Article

Epidemiology of Internet Behaviors and Addiction Among Adolescents in Six Asian Countries

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Abstract

Abstract Internet addiction has become a serious behavioral health problem in Asia. However, there are no up-to-date country comparisons. The Asian Adolescent Risk Behavior Survey (AARBS) screens and compares the prevalence of Internet behaviors and addiction in adolescents in six Asian countries. A total of 5,366 adolescents aged 12-18 years were recruited from six Asian countries: China, Hong Kong, Japan, South Korea, Malaysia, and the Philippines. Participants completed a structured questionnaire on their Internet use in the 2012-2013 school year. Internet addiction was assessed using the Internet Addiction Test (IAT) and the Revised Chen Internet Addiction Scale (CIAS-R). The variations in Internet behaviors and addiction across countries were examined. The overall prevalence of smartphone ownership is 62%, ranging from 41% in China to 84% in South Korea. Moreover, participation in online gaming ranges from 11% in China to 39% in Japan. Hong Kong has the highest number of adolescents reporting daily or above Internet use (68%). Internet addiction is highest in the Philippines, according to both the IAT (5%) and the CIAS-R (21%). Internet addictive behavior is common among adolescents in Asian countries. Problematic Internet use is prevalent and characterized by risky cyberbehaviors.

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... Regarding the prevalence of addiction by country or geographical area, numerous studies report high rates in Asian countries. Referring, in every case, to young adult population, these rates range between 51% in the Philippines and 48% in Japan (Mark et al., 2014). In Europe, and depending on the study and the country (Germany, Italy, Romania, Estonia and Spain), the prevalence of addiction ranges between 2% and 8% Ustinaviciene et al., 2016). ...
... Regarding geographical areas, the literature shows that Internet addiction decreases significantly in Australia and New Zealand, clearly differentiating themselves from Asian cultures, where there is a positive relationship. These results are in line with previous studies in Asian countries, where the prevalence rates range between 40% and 50% (Mark et al., 2014), whereas in European countries the range is 2-8% Ustinaviciene et al., 2016). Furthermore, each culture and society generates a series of rules, producing their own axiological scales. ...
Article
Internet addiction, although not recognized by the WHO or the APA, is a serious and problematic pathology. This meta-analysis shows that the incidence of Internet addiction in adults was high in recent years (2017–2020). The effect size returned according to the random effects model is Z = 24.63; SE = 0.205; p = .001. In addition, high heterogeneity is evident in the research addressing this topic (Q = 1240.719, df = 36, p < .001; I2 = 97.09%). On the other hand, the Eggers test indicated an absence of publication bias. The sample consisted of 30 studies with k = 37 samples from Europe, Asia, America and Oceania. The total sample was constituted by 21,378 participants (51.22% male, 48.78% women; Mean age = 23.55 years). The statistical analyses of meta-regression and model comparison show a complex problem at the international level, explained by age and sex, and apparently also by geographical area. The results of the systematic review show the increase of internet addiction in the new generations, with other variables playing a relevant role, such as: Increase of individualism, lower sociability and enculturation. We conclude highlighting the need to address this problem from a public health approach.
... In a South Korean study, 80.4% of participants at elementary schools started using smartphones at the age of 10 years or younger, and 59.9% of the participants used their smartphones for at least one hour or more every day [43]. In China, the average prevalence of problematic internet usage among adolescents was reported at 26.50% in one study [44], which is significantly higher than any other Asian countries (between 6.2% and 21.2%) [45]. In addition, problematic internet use has been associated with psychological conditions in children, such as anxiety, attention deficit disorder, depression, substance abuse disorder, and hyperactivity [46]. ...
... The most commonly reported risk factors for Chinese adolescent problematic internet use include poor sleep quality, anxiety, depression, and obesity [50][51][52]. Although there have been a number of studies [39,[44][45][46][47][48][49] examining the consequences of problematic internet use (including problematic social media use) among students and adolescents in China, there is no psychometric instrument that has been developed to assess problematic QQ use, even though it is one of the most frequently used social networking platforms. ...
Article
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The QQ social media platform is very popular among Chinese adolescents. As with other social media platforms (e.g., Facebook, Instagram, YouTube, etc.), there have been increasing reports that the use of QQ can be potentially problematic to a minority of users. However, unlike these other social media platforms, there is currently no scale to assess the risk of problematic QQ use. The present study developed the Problematic QQ Use Scale (PQQUS) among Chinese adolescents based on six core criteria of behavioral addiction (salience, tolerance, mood modification, loss of control, withdrawal, and conflict) that have been used in the development of other social media addiction scales. The scale was administered to a sample of 1008 Chinese school children to assess its psychometric properties, utilizing both classical test theory and item response theory. The analysis demonstrated that the PQQUS had good item discrimination indices relating to both CTT and IRT. The CFA results and Loevinger’s H-coefficient suggested the PQQUS had a unidimensional factor structure. The PQQUS had good internal reliability, good composite reliability, and good concurrent validity (based on correlations with measures of anxiety, depression, self-esteem, and life satisfaction). The invariance testing between boys and girls suggested this scale is a valid assessment tool for both groups. Overall, the PQQUS is a psychometrically robust tool for assessing problematic QQ use and will have a key role in further research on problematic QQ use among Chinese adolescents.
... The prevalence of internet gaming disorder (IGD) in European countries pre-pandemic varied from 1.2% to 5.0%, compared to a higher range of prevalence among Asian countries, i.e., from 7.5% to 26.7% [9]. The local prevalence for IG is 18% [10]. A recent study on IGD among Malaysian undergraduates found that 52.8% of them scored high on a validated IGD scale [11]. ...
... A European study performed among the adult population during the pandemic showed that the prevalence of IGD was 29.6% [38], while a study in Japan discovered that there was 1.6 times increment of the prevalence, from 3.7% to 5.6% before and during pandemic [39]. In this study, we found that the prevalence of IGD was only 2.5%, which is the lowest among other countries [9,10,36,39]. The discrepancies in the global prevalence could be the result of the non-uniform instrument tool used, the current pandemic situation, and different population samples [36,40]. ...
Article
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The internet has become an important medium for learning and communication during the COVID-19 pandemic, particularly for university students. Nevertheless, an increase in internet usage could predispose people to internet addiction (IA) and internet gaming (IG). Equally, there is concern that anxiety levels have increased during the pandemic. The aim of this study is to determine the prevalence of IA and IG, and their associations with anxiety among medical students during the pandemic. Data were collected during the second wave of the “Conditional Movement Control Order” (CMCO) in Malaysia between 12 November and 10 December 2020. A total of 237 students participated through proportionate stratified random sampling in this cross-sectional study. They completed a set of online questionnaires which consisted of a sociodemographic profile, the Malay version of the internet addiction test (MVIAT), the Malay version of the internet gaming disorder-short form (IGDS9-SF) and the Malay version of the depression, anxiety and stress scale (DASS-21). The prevalence of IA and internet gaming disorder (IGD) were 83.5% and 2.5%, respectively. A multiple logistic regression showed that those in pre-clinical years had a greater risk of anxiety than those in clinical years [(AOR) = 2.49, p-value 0.01, 95% CI = 1.22–5.07]. In contrast, those who scored high on IA were protected against anxiety [AOR = 0.100, p-value 0.03, 95% CI = 0.01–0.76)]. In conclusion, IA was highly prevalent during the COVID-19 pandemic and its high usage might serve as a protective factor against anxiety among the medical students in this study sample.
... We examine PIU symptoms with a widely used measure, the Revised Chinese Internet Addiction Scale (CIAS-R; Chen et al., 2003). Although none of the existing evaluation tools has been recognized as the gold standard for screening PIU (Zhou et al., 2018), the CIAS-R has been one of the most extensive assessments of PIU in adolescents (Dahl & Bergmark, 2020;Mak et al., 2014). ...
... The scale has achieved high split-half reliability, test-retest reliability, and convergent validity among Chinese and non-Chinese adolescents (S.-H. Chen et al., 2003;Mak et al., 2014). In this study, the Cronbach's alpha value was 0.89. ...
Article
Problematic Internet use (PIU) is often initiated in early adolescence and maintained or exacerbated during middle and late adolescence. Prior studies primarily focus on age differences in PIU prevalence and severity, but age differences in PIU symptom structure remain obscure. We use network analysis that conceptualizes PIU as a network of interacting symptoms to identify core symptoms (i.e., symptoms that are highly connected to other symptoms) and symptom relationships (i.e., associations among symptoms) of PIU. A total of 1375 adolescents (Mage = 14.49, SD = 2.24) who met the cutoff point of PIU were included in this study. The results reveal that increasing time for satisfaction and empty life are central symptoms in early adolescence; less sleep, failure to stop, and feeling depressed are central symptoms in middle adolescence; feeling depressed is the most central symptom in late adolescence. The core symptoms in early, middle, and late adolescence can direct differentiated interventions based on adolescent stages. The comparisons indicate that networks show similar overall structure and global strength but differ in specific symptom associations, offering nuanced insights into the essential differences in PIU symptoms across different stages of adolescence.
