc N Potenza
- Departments of Psychiatry, Neuroscience and Child Study, Yale University School of Medicine, New Haven, CT, USA.,National Center on Addiction and Substance Abuse, Yale University School of Medicine, New Haven, CT, USA.,Connecticut Mental Health Center, New Haven, CT, USA
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18
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Abstract
Recent studies have revealed a high rate of nonsuicidal self-injury (NSSI) behavior in Chinese students, but quantitative syntheses of pooled prevalence are sparse. There have been several NSSI prevalence meta-analyses in other populations. However, given the existence of cultural diversity, racial difference, educational system difference and so on, these results may not be ideal for Chinese populations. Furthermore, the above-mentioned meta-analyses did not include Chinese database which may have led to unintentional bias. Thus, we conducted this meta-analysis to estimate the prevalence of NSSI in Chinese middle-school students.The databases searched included PubMed, Embase, Web of Science, CBM (Chinese database), Chinese National Knowledge Infrastructure (CNKI), Wanfang Data (Chinese database) and the Weipu database (Chinese database). The search terms included: self-injury/self-harm/self-abuse/nonsuicidal self-injury/deliberate self-harm, adolescen*/youth/teen/students, and China/Chinese. All relevant articles published between January 2000 to November 2017, in either Chinese or English, were included. Two investigators were engaged in this process, and any disagreements were settled by a third investigator. A random effects model was then used to calculate the pooled prevalence.A total of 420 studies with 160,348 participants were retrieved. The pooled prevalence was 22.37% (95% CI: 18.84%-25.70%). Substantial heterogeneity in prevalence estimates was revealed. Subgroup analyses showed that the pooled estimate of prevalence of life time NSSI was 14.5% (95%CI: 0.06%-22.7%), and 6-24 months NSSI was23.3% (95%CI: 20.5%-26.1%). The prevalence for males was 20.6% (95% CI: 16.1%-25.0%), and for females was 21.9% (95% CI: 17.6%-26.2%).The prevalence of NSSI in Chinese middle-school students is relatively high. More attention should be paid to the current situation.
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Wu D, Yang T, Cottrell RR, Zhou H, Feng X. Prevalence and behavioural associations of unintentional injuries among Chinese college students: a 50-University population-based study. Inj Prev 2018; 25:52-59. [PMID: 30194259 DOI: 10.1136/injuryprev-2018-042751] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 07/13/2018] [Accepted: 08/09/2018] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To assess the prevalence, demographic characteristics and behavioural correlates of unintentional injuries among Chinese college students. METHODS A cross-sectional multistage survey sampling process was conducted among 11 770 undergraduates from 50 universities in China. Students were asked to report different types of unintentional injuries that required medical attention from a doctor over the past year. The χ² test and multiple logistic regression analysis were used to identify factors associated with these injuries. RESULTS The overall unintentional injury prevalence was 47.9% (95% CI 47.6% to 48.2%). Most injuries occurred at sport venues (24.0%), following by home/dormitory injuries (20.5%) and traffic injuries (13.0%). Some behavioural factors exhibiting significant associations with overall unintentional injuries were: sleeping less than 7 hours (OR=1.32, 95% CI 1.27 to 1.37), smoking (OR=1.28, 95% CI 1.23 to 1.32), alcohol consumption (OR=1.74, 95% CI 1.69 to 1.78) and heavy internet use (OR=1.60, 95% CI 1.52 to 1.67). Male students were more likely to be involved in traffic and sport injuries than female students. Students majoring in non-medical fields had a higher risk of sport and home injuries than students majoring in medical fields. Those who drank alcohol, slept less than 7 hours or who reported heavy internet use were more likely to experience all types of injuries than students who did not participate in these behaviours. Finally, students who smoked had a higher likelihood of traffic and sport injuries than non-smoking students. CONCLUSIONS A substantial number of college students reported injuries in the past year, and several key behavioural factors were associated with injuries. These findings could be beneficial for the design, implementation and assessment of injury intervention programme with college students. Based on these findings, policy implications for unintentional injury prevention and control were also considered.
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Affiliation(s)
- Dan Wu
- Department of Psychology/Research Center for Quality of Life and Applied Psychology, Guangdong Medical University, Dongguan, China
| | - Tingzhong Yang
- Center for Tobacco Control Research and Department of Social Medicine, School of Medicine, Zhejiang University, Hangzhou, China .,Injury Control Research Center, West Virginia University, Morgantown, West Virginia, USA
| | - Randall R Cottrell
- Public Health Studies Program, University of North Carolina Wilmington, Wilmington, North Carolina, USA
| | - Huan Zhou
- The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xueying Feng
- The First Affiliated Hospital, Zhejiang University, Hangzhou, China
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Pan PY, Yeh CB. Internet Addiction among Adolescents May Predict Self-Harm/Suicidal Behavior: A Prospective Study. J Pediatr 2018; 197:262-267. [PMID: 29550226 DOI: 10.1016/j.jpeds.2018.01.046] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 11/14/2017] [Accepted: 01/12/2018] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To explore the role of Internet addiction in the development of self-harm/suicidal behavior among adolescents after 1-year of follow-up. STUDY DESIGN We conducted this 1-year, prospective cohort study of 1861 adolescents (mean age 15.93 years) attending a senior high school in Taiwan; 1735 respondents (93.2%) were classified as having no history of self-harm/suicidal attempts in the initial assessment and were referred to as the "noncase" cohort. The Chen Internet Addiction Scale was used to identify individuals with Internet addiction. The participants were evaluated for self-harm/suicidal behavior again 1 year later and the "noncase" cohort was selected for statistical analysis. To examine the relationship between Internet addiction and self-harm/suicidal behavior, multivariate logistic regression analysis was performed using Internet addiction at baseline as the predictor for newly developed self-harm/suicidal behavior in the next year, after adjustment for potential confounding variables. RESULTS The prevalence rate of Internet addiction at baseline was 23.0%. There were 59 students (3.9%) who were identified as having developed new self-harm/suicidal behaviors on follow-up assessments. After controlling for the effects of potential confounders, the relative risk of newly emerging self-harm/suicidal behavior for participants who were classified as Internet addicted was 2.41 (95% CI 1.16-4.99, P = .018) when compared with those without Internet addiction. CONCLUSIONS Our findings indicate that Internet addiction is prospectively associated with the incidence of self-harm/suicidal behavior in adolescents.
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Affiliation(s)
- Pei-Yin Pan
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chin-Bin Yeh
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
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21
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Gunes H, Tanidir C, Adaletli H, Kilicoglu AG, Mutlu C, Bahali MK, Topal M, Bolat N, Uneri OS. Oppositional defiant disorder/conduct disorder co-occurrence increases the risk of Internet addiction in adolescents with attention-deficit hyperactivity disorder. J Behav Addict 2018; 7:284-291. [PMID: 29865863 PMCID: PMC6174595 DOI: 10.1556/2006.7.2018.46] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 02/19/2018] [Accepted: 04/15/2018] [Indexed: 01/30/2023] Open
Abstract
Objectives The aims of this cross-sectional study were to assess the prevalence of Internet addiction (IA) in a clinical sample of adolescents with attention-deficit hyperactivity disorder (ADHD) and to detect the moderating effects of co-occurring oppositional defiant disorder/conduct disorder (ODD/CD) on the association between ADHD and IA. Methods The study group comprised 119 adolescent subjects who were consecutively referred to our outpatient clinic with a diagnosis of ADHD. The Turgay DSM-IV-Based Child and Adolescent Disruptive Behavioral Disorders Screening and Rating Scale (T-DSM-IV-S) was completed by parents, and subjects were asked to complete the Internet Addiction Scale (IAS). Results The IAS results indicated that 63.9% of the participants (n = 76) fell into the IA group. Degree of IA was correlated with hyperactivity/impulsivity symptoms but not with inattention symptoms. As compared to the ADHD-only group (without comorbid ODD/CD), ADHD + ODD/CD subjects returned significantly higher scores on the IAS. Conclusions As adolescents with ADHD are at high risk of developing IA, early IA detection and intervention is of great importance for this group. In addition, adolescents with ADHD + ODD/CD may be more vulnerable to IA than those in the ADHD-only group and may need to be more carefully assessed for IA.
