Role of innate and acquired resilience in behavioral system, mental health, and internet addiction among Japanese adolescents in the COVID-19 pandemic.

Background: This study examines mediation models in which behavioral inhibition and activation systems (BIS/BAS) impact internet addiction through mental health and the moderating roles of innate and acquired resilience in the models. Methods: The data set used in this study was a cross-sectional survey among 952 adolescents in July 2021. Internet Addiction Test, Fear of COVID-19 Scale, BIS/BAS scales, and Depression Self-Rating Scale were used for analysis. After controlling for gender, the mediation and moderated mediation models were examined. Results: The results revealed that depressive symptoms partially mediated the relationship between BIS and internet addiction and between BAS-fun-seeking (BAS-FS) and internet addiction. Innate and acquired resilience moderated the relationship between depressive symptoms and internet addiction. The indirect effect of innate and acquired resilience on internet addiction via depressive symptoms was statistically significant in both low and high innate and acquired resilience. The results of conditional indirect effect analysis indicated that the depressive symptoms-internet addiction association decreased with the increase of innate or acquired resilience level. Discussion: Our results suggested that depression symptoms played a significant mediation role in the relationships between BIS/BAS and internet addiction, and higher innate and acquired resilience was associated with a reduced risk of internet addiction. BIS/BAS may be a risk for internet dependence via mental health, and innate and acquired resilience appears to serve as a protective factor.

Relationships between psychological flexibility and internet gaming disorder among adolescents: Mediation effects of depression and maladaptive cognitions.

Psychological flexibility may reduce addictive behaviours by adaptive and flexible emotional and cognitive processes. This study tested a mediation model of internet gaming disorder (IGD) in which psychological flexibility would reduce depression and maladaptive cognitions related to internet gaming and in turn lower the risk of IGD. A cross-sectional study surveyed 2102 secondary 1-4 students from seven schools during March to November 2021 in Hong Kong, China. The results showed that 12.7% and 52.2% of the students were classified as having probable IGD and depression, respectively. The proposed mediation model fitted the data well: χ2/df = 8.00, CFI = .99, NNFI = .99, RMSEA = .01. Psychological inflexibility was directly and positively associated with IGD (B = .01, ß = .07, p = .003) and indirectly and positively associated with IGD via depressive symptoms (B = .01, ß = .07, p = .001, PM = 23.7%) and maladaptive cognitions (B = .03, ß = .15, p = .001, PM = 50.8%). Multi-group analyses showed that gender significantly moderated the associations between psychological inflexibility and maladaptive cognitions (Δχ2/Δdf = 8.69/1, p < .05), between maladaptive cognitions and IGD (Δχ2/Δdf = 4.33/1, p < .05), and between psychological inflexibility and IGD (Δχ2/Δdf = 5.46/1, p < .05). Depression and maladaptive cognitions may be significant mediators that could explain the relationship between psychological flexibility and IGD. Also, gender difference may exist. Based on the findings, intervention strategies for IGD reduction are discussed.

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.

Risk-Taking Behaviors Considering Internet Gaming Disorder among Iranian University Students: A Latent Class Analysis.

BACKGROUND: Dangerous behaviors adversely affect the health of adolescents and young adults. This study aimed to identify the subgroups of college students based on the parameters of risky behavior and analyze the impact of demographic factors and internet gaming disorder (IGD) belonging to each class. STUDY DESIGN: A cross-sectional study. METHODS: The study was conducted on 1355 students through a multi-stage random sampling method in 2020. A survey questionnaire was used to collect data, and all students completed 1294 sets of questionnaires. The data were analyzed using t test and latent class analysis (LCA) through SPSS and PROC LCA in SAS 9.2 software. RESULTS: Three latent classes have been identified as low-risk (75%), tobacco smoker (8%), and high-risk (17%). There was a high possibility of risky behavior in the third class. Marital status (being single) (OR = 2.28, 95% CI: 1.19-4.37), unemployment (having no job) along with education (OR = 1.56, 95% CI: 1.04-2.33), and IGD (OR = 1.06, 95% CI: 1.04-1.09) increased the risk of inclusion in the tobacco smoker class. Moreover, unemployment (having no job) along with education (OR = 1.43, 95% CI: 1.11-1.84) increased the chance of being in the high-risk class. CONCLUSION: According to the findings of this study, 25% of the students were tobacco smokers or were in the high-risk class. The results of this study may help develop and evaluate preventive strategies that simultaneously take into account different behaviors.