... Statista reports that cell phone ownership in the U.S., for instance, doubled to a level of 85% from 2011 to 2021 (O'Dea, 2021). This mirrors growing digital media penetration rates noted across Asia (e.g., Mak et al., 2014;Tran et al., 2020). Mobile technology now represents a powerful communication and entertainment platform, with processing power that surpasses supercomputers from recent decades (Routley, 2017). ...
... When chronicling the take-off phase for cell phone diffusion across Asia, Mak et al. (2014) noted that the online gaming participation rate ranged from 11% in China to 39% in Japan. The authors documented comparable levels of Internet addiction, which was highest in the Philippines (IAT = 5%)-concluding that "Internet addictive behavior is common among adolescents in Asian countries" (p. ...
Article
Using Uses and Gratifications theory as a guide, the proposed framework explores how mobile games are utilized to escape reality and cope with stress in developing a ritualized media use orientation. A purposive online survey of mobile game users uncovered expected positive relationships between materialism and Internet addiction, as well as Internet addiction and amount of money spent. Additionally, survey results revealed a positive relationship between materialism and a negative relationship between social support and Internet addiction. Contrary to expectations, social support did not have a moderating effect on the relationship between materialism and Internet addiction. Theoretical implications stemming from the complexity of using social support as a moderator for problematic uses are discussed.
... Многие исследователи обращают внимание на опасность этого интернет-феномена, который может помешать умственному развитию детей и подростков, ищущих свою идентичность, а также формированию их самооценки [30,31]. Отмечается, что онлайн-игры приводят к эмоциональным проблемам, экстернализирующему расстройству, проблемам с социализацией и снижению удовлетворенности жизнью у детей [22]. ...
Article
Nowadays, there is a need for consensus on diagnostic criteria, measures to improve the reliability of researches and the development of effective and efficient treatment methods, despite the significant amount of researches conducted on digital addiction (both Internet and gadget addiction). At the present stage, it is advisable and possible to find a common approach that is relevant for providing preventive and medical care to children and adolescents with digital addiction. This review of recent scientific articles systematizes modern treatment tactics for the prevention, diagnosis and therapy of these conditions, primarily in children and adolescents, which can be summarized as follows: digital addiction is a behavioral addiction (1), the diagnosis of which requires a multimodal/integrated approach (2), which consists of preventive measures in childhood and adolescence ("digital hygiene") (3), psychotherapy of behavioral addiction, behavior disorders, social maladaptation and neurotic disorders (4), and psychopharmacotherapy of the existing depressive and neurotic spectrum (in particular, selective serotonin reuptake inhibitors, clomipramine) and attention deficit hyperactivity disorder (methylphenidate, atomoxetine) (5). KEYWORDS: digital addiction, Internet addiction, gadget addiction, behavioral addiction, psychotherapy, digital hygiene, psychiatry, children and adolescents. FOR CITATION: Pekonidi A.V. Digital addiction in children and adolescents. Modern diagnostics and treatment tactics. Russian Medical Inquiry. 2021;5(5):322–329 (in Russ.). DOI: 10.32364/2587-6821-2021-5-5-322-329.
... among adolescents in China 33 , which is much higher than that in other Asian countries (range: 6.2-21.2%) 34,35 . Internet addiction was found to affect sleep quality and lead to negative impact on health-related quality of life in adolescents 35 . ...
Article
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Hypertension is the leading single contributor to all-cause death and disability worldwide. However, there is scarce evidence on the prevalence and risk factors of hypertension for Chinese youth. This study aimed to investigate the prevalence of hypertension among Chinese college freshmen and to identify the influencing factors. We conducted a cross-sectional study of all freshmen from 2015 to 2017 at a university in Wuhan, China by physical examination and standard-structured questionnaire. The Pearson chi-square test was used to compare categorical variables. Forward stepwise logistic regression method was used in the multivariate analysis to identify independent predictors of hypertension in youth. A total of 12,849 participants were included, and the prevalence of hypertension of Chinese college freshmen was 4.3% (7.9% in men and 1.6% in women). Men had a higher risk of hypertension than women (odds ratio [OR]: 5.358, 95% confidence interval [CI]: 4.345–6.607, P < 0.001). Obese people were more likely to develop hypertension than those with normal body mass index (OR: 10.465, 95% CI: 8.448–12.964, P < 0.001). People with elevated resting heart rate (RHR) had a higher prevalence of hypertension (OR: 4.987, 95% CI: 3.641–6.832, P < 0.001). Staying up late (OR: 2.957, 95% CI: 2.482–3.523, P < 0.001), physical inactivity (OR: 4.973, 95% CI: 4.141–5.972, P < 0.001), living in urban district (OR: 1.864, 95% CI: 1.493–2.329, P < 0.001) and family history of cardiovascular diseases (CVDs) (OR: 2.685, 95% CI: 2.108–3.421, P < 0.001) were related to higher prevalence of hypertension in youth. Male, obesity, elevated RHR, physical inactivity and family history of CVDs were identified as important risk factors of hypertension in youth. These risk factors should be given more attention when designing and implementing the interventional programs.
... Hierbei zeigen sich kulturelle/nationale Unterschiede. Besonders betroffen mit durchschnittlich 5 % scheinen Menschen in Asien zu sein Mak et al. 2014;Yu und Cho 2016). In Europa sind durchschnittlich 1-2 % betroffen Müller et al. 2015;Rumpf et al. 2014). ...
Thesis
ZUSAMMENFASSUNG Hintergrund und Ziele: Internetspiele und Soziale Netzwerke (Social Network Sites = SNSs) bergen ein hohes Suchtpotential. Es ist wichtig die passionierte Nutzung der genannten Medien von der pathologischen Nutzung zu unterscheiden. Die Internet Gaming Disorder (IGD) und die Social Network Use Disorder (SND) gehen mit verschiedenen negativen Auswirkungen auf das Individuum und sein Umfeld einher, die denen in substanzgebundenen Süchten beobachteten Effekten gleichen. Jungen und Männer spielen mehr Internetspiele und haben ein größeres Risiko eine IGD zu entwickeln. Für Mädchen und Frauen scheint das Gleiche für SNSs und SND zu gelten. Es bestehen Geschlechtsunterschiede in verschiedenen Bereichen der Suchtentwicklung und -Aufrechterhaltung. Frauen haben beispielsweise eine höhere Tendenz den Substanzgebrauch oder das Glückspiel zu nutzen, um negative Emotionen zu modulieren, entwickeln nach im Vergleich zu Männern kürzeren Konsumzeiten ein süchtiges Verhalten und weisen höhere Rückfalltendenzen auf. Ein Ansatz die auch bei SND und IGD 2 beobachteten geschlechtsspezifischen Unterschiede zu erklären, sind die bereits in substanzbasierten Süchten und in der Glücksspielsucht (die bereits als Verhaltenssucht klassifiziert ist) beobachteten Effekte der weiblichen Sexualhormone Östrogen und Progesteron auf das Suchtverhalten und das mesolimbische Dopaminsystem. Östrogen hat bei Frauen und weiblichen Individuen eine das Suchtverhalten (Eskalation, Craving u.a.) fördernde Wirkung. Progesteron hingegen scheint in beiden Geschlechtern eine das Suchtverhalten hemmende Wirkung zu haben. Erklärt werden diese Effekte unter anderem über den Einfluss der Hormone auf das dopaminerge Belohnungssystem und GABA-erge Synapsen. Ziel dieser Arbeit ist es zu untersuchen, ob die von anderen Autoren beobachteten Geschlechterunterschiede bezüglich IGD und SND reproduziert werden können und ob ein Zusammenhang zwischen den Östrogen- und Progesteronkonzentrationen im Serum und der IGD und SND besteht. Methoden: Über einen Zeitraum von drei Jahren wurden insgesamt 192 Probanden rekrutiert (99 Frauen und 93 Männer). Die Rekrutierung erfolgte in drei Schritten. Im Onlinescreening (1), Telefonscreening (2) und der Testung vor Ort in der Psychiatrischen und Psychotherapeutischen Klinik (3). Es erfolgte jeweils die Erhebung des Internetnutzungsverhaltens mittels DSM-5 Kriterien für IGD und von uns adaptiert für SND, der Compulsive Internet Use Scale (CIUS), der Internetnutzungszeiten und ein vor Ort durchgeführtes Craving Experiment. Die Ausschlusskriterien waren u.a. Substanzsüchte, Hinweise auf eine Schizophrenie oder schwere körperliche Erkrankungen. Die Testung vor Ort und die Blutentnahme fanden immer zur gleichen Zeit zwischen 09:00 und 12:00 Uhr am Vormittag statt. Die Bestimmung der Hormone im Serum erfolgte nach Abschluss der Rekrutierung für alle Proben zum gleichen Zeitpunkt. Für die verschiedenen Formen des Estradiols Gesamtestradiol (E2), freies Estradiol (fE2) und bioverfügbares Estradiol (bE2) wurde eine ELISA und für Progesteron die Massenspektrometrie verwendet. Ergebnisse und Beobachtungen: Für die Auswertung der Hormonkonzentrationen im Serum erfolgte die Einteilung der Kohorte in drei Gruppen: Frauen mit hormoneller Kontrazeption (FmH), Frauen ohne hormonelle Kontrazeption (FoH) und Männer. Frauen beider Gruppen erfüllten mehr SND-Kriterien (Männer vs. FmH