Risk Factors and Protective Factors of Internet Addiction in University Students during the Pandemic: Implications for Prevention and Treatment.

While the prevalence rates of Internet addiction (IA) amongst young people during the pandemic are disturbing, few studies have investigated the risk and protective factors of IA in Hong Kong university students under COVID-19. In this study, we examined the relationship between COVID-19-related stress and IA and the role of psychological morbidity and positive psychological attributes in the relationship. In summer 2022, 978 university students completed a survey assessing pandemic-related stress, psychological morbidity, and positive psychological attributes. While psychological morbidity was indexed by depression, post-traumatic stress disorder, and suicidal behavior, positive psychological attributes included life satisfaction, flourishing, adversity beliefs, emotional competence, resilience, and family functioning measures. Results showed that stress and psychological morbidity positively predicted IA, and psychological morbidity mediated the association between stress and IA. Positive psychological attributes negatively predicted stress and IA, and mediated the connection between stress and IA. Positive psychological attributes moderated the mediating effect of psychological morbidity on the relationship between stress and IA. In addition to theoretical contributions, this study contributes to IA prevention and treatment: reducing psychological morbidity and promoting positive psychological attributes are promising strategies to address IA issues in young people.

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

OBJECTIVES: To determine the association between internet addiction disorder (IAD) and anxiety and depressive symptomatology in high school students in two private schools in Chiclayo, Peru, during the COVID-19 pandemic. MATERIALS AND METHODS: Analytical cross-sectional investigation of 505 adolescents from two private schools. The dependent variables were anxiety and depressive symptomatology, measured with the Beck Adapted Depression Questionnaire (BDI-IIA) and the Beck Anxiety Inventory (BAI), respectively. The main independent variable was IAD, measured with the Internet Addiction Test instrument(IATI). Prevalence ratios (PR) and 95% confidence intervals (95%CI) were estimated. RESULTS: The average age was 14.16 years and 54.9% were women. 22.2% and 3.2% presented mild and moderate IAD; respectively. 9.3% presented severe anxiety and 34.3% severe depressive symptomatology. In the simple regression, adolescents with mild, moderate and severe IAD presented 19% (PR = 1.19; 95%CI: 1.05-1.35), 25% (PR = 1.25; 95%CI: 1.02-1.53) and 53% (PR = 1.47; 95% CI: 1.47-1.60) higher prevalence of depressive symptomatology; however, this association was not maintained in the multiple model. Anxiety increased 196% in adolescents with severe IAD (PR = 2.96; 95%CI: 1.86-4.71). CONCLUSION: We found that 2, 1, and 3 out of 10 students presented IAD, depressive symptomatology, and anxiety, respectively. We did not find an association between IAD and depressive symptomatology, but we did find an association with anxiety. Among the factors associated with the development of depressive symptomatology were the male sex, the presence of eating disorders, subclinical insomnia, using devices for more than 2 h, and using the Internet for academic activities. About anxiety, the associated factors are the female sex, the presence of eating disorders, subclinical insomnia, and the use of the Internet as social interaction. We recommend implementing counseling programs in view of the imminent introduction of the Internet as a pillar in education.

Was retrospective change measurement conducted with Covid-19 containment inconsistent? Comparing prospective and retrospective change measures using data from a national survey on substance use and addictive behaviors.

Single-measurement-point data collection to assess change has increased with studies assessing the impact of the Covid-19 pandemic and of its containment, despite evidence of its lack of validity. Retrospective change is not equivalent to change in repeated self-reported measures giving raise to questions about the validity of the former. This paper purports to investigate inconsistencies between change measures by confronting retrospective change to information from longitudinally self-reported measures from the C-SURF cohort study. The study sample consists of 2,279 young men who participated in C-SURF between 2020 and 2021, and completed between May and June 2021 a survey covering change in alcohol, cigarette, cannabis and other addictive behaviors related to the pandemic. The aforementioned behaviors were assessed longitudinally at two time points using self-reports, and retrospective change since the onset of the Covid-19 crisis was also assessed at the second measurement time. Information from both prospective and retrospective change measures were confronted to identify inconsistent information for each behavior. Additionally, multiple logistic regressions were performed to assess associations between socioeconomic status, impulsivity, depression, and different indicators of motivation to complete the study and inconsistency between both measures for each behavior of interest. Importantly, inconsistent information in at least one of the investigated behaviors was found in about 90% of the participants. Small associations were found between inconsistency and different factors with a consistent effect of impulsivity. In the absence of evidence of the validity of retrospective change measures, studies relying on retrospective change should be interpreted with caution.