Boredom Proneness, Loneliness, and Smartphone Addiction Among Lebanese Young Adults: The Mediating Role of Depression, Anxiety, and Stress.

Objective: To evaluate the association between boredom proneness, loneliness, and smartphone addiction among Lebanese young adults and examine the mediating role of depression, anxiety, and stress in this association.Methods: This cross-sectional study was conducted between August and September 2020 during the lockdown period of the coronavirus disease 2019 pandemic. An online survey was completed by 461 young adults aged 18 to 29 years.Results: The results showed that 66 of 134 males (49.3%, scores ≥ 31) and 143 of 327 females (43.7%, scores ≥ 33) had smartphone addiction. Smartphone addiction was significantly associated with higher boredom proneness (P < .001), anxiety (P = .012), and loneliness (P = .025). Anxiety mediated the association between boredom proneness and smartphone addiction and between loneliness and smartphone addiction, whereas depression and stress did not mediate the association between boredom/loneliness and smartphone addiction.Conclusions: Smartphone addiction is highly associated with psychological disorders, and screening strategies are needed to minimize addiction. This study emphasizes the importance of investigating the relation between smartphone addiction and psychological disorders.

The Protective Role of Resilience in the Development of Social Media Addiction in Tertiary Students and Psychometric Properties of the Slovenian Bergen Social Media Addiction Scale (BSMAS).

With the onset of the COVID-19 pandemic, social media became one of the most utilized sources of information relating to the disease. With the increased reliance on social media, the risk of excessive use and the development of social media addiction emerges. The aim of the present study was to explore the psychometric properties of the Slovenian version of the Bergen Social Media Addiction Scale, and to explore how psychological resilience affects social media addiction symptoms directly and indirectly through symptoms of depression, anxiety and mental distress. A large online cross-sectional study was conducted in March 2021 among Slovenian tertiary students (N = 4868). The results showed the high reliability, unidimensionality and criterion validity of the Slovenian Bergen Social Media Addiction Scale. The proposed structural model fit the data well and showed a significant direct positive effect of depression and stress on social media addiction. Moreover, the majority of the negative effects of psychological resilience on social media addiction (87.2%) were indirect, through depression and stress symptoms, whereas resilience had a significantly smaller impact on social media addiction by reducing anxiety symptoms. The overall prevalence of social media addiction symptoms was 4.6%, with females exhibiting higher proportions than men. Additionally, female social media users reported a complete absence of social media addiction symptoms less often compared to males. Future research should further explore the mechanisms behind social media addiction, in order to gain a better understanding of the apparently different risk levels for both genders.

Association between 24-Hour Movement Behaviors and Smartphone Addiction among Adolescents in Foshan City, Southern China: Compositional Data Analysis.

Smartphone addiction has become a public health issue. To help reduce smartphone addiction, we assessed the combined effect of 24-Hour Movement Behaviors on smartphone addiction during Corona Virus Disease 2019 (COVID-19) home confinement in Foshan, China. Data were collected in a sample of 1323 senior middle school students ((mean age ± standard deviation): 16.4 ± 0.9 years; 43.46% males) during the COVID-19 lockdown. Their 24-Hour movement behaviors were assessed by a self-reported questionnaire, The Smartphone Addiction Scale-Short Version (SAS-SV). The compositional multiple linear regression model and compositional isotemporal substitution model were used to examine the association between the time budget composition of the day and smartphone addiction. Smartphone addiction occurred in 671 (50.72%) of the 1323 students. Compared with smartphone-addicted adolescents, non-smartphone-addicted adolescents had more moderate-to-vigorous physical activity (MVPA) and sleep duration (SLP), and less sedentary behavior (SB). The distribution of time spent in 24-Hour movement behaviors was significantly associated with smartphone addiction. The negative effect was found for the proportion of time spent in MVPA or SLP (ilr1-MVPA = -0.453, p < 0.001. ilr1-SLP = -3.641, p < 0.001, respectively) relative to the other three behaviors. Conversely, SB was positively associated with the score of smartphone addiction (ilr1-SB = 2.641, p < 0.001). Reallocating one behavior to remaining behaviors was associated with smartphone addiction. Noticeably, the effects of one behavior replacing another behavior and of one behavior being displaced by another behavior were asymmetric. The 24-Hour movement behaviors of adolescents are closely related to smartphone addiction, and future intervention studies should focus on the compositional attribute of 24-Hour movement behaviors.