p = 0,016; Männer vs. FoH p = 0,001), wählten signifikant häufiger SNSs für das Craving-Experiment (Männer vs. FmH p < 0,001; Männer vs. FoH p < 0,001) und FoH verbrachten signifikant mehr Zeit in SNSs (Männer vs. FoH p = 0,004) als Männer. Diese hingegen erfüllten mehr IGD-Kriterien (Männer vs. FmH p = 0,001; Männer vs. FoH p = 0,002) wählten häufiger das Internetspielen für das Craving-Experiment (Männer vs. FmH p < 0,001; Männer vs. FoH p < 0,001) und verbrachten signifikant mehr Zeit mit dem Spielen im Internet als Frauen (Männer vs. FmH p < 0,001; Männer vs. FoH p < 0,001). Insgesamt erfüllten wenige Proband:innen fünf oder mehr IGD-/ bzw. SND-Kriterien. Die 3 Werte für Östrogen und Progesteron waren bei FoH am höchsten und bei FmH am niedrigsten, die Männer lagen dazwischen. Die Estradiolkonzentrationen bei den Männern lagen über den angenommenen Referenzwerten. Bei Männern korrelierte die Estradiolkonzentration signifikant negativ mit den erfüllten SND-Kriterien (bE2) (p = -0,046) und dem maximalen Craving für das Spielen im Internet in den letzten 7 Tagen (E2, fE2, bE2) (p = -0,013; -0,008; -0,007). In der Gruppe FmH zeigte sich eine signifikant positive Korrelation der Estradiolkonzentrationen und der maximalen mit dem Spielen im Internet verbrachten Zeit (p = 0,049), sowie eine signifikant positive Korrelation der Progesteronkonzentration und den erreichten Punkten in der CIUS (p = 0,027). FoH wiesen keinerlei signifikante Korrelationen der untersuchten Parameter auf. Praktische Schlussfolgerungen: Die bereits durch andere Autoren beschriebenen Geschlechterunterschiede bezüglich IGD und SND konnten reproduziert werden. Die Männer erfüllten mehr IGD-Kriterien und verbrachten mehr Zeit mit dem Internetspielen, während die Frauen mehr SND-Kriterien erfüllten und mehr Zeit mit SNSs verbrachten. Höhere Estradiolkonzentrationen scheinen bei Männern im Hinblick auf SND und Craving für Internetspielen protektiv zu sein, während sie bei FmH mit längeren maximalen Internetspielzeiten korrelieren. FoH zeigten in unserer Kohorte keinen Zusammenhang zwischen den Serumkonzentrationen von Östrogen und Progesteron und der IGD bzw. SND. Ursächlich hierfür können unter anderem die geringe Stichprobengröße und die Schwankungen der Hormonkonzentrationen während des Zyklus in dieser Gruppe sein. Insgesamt werden größere Kohorten mit ≥ 5 Kriterien für IGD und SND unter gleichzeitiger Berücksichtigung des hormonellen Status bei weiblichen Probandinnen benötigt. Aufgrund der geringen Stichprobengröße und der bei multipler Testung bestehenden Gefahr falsch positiver Ergebnisse bedürfen unsere Ergebnisse der Replikation.
... In 2019, 59% of ESPAD students reported having played digital games on a typical school day, and 68% reported having played them on a non-school day within the last 30 days (ESPAD Group, 2020). However, problematic adolescent video gaming has been reported to vary from 1.2 to 18.4%, depending on the measure used (Chia et al., 2020;King et al., 2020;Lemmens, Valkenburg, & Peter, 2009;Mak et al., 2014;Mentzoni et al., 2011;M€ uller et al., 2015;Rehbein, Kliem, Baier, M€ ossle, & Petry, 2015). ...
Article
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Background and aims The convergence of gaming and gambling may pose a risk for adolescents. Thus, it is important to find out how these behaviours are associated with other addictive behaviours in order to develop efficient preventive measures for youth. The aim of this study was to examine 1) whether problematic gaming and money used for gaming activities are risk factors for gambling, and 2) what kind of impact adolescents’ substance use along with other factors related to friends and parents have on this association. Methods The European School Survey Project on Alcohol and Other Drugs data, 2019 of Finnish adolescents aged 15 to 16 ( N = 4595). Cross-tabulations with Rao-Scott’s chisquare tests were applied to study the associations of the background factors with gambling in the past 12 months. A multinomial logistic regression model was fitted for the outcome variable (gambling in the past 12 months) adjusted for all independent and background variables. Results Problematic gaming alone was not associated with gambling participation, whereas using money for digital games increased the risk of gambling. Boys gamble more than girls. The use of alcohol and drugs increased the risk of gambling. Parental monitoring reduced the risk of gambling, whereas hanging around weekly with friends increased the risk. Discussion and conclusions Using money on gaming sites may put some adolescents at risk of developing problems with either gaming or gambling. The link between using money in digital games and gambling participation calls for preventive measures, intervention and regulatory acts.
... Prevalensi paling tinggi adalah di Filipina (51%) dan Jepang (48%). 9 Penggunaan internet yang berlebihan dapat menyebabkan penarikan diri dari kontak sosial dan hampir seluruhnya berfokus pada internet daripada kehidupan sehari-hari. Individu yang kecanduan internet menghabiskan lebih banyak waktu untuk menggunakan internet daripada berinteraksi langsung dengan keluarga dan teman, yang mengarah ke lingkaran sosial yang lebih kecil serta tingkat kesepian dan stres yang lebih tinggi. ...
Research Proposal
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Internet addiction is defined as an excessive use of the internet that can interfere individual's health and cause psychological, social and school problems. One of the psychological impact of internet addiction is the decreased of quality time with friends and family that can cause social isolation. This condition can lead to depression. Aim: This research aims to determine the relationship between internet addiction and depression in 11 th grade high school students at SMA Negeri 9 Binsus Manado School Year 2018/2019. Method: This research is an analytical observational research with cross-sectional approach. Internet addiction was assessed using the Internet Addiction Test (IAT), whilst depression by using Children's Depression Inventory (CDI) in Indonesian version. The participants of this research are 11 th grade students in SMA Negeri 9 Binsus Manado that fulfilled the inclusion criterias. Results: There were 171 participants which are 14-17 years old and most of the participants are woman (63,2%). The result using IAT and CDI showed that 120 students (70,2%) have moderate internet addiction and 55 students (32,2%) have depression. Statistical analysis using Chi-Square showed p=0,0002. Conclusion: There is a relationship between internet addiction and depression on 11 th grade high school students at SMA Negeri 9 Binsus Manado School Year 2018/2019.
... Although mobile phones make daily life more convenient, frequent use can also lead to mobile phone addiction [2,3]. Adolescents are in a critical period of behaviour change [4], and their low level of self-control and strong curiosity about new things make it easy for mobile phone use to lead to problems [5,6]. At present, mobile phone addiction has become a social problem that affects the healthy growth of adolescents. ...
Article
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Background: Mobile phone addiction has become a social problem that affects the healthy growth of adolescents, and it may be correlated with coping style. The aim of this study was to investigate the relationship between mobile phone addiction and coping style and the influencing factors for adolescents. Methods: A meta-analysis was conducted by searching China National Knowledge Infrastructure (CNKI), WANFANG DATA and Chongqing VIP Information Co., Ltd. (VIP), PubMed, Web of Science, Embase, and PsycINFO. Stata 16.0 was used to analyse the overall effect and test the moderating effect. Results: Thirty-three studies were included, involving a total of 20,349 subjects. There was no significant correlation between adolescents' mobile phone addiction and positive coping style (r = - 0.02, 95% CI = - 0.06 to 0.02, P > 0.05), but there was a moderate positive correlation between adolescents' mobile phone addiction and negative coping style (r = 0.31, 95% CI = 0.26 to 0.36, P < 0.001). The moderating effect analysis showed that the effect of dissertations on mobile phone addiction and positive coping style among adolescents was significantly larger than that of journal articles. The Smartphone Addiction Scale for College Students (SAS-C) showed the largest effect on mobile phone addiction and positive coping style among adolescents. The time of publication significantly positively moderated the relationship between mobile phone addiction and negative coping style among adolescents. The Simplified Coping Style Questionnaire (SCSQ) showed the largest effect on adolescents' mobile phone addiction and negative coping style. However, the correlation between adolescents' mobile phone addiction and coping style was not affected by age or gender. Conclusions: There was a close relationship between mobile phone addiction and coping style among adolescents. In the future, longitudinal research should be carried out to better investigate the dynamic changes in the relationship between mobile phone addiction and coping style.
... Vietnam (21.2%), South Korea (20%), and other parts of Asia such as the Philippines (21%) [2]. Considering the negative impact and prevalence of IA, it is critical to diagnose IA accurately for timely follow-up treatment. ...