Internet addiction and residual depressive symptoms among clinically stable adolescents with major psychiatric disorders during the COVID-19 pandemic: a network analysis perspective.

To assess the inter-relationships between residual depressive symptoms (RDS) and Internet addiction (IA) using network analysis among clinically stable adolescents with major psychiatric disorders during the COVID-19 pandemic. RDS and IA were assessed using the Patient Health Questionnaire-9 (PHQ-9) and the Internet Addiction Test (IAT), respectively. Central symptoms and bridge symptoms in the network model were examined. A total of 1,454 adolescents met the study criteria and were included in the analyses. The prevalence of IA was 31.2% (95% CI: 28.8%-33.6%). In the network analysis, the nodes IAT15 ("Preoccupation with the Internet"), PHQ2 ("Sad mood"), and PHQ1 ("Anhedonia") were the most central symptoms in the IA-RDS network model. Bridge symptoms included IAT10 ("Sooth disturbing about your Internet use"), PHQ9 ("Suicide ideation"), and IAT3 ("Prefer the excitement online to the time with others"). Additionally, PHQ2 ("Sad mood") was the main node linking "Anhedonia" to other IA clusters. Internet addiction was common among clinically stable adolescents with major psychiatric disorders during the COVID-19 pandemic. Core and bridge symptoms identified in this study could be prioritized as targets for the prevention and treatment of IA in this population.

The association between online learning, parents' marital status, and internet addiction among adolescents during the COVID-19 pandemic period: A cross-lagged panel network approach.

INTRODUCTION: Previous research has identified the association between online learning and Internet addiction (IA) and the role of family factors in it. However, few studies have treated IA as a multidimensional mechanism and explored the underlying linkage of online learning, IA, and parental marital status with a cross-lagged network approach. The study aimed to examine the relationship between online learning during the COVID-19 pandemic, Internet addiction (IA), and parental marital status among Chinese adolescents. METHODS: The sample consisted of 2356 adolescents who completed the Internet Addiction Test twice over a four-month period. Four symptom networks and two cross-lagged panel networks were performed. RESULTS: The results showed that adolescents from divorced families had a higher prevalence of IA (27 %) compared to those from non-divorced families (17 %). The strongest cross-lagged association was found between "spending more time online" and "preferring the excitement online". In the divorced group, "school grades suffering" had the highest influence, while in the non-divorced group, "anticipation" had the highest influence. CONCLUSION: This study highlights the relationship between online learning, IA, and parental divorce and suggests that long-term online learning may contribute to IA, and parental divorce may exacerbate problematic Internet use and increase IA levels.

Risk Factors for Gambling Disorder: A Systematic Review.

Gambling disorder is a common and problematic behavioral disorder associated with depression, substance abuse, domestic violence, bankruptcy, and high suicide rates. In the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), pathological gambling was renamed "gambling disorder" and moved to the Substance-Related and Addiction Disorders chapter to acknowledge that research suggests that pathological gambling and alcohol and drug addiction are related. Therefore, this paper provides a systematic review of risk factors for gambling disorder. Systematic searches of EBSCO, PubMed, and Web of Science identified 33 records that met study inclusion criteria. A revised study acknowledges as risk factors for developing/maintaining a gambling disorder being a single young male, or married for less than 5 years, living alone, having a poor education, and struggling financially.

Symptom relationships between internet addiction and anxiety across primary and middle school students during the Omicron lockdown.