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Affiliation(s)
- Hatice Gunes
- Department of Child and Adolescent Psychiatry, Bakirkoy Training and Research Hospital for Mental Health and Neurological Disorders, Istanbul, Turkey
| | - Canan Tanidir
- Department of Child and Adolescent Psychiatry, Bakirkoy Training and Research Hospital for Mental Health and Neurological Disorders, Istanbul, Turkey
| | - Hilal Adaletli
- Department of Child and Adolescent Psychiatry, Bakirkoy Training and Research Hospital for Mental Health and Neurological Disorders, Istanbul, Turkey
| | - Ali Guven Kilicoglu
- Department of Child and Adolescent Psychiatry, Bakirkoy Training and Research Hospital for Mental Health and Neurological Disorders, Istanbul, Turkey
| | - Caner Mutlu
- Department of Child and Adolescent Psychiatry, Bakirkoy Training and Research Hospital for Mental Health and Neurological Disorders, Istanbul, Turkey
| | - Mustafa Kayhan Bahali
- Department of Child and Adolescent Psychiatry, Bakirkoy Training and Research Hospital for Mental Health and Neurological Disorders, Istanbul, Turkey
| | - Melike Topal
- Department of Child and Adolescent Psychiatry, Bakirkoy Training and Research Hospital for Mental Health and Neurological Disorders, Istanbul, Turkey
| | - Nurullah Bolat
- Department of Child and Adolescent Psychiatry, Izmir Tepecik Training and Research Hospital, Izmir, Turkey
| | - Ozden Sukran Uneri
- Department of Child and Adolescent Psychiatry, Bakirkoy Training and Research Hospital for Mental Health and Neurological Disorders, Istanbul, Turkey
- Department of Child and Adolescent Psychiatry, Ankara Pediatric & Pediatric Hematology Oncology Training and Research Hospital, Ankara, Turkey
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Machado MDR, Bruck I, Antoniuk SA, Cat MNL, Soares MC, Silva AFD. Internet addiction and its correlation with behavioral problems and functional impairments – A cross-sectional study. J bras psiquiatr 2018. [DOI: 10.1590/0047-2085000000181] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
ABSTRACT Objective Evaluate the prevalence of internet addiction (IA) among adolescents, as well as characterize behaviors that are considered to be a risk in this population regarding the use and addiction of the Internet. Methods In this cross-sectional study conducted in one public and one private school 91 adolescents, aged 12 to 16 years old, responded the Internet Addiction Test – Brazilian version (IAT) and Child Behavior Checklist (CBCL). Results The prevalence of internet addiction found was 21%, with no difference between private and public schools. On the group dependent on the Internet, there was a statistically significant correlation with Anxiety/Depression, Withdrawn/Depression, Rule Breaking Behavior and Aggressive Behavior, as well as the syndrome scales Social Problems, Thought Problems and Attention Problems. Conclusion Our study provides evidence of a relationship between internet addiction and behavioral problems among adolescents. As this is a cross-sectional study, we consider that future research is necessary to corroborate our results.
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Islam S, Malik MI, Hussain S, Thursamy R, Shujahat M, Sajjad M. Motives of excessive Internet use and its impact on the academic performance of business students in Pakistan. Journal of Substance Use 2017. [DOI: 10.1080/14659891.2017.1388857] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Samina Islam
- Department of Management Sciences, Shaheed Zulfikar Ali Bhutto Institute of Science and Technology (SZABIST), Islamabad, Pakistan
| | - Muhammad Imran Malik
- Department of Management Sciences, COMSATS Institute of Information Technology, Attock Campus, Attock, Pakistan
| | - Saddam Hussain
- Department of Management Sciences, COMSATS Institute of Information Technology, Attock Campus, Attock, Pakistan
| | - Ramayah Thursamy
- School of Management, Universiti Sains Malaysia, Minden, Penang, Malaysia
- UTM International Business School (UTM-IBS), Universiti Teknologi Malaysia, Kuala Lumpur, Malaysia
| | - Muhammad Shujahat
- Department of Management Sciences, COMSATS Institute of Information Technology, Attock Campus, Attock, Pakistan
| | - Muhammad Sajjad
- Department of Management Sciences, COMSATS Institute of Information Technology, Vehari Campus, Vehari, Pakistan
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Islam S, Malik MI, Hussain S, Thursamy R, Shujahat M, Sajjad M. Motives of excessive Internet use and its impact on the academic performance of business students in Pakistan. Journal of Substance Use 2017. [DOI: 10.1080/14659891.2017.1358305] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Samina Islam
- Department of Management Sciences, Shaheed Zulfikar Ali Bhutto Institute of Science and Technology (SZABIST), Islamabad, Pakistan
| | - Muhammad Imran Malik
- Department of Management Sciences, COMSATS Institute of Information Technology, Attock Campus, Attock, Pakistan
| | - Saddam Hussain
- Department of Management Sciences, COMSATS Institute of Information Technology, Attock Campus, Attock, Pakistan
| | - Ramayah Thursamy
- School of Management, Universiti Sains Malaysia, Minden, Penang, Malaysia
- UTM International Business School (UTM-IBS), Universiti Teknologi Malaysia, Kuala Lumpur, Malaysia
| | - Muhammad Shujahat
- Department of Management Sciences, COMSATS Institute of Information Technology, Attock Campus, Attock, Pakistan
| | - Muhammad Sajjad
- Department of Management Sciences, COMSATS Institute of Information Technology, Vehari Campus, Vehari, Pakistan
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Marchant A, Hawton K, Stewart A, Montgomery P, Singaravelu V, Lloyd K, Purdy N, Daine K, John A. A systematic review of the relationship between internet use, self-harm and suicidal behaviour in young people: The good, the bad and the unknown. PLoS One 2017; 12:e0181722. [PMID: 28813437 PMCID: PMC5558917 DOI: 10.1371/journal.pone.0181722] [Citation(s) in RCA: 188] [Impact Index Per Article: 26.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Accepted: 07/06/2017] [Indexed: 11/18/2022] Open
Abstract
Background Research exploring internet use and self-harm is rapidly expanding amidst concerns regarding influences of on-line activities on self-harm and suicide, especially in young people. We aimed to systematically review evidence regarding the potential influence of the internet on self-harm/suicidal behaviour in young people. Methods We conducted a systematic review based on an electronic search for articles published between 01/01/2011 and 26/01/2015 across databases including Medline, Cochrane and PsychInfo. Articles were included if: the study examined internet use by individuals who engaged in self-harm/ suicidal behaviour, or internet use clearly related to self-harm content; reported primary empirical data; participants were aged under 25 years. New studies were combined with those identified in a previous review and subject to data extraction, quality rating and narrative synthesis. Results Forty-six independent studies (51 articles) of varying quality were included. Perceived influences were: positive for 11 studies (38191 participants); negative for 18 studies (119524 participants); and mixed for 17 studies (35235 participants). In contrast to previous reviews on this topic studies focused on a wide range of internet mediums: general internet use; internet addiction; online intervention/treatment; social media; dedicated self-harm websites; forums; video/image sharing and blogs. A relationship between internet use and self-harm/suicidal behaviour was particularly associated with internet addiction, high levels of internet use, and websites with self-harm or suicide content. While there are negative aspects of internet use the potential for isolation reduction, outreach and as a source of help and therapy were also identified. Conclusions There is significant potential for harm from online behaviour (normalisation, triggering, competition, contagion) but also the potential to exploit its benefits (crisis support, reduction of social isolation, delivery of therapy, outreach). Young people appear to be increasingly using social media to communicate distress, particularly to peers. The focus should now be on how specific mediums’ (social media, video/image sharing) might be used in therapy and recovery. Clinicians working with young people who self-harm or have mental health issues should engage in discussion about internet use. This should be a standard item during assessment. A protocol for this review was registered with the PROSPERO systematic review protocol registry: (http://www.crd.york.ac.uk/prospero/display_record.asp?ID=CRD42015019518).