Article
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Internet addiction (IA), as a new and often unrecognized psychosocial disorder, endangers people’s health and their lives. However, the common biometric analysis based on the combination of EEG signals and results of questionnaires is not quantitative, and thus difficult to ensure a specific biomarker. This work aims to develop a deep learning algorithm (no need to identify biomarkers) used for diagnosing IA and evaluating therapy efficacy. Herein, a five-layer CNN model combined with a fast Fourier transform is proposed to diagnose IA quantitatively. This algorithm is validated in the Lemon dataset by using it to process raw data, full spectral power, and alpha-beta-gamma spectral power (related to IA). In contrast to alpha-beta-gamma spectral power, the results based on full spectral power show better performance (87.59% accuracy, 88.80% sensitivity, and 86.41% specificity), which confirms that the proposed algorithm can diagnose IA without biomarkers. In addition, this proposed CNN model presents obvious advantages in processing raw data, achieving 81.1% accuracy. Such results verify that this method can contribute to the reduction of diagnosis time and be potentially used in real-time health monitoring systems. This work provides a quantitative approach to diagnose IA and evaluate therapy efficacy, as a general strategy, and can be widely used in other disorder diagnoses that affect EEG signals, such as psychiatric disorders, substance dependence, and depression.
... This has been further highlighted in studies showing the negative impact of problematic internet use during the COVID-19 pandemic lockdown in countries such as the Philippines and India (Subudhi & Palai, 2020;Tee et al., 2020). This high level of problematic use of internet has also been reported in India (Anand et al., 2018;Vadher et al., 2019), Philippines (Mak et al., 2014) and Turkey (Kirik, Arslan, Çetinkaya, & Gül, 2015) prior to the lockdowns associated with the COVID-19 pandemic, suggesting that perhaps the increase in problematic internet use may be a growing concern for LMIC even before the pandemic (Anand et al., 2018;Fernandes et al., 2020;Kirik et al., 2015). Moreover, a study conducted in the western parts of India just before the outbreak of the pandemic examining the relationship between internet overuse loneliness and addictive symptoms report a significant positive correlation with loneliness and symptoms of withdrawal, alongside functional and social impairments (Shah, 2020). ...
Article
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Problematic internet use in adolescents has been shown to significantly increase over the past few years, with the COVID-19 pandemic lockdowns reinforcing this phenomena globally. We sought to explore whether problematic internet use in specific countries was related to emotional well-being and importantly whether this is predicted by psychological distress. There is a growing number of studies showing that problematic internet use is increasingly prevalent in countries with emerging economies, however we have yet to find out to what extent other factors are influencing this behaviour in adolescents and young people. This study invited young people from countries such India, Mexico, Philippines and Turkey to complete a set of self-reports on their daily internet habits, social media use, alongside questions on psychological distress, self-esteem, loneliness and escapism. A total of 1182 young people aged between 16 – 25 years old completed these questionnaires online. The results showed that there were significant difference in problematic internet use scores among adolescents in the Philippines and Turkey. More specifically, social media use was significantly higher amongst young people from the Philippines whereas gaming addiction was significantly high in the Turkish sample. These findings also revealed that psychological distress, loneliness, and low self-esteem consistently predicted problematic internet use. Taken together these results emphasise that there are several factors underlying growing figures of problematic internet use in young people, these factors include emotional distress, need for escapism, loneliness, and social media use, however, going forward more nuanced cultural differences should also be considered.
... Di antara mereka, 6% atau 10 juta adalah pecandu berat. Berbeda dengan (Mak et al., 2014) melakukan penelitian lain di 6 negara asia pada tahun 2013 -2014 . Mereka mensurvei 5366 responden yang menggunakan young's internet addiction test. ...
Article
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ABSTRAK:Latar Belakang: Penggunaan Internet yang berlebihan saat ini menyebabkan masalah yang disebut Internet Addiction Disorder (IAD) atau kecanduan internet. Adiksi internet adalah seseorang yang tidak mampu mengontrol diri untuk menggunakan internet, yang dapat menyebabkan gangguan kesehatan fisik, psikis, maupun kemampuan sosialisasi, dam perubahan pola makan yang mengakibatkan berubahan status gizi. Akses internet yang mudah merupakan faktor utama dalam kecanduan internet dan dapat mengubah gaya hidup. Karena kampus menyediakan fasilitas Internet gratis dan tidak ada pengawasan orang tua, risiko masalah penggunaan Internet mahasiswa meningkat.Tujuan: Tujuan dari penelitian ini adalah mempelajari hubungan adiksi internet dengan status gizi pada mahasiswa Fakultas Kesehatan Masyarakat, Universitas AirlanggaMetode: Penelitian ini termasuk jenis penelitian obeservasional analitik dengan desain studi cross-sectional. Sampel penelitian ini adalah mahasiswa Fakultas Kesehatan Masyarakat Universitas Airlangga sebanyak 72 mahasiswa. Pengumpulan data adiksi internet menggunakan kuesioner Young’s Internet Addiction Test , status gizi menggunakan perhitungan indeks massa tubuh melalui pengukuran berat badan serta tinggi badan dan analisis data menggunakan uji korelasi Spearman.Hasil: Hasil penelitian menunjukkan terdapat hubungan antara adiksi internet dengan status gizi (p = 0,020;r=-0,274). Berdasarkan penelitian ini, diketahui bahwa semakin seseorang adiksi terhadap internet maka akansemakin tinggi tingkat status gizinya.Kesimpulan: Kesimpulan pada penelitian ini adalah adanya hubungan negatif yang lemah antara adiksi internet dengan status gizi. Hubungan negatif menunjukkan bahwa semakin seseorang memiliki adiksi pada internet yang tinggi maka semakin rendah status gizinya. Penggunaan internet sebaiknya dibatasi terutama pada area kampus dengan cara membatasi akses wi-fi gratis yang hanya dapat digunakan untuk kebutuhan studi, sehingga dapat mencegah terjadinya permasalahan kesehatan secara psikis dan fisik.Kata kunci: adiksi internet, status gizi, mahasiswa
... Among the Middle Eastern countries, a survey in Iran indicated that approximately 72% of the Iranian populations were using the Internet in 2017. Furthermore, more than 80% of the adolescent population aged 12 to 19 used the Internet at least 5 days per week (17). ...
Article
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Appearance of different kinds of physical and social pain among students is expectable. Long time sitting and absence of enough physical activity and having various types of stress are the main reasons for those issues. With attention to the new lifestyle of individuals and long term using of internet, there is a need to manage the behavior of students to prevent from those issues. Principal leadership could be considered as a practical method for this matter. This paper has tried to review the literature and highlight the previous findings about this topic. The findings of this paper showed that, leadership has an important impact on controlling the behavior of students and it could be useful to prevent from future issues.
... A study conducted in six Asian countries reported the prevalence of IA varies from 5% to 21%. 8 Even within the same country, there is a marked difference in the prevalence of IA due to diverse screening scales with inconsistent cutoff scores. For example, studies conducted across various parts of the Indian subcontinent revealed variable prevalence estimates of IA among college students (5% to 46.7%). ...
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Background The internet is an integral part of everyone’s life. College going adolescents are highly vulnerable to the misuse of the internet. Aims To estimate the pooled prevalence of internet addiction (IA) among college students in India. Methods Literature databases (PubMed, Web of Science, Scopus, EMBASE, PsycINFO and Google Scholar) were searched for studies assessing IA using the Young Internet Addiction Test (Y-IAT) among adolescents from India, published in the English language up to December 2020. We included studies from 2010 to 2020 as this is the marked era of momentum in wireless internet connectivity in India. The methodological quality of each study was scored, and data were extracted from the published reports. Pooled prevalence was estimated using the fixed-effects model. Publication bias was evaluated using Egger’s test and visual inspection of the symmetry in funnel plots. Results Fifty studies conducted in 19 states of India estimated the prevalence of IA and the overall prevalence of IA as 19.9% (95% CI: 19.3% to 20.5%) and 40.7% (95% CI: 38.7% to 42.8%) based on the Y-IAT cut-off scores of 50 and 40, respectively. The estimated prevalence of severe IA was significantly higher in the Y-IAT cut-off points of 70 than 80 (12.7% (95% CI: 11.2% to 14.3%) vs 4.6% (95% CI: 4.1% to 5.2%)). The sampling method and quality of included studies had a significant effect on the estimation of prevalence in which studies using non-probability sampling and low risk of bias (total quality score ≥7) reported lower prevalence. The overall quality of evidence was rated as ‘moderate’ based on the Grading of Recommendations Assessment, Development and Evaluation criteria. Conclusions Our nationally representative data suggest that about 20% to 40% of college students in India are at risk for IA. There is a need for further research in the reconsideration of Y-IAT cut-off points among Indian college students. PROSPERO registration number CRD42020219511.
... There exists a rich collection of local internet addiction studies. Of these, a handful of internet overdependence studies targeting primary, secondary school students, college, and university students were reported (2)(3)(4)(5)(6)(7)(8)(9). Often, the emphasis of these studies was placed on the variables that were linked to internet overdependence, however, less attention has been paid to researching its consequences and implications. ...