The relationship between internet addiction and aggressive behavior among adolescents during the COVID-19 pandemic: Anxiety as a mediator.

The COVID-19 pandemic has brought unprecedented challenges for adolescents, who tended to experience more emotional instability, impulsivity, and aggressive behavior driven by the fear of infection and the uncertainty of network information. In the present study, we investigated the relationship between Internet addiction and aggressive behavior, and the mediating effects of depression and anxiety. There were differences in Internete addiction and aggressive behavior in gender, thus the moderating role of gender between them were explored. A total of 1148 middle school students were invited to complete the Buss Perry Aggression Questionnaire, the Internet Addition Scale, the Self-rating Depression Scale (SDS), and the Self-rating Anxiety Scale (SAS) separately. The results suggested that 1) there was a significant positive correlation between Internet addiction and aggressive behavior; 2) anxiety, but not depression, mediated the effect of Internet addiction on aggressive behavior; 3) gender did not moderate the effect of Internet addiction on aggressive behavior. The practical implication of the current findings on boosting adolescents' mental health was discussed and further suggestions were provided.

Internet Addiction in Socio-Demographic, Academic, and Psychological Profile of College Students During the COVID-19 Pandemic in the Czech Republic and Slovakia.

Internet addiction is a serious problem among young adults that requires increased attention, especially at a time of distance learning during the coronavirus disease 2019 (COVID-19) pandemic. The aim of the study was to assess the relationships between internet addiction and selected socio-demographic, study-related, and psychological characteristics of college students. Internet addiction was measured using the Internet Addiction Test both overall and in its individual subscales (Salience, Excessive Use, Neglect Work, Anticipation, Lack of Control, and Neglect Social Life). The selected characteristics represented (1) socio-demographic profile (gender, age, residence, family), (2) academic profile (housing during the semester, form of study), and (3) psychological profile (depressive symptoms-the Patient Health Questionnaire, stress-the Perceived Stress Scale, anxiety symptoms-the Generalized Anxiety Disorder). Data collection took place during the first wave of the COVID-19 pandemic in 2020 at Czech and Slovak colleges, with 1,422 students from the Czech Republic and 1,677 students from Slovakia participating in the research. The analytical processes were carried out through descriptive analysis, non-parametric difference analysis, and multiple negative binomial regression. Mild internet addiction was found in 387 (27.2%) Czech and 452 (27.0%) Slovak students. Moderate internet addiction was identified in 49 (3.4%) students from the Czech Republic and in 100 (6.0%) students from Slovakia. Two (0.1%) Czech and three (0.2%) Slovak students reported severe internet addiction. Increased likelihood of internet addiction overall, as well as in most individual subscales, was found particularly among male students and students who lived away from home during the semester. Depressive symptoms and stress could also be considered significant predictors in both countries. These results are important for the development of effective strategies and prevention programs, as Internet addiction may be a serious problem in the future, given the current times. When assessing internet addiction among college students, it would also be appropriate to evaluate the individual internet addiction subscales and their specifics.

Internet Addiction, Symptoms of Anxiety, Depressive Symptoms, Stress Among Higher Education Students During the COVID-19 Pandemic.

Poor mental health is a growing concern among young people during the coronavirus disease 2019 (COVID-19) pandemic. The aim of this study was to assess the associations of Internet addiction with depressive symptoms, anxiety symptoms, and stress in higher education students during the COVID-19 pandemic, as well as to examine these mental health problems in the context of study-related characteristics. The research sample consisted of 3,099 participants from the Czech Republic (CZ: 1,422) and Slovak Republic (SK: 1,677). The Internet Addiction Test (IAT), the Generalized Anxiety Disorder (GAD-7) scale, the Patient Health Questionnaire for depressive symptoms (PHQ-9), and the Perceived Stress Scale (PSS) were used to measure mental health problems. The analyses also included demographic data (gender and age) and study-related characteristics (form of study, degree of study, field of study, distance between college and home, and housing during the semester). Based on the results of frequency and descriptive analyses, the prevalence of mental health problems was high. The most serious levels of Internet addiction (IAT cut-off point ≥ 50), to which attention should be paid, were found in 3.5% of Czech and 6.2% of Slovak students. Using the standard cut-off point of GAD-7 ≥ 10, 14.1% of Czech and 11.6% of Slovak students were identified with anxiety symptoms. Regarding the PHQ-9 with the cut-off point ≥ 10, 23.4% of Czech and 19.1% of Slovak students had depressive symptoms, which should be addressed. Using the PSS cut-off point ≥ 27, 12.9% of Czech students and 9.1% of Slovak students perceived high stress. The quantile regression analysis showed that Internet addiction was positively associated with anxiety symptoms, depressive symptoms, and stress in all of the analyzed cases (p-value < 0.001). In terms of study-related characteristics, the binomial logistic regression analysis revealed that risk factors for mental health problems in Czech and Slovak students were mainly full-time form of study and living away from home during the semester. Internet addiction, anxiety symptoms, depressive symptoms, and stress are issues that require increased attention, and professionals and policy-makers should implement interventions to effectively prevent and help students with psychological problems.