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Affiliation(s)
- Amanda Marchant
- Medical School, Swansea University, Swansea, Wales, United Kingdom
| | - Keith Hawton
- Centre for Suicide Research, University of Oxford, Oxford, United Kingdom
| | - Ann Stewart
- Oxford Central Child and Adolescent Mental Health Services, Oxford Health NHS Foundation Trust, Oxford, United Kingdom
| | - Paul Montgomery
- Centre for Evidence Based Intervention, University of Oxford, Oxford, United Kingdom
| | | | - Keith Lloyd
- Medical School, Swansea University, Swansea, Wales, United Kingdom
| | - Nicola Purdy
- Medical School, Swansea University, Swansea, Wales, United Kingdom
| | - Kate Daine
- Centre for Evidence Based Intervention, University of Oxford, Oxford, United Kingdom
| | - Ann John
- Medical School, Swansea University, Swansea, Wales, United Kingdom
- * E-mail:
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Kim SY, Kim MS, Park B, Kim JH, Choi HG. The associations between internet use time and school performance among Korean adolescents differ according to the purpose of internet use. PLoS One 2017; 12:e0174878. [PMID: 28369147 DOI: 10.1371/journal.pone.0174878] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Accepted: 03/16/2017] [Indexed: 11/19/2022] Open
Abstract
Although overuse of the internet has been suggested to be related to poor academic performance, the effects of internet use for education on academic performance showed conflict results in previous studies. Accordingly, the associations of school performance with internet use for study and for general purpose were explored in a large population of Korean adolescents. Cross-sectional data from the 2013 Korean Youth Risk Behaviour Web-based Survey (KYRBWS) were retrieved for 59,105 12- to 18-year-old adolescents. The associations between school performance and internet use were analysed using multinomial logistic regression with complex sampling. Days of physical activity, sex, obesity, region of residence, income level, parental education level, stress, sleep time, smoking, alcohol consumption, drug use, and total study time were recorded and adjusted for as confounders. Higher school performance was positively associated with longer internet use for study (adjusted odds ratio, AOR, of 2+ h [95% confidence interval] = 2.43 [2.10-2.82], 2.02 [1.78-2.30], 1.66 [1.46-1.89], and 1.30 [1.15-1.47] for performance groups A, B, C, and D, respectively, P < 0.001) but negatively associated with longer internet use for general purpose (AOR of 3+ h [95% confidence interval] = 0.68 [0.60-0.78], 0.85 [0.76-0.94], 0.83 [0.75-0.92], and 0.98 [0.89-1.08] for performance groups A, B, C, and D, respectively, P < 0.001). Higher school performance significantly positively correlated with internet use for study but negatively correlated with internet use for general purpose. Academic use of the internet could be a means of achieving good school performance.
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Rikkers W, Lawrence D, Hafekost J, Zubrick SR. Internet use and electronic gaming by children and adolescents with emotional and behavioural problems in Australia - results from the second Child and Adolescent Survey of Mental Health and Wellbeing. BMC Public Health 2016; 16:399. [PMID: 27178325 PMCID: PMC4866411 DOI: 10.1186/s12889-016-3058-1] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Accepted: 04/28/2016] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Concerns have been raised of a potential connection between excessive online activity outside the academic realm and increased levels of psychological distress in young people. Young Minds Matter: the second Australian Child and Adolescent Survey of Mental Health and Wellbeing provides estimates of the prevalence of online activity and allows an exploration of associations between this activity, a range of mental disorders, socio-demographic characteristics and risk taking behaviour. METHODS Based on a randomized nationally representative sample, a household survey of mental health and wellbeing (Young Minds Matter) was conducted in 2013-14. Interviews were conducted with 6,310 parents and carers of 4-17 year-olds (55 % response rate), together with self-report questionnaires completed by 2,967 11-17 year-olds in these households (89 % response rate). The survey identified a range of mental disorders and emotional problems using a variety of diagnostic tools, with the self-report including questions about use of the Internet and electronic games. Five behaviours were measured related to this activity, with 'problem behaviour' being defined as exhibiting at least four out of five behaviours. RESULTS Levels of Internet use (98.9 %, CI 98.5-99.3 %) and electronic gaming (85.3 %, CI 83.9-86.6 %) were high, and 3.9 % (CI 3.2-4.6 %) of young people reported problem behaviour. The proportion of girls with very high levels of psychological distress and problem behaviour (41.8 %,CI 28.8-54.9 %) was twice that for boys (19.4 %, CI 7.7-31.1 %). Those engaging with a range of risk factors reported higher prevalence of problem behaviour than others. Youth who suffered from emotional problems or high levels of psychological distress spent the most time online or playing games. Multivariate analysis showed associations with problem behaviour and having attempted suicide, experiencing high to very high levels of psychological distress, using alcohol, and living in a poorly functioning family. It was not possible to determine the direction of the associations. CONCLUSION There are links between problem behaviours associated with Internet use and electronic gaming, and mental disorders and risk-taking behaviour in young people. Further studies are required to determine whether these are precursors or sequelae.
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Affiliation(s)
- Wavne Rikkers
- Telethon Kids Institute, The University of Western Australia, PO Box 855, West Perth, WA, 6872, Australia.
| | - David Lawrence
- Telethon Kids Institute, The University of Western Australia, PO Box 855, West Perth, WA, 6872, Australia.,Faculty of Education, The University of Western Australia, Perth, Australia
| | - Jennifer Hafekost
- Telethon Kids Institute, The University of Western Australia, PO Box 855, West Perth, WA, 6872, Australia
| | - Stephen R Zubrick
- Telethon Kids Institute, The University of Western Australia, PO Box 855, West Perth, WA, 6872, Australia.,Faculty of Education, The University of Western Australia, Perth, Australia
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Liu HC, Liu SI, Tjung JJ, Sun FJ, Huang HC, Fang CK. Self-harm and its association with internet addiction and internet exposure to suicidal thought in adolescents. J Formos Med Assoc 2016; 116:153-160. [PMID: 27146126 DOI: 10.1016/j.jfma.2016.03.010] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Revised: 03/08/2016] [Accepted: 03/18/2016] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND/PURPOSE Self-harm (SH) is a risk factor for suicide. We aimed to determine whether internet addiction and internet exposure to confided suicidal ideation are associated with SH in adolescents. METHODS This study was a cross-sectional survey of students who self-completed a series of online questionnaires including a sociodemographic information questionnaire, questionnaire for suicidality and SH, Chen Internet Addiction Scale (CIAS), Patient Health Questionnaire (PHQ-9), multi-dimensional support scale (MDSS), Rosenberg self-esteem scale (RSES), Alcohol Use Disorder Identification Test-Consumption (AUDIT-C), and questionnaire for substance abuse. RESULTS A total of 2479 students completed the questionnaires (response rate = 62.1%). They had a mean age of 15.44 years (range 14-19 years; standard deviation 0.61), and were mostly female (n = 1494; 60.3%). The prevalence of SH within the previous year was 10.1% (n = 250). Among the participants, 17.1% had internet addiction (n = 425) and 3.3% had been exposed to suicidal content on the internet (n = 82). In the hierarchical logistic regression analysis, internet addiction and internet exposure to suicidal thoughts were both significantly related to an increased risk of SH, after controlling for gender, family factors, exposure to suicidal thoughts in the real life, depression, alcohol/tobacco use, concurrent suicidality, and perceived social support. However, the association between internet addiction and SH weakened after adjusting for the level of self-esteem, while internet exposure to suicidal thoughts remained significantly related to an increased risk of SH (odds ratio = 1.96; 95% confidence interval: 1.06-3.64). CONCLUSION Online experiences are associated with SH in adolescents. Preventive strategies may include education to increase social awareness, to identify the youths most at risk, and to provide prompt help.