Article
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Overdependence on the internet is a grave concern that has enveloped Malaysian youths which could lead to a variety of sequelae. This narrative review aims to determine the definition of internet overdependence and its associated factors, as well as the potential preventive and treatment strategies for internet overdependence. From the literature, internet overdependence is regarded as a 3-factor model encompassing salience, self-control failure, and serious consequences. Sociodemographic factors such as age, gender, and ethnicity, as well as psychosocial factors such as depression, anxiety, stress, and loneliness, were found to be associated with internet overdependence among Malaysian youths. A multimodal treatment approach is recommended by the implementation of various types of treatments, integrating disciplines such as pharmacology, psychotherapy, and family counseling. Despite various terminologies being used and unclear conceptualization of its nomenclature, overdependence on the internet is prevalent among youths in Malaysia. Future research should go toward establishing a clear definition of its terminology and attaining more robust evidence on treatment strategies.
... Digital technology offers a broad range of functions, facilitating access to the internet and social networks, instant and text message exchange, multimedia, and entertainment. Despite unambiguous advantages such as easy access to information and fast communication, overuse of digital technology is prevalent in children and adolescents because of its powerful potential for diversion and escape from daily life [2,3]. This is becoming a major public health concern with adverse effects on physical health, psychological well-being, and academic achievement in adolescents [4][5][6]. ...
Article
Background The use of digital technology such as mobile phones is ubiquitous in adolescents. However, excessive use may have adverse health effects, possibly partially mediated by disruptions to sleep. Objective This study aims to assess the social predictors of digital technology use and their cross-sectional association with BMI z scores and being overweight in a large sample of adolescents. Methods We used baseline data from a subset of a large adolescent cohort from 39 schools across Greater London who participated in the Study of Cognition, Adolescents and Mobile Phones (n=1473). Digital technology use included phone calls, internet use on mobile phones, and video gaming on any device. Multilevel regression was used to assess the associations between digital technology use and age-specific and sex-specific BMI z scores and being overweight (including obesity). Measurements were derived from height and weight, obtained by the Tanita BC-418 Body Composition Analyzer. We examined whether these associations were mediated by insufficient sleep. Results Generally, participants with lower socioeconomic status reported more use of digital technology. Controlling for socioeconomic status, internet use on mobile phones for more than 3 hours per day was associated with higher BMI z scores (adjusted β=.30, 95% CI 0.11-0.48) and greater odds of being overweight (adjusted odds ratio 1.60, 95% CI 1.09-2.34), compared with low use (≤30 minutes). Similar associations were found between video gaming and BMI z scores and being overweight. The BMI z score was more strongly related to weekday digital technology use (internet use on mobile phones and video gaming) than weekend use. Insufficient sleep partly mediated the associations between digital technology use and BMI z scores (proportion of mediation from 8.6% to 17.8%) by an indirect effect. Conclusions We found an association between digital technology use and BMI in adolescents, partly mediated by insufficient sleep, suggesting that the underlying mechanisms may be multifactorial. Further research with longitudinal data is essential to explore the direction of the relationships.
... Examples include such as online gaming, downloading films and music, online shopping and gambling. 1, 11 Presently, internet addiction can be diagnosed based on 8 diagnostic questions; as such, giving responses to these queries can reveal the individuals' type of internet addiction. 12, 13 Pathological internet addiction is more common among college and university students. ...
Article
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BACKGROUND: Technology evolution and internet availability has brought several innovations in the field of science and technology. With these advances, internet addiction is appeared as serious obsessive conditions that have numerous dreadful effects on human physical and mental health. OBJECTIVE: To determine the level of internet addiction among medical undergraduate students of Isra University, Hyderabad. METHODOLOGY: Cross sectional survey was conducted at the Isra University, Hyderabad from August 2018 to January 2019. All medical (MBBS) undergraduate students of either sex were included. Stratified sampling technique is used for selection of participants. A structured questionnaire for internet addiction was used for collection of participant's information. One way ANOVA and students t-test was used to analyze the gathered data. RESULTS: Total 263 undergraduate medical students participated in the study. Majority (56.65%) of them were male while over half (51.71%) of them were from age group 21-22 years. Over two-third (85.17%) participants were found to be internet addict. Of these internet addicts, 63.84% were mild or minimal internet addict while 12.05% were severely addict participants. There was a statistically significant difference (p<0.05) was observed between gender, age groups, year of study and current residential status of participants. CONCLUSION: Internet addiction is high prevalent among undergraduate medical students especially those belongs age group (19-20) years and males are mainly addicted to internet.
... People's need for connectivity and internet usage climbed from about 6.5% to 43.0% worldwide between 2000 and 2015; there was a sevenfold increase [1]. With this phenomenon, smartphones have become indispensable for most young people [2,3], and smartphone addiction has also increased, especially among adolescents [4][5][6][7]. According to the 2019 survey on smartphone overdependence, one in three teenagers aged 10-19 was addicted to smartphones in South Korea at that time [8]. ...
Article
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Background: Smartphone addiction among children and adolescents has a negative effect, as excessive use of smartphones can cause physical symptoms, such as fatigue, indigestion, and sleep problems, as well as psychopathological problems, such as depression, anxiety, and impulsiveness. Materials and Methods: This study was carried out using the Korean Children and Youth Panel Survey 2019 conducted by the National Youth Policy Institute. The total number of participants was 4656 youths (2290 in grade 5 and 2366 in grade 8), and the dependent and independent variables were smartphone addiction in children and parents, respectively. Multiple regression analysis was conducted by Stata 15.0 SE. Results: First, the level of parents’ smartphone addiction affected that of children and adolescents. Second, the children’s and adolescents’ age affected the level of smartphone addiction, while their gender did not affect it. Third, the relationship between the levels of parents’ and children’s smartphone addiction was not moderated by the genders and ages of the children and adolescents. Conclusions: It was confirmed that as parents’ smartphone addiction increased, that of children increased, and smartphone addiction was found to increase in the second grade of middle school (12 years old) rather than grade 5 of elementary school (10 years old). Parents’ and children’s smartphone addiction was not moderated by children’s and adolescents’ gender and age.
... 1 Other terms used interchangeably with PIU in the literature are "Internet addiction," "compulsive Internet use," and "pathological Internet use." 2 PIU is associated with a range of negative health outcomes, including poor mental health, reduced physical activity, bad eating habits leading to obesity and diabetes, [3][4][5][6][7] impaired cognition, poor academic performance, reduced sleep time, 8 tendency to sleep late, insomnia disorder, [9][10][11][12] and daytime fatigue and drowsiness, 13 which explains the growing attention in PIU. 14 The global prevalence of PIU among students varied greatly between studies; 40% in Jordan, 34% in India, 15% in Japan, and 11% in China. 15 The discrepancy in the prevalence of PIU between studies could be due to the use of different target populations, measurement tools, sampling methods, study sites and timeframe, and access to Internet services. In a meta-analysis, the prevalence of PIU was 9.2% in medical students, 12.6% in science and engineering students, and 8.4% in arts students; 16 while another meta-analysis found that PIU prevalence was 30.1% among medical students in China. ...
Article
Background and objectives: The prevalence of problematic Internet use (PIU) in the post-COVID-19 pandemic era is not known. This cross-sectional study aimed to determine the prevalence of PIU among baccalaureate nursing students (hereafter: nursing students) in the post-COVID-19 era. Methods: A total of 1070 nursing students were consecutively invited to participate in this study from the nursing schools of five universities. PIU and quality of life (QOL) were assessed using the Internet Addiction Test (IAT) and the World Health Organization Quality of Life Scale Brief Version (WHOQOL-BREF), respectively. t Tests, χ2 , tests, and Kruskal-Wallis tests were used to compare basic demographic and clinical characteristics between participants with and without PIU. Binary logistic regression analysis was used to examine independent correlates. Results: The prevalence of PIU was 23.3% (95% confidence interval [CI]: 20.7%-25.8%). Multiple logistic regression analysis revealed that second- (p = .024) and third-year (p = .012) students were more likely to suffer from PIU compared with first year students. Students with more severe depressive (p = .014) and anxiety symptoms (p = .011) were independently and significantly associated with more severe PIU. After controlling for covariates, nursing students with PIU had a lower overall QOL score (p = .002). Conclusion and scientific significance: Problematic Internet use (PIU) was common among nursing students in the post-COVID-19 era. Considering the negative impact of PIU on QOL and academic performance, regular screening should be conducted and effective interventions implemented for nursing students with PIU. This was the first study on the prevalence of PIU among nursing students in the post-COVID-19 era. The findings of this study could help health professionals and education authorities to understand the patterns of PIU and its influence on QOL among nursing students and to allocate health resources and develop effective measures to reduce the risk of PIU in this population.
... As a secondary prevention measure, the Ministry of Culture proposed the Comprehensive Prevention Program Plan for Minors' Online Gaming Addition in 2013 and highlighted conducting research on prevalence, diagnostic tools, and addiction development models as one of the major measures. The central and local governments have funded independent research undertaken by various institutes, such as the National Key Laboratory of Cognitive Neuroscience and Learning at Beijing Normal University and the School of Public Health and Primary Care at the Chinese University of Hong Kong, to investigate the prevalence of IA across multiple regions in China (Li, 2013;Li, Zhang, Lu, Zhang, & Wang, 2014;Mak et al., 2014;Wang, Wu, & Lau, 2016). Gaming disorder or Internet gaming addiction is a recognized disorder in mainland China, and affected individuals may seek treatment at specialist outpatient clinics at public hospitals. ...