Psychological distress among health professional students during the COVID-19 outbreak.

BACKGROUND: Due to the drastic surge of COVID-19 patients, many countries are considering or already graduating health professional students early to aid professional resources. We aimed to assess outbreak-related psychological distress and symptoms of acute stress reaction (ASR) in health professional students and to characterize individuals with potential need for interventions. METHODS: We conducted a prospective cohort study of 1442 health professional students at Sichuan University, China. At baseline (October 2019), participants were assessed for childhood adversity, stressful life events, internet addiction, and family functioning. Using multivariable logistic regression, we examined associations of the above exposures with subsequent psychological distress and ASR in response to the outbreak. RESULTS: Three hundred and eighty-four (26.63%) participants demonstrated clinically significant psychological distress, while 160 (11.10%) met the criterion for a probable ASR. Individuals who scored high on both childhood adversity and stressful life event experiences during the past year were at increased risks of both distress (ORs 2.00-2.66) and probable ASR (ORs 2.23-3.10), respectively. Moreover, internet addiction was associated with elevated risks of distress (OR 2.05, 95% CI 1.60-2.64) and probable ASR (OR 2.15, 95% CI 1.50-3.10). By contrast, good family functioning was associated with decreased risks of distress (OR 0.43, 95% CI 0.33-0.55) and probable ASR (OR 0.48, 95% CI 0.33-0.69). All associations were independent of baseline psychological distress. CONCLUSIONS: Our findings suggest that COVID-19 related psychological distress and high symptoms burden of ASR are common among health professional students. Extended family and professional support should be considered for vulnerable individuals during these unprecedented times.

Associations Between Online Learning, Smartphone Addiction Problems, and Psychological Symptoms in Chinese College Students After the COVID-19 Pandemic.

Background: Smartphone-based online education gained popularity during and after the COVID-19 pandemic. Although recent studies have highlighted the association between problematic smartphone use (PSU) and mental health symptoms, the potential role of online learning in this relationship remains unclear. This study aimed to analyze the relationships between higher education modes, PSU, and related psychological symptoms in university students. Methods: A total of 1,629 Chinese university students from five provinces completed a web-based questionnaire survey between March 2020 and October 2021. Demographic characteristics and learning conditions were recorded. All participants completed the Smartphone Addiction Scale-Short Version, Patient Health Questionnaire, Generalized Anxiety Disorder Scale, and Athens Insomnia Scale. Multiple regressions models and stratified analyses were used to examine the association between online education mode, PSU, and symptoms of depression, anxiety, and insomnia. Results: The prevalence of PSU was 58.5%. Students who relied primarily on online learning had a higher prevalence of depressive symptoms (29.95% vs. 22.24%), anxiety symptoms (25.13% vs. 18.91%), and insomnia symptoms (75.89% vs. 70.27%) than those who relied on traditional face-to-face learning (Ps < 0.05). After adjusting for covariates, subjects with PSU were more likely to report depressive symptoms (AdjOR = 3.14, 95% CI = 2.26-4.37), anxiety symptoms (AdjOR = 3.73, 95% CI = 2.13-4.59), and insomnia symptoms (AdjOR = 2.96, 95% CI = 2.23-3.92) than those without PSU. Furthermore, the associations of PSU with depressive symptoms (OR = 4.66 vs. 2.33, P for interaction = 0.015) and anxiety symptoms (OR = 6.05 vs. 2.94, P for interaction = 0.021) were more pronounced in the online learning group. Conclusion: Our study provides preliminary evidence that Chinese university students have serious smartphone addiction problems, which are associated with depressive, anxiety, and insomnia symptoms. Online learning is found to exacerbate PSU and mental health problems. Our findings provide valuable information for targeted psychological interventions in the post-COVID-19 era.