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Affiliation(s)
- Hui-Ching Liu
- Department of Psychiatry, MacKay Memorial Hospital, Taipei, Taiwan; MacKay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan
| | - Shen-Ing Liu
- Department of Psychiatry, MacKay Memorial Hospital, Taipei, Taiwan; MacKay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan; Department of Medical Research, MacKay Memorial Hospital, Taipei, Taiwan; Department of Medicine, MacKay Medical College, Taipei, Taiwan.
| | - Jin-Jin Tjung
- Department of Family Medicine, MacKay Memorial Hospital, Taipei, Taiwan
| | - Fang-Ju Sun
- MacKay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan; Department of Medical Research, MacKay Memorial Hospital, Taipei, Taiwan
| | - Hui-Chun Huang
- MacKay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan; Department of Medical Research, MacKay Memorial Hospital, Taipei, Taiwan
| | - Chun-Kai Fang
- Department of Psychiatry, MacKay Memorial Hospital, Taipei, Taiwan; Department of Medical Research, MacKay Memorial Hospital, Taipei, Taiwan; Department of Medicine, MacKay Medical College, Taipei, Taiwan; Department of Thanatology and Health Counseling, National Taipei University of Nursing and Health Sciences, Taiwan
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Tsitsika AK, Andrie EK, Psaltopoulou T, Tzavara CK, Sergentanis TN, Ntanasis-Stathopoulos I, Bacopoulou F, Richardson C, Chrousos GP, Tsolia M. Association between problematic internet use, socio-demographic variables and obesity among European adolescents. Eur J Public Health 2016; 26:617-22. [PMID: 27114408 DOI: 10.1093/eurpub/ckw028] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Overweight of children and adolescents continues to be an important and alarming global public health problem. As the adolescent's time spent online has increased, problematic internet use (PIU) potentially leads to negative health consequences. This study aimed to examine the relation between PIU and overweight/obesity among adolescents in seven European countries and assess the effect of demographic and lifestyle factors recorded in the European Network for Adolescent Addictive Behaviour (EU NET ADB) survey (www.eunetadb.eu). METHODS A cross-sectional school-based survey of 14- to 17-year-old adolescents was conducted in seven European countries: Germany, Greece, Iceland, the Netherlands, Poland, Romania and Spain. Anonymous self-completed questionnaires included sociodemographic data, internet usage characteristics, school achievement, parental control and the Internet Addiction Test. Associations between overweight/obesity and potential risk factors were investigated by logistic regression analysis, allowing for the complex sample design. RESULTS The study sample consisted of 10 287 adolescents aged 14-17 years. 12.4% were overweight/obese, and 14.1% presented with dysfunctional internet behavior. Greece had the highest percentage of overweight/obese adolescents (19.8%) and the Netherlands the lowest (6.8%). Male sex [odds ratio (OR) = 2.89, 95%CI: 2.46-3.38], heavier use of social networking sites (OR = 1.26, 95%CI: 1.09-1.46) and residence in Greece (OR = 2.32, 95%CI: 1.79-2.99) or Germany (OR = 1.48, 95%CI: 1.12-1.96) were independently associated with higher risk of overweight/obesity. A greater number of siblings (OR = 0.79, 95%CI: 0.64-0.97), higher school grades (OR = 0.74, 95%CI: 0.63-0.88), higher parental education (OR = 0.89, 95%CI: 0.82-0.97) and residence in the Netherlands (OR = 0.49, 95%CI: 0.31-0.77) independently predicted lower risk of overweight/obesity. CONCLUSIONS The results indicate an association of overweight/obesity with PIU and suggest the importance of formulating preventive public health policies that target physical health, education and sedentary online lifestyle early in adolescence with special attention to boys.
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Affiliation(s)
- Artemis K Tsitsika
- 1 Adolescent Health Unit, Second Department of Pediatrics, P. and A. Kyriakou Children's Hospital, University of Athens, Athens, Greece
| | - Elisabeth K Andrie
- 1 Adolescent Health Unit, Second Department of Pediatrics, P. and A. Kyriakou Children's Hospital, University of Athens, Athens, Greece
| | - Theodora Psaltopoulou
- 2 Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, University of Athens, Athens, Greece
| | - Chara K Tzavara
- 1 Adolescent Health Unit, Second Department of Pediatrics, P. and A. Kyriakou Children's Hospital, University of Athens, Athens, Greece
| | - Theodoros N Sergentanis
- 2 Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, University of Athens, Athens, Greece
| | - Ioannis Ntanasis-Stathopoulos
- 2 Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, University of Athens, Athens, Greece
| | - Flora Bacopoulou
- 3 Center for Adolescent Medicine and UNESCO Chair Adolescent Health Care, First Department of Pediatrics, University of Athens, Athens, Greece
| | - Clive Richardson
- 4 Panteion University of Social and Political Sciences, Athens, Greece
| | - George P Chrousos
- 3 Center for Adolescent Medicine and UNESCO Chair Adolescent Health Care, First Department of Pediatrics, University of Athens, Athens, Greece
| | - Maria Tsolia
- 5 Second Department of Pediatrics, P. and A. Kyriakou Children's Hospital, University of Athens, Athens, Greece
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O'Brien JE, Li W, Snyder SM, Howard MO. Problem Internet Overuse Behaviors in College Students: Readiness-to-Change and Receptivity to Treatment. ACTA ACUST UNITED AC 2016; 13:373-85. [PMID: 26963733 DOI: 10.1080/23761407.2015.1086713] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
This mixed methods study explores college students' readiness-to-change and receptivity to treatment for problem Internet overuse behaviors. Focus groups were conducted with 27 college students who self-identified as Internet over-users, and had experienced biopsychosocial problems related to Internet overuse. Participants completed standardized questionnaires assessing their Internet use and sociodemographic forms. Focus groups explored readiness to change problem Internet overuse behaviors and receptivity to treatment. Similar to college students with other addictive behaviors, students with problem Internet overuse fall along a continuum vis-à-vis readiness-to-change their behaviors. Over half of the participants were receptive to treatment for their problem Internet overuse behaviors.
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Affiliation(s)
- Jennifer E O'Brien
- a School of Social Work, University of North Carolina , Chapel Hill , North Carolina , USA
| | - Wen Li
- a School of Social Work, University of North Carolina , Chapel Hill , North Carolina , USA
| | - Susan M Snyder
- a School of Social Work, University of North Carolina , Chapel Hill , North Carolina , USA
| | - Matthew O Howard
- a School of Social Work, University of North Carolina , Chapel Hill , North Carolina , USA
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Tang J, Yang W, Ahmed NI, Ma Y, Liu HY, Wang JJ, Wang PX, Du YK, Yu YZ. Stressful Life Events as a Predictor for Nonsuicidal Self-Injury in Southern Chinese Adolescence: A Cross-Sectional Study. Medicine (Baltimore) 2016; 95:e2637. [PMID: 26945351 PMCID: PMC4782835 DOI: 10.1097/md.0000000000002637] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Stressful life events have been implicated in the etiology of kinds of psychopathology related to nonsuicidal self-injury (NSSI); however, few studies have examined the association between NSSI and stressful life events directly in Chinese school adolescents. In this study, we aim to estimate the prevalence rate of NSSI and examine its association with stressful life events in Southern Chinese adolescents. A total sample of 4405 students with age ranged from 10 to 22 years was randomly selected from 12 schools in 3 cities of Guangdong Province, China. NSSI, stressful life events, self-esteem, emotional management, and coping methods were measured by structured questionnaires. Multinomial logistic regression was used to examine the association of NSSI with stressful life events. Results showed the 1 year self-reported NSSI was 29.2%, with 22.6% engaged in "minor" NSSI (including hitting self, pulling hair, biting self, inserting objects under nails or skin, picking at a wound) and 6.6% in "moderate/sever" NSSI (including cutting/carving, burning, self-tattooing, scraping, and erasing skin). Self-hitting (15.9%), pulling hair out (10.9%), and self-inserting objects under nails or skin picking areas to dram blood (18.3%) were the most frequent types of NSSI among adolescents. Results also showed that "Minor NSSI" was associated with stressful life events on interpersonal, loss and health adaption, and "moderate/severe NSSI" was associated with life events on interpersonal, health adaption in Southern Chinese adolescents, even after adjusted for sex, age, residence, self-esteem, coping style, and emotional management. Results further suggested stressful life events were significantly associated with less risk of NSSI in those who had good emotional management ability.