During the Omicron pandemic, students in Shenzhen took classes at home via the internet, which could lead to internet addiction (IA) symptoms, and anxiety is often considered an important risk factor for IA. There are several different developmental stages within adolescence. However, no studies have explored the interaction between IA and anxiety at the symptom level using a longitudinal design stratified by age. A total of 2744 students completed the questionnaire 50 days after starting the online classes (T1) and 50 days after they returned to school (T2). A cross-lagged panel network model was used to describe the structure of the comorbidity network. With the help of bootstrapping, the Mann-Whitney U test was used to examine the differences between primary school students' and middle school students' networks. The results found that there is a bidirectional interaction between IA and anxiety, and anxiety plays a dominant role. Feeling afraid is the bridge symptom between IA and anxiety. IA did not show developmental stage differences, but anxiety did. These findings extend the model of compensatory internet use and suggest that, when alleviating IA symptoms in adolescents, attention should be given to their possible comorbid anxiety symptoms, especially in middle school students.

Longitudinal association between problematic smartphone use and sleep disorder among Chinese college students during the COVID-19 pandemic.

BACKGROUND: Problematic smartphone use (PSU) and sleep disorders (SD) are common public health problems among college students. While previous cross-sectional studies have found a relationship between PSU and SD, the causal direction of this relationship remains unclear. This study aims to examine the longitudinal changes of PSU and SD during the COVID-19 pandemic, determine the causal relationship between them, and identify confounding factors that affect this association. METHODS: The study sample consisted of 1186 Chinese college students (47.7% male) with a mean age of 18.08 years. Participants completed the Smartphone Addiction Scale - Short Version (SAS-SV) and the Pittsburgh Sleep Quality Index (PSQI) at both baseline and follow-up surveys, conducted one year apart. The cross-lagged panel model (CLPM) was used to examine the causal relationship between PSU and SD, stratified by gender and duration of daily physical activity. The fixed effect panel regression was used to confirm the findings of CLPM. RESULTS: The results of the CLPM analysis showed a significant bidirectional relationship between PSU and SD for the overall sample, which was consistent with the fixed effects model findings. However, subgroup analyses revealed that the bidirectional association disappeared among males or those who engaged in daily physical activity for more than 1 h. CONCLUSIONS: Our study shows a significant bidirectional association between PSU and SD, with variations across gender and daily physical activity levels. Encouraging physical activity may serve as a potential intervention to disrupt the bidirectional association between PSU and SD, which has important implications for public health strategies aimed at reducing the negative consequences of PSU and SD.

Association between urbanization and Internet addiction.

PURPOSE OF REVIEW: Understanding the association between urbanization and Internet addiction is essential to the design and implementation of Internet addiction prevention measures in urban areas. This epidemiological review explores the urbanization-Internet addiction association and its potential underlying factors. RECENT FINDINGS: Nine studies have reported that Internet addiction prevalence is higher in urban areas, but three studies have noted the opposite. Psychiatric disorders and stress are the most commonly mentioned factors underlying the association. The effects of urbanization on Internet availability, Internet cafes, online gaming, outdoor or interactive activities, and family regulation and monitoring have been suggested to lead to higher Internet addiction risk. The ongoing COVID-19 pandemic, obesity, sleep problems, and the migration of parents to urban areas in search of work have strengthened the effect of urbanization on Internet addiction. SUMMARY: Early assessment and treatment provided by mental health services are crucial for mitigating the effect of urbanization on Internet addiction risk. Cities should be designed to provide adequate space for physical and interactive activities. To promote outdoor activities, air pollution, traffic congestion, and crime should be controlled. Prospective face-to-face studies involving analysis of data on pollution, traffic, and Internet addiction could provide evidence to elucidate the urbanization- Internet addiction association.

Differences between recreational gamers and Internet Gaming Disorder candidates in a sample of Animal Crossing: New Horizons players.

Throughout the last decade, research has considered players' gaming motives as risk and the perceived social support (PSS) as protective factors in the context of Internet Gaming Disorder (IGD). However, the literature is lacking diversity regarding the representation of female gamers as well as of casual and console-based games. The aim of this study was to assess IGD, gaming motives, and PSS comparing recreational gamers and IGD candidates in a sample of Animal Crossing: New Horizons players. A total of 2909 ACNH players (93.7% of them female gamers) took part in an online survey which collected demographic, gaming-related, motivational, and psychopathologic data. Using the cut-off of at least five positive answers to the IGDQ, potential IGD candidates were identified. ACNH players reported a high prevalence rate for IGD (10.3%). IGD candidates differed from recreational players regarding age, sex, and game-related, motivational, and psychopathological variables. A binary logistic regression model was computed to predict membership in the potential IGD group. Age, PSS, escapism and competition motives as well as psychopathology were significant predictors. To discuss IGD in the context of casual gaming, we consider demographic, motivational, and psychopathological player characteristics as well as game design and the COVID-19 pandemic. IGD research needs to broaden its focus concerning game types as well as gamer populations.