Relationship between Lifestyle and Self-Reported Smartphone Addiction in adolescents in the COVID-19 pandemic: A mixed-methods study.

OBJECTIVES: 1) To verify the association between Lifestyle and Self-Reported Smartphone Addiction in adolescents; and 2) to analyze the adolescents' perception of this relationship in the context of the COVID-19 pandemic. METHOD: A mixed-methods research study with a sequential and explanatory design, developed with Brazilian adolescents aged between 15 and 18 years old. In the first phase, a quantitative, observational and cross-sectional study was carried out with 479 participants and, in the second, a qualitative approach of an exploratory and descriptive nature, with 16 participants. RESULTS: An association was verified between Lifestyle and Self-Reported Smartphone Addiction by adolescents (p < 0.01), with a large size effect (d=0.98). All the domains related to lifestyle were associated with Self-Reported Smartphone Addiction, with greater effects evidenced in the following aspects: high effect for sleep, seat belt, stress and safe sex (d=0.85); and moderate effect for insight (d=0.74) and career (d=0.71). Subsequently, the qualitative analysis resulted in a category that describes how the adolescents understand this relationship in the face of the COVID-19 pandemic. CONCLUSION: More problematic lifestyles were evidenced among the adolescents classified as dependent. In addition to that, it was understood that the COVID-19 pandemic exerted a considerable impact on the lifestyle and behavior established by the adolescents with their smartphones. IMPLICATIONS FOR THE PRACTICE: Nurses and other health professionals are essential in the promotion of healthy lifestyles and adaptive behavior in smartphone use, especially in the face of this pandemic scenario and, thus, mitigating the harms to the adolescents' health.

Psychological distress and internet addiction following the COVID-19 outbreak: Fear of missing out and boredom proneness as mediators.

COVID-19 has caused major changes in people's mental health and behavior. This study aimed to investigate whether boredom proneness and fear of missing out acted as mediators between psychological distress and Internet addiction (IA). A cross-sectional survey was conducted in 2020, including 552 youths aged 17-28 years. The recruited participants were asked to complete a series of self-reported questionnaires regarding psychological distress, fear of missing out, boredom proneness and IA. The results indicate that during the COVID-19 pandemic, the reporting rate of IA in young adults was 28.1%, and fear of missing out and boredom proneness played multiple mediation roles in the relationship between psychological distress and IA. Governments and education departments should focus on young people with psychological deficits to prevent them from succumbing to IA.

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

PURPOSE: We aimed to investigate the prevalence of Internet addiction (IA) and explore its related factors among undergraduates during widespread online learning in China. DESIGN AND METHODS: The online survey was conducted in April 2020. The Young diagnostic questionnaire and academic burnout scale were respectively used to measure IA and academic burnout. FINDINGS: A total of 28.4% of 7562 participants developed IA, which correlated with academic burnout. Additionally, positive attitude and practice towards COVID-19 and exercise were protective factors of it. PRACTICE IMPLICATIONS: IA was associated with academic burnout, and better cognition of COVID-19 and positive lifestyles might reduce its risk.

Smartphone de-addiction among children and adolescents: An hour of need.

Sudden closure of schools due to coronavirus disease 2019 (COVID-19) pandemic introduced extensive use of digital technology in education across the globe. The gadgets connected to the internet have become an essential part of the lives of children in the contemporary world. Children and adolescents are more exposed to smart devices for academic learning and entertainment. The concern of smartphone addiction among children and adolescents in recent decades has been heightened by the spread of COVID-19. Excessive use of smartphones has physical, psychological, and social unfavorable outcomes signifying the need for developing strategies to reduce the usage.

Internet addiction and sleep quality among medical students during the COVID-19 pandemic: A multinational cross-sectional survey.