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Affiliation(s)
- Jie Tang
- From the School of Public Health, Guangzhou Medical University, Guangzhou, Guangdong (JT, PXW, JJW); Department of Nutrition and Food Hygiene, and MOE Key Lab of Environment and Health (WY); Department of Child, Adolescence & Women Health Care, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, Hubei (NIA, YKD & YZY); and Guangzhou Women and Children Medical Center (YM & HYL), Guangzhou, Guangdong, China
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Abstract
This article examines the health implications of new age technology use among adolescents. As Internet prevalence has increased, researchers have found evidence of potential negative health consequences on adolescents. Internet addiction has become a serious issue. Pornography is now easily accessible to youth and studies have related pornography with several negative health effects. Cyberbullying has become a large problem as new age technologies have created a new and easy outlet for adolescents to bully one another. These technologies are related to increased morbidity and mortality, such as suicides due to cyberbullying and motor vehicle deaths due to texting while driving.
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Li W, O’Brien JE, Snyder SM, Howard MO. Diagnostic Criteria for Problematic Internet Use among U.S. University Students: A Mixed-Methods Evaluation. PLoS One 2016; 11:e0145981. [PMID: 26751569 PMCID: PMC4709169 DOI: 10.1371/journal.pone.0145981] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Accepted: 12/12/2015] [Indexed: 12/26/2022] Open
Abstract
Empirical studies have identified increasing rates of problematic Internet use worldwide and a host of related negative consequences. However, researchers disagree as to whether problematic Internet use is a subtype of behavioral addiction. Thus, there are not yet widely accepted and validated diagnostic criteria for problematic Internet use. To address this gap, we used mixed-methods to examine the extent to which signs and symptoms of problematic Internet use mirror DSM-5 diagnostic criteria for substance use disorder, gambling disorder, and Internet gaming disorder. A total of 27 university students, who self-identified as intensive Internet users and who reported Internet-use-associated health and/or psychosocial problems were recruited. Students completed two measures that assess problematic Internet use (Young’s Diagnostic Questionnaire and the Compulsive Internet Use Scale) and participated in focus groups exploring their experiences with problematic Internet use. Results of standardized measures and focus group discussions indicated substantial overlap between students’ experiences of problematic Internet use and the signs and symptoms reflected in the DSM-5 criteria for substance use disorder, gambling disorder, and Internet gaming disorder. These signs and symptoms included: a) use Internet longer than intended, b) preoccupation with the Internet, c) withdrawal symptoms when unable to access the Internet, d) unsuccessful attempts to stop or reduce Internet use, e) craving, f) loss of interest in hobbies or activities other than the Internet, g) excessive Internet use despite the knowledge of related problems, g) use of the Internet to escape or relieve a negative mood, and h) lying about Internet use. Tolerance, withdrawal symptoms, and recurrent Internet use in hazardous situations were uniquely manifested in the context of problematic Internet use. Implications for research and practice are discussed.
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Affiliation(s)
- Wen Li
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
- * E-mail:
| | - Jennifer E. O’Brien
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Susan M. Snyder
- School of Social Work, Georgia State University, Atlanta, GA, United States of America
| | - Matthew O. Howard
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
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Snyder SM, Li W, O'Brien JE, Howard MO. The Effect of U.S. University Students' Problematic Internet Use on Family Relationships: A Mixed-Methods Investigation. PLoS One 2015; 10:e0144005. [PMID: 26658077 DOI: 10.1371/journal.pone.0144005] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2015] [Accepted: 11/12/2015] [Indexed: 12/27/2022] Open
Abstract
This is the first study to investigate how college students in the U.S. with problematic Internet use perceive the role the Internet plays within their families of origin. The sample included 27 U.S. university students who self-identified as excessive Internet users. Participants reported spending more than 25 hours a week on the Internet on non-school or non-work-related activities and reported Internet-associated health and/or psychosocial problems. This study provides descriptive statistics from participants' completion of two problematic Internet use measures (i.e., Young's Diagnostic Questionnaire and the Compulsive Internet Use Scale) and reports findings from four focus groups. Three themes emerged from the focus groups: (1) family connectedness, (2) family conflict/family disconnection, and (3) family Internet overuse. The findings of this study are a first step toward the design of effective interventions for problematic Internet use among U.S. college students and serve to inform clinical practice and health policy in this area.
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Gholamrezaei M, De Stefano J, Heath NL. Nonsuicidal self-injury across cultures and ethnic and racial minorities: A review. Int J Psychol 2015; 52:316-326. [PMID: 26644040 DOI: 10.1002/ijop.12230] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Accepted: 10/01/2015] [Indexed: 11/08/2022]
Abstract
The field of nonsuicidal self-injury (NSSI) is dominated by research conducted with Caucasian-majority samples in Western countries such as United States, Canada, Australia and European countries. This article critically reviewed the empirical research on NSSI in non-Western countries and among ethnic/racial minority individuals who live in the West to give voice to and understand the patterns of NSSI among individuals who do not fall within the dominant Caucasian majority. The study found both similarities and differences between Western and non-Western data in terms of characteristics and functions of NSSI. Differences in gender patterns in regards to prevalence of NSSI and methods used as well as presence of a more relational functionality of NSSI rather than emotion regulation functionality were two points of divergence in the findings of these studies. In addition, the findings seem to indicate that the role of ethnicity/race is mediated by important factors such as socioeconomic status (SES) and gender. Existing gaps in the literature and suggestions for further research are discussed.
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Affiliation(s)
- Maryam Gholamrezaei
- Department of Educational and Counselling Psychology, McGill University, Montreal, Canada
| | - Jack De Stefano
- Department of Educational and Counselling Psychology, McGill University, Montreal, Canada
| | - Nancy L Heath
- Department of Educational and Counselling Psychology, McGill University, Montreal, Canada
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Abstract
Over the last decade, research on Internet addiction (IA) has increased. However, almost all studies in the area are cross-sectional and do not examine the context in which Internet use takes place. Therefore, a longitudinal study examined the role of conscientiousness (as a personality trait) and classroom hostility (as a contextual factor) in the development of IA. The participants comprised 648 adolescents and were assessed over a 2-year period (while aged 16-18 years). A three-level hierarchical linear model was carried out on the data collected. Findings revealed that (a) lower conscientiousness was associated with IA and this did not change over time and (b) although being in a more hostile classroom did not initially have a significant effect, it increased girls’ IA vulnerability over time and functioned protectively for boys. Results indicated that the contribution of individual and contextual IA factors may differ across genders and over time. More specifically, although the protective effect of conscientiousness appeared to hold, the over-time effect of classroom hostility increased the risk of IA for girls. These findings are discussed in relation to the psychological literature. The study’s limitations and implications are also discussed.
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Tseng FY, Yang HJ. Internet use and web communication networks, sources of social support, and forms of suicidal and nonsuicidal self-injury among adolescents: different patterns between genders. Suicide Life Threat Behav 2015; 45:178-91. [PMID: 25255896 DOI: 10.1111/sltb.12124] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2012] [Accepted: 05/28/2014] [Indexed: 11/30/2022]
Abstract
The relationships of Internet use, web communication, and sources of social support with adolescent self-injurious thoughts and behaviors (SITBs) in Taiwan were investigated. The study sample of 391 12 to 18-year-olds was selected from nine public high schools. Findings show that girls are more likely to have SITBs, except for suicide gestures. Web communication is a risk factor for SITBs in boys but not in girls. Family support is protective in both genders. Support from friends is protective and support from significant others was a risk factor for suicide plans in girls. Support from virtual social communities can have both positive and negative effects on adolescent SITBs, with different effects by gender.
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Affiliation(s)
- Fang-Yi Tseng
- School of Public Health, Chung Shan Medical University, Taichung City, Taiwan
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Wang Y, Yin Y, Sun YW, Zhou Y, Chen X, Ding WN, Wang W, Li W, Xu JR, Du YS. Decreased prefrontal lobe interhemispheric functional connectivity in adolescents with internet gaming disorder: a primary study using resting-state FMRI. PLoS One 2015; 10:e0118733. [PMID: 25738502 PMCID: PMC4349655 DOI: 10.1371/journal.pone.0118733] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2014] [Accepted: 01/22/2015] [Indexed: 12/18/2022] Open
Abstract
Purposes Recent neuroimaging studies have shown that people with Internet gaming disorder (IGD) have structural and functional abnormalities in specific brain areas and connections. However, little is known about the alterations of the interhemispheric resting-state functional connectivity (rsFC) in participants with IGD. In the present study, we used a newly developed voxel-mirrored homotopic connectivity (VMHC) method to investigate the interhemispheric rsFC of the whole brain in participants with IGD. Methods We compared interhemispheric rsFC between 17 participants with IGD and 24 healthy controls, group-matched on age, gender, and education status. All participants were provided written informed consent. Resting-state functional and structural magnetic resonance images were acquired for all participants. The rsFC between bilateral homotopic voxels was calculated. Regions showing abnormal VMHC in IGD participants were adopted as regions of interest for correlation analyses. Results Compared to healthy controls, IGD participants showed decreased VMHC between the left and right superior frontal gyrus (orbital part), inferior frontal gyrus (orbital part), middle frontal gyrus and superior frontal gyrus. Further analyses showed Chen Internet Addiction Scale (CIAS)-related VMHC in superior frontal gyrus (orbital part) and CIAS (r = −0.55, p = 0.02, uncorrected). Conclusions Our findings implicate the important role of altered interhemispheric rsFC in the bilateral prefrontal lobe in the neuropathological mechanism of IGD, and provide further supportive evidence for the reclassification of IGD as a behavioral addiction.