Internet Gaming Disorders and Early Onset Psychosis in Young People: A Case Study and Clinical Observations.

BACKGROUND: Over the last ten years, the video game industry has grown exponentially, involving about 2.5 billion young adults in the world. The estimated global prevalence of gaming addiction has been reported to be 3.5% ranging from 0.21% to 57.5% in the general population. Moreover, during the recent COVID-19 pandemic period, school closures and stay-at-home measures have also further increased the opportunities for prolonged and intensified playing of video games. Little is known about the relationship between IGD and psychosis, and the literature is still scarce. Some characteristics of patients with psychosis, particularly those with a first-episode psychosis (FEP), may suggest that these individuals would be particularly liable to develop IGD. CASE PRESENTATION: We report two cases of young patients with to Internet gaming disorder, experiencing early onset psychosis treated with antipsychotic therapy. CONCLUSION: Although it is difficult to show the specific mechanisms underlying the psychopathological alterations in IGD, it is clear that excessive exposure to video games could be a risk factor for precipitating psychosis especially in a vulnerable age group such as adolescence. Clinicians should be aware of the possibility of a higher risk of psychotic onset associated specifically with gaming disorders in very young people.

Longitudinal relationship between problematic internet use with loneliness during and after COVID-19 social restrictions: Short title: Internet use and loneliness.

Two, three-month long longitudinal studies examined the temporal relationships between problematic internet use (PIU), internet usage, and loneliness ratings, during and after lockdown restrictions. Experiment 1 examined 32, 18-51 year old participants, over a three-month period of lockdown restrictions. Experiment 2 studied 41, 18-51 year old participants, over a three-month period following the lifting of lockdown restrictions. Participants completed the internet addiction test, UCLA loneliness scale, and answered questioned about their online usage, at two time points. All cross-sectional analyses revealed a positive relationship between PIU and loneliness. However, there was no association between online use and loneliness. Longitudinal relationships between PIU and loneliness differed during and after lockdown restrictions. During a period of lockdown, there were both positive associations between earlier PIU and subsequent loneliness, and between earlier loneliness and subsequent PIU. However, following the easing of lockdown restrictions, only the temporal relationship between earlier internet addiction and later loneliness was significant.

Impulsivity as a Risk Factor for Addictive Disorder Severity during the COVID-19 Lockdown: Results from a Mixed Quantitative and Qualitative Study.

Interindividual differences in personality traits, especially impulsivity traits, are robust risk factors for addictive disorders. However, their impact on addictive disorders during the COVID-19 lockdown remains unknown. This study assessed patients being followed for addictive disorders before the lockdown. We aimed to determine whether impulsivity traits (i.e., negative- and positive urgency) were associated with addictive disorders severity during the lockdowns. We also explored the patients' subjective experiences, focusing on high versus low impulsivity. The quantitative study assessed 44 outpatients consulting for addictive disorders, for impulsivity, emotion regulation, anxiety/depression, and their addictive disorder characteristics, using self-administered questionnaires. In the qualitative study, six patients from the quantitative study were assessed using guided interviews. We observed that higher negative and positive urgencies were associated with addictive disorder severity. The subjective experiences of patients during the lockdowns differed according to their emotion-related impulsivity: high versus low. Low impulsive patients used online technologies more effectively to maintain follow-up, with more positive reappraisal. In contrast, highly impulsive patients reverted more frequently to self-medication with substances and/or behaviors, more social isolation, and found coping with negative emotions more challenging. Overall, the patient's ability to cope with stressful events, like the COVID-19 lockdown, depended on their emotion-related impulsivity.

Social Media Use and Its Association with Mental Health and Internet Addiction among Portuguese Higher Education Students during COVID-19 Confinement.