BACKGROUND: The emergence of the COVID-19 pandemic has affected the lives of many people, including medical students. The present study explored internet addiction and changes in sleep patterns among medical students during the pandemic and assessed the relationship between them. METHODS: A cross-sectional study was carried out in seven countries, the Dominican Republic, Egypt, Guyana, India, Mexico, Pakistan, and Sudan, using a convenience sampling technique, an online survey comprising demographic details, information regarding COVID-19, the Pittsburgh Sleep Quality Index (PSQI), and the Internet Addiction Test (IAT). RESULTS: In total, 2749 participants completed the questionnaire. Of the total, 67.6% scored above 30 in the IAT, suggesting the presence of an Internet addiction, and 73.5% scored equal and above 5 in the PSQI, suggesting poor sleep quality. Internet addiction was found to be significant predictors of poor sleep quality, causing 13.2% of the variance in poor sleep quality. Participants who reported COVID-19 related symptoms had disturbed sleep and higher internet addiction levels when compared with those who did not. Participants who reported a diagnosis of COVID-19 reported poor sleep quality. Those living with a COVID-19 diagnosed patient reported higher internet addiction and worse sleep quality compared with those who did not have any COVID-19 patients in their surroundings. CONCLUSION: The results of this study suggest that internet addiction and poor sleep quality are two issues that require addressing amongst medical students. Medical training institutions should do their best to minimize their negative impact, particularly during the current COVID-19 pandemic.

Internet addiction among medical and non-medical students during COVID-19 pandemic, Tanta University, Egypt.

Internet addiction is one of the most growing addictive behaviors worldwide, especially among university students affecting their physical and mental health negatively. During COVID-19, accessing online books, completing assignments, and online assessments are highly recommended by universities, teachers, and students. The Internet has increasingly become a vital part of our lives, and distant online classes increase the dependency of students on the Internet. The aim of this study is to assess the level of internet addiction among medical or non-medical students in Tanta University, Egypt. This was a cross-sectional study conducted during October and November 2020. It included 373 students from the faculty of medicine and 373 non-medical students from the faculty of science. The validated (IAT-20) was used to assess the level of Internet addiction among these students. A total of 51.7% of medical students were found severe internet addicts and 43.4% of them were possible addicts compared to only 11.3% of non-medical students who were found severely addicted to the Internet and 68.9% of them were possible addicts with statistically significant difference between them. Female students of both colleges were found addicted to the Internet than males. Female medical and non-medical students suffered from severe Internet addiction more than non-medical and male ones. Appropriate awareness creation intervention strategies should be implemented to decrease the level of Internet addiction among university students and to reduce its harmful and negative consequences.

Influences of digital media use on children and adolescents with ADHD during COVID-19 pandemic.

OBJECTIVE: To explore the influences of digital media use on the core symptoms, emotional state, life events, learning motivation, executive function (EF) and family environment of children and adolescents diagnosed with attention deficit hyperactivity disorder (ADHD) during the novel coronavirus disease 2019 (COVID-19) pandemic. METHOD: A total of 192 participants aged 8-16 years who met the diagnostic criteria for ADHD were included in the study. Children scoring higher than predetermined cut-off point in self-rating questionnaires for problematic mobile phone use (SQPMPU) or Young's internet addiction test (IAT), were defined as ADHD with problematic digital media use (PDMU), otherwise were defined as ADHD without PDMU. The differences between the two groups in ADHD symptoms, EF, anxiety and depression, stress from life events, learning motivation and family environment were compared respectively. RESULTS: When compared with ADHD group without PDMU, the group with PDMU showed significant worse symptoms of inattention, oppositional defiant, behavior and emotional problems by Swanson, Nolan, and Pelham Rating Scale (SNAP), more self-reported anxiety by screening child anxiety-related emotional disorders (SCARED) and depression by depression self-rating scale for children (DSRSC), more severe EF deficits by behavior rating scale of executive function (BRIEF), more stress from life events by adolescent self-rating life events checklist (ASLEC), lower learning motivation by students learning motivation scale (SLMS), and more impairment on cohesion by Chinese version of family environment scale (FES-CV). The ADHD with PDMU group spent significantly more time on both video game and social media with significantly less time spend on physical exercise as compared to the ADHD without PDMU group. CONCLUSION: The ADHD children with PDMU suffered from more severe core symptoms, negative emotions, EF deficits, damage on family environment, pressure from life events, and a lower motivation to learn. Supervision of digital media usage, especially video game and social media, along with increased physical exercise, is essential to the management of core symptoms and associated problems encountered with ADHD.