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Affiliation(s)
- Yao Wang
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China
| | - Yan Yin
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China
| | - Ya-wen Sun
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China
| | - Yan Zhou
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China
- * E-mail: (YZ); (J-rX)
| | - Xue Chen
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China
| | - Wei-na Ding
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China
| | - Wei Wang
- Department of Radiology, Tangdu Hospital, The Fourth Military Medical University, Xi’an, Shaanxi, P.R. China
| | - Wei Li
- Department of Radiology, Tangdu Hospital, The Fourth Military Medical University, Xi’an, Shaanxi, P.R. China
| | - Jian-rong Xu
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China
- * E-mail: (YZ); (J-rX)
| | - Ya-song Du
- Department of Child & Adolescent Psychiatry Shanghai Mental Health Center, Shanghai Jiao Tong University, Shanghai, P.R. China
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Li W, O'Brien JE, Snyder SM, Howard MO. Characteristics of internet addiction/pathological internet use in U.S. university students: a qualitative-method investigation. PLoS One. 2015;10:e0117372. [PMID: 25647224 PMCID: PMC4315426 DOI: 10.1371/journal.pone.0117372] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Accepted: 12/21/2014] [Indexed: 12/13/2022] Open
Abstract
Studies have identified high rates and severe consequences of Internet Addiction/Pathological Internet Use (IA/PIU) in university students. However, most research concerning IA/PIU in U.S. university students has been conducted within a quantitative research paradigm, and frequently fails to contextualize the problem of IA/PIU. To address this gap, we conducted an exploratory qualitative study using the focus group approach and examined 27 U.S. university students who self-identified as intensive Internet users, spent more than 25 hours/week on the Internet for non-school or non-work-related activities and who reported Internet-associated health and/or psychosocial problems. Students completed two IA/PIU measures (Young’s Diagnostic Questionnaire and the Compulsive Internet Use Scale) and participated in focus groups exploring the natural history of their Internet use; preferred online activities; emotional, interpersonal, and situational triggers for intensive Internet use; and health and/or psychosocial consequences of their Internet overuse. Students’ self-reports of Internet overuse problems were consistent with results of standardized measures. Students first accessed the Internet at an average age of 9 (SD = 2.7), and first had a problem with Internet overuse at an average age of 16 (SD = 4.3). Sadness and depression, boredom, and stress were common triggers of intensive Internet use. Social media use was nearly universal and pervasive in participants’ lives. Sleep deprivation, academic under-achievement, failure to exercise and to engage in face-to-face social activities, negative affective states, and decreased ability to concentrate were frequently reported consequences of intensive Internet use/Internet overuse. IA/PIU may be an underappreciated problem among U.S. university students and warrants additional research.
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Abstract
PURPOSE OF REVIEW Within the past 20 years, there have been profound advances in personal technology. Although adolescents have embraced the Internet, video games and smart phones, with their extraordinary potential for education, entertainment and connecting with peers, respectively, there is a 'dark side' to these new age technologies. This article identifies many of the adverse physical, psychological, developmental and emotional consequences of our new age technologies. RECENT FINDINGS As Internet access has become easier, faster and more ubiquitous, there is increased evidence of its potential for direct and indirect harm to teens. Sexually explicit material is now indiscriminately available to youth, and studies have linked pornography with a number of negative health effects. Internet addiction is a problem even among teenagers who do not view pornography online. The rise of the Internet and social media sites now makes it easier for a student to bully a peer, and adolescents represent the majority of cyberbullying victims These technologies not only carry increased morbidity but also mortality, with increased suicides due to cyberbullying and motor vehicle deaths due to texting while driving. SUMMARY Paediatricians play a critical role in educating adolescents and their parents about the risks associated with new age technologies.
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Chang FC, Chiu CH, Lee CM, Chen PH, Miao NF. Predictors of the initiation and persistence of internet addiction among adolescents in Taiwan. Addict Behav 2014; 39:1434-40. [PMID: 24930050 DOI: 10.1016/j.addbeh.2014.05.010] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2013] [Revised: 04/17/2014] [Accepted: 05/21/2014] [Indexed: 01/28/2023]
Abstract
PURPOSE The present study examined the psychosocial factors associated with the initiation and persistence of Internet addiction among adolescents in Taiwan. METHODS A total of 2315 students from 26 high schools were assessed in the 10th grade, with follow-up performed in the 11th grade, in Taipei, Taiwan. Self-administered questionnaires were collected in each year to assess the pattern of changes in Internet addiction and psychosocial factors. RESULTS Of the 1602 students without an Internet addiction in the 10th grade, 253 (15.8%) had initiated Internet addiction by grade 11. Multivariate analysis results indicated that greater engagement in online activities (i.e., social network website use, online gaming), depression, and lower school bonding in grade 10 coupled with an increase in online activities, depression, and smoking from grades 10 to 11 predicted the initiation of Internet addiction. Of the 605 students with Internet addiction in the 10th grade, the addiction had persisted for 383 students (63.3%) in grade 11. An increase in the existence of depression and alcohol use from grades 10 to 11 predicted the persistence of Internet addiction. CONCLUSIONS Online activities, depression, and substance use were important predictors of youth initiation and of the persistence of Internet addiction.
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Lin IH, Ko CH, Chang YP, Liu TL, Wang PW, Lin HC, Huang MF, Yeh YC, Chou WJ, Yen CF. The association between suicidality and Internet addiction and activities in Taiwanese adolescents. Compr Psychiatry 2014; 55:504-10. [PMID: 24457034 DOI: 10.1016/j.comppsych.2013.11.012] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2013] [Revised: 11/19/2013] [Accepted: 11/20/2013] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE The aims of this cross-sectional study were to examine the associations of suicidal ideation and attempt with Internet addiction and Internet activities in a large representative Taiwanese adolescent population. METHODS 9510 adolescent students aged 12-18 years were selected using a stratified random sampling strategy in southern Taiwan and completed the questionnaires. The five questions from the Kiddie Schedule for Affective Disorders and Schizophrenia were used to inquire as to the participants' suicidal ideation and attempt in the past one month. The Chen Internet Addiction Scale was used to assess participants' Internet addiction. The kinds of Internet activities that the adolescents participated in were also recorded. The associations of suicidal ideation and attempt with Internet addiction and Internet activities were examined using logistic regression analysis to control for the effects of demographic characteristics, depression, family support and self-esteem. RESULTS After controlling for the effects of demographic characteristics, depression, family support and self-esteem, Internet addiction was significantly associated with suicidal ideation and suicidal attempt. Online gaming, MSN, online searching for information, and online studying were associated with an increased risk of suicidal ideation. While online gaming, chatting, watching movies, shopping, and gambling were associated with an increased risk of suicidal attempt, watching online news was associated with a reduced risk of suicidal attempt. CONCLUSIONS The results of this study indicated that adolescents with Internet addiction have higher risks of suicidal ideation and attempt than those without. Meanwhile, different kinds of Internet activities have various associations with the risks of suicidal ideation and attempt.