Chapter
Although digital media use confers many personal and social benefits, it is recognized that unrestricted and habitual use can have major negative health consequences, particularly for young people. Problematic gaming in its most serious form, for example, is recognized as an addictive disorder by the World Health Organization. In recent years, there have been calls from researchers and clinicians to also recognize problematic use of a range of online activities (e.g., social media, online shopping, pornography) in mental disorder classification systems, including the DSM-5 and ICD-11. There are continuing debates on the nature and prevalence of these potential conditions in the general population and in special populations (e.g., adolescents, individuals with preexisting disorders). At the same time, some jurisdictions have introduced various public health measures to attempt to respond to these problems. One of the larger areas of literature on interventions has been the study of treatments for gaming disorder, notably cognitive-behavioral therapies. In East Asia in particular, there have been broad prevention measures introduced to address less serious but nevertheless harmful digital technology use. This chapter will review and discuss the literature on interventions for digital technology-based problems, recognizing that the optimal approach to these problems may often entail the coordinated efforts of different areas of influence ranging from families and peers, schools, health providers, government bodies, and the industries that provide online content.
... One study showed that the fear resulting from the COVID-19 disease, and the consequences of home quarantine have been mounting affecting individuals' behaviors. As a result, the prevalence of online gaming disorder among Chinese teenagers Frontiers in Psychiatry | www.frontiersin.org is relatively high (33). Isolated populations use the Internet and social media for longer periods due to mobility constraints, which increases the risk of Internet addiction. ...
Article
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Background Strict quarantines can prevent the spread of the COVID-19 pandemic, but also increase the risk of mental illness. This study examined whether the people who have experienced repeated home quarantine performance more negative emotions such as anxiety, depression, and post-traumatic stress disorder (PTSD) in a Chinese population. Methods We collected data from 2,514 participants in Pi County, Chengdu City, and stratified them into two groups. Group 1 comprised 1,214 individuals who were quarantined only once in early 2020, while Group 2 comprised 1,300 individuals who were quarantined in early 2020 and again in late 2020. Both groups were from the same community. The GAD-7, PHQ-9, and PCL-C scales were used to assess symptoms of anxiety, depression, and PTSD between the two groups. Results Analyses showed that total PHQ-9 scores were significantly higher in Group 2 than in Group 1 ( p < 0.001) and the quarantine times and age are independent predictors of symptoms of depression ( p < 0.001). The two groups did not differ significantly in total GAD-7 or PCL-C scores. Conclusion Increasing quarantine times was associated with moderate to severe depression symptoms, but not with an increase in symptoms of anxiety or PTSD.
... Although the Internet has many educational benefits, excessive usage may result in negative consequences such as medical and neurological difficulties, psychological instability, social isolation, and poor academic performance [6] . Internet addiction has sparked widespread alarm and has been identified as one of the greatest public health threats, especially among teenagers [8] . ...
Article
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Background: Use of the Internet, computers, smartphones, and other electronic devices has dramatically increased over recent years, and this increase is associated not only with tremendous benefits to the users but also with documented cases of excessive use, which has negative health consequences. In many countries, the problem has reached the magnitude of a significant public health concern. Objective: This study aimed at estimating the prevalence of Internet addiction among Egyptian medical students and its relation to their depression, anxiety and stress. Results: Across sectional study including 678 medical students. Their age ranged from 17 – 24 years, 41.4% of them were males. The participants were subjected to a self-administered questionnaire that included personal data, family history and their previous year academic degree, compulsive Internet use scale (CIUS) was used, and also Depression Anxiety Stress Scale-21 (DASS -21) was used for assessing anxiety, depression, and stress. Problematic Internet use (PIU) among the participant students was 68.3%, PIU was significantly associated with increased family income, depression, anxiety and stress were also associated with PIU with odds ratio [1.57 (1.11 – 2.22), 1.65 (1.11 – 2.43), 1.48 (1.03 – 2.12)] respectively. Conclusion: The high prevalence of problematic internet use (PIU) among medical students in Menoufia University is a matter of concern that is also associated with stress, anxiety, and depression as well as its negative impact on their academic achievement. It is important to plan comprehensive programs to raise public awareness about the hazards and introducing awareness and treatment services in primary health care facilities. Keywords: Anxiety, Depression, Internet addiction, Medical students, Stress.
... Bangladesh (32.6%) and the Philippines (21.0%). [7][8][9][10] Its prevalence is also increasing in the Western countries. 11 The COVID-19 pandemic had unprecedented social, economic, and healthcare consequences, and it caused widespread psychological issues. ...
Article
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Background : The restricted movement period related to COVID-19 has presumably contributed to the deterioration of the Internet addiction crisis. Therefore, this study aimed to determine the prevalence of Internet addiction and identify the factors associated with the increase in severity of Internet addiction among the general population of Bangladesh during the COVID-19 related restricted movement period. Methods : We conducted a cross-sectional online survey in Bangladesh from September 20 to October 5, 2020, and 315 Bangladeshi adults were included in the study. We used Young’s Internet Addiction Scale to assess the prevalence of Internet addiction and identified the factors associated with the increase in severity of Internet addiction during the restricted movement period using multivariable logistic regression analysis. Results : The overall prevalence of Internet addiction was 39.7% among the general population of Bangladesh during the restricted movement period. Almost 75% of the respondents reported increased time spent on recreational use of the Internet during the period of interest, and 48.5% of the respondents reported increases in the severity of Internet addiction. In logistic regression analyses, the increase in severity of Internet addiction was found to be significantly associated with social class, occupation, sleeping hours, and increased time spent on recreational use of the internet (p < 0.05). Watching movies/series was the main activity of the respondents during the restricted movement period. Conclusion : Our study reported an increase in the prevalence of Internet addiction among the general population of Bangladesh during the restricted movement period. Social class, occupation, sleeping hours, and increased time spent on recreational use were the significant determinants of the increase in severity of Internet addiction. The policymakers should undertake tailored policies to prevent people from being victims of the consequences of psychological issues in the long run.
... Access to Internet sites is no longer dependent on computer availability. Today between 45 and 95% of adolescents across the USA, Europe, and Southeast Asia report having their own smartphones with many reporting being online "constantly" and not being able to go more than a day without accessing their smartphone (Anderson & Jiang, 2018;Mak et al., 2014;Mascheroni & Ólafsson, 2016;Statistica, 2019). Moreover, the age of smartphone ownership continues to fall, now approximating age 10 years in some countries (Howard, 2017;Influence Central, 2016). ...
Article
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Youth bullying is a global public health problem; Internet addiction is on the rise globally among youths. Because the linkage between these behaviors has not been clearly explicated, this integrative review evaluated the relevant empirical evidence. A search of five electronic databases identified 2,761 original citations published between January 2000 and May 2019. After further abstract screening and detailed evaluation of 262 full-text articles, the final sample consisted of 14 prospective descriptive studies representing 10 countries. Review results clearly established that the relationship between bullying and Internet addiction is firmly supported; less is known as to the contribution of gender, age, and other demographic variables, their impact on health outcomes, problematic behaviors, and the role of parental mediation. Inconsistent definitions and instrumentation and lack of sophisticated study designs limited the synthesis of findings. Future research is needed to explicate these relationships, so data-driven interventions can be developed.
... More specifically, prior studies using other instruments have found that the prevalence rates were different between Western and non-Western countries. For instance, a higher prevalence of internet use disorder has been reported among individuals in Asian countries (e.g., 51% in Philippines, 48% in Japan, 27% in Bangladesh, 20% in Iran, and 50% in Pakistan) (Ansar et al., 2020;Cheng & Li, 2014;Hassan et al., 2020;Lozano-Blasco et al., 2020;Mak et al., 2014;Modara et al., 2017) than among Western countries (e.g., 2% to 8% among European countries of Germany, Italy, Romania, Estonia and Spain; Cheng & Li, 2014;Lozano-Blasco et al., 2020). Such differences could be attributed to cultural beliefs and modesty standards. ...
Article
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The Internet Disorder Scale-Short Form (IDS9-SF) is a validated instrument assessing internet disorder which modified the internet gaming disorder criteria proposed in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). However, the relationships between the nine items in the IDS9-SF are rarely investigated. The present study used network analysis to investigate the features of the IDS9-SF among three populations in Bangladesh, Iran, and Pakistan. Data were collected (N = 1901; 957 [50.3%] females; 666 [35.0%] Pakistani, 533 [28.1%] Bangladesh, and 702 [36.9%] Iranians) using an online survey platform (e.g., Google Forms). All the participants completed the IDS9-SF. The central-stability-coefficients of the nine IDS9-SF items were 0.71, 0.89, 0.96, 0.98, 0.98, 1.00, 0.67, 0.79, and 0.91, respectively. The node centrality was stable and interpretable in the network. The Network Comparison Test (NCT) showed that the network structure had no significant differences among Pakistani, Bangladeshi, and Iranian participants (p-values = 0.172 to 0.371). Researchers may also use the IDS9-SF to estimate underlying internet addiction for their target participants and further explore and investigate the phenomenon related to internet addiction. Supplementary information: The online version contains supplementary material available at 10.1007/s12144-022-03284-8.
