Parent-adolescent interaction and risk of adolescent internet addiction: a population-based study in Shanghai.

BACKGROUND: Family-based intervention is essential for adolescents with behavioral problems. However, limited data are available on the relationship between family-based factors and adolescent internet addiction (AIA). We aimed to examine this relationship using a representative sample of Shanghai adolescents. METHODS: In October 2007, a total of 5122 adolescents were investigated from 16 high schools via stratified-random sampling in Shanghai. Self-reported and anonymous questionnaires were used to assess parent-adolescent interaction and family environments. AIA was assessed by DRM-52 Scale, developed from Young's Internet-addiction Scale, using seven subscales to evaluate psychological symptoms of AIA. RESULTS: Adjusting for adolescents' ages, genders, socio-economic status, school performances and levels of the consumption expenditure, strong parental disapproval of internet-use was associated with AIA (vs. parental approval, OR = 2.20, 95% CI: 1.24-3.91). Worse mother-adolescent relationships were more significantly associated with AIA (OR = 3.79, 95% CI: 2.22-6.48) than worse father-adolescent relationships (OR = 1.76, 95% CI: 1.10-2.80). Marital status of "married-but-separated" and family structure of "left-behind adolescents" were associated with symptoms of some subscales. When having high monthly allowance, resident students tended to develop AIA but commuter students did not. Family social-economic status was not associated with the development of AIA. CONCLUSIONS: The quality of parent-adolescent relationship/communication was closely associated with the development of AIA, and maternal factors were more significantly associated with development of AIA than paternal factors. Family social-economic status moderated adolescent internet-use levels but not the development of AIA.

Personal characteristics related to the risk of adolescent internet addiction: a survey in Shanghai, China.

BACKGROUND: Paralleling the rapid growth in computers and internet connections, adolescent internet addiction (AIA) is becoming an increasingly serious problem, especially in developing countries. This study aims to explore the prevalence of AIA and associated symptoms in a large population-based sample in Shanghai and identify potential predictors related to personal characteristics. METHODS: In 2007, 5,122 adolescents were randomly chosen from 16 high schools of different school types (junior, senior key, senior ordinary and senior vocational) in Shanghai with stratified-random sampling. Each student completed a self-administered and anonymous questionnaire that included DRM 52 Scale of Internet-use. The DRM 52 Scale was adapted for use in Shanghai from Young's Internet Addiction Scale and contained 7 subscales related to psychological symptoms of AIA. Multiple linear regression and logistic regression were both used to analyze the data. RESULTS: Of the 5,122 students, 449 (8.8%) were identified as internet addicts. Although adolescents who had bad (vs. good) academic achievement had lower levels of internet-use (p < 0.0001), they were more likely to develop AIA (odds ratio 4.79, 95% CI: 2.51-9.73, p < 0.0001) and have psychological symptoms in 6 of the 7 subscales (not in Time-consuming subscale). The likelihood of AIA was higher among those adolescents who were male, senior high school students, or had monthly spending >100 RMB (all p-values <0.05). Adolescents tended to develop AIA and show symptoms in all subscales when they spent more hours online weekly (however, more internet addicts overused internet on weekends than on weekdays, p < 0.0001) or when they used the internet mainly for playing games or real-time chatting. CONCLUSIONS: This study provides evidence that adolescent personal factors play key roles in inducing AIA. Adolescents having aforementioned personal characteristics and online behaviors are at high-risk of developing AIA that may compound different psychological symptoms associated with AIA. Spending excessive time online is not in itself a defining symptom of AIA. More attention is needed on adolescent excessive weekend internet-use in prevention of potential internet addicts.

Lifecourse factors and likelihood of rural practice and emigration: a survey of Ghanaian medical students.

INTRODUCTION: Health worker shortages and maldistribution have important implications for the capacity of health systems. Ghana has one of the highest physician emigration rates in the world, and over 75% of those who remain work in Ghana's two largest cities. The aim of this study was to investigate the contribution of experiential factors across Ghanaian medical students' lifespans on intent to practice in a rural area and intent to emigrate. METHODS: All fourth year medical students in Ghana were surveyed on demographics, rural and international experience, and future career plans. Key outcomes of interest were students' stated likelihood of practicing in a deprived rural area or emigrating after graduation. Lifecourse predictors of interest were parental socioeconomic status, gender, relationship status, rural and international living experience, and school of study. Bivariate and multivariate logistic regression were used to estimate associations between predictors and outcomes of interest. RESULTS: Of 310 eligible students, 307 (99%) participated in the survey. Of these, 228 were Ghanaian and the focus of this analysis. It was found that 131 (57.5%) were willing to work in a deprived area in Ghana and 148 (64.9%) had considered emigrating after graduation. In the multivariate regression models, willingness to work in a deprived area was predicted by male gender (OR: 2.31, 95%CI: 1.23-4.35), having lived in a rural area but never lived abroad (OR: 2.77, 95%CI: 1.08-7.13), and low parental professional and educational status (OR: 2.33, 95%CI: 1.23-4.43). Consideration of emigration was predicted by having lived abroad but never in a rural area (OR: 3.39, 95%CI: 1.15-9.97). A sub-set of 80 individuals (35%) reported that they were willing to work in a deprived area in Ghana but also considering emigration. These subjects were more likely to be male. CONCLUSIONS: Students with parents of a lower socioeconomic class, those with rural experience, and those without international experience are more likely to stay in Ghana and are also more likely to work in a deprived area after graduation. Selective admissions policies based on lifecourse factors combined with exposure to rural practice in medical school may have a role in increasing the number of rural physicians.