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Affiliation(s)
- I-Hsuan Lin
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan; Master Program and Department of Neurology, School of Medicine, Kaohsiung Medical University, Taiwan
| | - Chih-Hung Ko
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan; Department of Psychiatry, Faculty of Medicine, Kaohsiung Medical University, Taiwan
| | - Yu-Ping Chang
- School of Nursing, The State University of New York, University at Buffalo, NY, USA
| | - Tai-Ling Liu
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan; Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Taiwan
| | - Peng-Wei Wang
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan; Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Taiwan
| | - Huang-Chi Lin
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan; Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Taiwan
| | - Mei-Feng Huang
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan; Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Taiwan
| | - Yi-Chun Yeh
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan; Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Taiwan
| | - Wen-Jiun Chou
- Department of Child and Adolescent Psychiatry, Chang Gung Memorial Hospital, Kaohsiung Medical Center and College of Medicine, Chang Gung University, Kaohsiung, Taiwan.
| | - Cheng-Fang Yen
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan; Department of Psychiatry, Faculty of Medicine, Kaohsiung Medical University, Taiwan; Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Taiwan.
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Kaess M, Durkee T, Brunner R, Carli V, Parzer P, Wasserman C, Sarchiapone M, Hoven C, Apter A, Balazs J, Balint M, Bobes J, Cohen R, Cosman D, Cotter P, Fischer G, Floderus B, Iosue M, Haring C, Kahn JP, Musa GJ, Nemes B, Postuvan V, Resch F, Saiz PA, Sisask M, Snir A, Varnik A, Žiberna J, Wasserman D. Pathological Internet use among European adolescents: psychopathology and self-destructive behaviours. Eur Child Adolesc Psychiatry 2014; 23:1093-102. [PMID: 24888750 PMCID: PMC4229646 DOI: 10.1007/s00787-014-0562-7] [Citation(s) in RCA: 124] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2013] [Accepted: 05/15/2014] [Indexed: 12/13/2022]
Abstract
Rising global rates of pathological Internet use (PIU) and related psychological impairments have gained considerable attention in recent years. In an effort to acquire evidence-based knowledge of this relationship, the main objective of this study was to investigate the association between PIU, psychopathology and self-destructive behaviours among school-based adolescents in eleven European countries. This cross-sectional study was implemented within the framework of the European Union project: Saving and Empowering Young Lives in Europe. A representative sample of 11,356 school-based adolescents (M/F: 4,856/6,500; mean age: 14.9) was included in the analyses. PIU was assessed using the Young's Diagnostic Questionnaire. Psychopathology was measured using the Beck Depression Inventory-II, Zung Self-Rating Anxiety Scale and Strengths and Difficulties Questionnaire. Self-destructive behaviours were evaluated by the Deliberate Self-Harm Inventory and Paykel Suicide Scale. Results showed that suicidal behaviours (suicidal ideation and suicide attempts), depression, anxiety, conduct problems and hyperactivity/inattention were significant and independent predictors of PIU. The correlation between PIU, conduct problems and hyperactivity/inattention was stronger among females, while the link between PIU and symptoms of depression, anxiety and peer relationship problems was stronger among males. The association between PIU, psychopathology and self-destructive behaviours was stronger in countries with a higher prevalence of PIU and suicide rates. These findings ascertain that psychopathology and suicidal behaviours are strongly related to PIU. This association is significantly influenced by gender and country suggesting socio-cultural influences. At the clinical and public health levels, targeting PIU among adolescents in the early stages could potentially lead to improvements of psychological well-being and a reduction of suicidal behaviours.
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Affiliation(s)
- Michael Kaess
- Section for Disorders of Personality Development, Clinic of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Tony Durkee
- National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institutet, Stockholm, Sweden
| | - Romuald Brunner
- Section for Disorders of Personality Development, Clinic of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Vladimir Carli
- National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institutet, Stockholm, Sweden
| | - Peter Parzer
- Section for Disorders of Personality Development, Clinic of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Camilla Wasserman
- Department of Child and Adolescent Psychiatry, New York State Psychiatric Institute, Columbia University, New York, NY USA
- Department of Health Sciences, University of Molise, Campobasso, Italy
| | - Marco Sarchiapone
- Department of Health Sciences, University of Molise, Campobasso, Italy
| | - Christina Hoven
- Department of Child and Adolescent Psychiatry, New York State Psychiatric Institute, Columbia University, New York, NY USA
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY US
| | - Alan Apter
- Feinberg Child Study Centre, Schneider Children’s Medical Centre, Tel Aviv University, Tel Aviv, Israel
| | - Judit Balazs
- Vadaskert Child and Adolescent Psychiatric Hospital, Budapest, Hungary
- Institute of Psychology, Eotvos Lorand University, Budapest, Hungary
| | - Maria Balint
- Pedagogical and Psychological Counsel, Kobanya, Hungary
| | - Julio Bobes
- Department of Psychiatry, School of Medicine, Centro de Investigación Biomédica en Red de Salud Mental CIBERSAM, University of Oviedo, Oviedo, Spain
| | - Renaud Cohen
- Department of Psychiatry, Centre Hospitalo-Universitaire de NANCY, Université H. Poincaré, Nancy, France
| | - Doina Cosman
- Department of Clinical Psychology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | | | - Gloria Fischer
- Section for Disorders of Personality Development, Clinic of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Birgitta Floderus
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Miriam Iosue
- Department of Health Sciences, University of Molise, Campobasso, Italy
| | - Christian Haring
- Research Division for Mental Health, University for Medical Information Technology (UMIT), Innsbruck, Austria
| | - Jean-Pierre Kahn
- Department of Psychiatry, Centre Hospitalo-Universitaire de NANCY, Université H. Poincaré, Nancy, France
| | - George J. Musa
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY US
| | - Bogdan Nemes
- Department of Clinical Psychology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Vita Postuvan
- Health Research Department, PINT, University of Primorska, Koper, Slovenia
| | - Franz Resch
- Section for Disorders of Personality Development, Clinic of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Pilar A. Saiz
- Department of Psychiatry, School of Medicine, Centro de Investigación Biomédica en Red de Salud Mental CIBERSAM, University of Oviedo, Oviedo, Spain
| | - Merike Sisask
- Estonian-Swedish Mental Health and Suicidology Institute, Centre of Behavioural and Health Science, Tallinn University, Tallinn, Estonia
| | - Avigal Snir
- Feinberg Child Study Centre, Schneider Children’s Medical Centre, Tel Aviv University, Tel Aviv, Israel
| | - Airi Varnik
- Estonian-Swedish Mental Health and Suicidology Institute, Centre of Behavioural and Health Science, Tallinn University, Tallinn, Estonia
| | - Janina Žiberna
- Health Research Department, PINT, University of Primorska, Koper, Slovenia
| | - Danuta Wasserman
- National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institutet, Stockholm, Sweden
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Daine K, Hawton K, Singaravelu V, Stewart A, Simkin S, Montgomery P. The power of the web: a systematic review of studies of the influence of the internet on self-harm and suicide in young people. PLoS One 2013; 8:e77555. [PMID: 24204868 PMCID: PMC3813687 DOI: 10.1371/journal.pone.0077555] [Citation(s) in RCA: 182] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Accepted: 09/04/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND There is concern that the internet is playing an increasing role in self-harm and suicide. In this study we systematically review and analyse research literature to determine whether there is evidence that the internet influences the risk of self-harm or suicide in young people. METHODS An electronic literature search was conducted using the PsycINFO, MEDLINE, EMBASE, Scopus, and CINAHL databases. Articles of interest were those that included empirical data on the internet, self-harm or suicide, and young people. The articles were initially screened based on titles and abstracts, then by review of the full publications, after which those included in the review were subjected to data extraction, thematic analysis and quality rating. RESULTS Youth who self-harm or are suicidal often make use of the internet. It is most commonly used for constructive reasons such as seeking support and coping strategies, but may exert a negative influence, normalising self-harm and potentially discouraging disclosure or professional help-seeking. The internet has created channels of communication that can be misused to 'cyber-bully' peers; both cyber-bullying and general internet use have been found to correlate with increased risk of self-harm, suicidal ideation, and depression. Correlations have also been found between internet exposure and violent methods of self-harm. CONCLUSIONS Internet use may exert both positive and negative effects on young people at risk of self-harm or suicide. Careful high quality research is needed to better understand how internet media may exert negative influences and should also focus on how the internet might be utilised to intervene with vulnerable young people.