... Adolescents scoring 58 or above are classified as having PIU (Zhou et al., 2018). The CIAS-R has achieved high split-half reliability, test-retest reliability, and convergent validity among Chinese adolescents (Chen et al., 2003;Mak et al., 2014). The Cronbach's alpha values of the five subscales were 0.87, 0.87, 0.82, 0.90, and 0.83. ...
Article
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Background During the COVID-19 pandemic, the transition of online learning introduces challenges for adolescents to engage in learning. The increased access and persistent Internet use could heighten the risk of problematic Internet use (PIU) that has been increasingly recognized as a risk factor for academic engagement. This study aims to investigate the direct and indirect relationships between PIU and academic engagement through psychopathological symptoms (i.e., depression, anxiety, insomnia) in early, middle, and late adolescence. Methods In all, 4852 adolescents (51.5% females; Mage = 13.80 ± 2.38) from different regions of Chinese mainland participated in the study and completed questionnaires. Results Depression and then insomnia as well as anxiety and then insomnia mediated the relationship between PIU and academic engagement. Anxiety exhibited a double-edged effect, that is, a positive relation with academic engagement directly and a negative relation with academic engagement indirectly through insomnia. Multigroup analyses showed that the indirect effects of PIU on academic engagement through depression and subsequent insomnia in middle and late adolescence were stronger than that in early adolescence, whereas the direct effect in early adolescence was stronger than that in middle adolescence. Limitation This study was cross-sectional in design and relied upon self-report measures. Conclusion These findings improve the understandings of how PIU relates to academic engagement through psychopathological symptoms and highlight developmental differences of adolescence.
... Males has been repeatedly claimed to be a risk factor for Internet addiction (35,36). Serval previous investigations showed that males had a higher prevalence of mild and severe Internet addiction than females (37)(38)(39). The higher prevalence of Internet addiction in boy students may be due to less limitation and supervision from parents. ...
Article
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Background and purpose: Virtual social networks (VSNs) are among the most popular communication paths that have become an integral part of most people's lives, including students. This study aimed to investigate the prevalence of VSNs addiction and their related factors, and identify the patterns of addictive-related factors among the students in Kerman, Iran in 2019. Materials and Methods: This cross-sectional study was conducted on 400 students from Kerman University of Medical Sciences. The study instrument was a standardized questionnaire. Descriptive analysis, logistic regression models, and latent class analysis were used to analyze the data. The data were analyzed using SPSS26, Stata12 and WinLTA (v. 3.1) software. Results: 50% of the participants were male, staying in dormitory. The number of individuals in the levels of education in the four groups was equal. Around 0.5% of the students were addicted and 36.5% were at the risk of addiction to VSNs. The most commonly used VSNs was the Telegram (76.8%), and most students (28.8%) spent between 2-3 hours a day on VSNs. In the multivariate model, using 1-2 hours (AOR = 3.33, 95% CI: 1.07 - 10.19), 2-3 hours (AOR = 7.33, 95% CI: 2.50 - 21.52) and more than 3 hours a day (AOR = 18.54, 95% CI: 6.05 - 56.8) of VSNs were associated with an increased odds of being at the risk of VSNs addiction. The Latent Class Analysis showed that high-risk addictive factors including using Telegram for entertainment, providing accommodation in the dormitory, and having a graduate degree significantly influenced the classification. Conclusion: More than one-third of Kerman college students were found to be at the risk of VSNs addiction. Providing appropriate interventions including alternative activities as well as raising knowledge especially for undergraduate students is urgently needed.
... We described the prevalence of IGA in Chinese teenagers before testing the aforementioned model. The current sample had 7.69% of participants who were addicted, which is consistent with the previous researches of "rates of possible IGD among Adolescents in China ranged between 2% and 17%" [27][28][29][30]. It is possible that this is due to the fact that the individuals in the current study are younger than those in the study by Yu and colleagues [27]. ...
Article
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Adolescent internet gaming addiction (IGA) has become a serve public health problem, particularly in China. Despite the fact that the school climate has a significant impact on teenage IGA, little research has looked into the underlying mediating processes. This cross-sectional study looked at the impact of adolescents’ perceptions of their school climate (including teacher–student support, student–student support, and opportunities for autonomy) on IGA in a sample of 1053 Chinese adolescents (Meanage = 13.52 years; 52.4% females) using convenient sampling methodology, as well as whether deviant peer affiliation mediated this association. Adolescents’ school climate, IGA, and deviant peer affiliation were examined using the School Climate Questionnaire, Internet Gaming Addiction Scale, and two validated tools in this study. The results showed that teacher–student support and student–student support were both negatively associated with IGA, and that these correlations were mediated by deviant peer affiliation. The implications of these findings are discussed.
... The pervasiveness of Internet use by teens (Anderson & Jiang, 2018;Lenhart, 2015) provides a microcosm in which to observe teen social behaviours, including risk-taking behaviours. Examinations of adolescent Internet use have documented relatively high rates of problematic behaviours online (Durkee et al., 2016;Hinduja & Patchin, 2008;Kormas et al., 2011;Lopez-Fernandez & Kuss, 2020;Mak et al., 2014;Mikami et al., 2010;Moreno et al., 2009). Two areas of online risk-taking behaviours of increasing concern are that of cyberbullying (Kowalski et al., 2014) and sexting (Klettke et al., 2014;Korenis & Billick, 2014). ...
Article
This study explored the role of caregivers in promoting Internet safety among adolescents (n = 58; 13–16 years old) diagnosed with attention‐deficit/hyperactivity disorder in the United States. Teen participants reported their cyberbullying and sexting behaviours and their parents’ knowledge and monitoring of their online activities; parent‐reported opposition‐defiant disorder symptoms were also collected. Teens reported their parents monitored their Internet behaviours in a variety of ways; however, the only variables associated with decreased online risk behaviours were the teens’ perception of their parents’ general knowledge of their online engagements. Parent‐reported teen oppositional behaviours did not alter results. Cultivating communicative parent–teen relationships may be the most beneficial strategy in promoting online safety.
... Surveys conducted among university students in Tunisia with mild and moderate internet addictions were 37.8% and 50.6%, respectively [16]. Problematic internet use (mild and moderate internet addiction) was detected among 76%, which was found to be higher when compared to studies conducted on adolescents aged between 12 and 18 years in the Philippines, which found that Problematic Internet Use was prevalent by (46%) and in Malaysian students (35.1%) [17]. This difference may be attributed to the different age groups being sampled. ...
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... The severity of internet addiction was measured by the Revised Chen Internet Addiction Scale (Cronbach's alpha = 0.92) (Mak et al., 2014). This scale comprises 26 four-point items for compulsive use, withdrawal, tolerance symptoms of Internet addiction, interpersonal and health-related problems, and time management problems. ...
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... As IGD has become a global public health issue, it has been included in the updated version of the Diagnostic and Statistical Manual Disorders (DSM-5) and the International Classification of Diseases (ICD-11) and is thus attracting enormous attention from researchers [3,4]. Due to the differences in measurement tools, the rates of possible IGD among adolescents in China ranged between 2% and 17% [5,6]. IGD has serious adverse effects on youth and adolescents because it not only leads to a variety of externalizing problems (e.g., academic dysfunction, poor sleep quality, substance use) but also causes a1111111111 a1111111111 a1111111111 a1111111111 a1111111111 internalizing problems (e.g., anxiety, depression) among adolescents [7,8]. ...
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... According to a study conducted by Kaess et al. (2014) with the participation of 11 countries in Europe, the prevalence of internet addiction in adolescents is 4.2% while the rate of adolescents in the risk group is 13.4%. Another study involving adolescents from 6 countries of Asia indicates that internet addiction rates among adolescents range from 1.2% to 4.9% (Mak et al., 2014). Besides these, a study conducted with high school students in the United States shows that the prevalence of internet addiction is 4% (Liu et al., 2011). ...
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Problematic Internet use (PUI) has become of increasing interest in mental health. Despite the rising number of PUI in all ages, the exact underpinning etiology is still missing. There is increasing evidence that, in particular, genetic, environmental, and personality factors are involved in the development and maintenance of PUI. However, the neurobiological mechanism of PUI has not been yet extensively investigated, and still reports conflicting results. Previous studies have focused on candidate genes, mainly of the serotonergic, dopaminergic, or acetylcholinergic pathways known partly as risk factors in other substance-use disorders. This review focuses on preexisting literature on the genetic basis of PUI, and implications for future research approaches to fill the gap of its etiology. Understanding the exact etiology and potential genetic mechanism is the basis for a better understanding of PUI and future therapy implications.