The use of social media was one of the most common way to keep in touch with friends and family during confinement. For higher education students, the fact that their universities were closed was a major change in their lives. The aim of this study is to relate the prevalence and type of social media with Internet addiction and mental health of university students in a district of Portugal during COVID-19 confinement. Mental health was studied by applying the reduced version of the Mental Health Inventory (MHI-5) and to measure the Internet use and dependence, the Internet Addiction Test (IAT) was used. The study (cross-sectional, descriptive, and correlational) used an online questionnaire, conducted on Google® Forms and the link was sent to 4450 students, in the months of April to June 2020, during the confinement. A total of 329 valid questionnaires were obtained. We can conclude that regarding mental health, students in the 18-24 age group, single or divorced and who are not in a relationship, and with worse academic results, show worse levels of mental health. It is noteworthy that the students with the same characteristics also have the highest levels of addiction to internet.

Investigating problematic uses of Facebook and other Internet activities among university students in Bangladesh during the COVID-19 pandemic.

Problematic use of Internet (PUI) and problematic use of Facebook (PUF) has been linked to escalating behavioral health issues among university students and has increased during the COVID-19 pandemic. This study estimated the prevalence of and explored associated factors for PUI and PUF among Bangladeshi university students during the COVID-19 pandemic. A cross-sectional online survey was undertaken among 1101 Bangladeshi university students between November and December 2020. The Internet Addiction Test and Facebook Addiction Scale were used to assess PIU and PUF, respectively. A multiple linear regression analysis was performed to adjust for confounders. Among the participants, PUI and PUF were found in 39.3% and 37.1%, respectively. The multiple linear regression model indicated PUI was significantly associated with participants residing in a village, arts majors, those unsatisfied with their major, having mediocre parental relationships, failure in romantic relationships, physical comorbidities, longer use of the Internet, using the Internet for purposes other than education, using social media, and downloading movies/TV series. PUF was significantly associated with village residence, lower income, arts majors, failure in romantic relationships, longer use of the Internet, using the Internet for purposes other than education, and downloading movies/TV series. Both PUI and PUF have been prevalent among Bangladeshi university students during the COVID-19 pandemic. Longitudinal & exploratory studies are warranted in the future to identify causal factors for PUI and PUF and appropriate interventions should be designed quickly for this population.

Adolescent resilience and mobile phone addiction in Henan Province of China: Impacts of chain mediating, coping style.

BACKGROUND: As mobile phone use grows, so it brings benefits and risks. As an important part of adolescents healthy growth, resilience plays an indispensable role. Thus, it is important to identify when mobile phone use of an adolescent becomes an addiction. This study proposed to explore the effects of adolescent resilience on mobile phone addiction, and tested the mediating role of coping style and depression, anxiety, and stress (DASS) on phone addiction among 2,268 adolescents in the Henan province, China. METHODS: The adolescents were surveyed via an online questionnaire, a mobile phone addiction index (MPAI), a depression, anxiety, and stress scale with 21 items (DASS-21), the Resilience Scale for Chinese Adolescents (RSCA), and the Simplified coping style questionnaire (SCSQ), and we used structural equation modeling to examine the correlations and moderation effects. All data analyses were performed using SPSS 26.0 and Amos 23.0. RESULTS: The results show that adolescences resilience were negatively related to negative coping, DASS, and mobile phone addiction; both coping style and DASS could mediate the relationship between adolescent resilience and mobile phone addiction among Chinese adolescents. The relationship between adolescent resilience and mobile phone addiction in Chinese adolescents was mediated by the chain of coping styles and DASS. CONCLUSIONS: There is a negative relationship which exists between resilience and mobile phone addiction in this population. In addition, stress, anxiety, depression, and coping style significantly influence the risk of adolescent mobile phone addiction and play an intermediary role in Chinese adolescent resilience and mobile phone addiction.

Prevalence of internet addiction among Syrian undergraduate medical students.