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Affiliation(s)
- Kate Daine
- Centre for Evidence Based Intervention, University of Oxford, Oxford, United Kingdom
| | - Keith Hawton
- Centre for Suicide Research, University of Oxford Department of Psychiatry, Warneford Hospital, Oxford, United Kingdom
| | - Vinod Singaravelu
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, United Kingdom
| | - Anne Stewart
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, United Kingdom
| | - Sue Simkin
- Centre for Suicide Research, University of Oxford Department of Psychiatry, Warneford Hospital, Oxford, United Kingdom
| | - Paul Montgomery
- Centre for Evidence Based Intervention, University of Oxford, Oxford, United Kingdom
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Kuss DJ, van Rooij AJ, Shorter GW, Griffiths MD, van de Mheen D. Internet addiction in adolescents: Prevalence and risk factors. Computers in Human Behavior 2013; 29:1987-96. [DOI: 10.1016/j.chb.2013.04.002] [Citation(s) in RCA: 253] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Moreno MA, Jelenchick LA, Christakis DA. Problematic internet use among older adolescents: A conceptual framework. Computers in Human Behavior 2013; 29:1879-87. [DOI: 10.1016/j.chb.2013.01.053] [Citation(s) in RCA: 81] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Fischer G, Brunner R, Parzer P, Klug K, Durkee T, Carli V, Wasserman D, Vonderlin E, Resch F, Kaess M. [Depression, deliberate self-harm and suicidal behaviour in adolescents engaging in risky and pathological internet use]. Prax Kinderpsychol Kinderpsychiatr 2012; 61:16-31. [PMID: 22400376 DOI: 10.13109/prkk.2012.61.1.16] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
To investigate associations between risky and pathologic internet use with depression, deliberate self-harm and suicidal behaviour among a representative sample of German adolescents. A total of 1,435 students (48% boys, 52% girls) from the area of Heidelberg/Germany were recruited during the SEYLE study, a European school-based intervention study and completed an assessment of different questionnaires, including the Young Diagnostic Questionnaire for the assessment of risky and pathological internet use, the Beck Depression Inventory, the Deliberate Self Harm Inventory, and the Paykel Suicide Scale. 80.7% of the students reported regular, 14.5% risky, and 4.8% pathological internet use. The risky and the pathological internet users showed significant higher rates of depression, deliberate self-harm and suicidal behaviour compared to students with regular internet use. Remarkably, there were no significant differences of levels of depression and suicidal behaviour between risky and pathological users. These results suggest that not only pathologic internet use but also risky internet use is associated with symptoms of depression, self-harm and suicidal behaviour. Therefore, more attention should be paid to adolescents with risky internet use for the early recognition of depression, self-harm and suicidality in adolescence.
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48
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Muehlenkamp JJ, Claes L, Havertape L, Plener PL. International prevalence of adolescent non-suicidal self-injury and deliberate self-harm. Child Adolesc Psychiatry Ment Health 2012; 6:10. [PMID: 22462815 PMCID: PMC3348041 DOI: 10.1186/1753-2000-6-10] [Citation(s) in RCA: 550] [Impact Index Per Article: 45.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2011] [Accepted: 03/30/2012] [Indexed: 03/07/2023] Open
Abstract
BACKGROUND The behaviours of non-suicidal self-injury (NSSI) and deliberate self-harm (DSH) are prevalent among adolescents, and an increase of rates in recent years has been postulated. There is a lack of studies to support this postulation, and comparing prevalence across studies and nations is complicated due to substantial differences in the methodology and nomenclature of existing research. METHODS We conducted a systematic review of current (2005 - 2011) empirical studies reporting on the prevalence of NSSI and DSH in adolescent samples across the globe. RESULTS Fifty-two studies fulfilling the inclusion criteria were obtained for analysis. No statistically significant differences were found between NSSI (18.0% SD = 7.3) and DSH (16.1% SD = 11.6) studies. Assessment using single item questions led to lower prevalence rates than assessment with specific behaviour checklists. Mean prevalence rates have not increased in the past five years, suggesting stabilization. CONCLUSION NSSI and DSH have a comparable prevalence in studies with adolescents from different countries. The field would benefit from adopting a common approach to assessment to aide cross-cultural study and comparisons.
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Affiliation(s)
- Jennifer J Muehlenkamp
- Department of Psychology, University of Wisconsin, UW-Eau Claire, 105 Garfield Ave, Eau Claire, WI 54702, USA
| | - Laurence Claes
- Department of Psychology, Katholieke Universiteit Leuven, Tiensestraat 102, 3000 Leuven, Belgium
| | - Lindsey Havertape
- Department of Psychology, University of Wisconsin, UW-Eau Claire, 105 Garfield Ave, Eau Claire, WI 54702, USA
| | - Paul L Plener
- Department of Child and Adolescent Psychiatry and Psychotherapy, University of Ulm, Steinhoevelstr. 5, 89075 Ulm, Germany
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Abstract
The present study examined adolescents' experiences of loneliness and solitude in their responses to an online survey on self-care. Both quantitative (n = 272) and qualitative (n = 150) responses were coded for these feelings when home alone. Results indicate that adolescents experience the duality of aloneness, including both positive solitude and negative loneliness. Adolescents' responses range from embraced solitude and self-care to feelings of loneliness and rejection of time by themselves. Adolescents reporting loneliness were significantly less likely to enjoy being home alone during the day and at night (p < or = .001). Also, gender, age, and emotions such as fear, boredom, and separation anxiety are associated with loneliness among adolescents in self-care. Interventions to increase connectedness and combat loneliness during out-of-school hours are recommended.
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Affiliation(s)
- Mónica Ruiz-Casares
- Division of Social and Cultural Psychiatry, Center for Research on Children and Families, McGill University, Montréal, QC, Canada.
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50
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Durkee T, Hadlaczky G, Westerlund M, Carli V. Internet pathways in suicidality: a review of the evidence. Int J Environ Res Public Health 2011; 8:3938-52. [PMID: 22073021 PMCID: PMC3210590 DOI: 10.3390/ijerph8103938] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/05/2011] [Revised: 10/04/2011] [Accepted: 10/05/2011] [Indexed: 01/28/2023]
Abstract
The general aim of this study was to review the scientific literature concerning the Internet and suicidality and to examine the different pathways by which suicidal risks and prevention efforts are facilitated through the Internet. An online literature search was conducted using the MEDLINE and Google Scholar databases. The main themes that were investigated included pathological Internet use and suicidality, pro-suicide websites, suicide pacts on the Internet, and suicide prevention via the Internet. Articles were screened based on the titles and abstracts reporting on the themes of interest. Thereafter, articles were selected based on scientific relevance of the study, and included for full text assessment. The results illustrated that specific Internet pathways increased the risk for suicidal behaviours, particularly in adolescents and young people. Several studies found significant correlations between pathological Internet use and suicidal ideation and non-suicidal self-injury. Pro-suicide websites and online suicide pacts were observed as high-risk factors for facilitating suicidal behaviours, particularly among isolated and susceptible individuals. Conversely, the evidence also showed that the Internet could be an effective tool for suicide prevention, especially for socially-isolated and vulnerable individuals, who might otherwise be unreachable. It is this paradox that accentuates the need for further research in this field.
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Affiliation(s)
- Tony Durkee
- The National Swedish Prevention of Suicide and Mental Ill-Health (NASP), Department of Public Health Sciences, Karolinska Institutet (KI), Stockholm SE-171 77, Sweden; E-Mails: (G.H.); (V.C.)
| | - Gergo Hadlaczky
- The National Swedish Prevention of Suicide and Mental Ill-Health (NASP), Department of Public Health Sciences, Karolinska Institutet (KI), Stockholm SE-171 77, Sweden; E-Mails: (G.H.); (V.C.)
| | - Michael Westerlund
- Department of Journalism, Media and Communication (JMK), Stockholm University, Stockholm SE-115 93, Sweden; E-Mail:
| | - Vladimir Carli
- The National Swedish Prevention of Suicide and Mental Ill-Health (NASP), Department of Public Health Sciences, Karolinska Institutet (KI), Stockholm SE-171 77, Sweden; E-Mails: (G.H.); (V.C.)
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