The purpose of this study is to determine the prevalence and risk factors for internet addiction disorder among Syrian medical students. Syrian medical students from 8 different universities participated in an online cross-sectional questionnaire study between May 13 and June 16, 2022. DASS-21 Depression, Anxiety, Stress Scale, and Internet Addiction Test were the 3 main determinants of the questionnaire. One thousand nine hundred fifty-three medical students from 8 different Syrian universities have participated in our cross-sectional. Half of the participants were from the Syrian private and Damascus universities. 62.1% were females, and most participants had good academic degrees (70-90/100). Sixty-nine percent of the study participants thought that COVID19 increased internet use rates. The Internet Addiction Scale's average score was 33.48 ±â€…16.29 (1-100). The total young internet addiction test score was high among medical students from the faculty of medicine university, students from Damascus University, males, smokers, and medical students with lower academic credentials than other subgroups. Both the relationship between internet addiction and DASS-21 subgroups and the correlation between DASS-21 subgroups were statistically significant. Our research showed that internet addiction was widespread among Syrian medical students, particularly when used more for entertainment than educational purposes. Additionally, it was linked to poor academic degrees in the exams at the university and mental health conditions, including depression, anxiety, and stress.

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

Background: Internet addiction is a global public health issue among college students that is associated with a range of negative outcomes. Especially the COVID-19 pandemic has forced them to shift most of their studies and life activities from offline to online, leading to a growing problem of Internet dependence and even Internet addiction. Although previous studies have indicated that the Behavioral Inhibition/Activation System (BIS/BAS) have important effects on college students' Internet addiction, the mechanisms underlying these associations and gender differences are still unclear. Aims: The present study investigated the mediating roles of intolerance of uncertainty and self-control in the association between BIS/BAS and Internet addiction following the Interaction of Person-Affect-Cognition-Execution model. Gender differences in such associations between variables were also tested. Method: A total of 747 Chinese college students were surveyed by using Young's Diagnostic Questionnaire for Internet Addiction, BIS/BAS Scales, the Intolerance of Uncertainty Scale and the Brief Self-Control Scale. Results: The results from the structural equation modeling analysis showed that BIS was positively related to Internet addiction and that BAS had a negative association with Internet addiction. Moreover, intolerance of uncertainty and self-control mediated the relationships between BIS/BAS and Internet addiction. Multi-group analysis further revealed that the associations between BAS and Internet addiction and between intolerance of uncertainty and Internet addiction were stronger among the male students than among female students. The relationship between self-control and Internet addiction was greater in the female sample than in the male sample. Conclusions: These findings extend our understanding of how BIS/BAS influence Internet addiction among college students and suggest that not only should training approaches based on intolerance of uncertainty and self-control be fully considered, but different intervention programs should be focused on gender sensitivity to maximize the intervention effect.

Smartphone addiction in children: patterns of use and musculoskeletal discomfort during the COVID-19 pandemic in Iran.

BACKGROUND: Smartphone use has increased significantly, especially during the period of global pandemic caused by the novel SARS-CoV2 coronavirus (COVID-19). Concurrently, smartphone addiction is a growing social problem in children and adolescents with the consequence of adverse health outcomes. This study assessed the prevalence of smartphone addiction, patterns of use, and the experienced body-region discomfort among Iranian school students during the COVID-19 pandemic. METHODS: A cross-sectional study with students from grades 1-9 recruited n = 585 participants (mean age = 14.49 (2.26 years); female = 65.8%). Data were collected from parents and students through the online 'Smartphone addiction scale-short version' (SAS-SV), self-reported demographic questionnaires, and extracts of the Nordic musculoskeletal questionnaire for the evaluation of musculoskeletal disorders. RESULTS: The prevalence rate of smartphone addiction (53.3%) was relatively high in the overall sample. Participants spent 6.85 (4.62) hours per day on their smartphones, which had increased 53.86% relative to the pre-pandemic period. The primary smartphone uses were for social networking (77.9%), web-surfing (53.3%), and camera activities (50.9%). There was a positive correlation between smartphone addiction as assessed with the SAS-SV and daily use time (r = 0.34, p < 0.001), and the percentage of change relative to the pre-pandemic period (r = 0.26, p < 0.001). Discomfort related to smartphone use was mostly reported as present in the eyes (39.7%) and neck (39.1%). A positive correlation was found (p < 0.001) between smartphone addiction and discomfort in the eyes, neck, wrists, shoulders, and upper-back. CONCLUSION: The more frequent usage of smartphones by students during the Covid-19 pandemic were associated predominantly with discomfort to the eyes and neck. Parents should consider the complications of musculoskeletal and postural changes during the child's future years and pay particular attention to the individual's patterns of smartphone use with an emphasis on posture and usage that reduces discomfort to the eyes and the musculoskeletal system, particularly the neck.