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Objectives We investigated the association between maternal depression trajectories from pregnancy until 2 years postpartum, and problematic internet use in children at nine years of age. Methods A total of 1132 mother-child pairs from the Panel Korea Study for Children were used. Maternal depression was assessed repeatedly using the Kessler scale (K-scale) (during pregnancy, and at 6, 12, and 24 months of age). Problematic internet use was assessed in children 9 years old using the K-scale. The children's behavioral problems were assessed using the Child Behavior Checklist at nine years old. Latent profile analysis was used to identify the group trajectories of maternal depression. We compared the severity of problematic internet use of the children according to the maternal depression trajectories. We also identified behavioral problems in children with problematic internet use in each maternal depression trajectory. Results Trajectory analysis identified three group trajectories of maternal depression: no symptoms (n = 478), mild symptoms (n = 534), and moderate symptoms (n = 120). The mild and moderate maternal depression trajectory groups were more associated with high-risk internet use in 9-year-old children compared to the non-depressed group. In children with high-risk internet use, more severe behavioral problems were reported when their mothers had depression. Conclusion Maternal depression up to two years after childbirth affected problematic internet use in middle childhood.
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Aim: This study investigated the association between Internet Addition (IA) and fatigue, sleep disturbance, depression, and life style factors among school children. Subjects and Methods: A cross-sectional survey was conducted on 1366 intermediate and secondary school students in Istanbul. The study included socio-demographic, Internet Addiction (IA) test, Fatigue Scale, Epworth Sleepiness Scale [ESS], depression, anxiety and stress (DASS21), test lifestyle and dietary habits. Results: The overall prevalence of IA among school children was 22.8%. The IA score was significantly higher among males (53.7%) than in females (46.3%; p = 0.028), significantly associated with school performance (p = 0.006) and family income (p = 0.024). Also, students with IA reported significantly less hours of sleep (6.21 ± 0.87 vs. 6.51 ± 1.29; p < 0.001), higher internet use (hours spent: 3.82 ± 1.64 vs. 3.03 ± 1.64; p < 0.001), when compared to the healthy ones. The rates of internet use among students with IA were: gratifying site (17.0% vs. 12.2%; p = 0.028), browsed games (37.3% vs. 30.1%; p = 0.017), chat sites (28.6% vs. 22.7%; p = 0.013), emails (54.3% vs. 62.7%; p = 0.008), and online research (60.8% vs. 693%; p = 0.005). A multivariate stepwise regression has shown that a significantly larger proportion of IA students reported higher internet use than normal subjects (as expected; p < 0.001), more fatigue physical symptoms (p < 0.001), higher Epworth sleepiness score (p < 0.001), more stress (p < 0.001), more fatigue mental symptom (p < 0.001) and sleeping hours (p = 0.008), more depression(p = 0.009), headache (p = 0.018), dizziness (p = 0.024), anxiety (p = 0.047), and game playing problems were significantly associated to their internet addiction (p = 0.050). Conclusion This study suggested the evidence that IA children are vulnerable to physical and mental issues related to their problematic internet use.
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The Digital Revolution is the shift from mechanical and analog electronic technology to digital electronics. One cannot deny the ever- the increasing importance of the internet in today’s world. The internet plays a vital role in communication, education, entertainment, shopping, traveling, etc. The Internet has undoubtedly made life easier. But every coin has two sides. The Internet has also introduced a new type of addiction- Internet Addiction (IA), which is universal in nature. Internet addiction is one of the worst consequences of the Digital Revolution. Adolescence is the most vulnerable age to IA as compared to others. Internet addiction means the overuse of the Internet to the extent that the individual’s daily life collapses. Though Internet Addiction has not officially been included in DSM-V (Diagnostic and Statistical Manual for Mental Disorders, fifth edition), but Internet Gaming The disorder has been included in the appendix of its updated version. This review paper aims to collect information related to internet addiction covering its various aspects including definition, types, prevalence, impact, predicting factors, and treatments. The paper offers a view of a detailed theoretical base and a variety of research in the field.
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Purpose: To examine the associations of excessive internet use with depression, anxiety, and sleep quality among high school students in northern Vietnam, a country experiencing rapid economic growth. Design and methods: A cross-sectional study was conducted in a high school in northern Vietnam from July to September 2019. Symptoms of depression and anxiety were respectively assessed using the Center for Epidemiological Studies Depression Scale and the Vietnamese Anxiety Scale. Sleep quality was measured using the Pittsburgh Sleep Quality Index. Internet use and demographic characteristics were obtained using structured questionnaires. A multiple logistic regression was performed. Results: In total, 678 participants with an average age of 16.1 (standard deviation 0.9) years were included. Nearly one-third of the adolescents (30.7%) exhibited excessive internet use (> 4 h/day), 19.6% experienced depressive symptoms, 14.5% presented anxiety symptoms, and 58.8% reported poor sleep quality. Compared to non-excessive internet users, excessive internet users (> 4 h/day) experienced significantly higher levels of depressive symptoms (p = .001), anxiety (p = .008), and poorer sleep quality (p < .001). Students who were female and with fair/poor self-rated health experienced higher depression, anxiety, and poor sleep quality (p < .05). After adjusting for demographic and health-related factors, students with excessive internet use were 58% more likely to experience poor sleep quality (odds ratio, 1.58, 95% confidence interval [1.06, 2.35]). Conclusions: Excessive internet use in Vietnamese high school students was significantly associated with poor sleep quality, but not with depression or anxiety.
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Utilization of online social networking sites (SNSs) is often problematic in young people. However, studies seldom seek to understand personal differences and deep-seated reasons in its problematic utilization. This study aims to explore the longstanding and recent psychosocial predictors of problematic utilization of WeChat friend center (PUWF) longitudinally. A total of 433 college students (17-25 years old, male/female ratio: 389/44) were investigated over 2 successive years (T1: first year; T2: second year) using the Sixteen Personality Factor Questionnaire, Adolescent Self-Rating Life Events Checklist, Social Support Scale, Patient Health Questionnaire, Connor-Davidson Resilience Scale, and the problematic utilization scale of the WeChat friend center which was developed in this study. Correlation, regression, and structural equation analyses were conducted. A problematic utilization scale of the WeChat friend center was developed with Cronbach's alpha of .836. 21.02% of students reported WeChat PUWF. Males utilized the WeChat friend center less than females, and females were at higher risk of PUWF, which was correlated with worse mental health. In the longitudinal prediction, regression and modeling analyses showed that apprehension of personality predicted PUWF consistently and directly, and this was partially mediated by T1 depression and T2 negative life events. Resultys suggest that females are at higher risk for PUWF. Apprehension personality has a direct and indirect effect on PUWF through recent depression and life events. The findings help to recognize individuals at risk for PUWF as well as to better prevent it, and provide suggestions as to the functional design of SNSs according to different need of users. Core tips: Utilization of SNSs is often problematic in young people. However, personal differences and deep-seated reasons in its problematic utilization has been poorly revealed. Through a longitudinal investigation, this study confirms that females are at higher risk for PUWF. Apprehension personality has a direct and indirect effect on PUWF through recent depression and life events. The findings help to recognize individuals at risk for PUWF and give theoretical evidence to the functional design of SNSs for diferent users. Supplementary information: The online version contains supplementary material available at 10.1007/s12144-022-03150-7.
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The WHO recently included Gaming Disorder as a psychiatric diagnosis. Whether there are distinct groups of adolescents who differ based on severity of gaming disorder and their relationships with other mental health and addictive behavior outcomes, including problematic smartphone use (PSU), remains unclear. The current study explored and identified subtypes of Internet Gaming Disorder (IGD) severity and estimated the association between these subtypes and other disorders. Participants completed online questionnaires assessing the severity of IGD, PSU, depression, and anxiety during COVID-19. We conducted a latent class analysis of IGD symptoms among 1,305 Chinese adolescents (mean age = 15.2; male = 58.5%) from 11 secondary schools in Macao (SAR), China. Multinomial logistic regression estimated correlates of latent class membership and PSU. A 4-class model adequately described the sample subgroups. Classes were labeled as normative gamers (30.9%), occasional gamers (42.4%), problematic gamers (22.7%), and addictive gamers (4.1%). Relative to normative gamers, PSU severity, depression, and being male were significantly higher among problematic gamers, addictive gamers, and occasional gamers. Only problematic gamers showed significant positive associations with anxiety severity compared to the other groups. The study revealed the differences in severity of gaming disorder and its association with psychopathology outcomes. Application in screening for IGD and comorbidity is discussed. Supplementary information: The online version contains supplementary material available at 10.1007/s12144-022-03133-8.
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Background: Background: The effects of behavioral addiction to video gaming (VG) has received increasing attention in the literature given increased use intensity among sub-groups of VG players. Objective: Objectives: This study seeks to determine empirically the relationship between Video Gaming (VG) intensity of use and hedonic experience of the user. Methods: Methods: We conducted a survey of n = 835 individuals who regularly play video games to determine the relationship between Video Gaming (VG) intensity of use and hedonic experience of the user. We divide the sample into four quartiles by self-reported VG addictive symptom level (from the Internet Gaming Disorder Scale) and conduct polynomial regressions separately for each quartile. Results: Results: We find that the higher VG addictive symptom level groups experience a U-shaped (curvilinear) relationship between hedonic experience and intensity of play, whereas groups with lower VG addictive symptom levels exhibit no such relationship. The coefficients that collectively support this result for the highest addictive symptom level group (quartile 4), those representing marginal effects for hours played per week and hours played per week squared, are significantly negative ( p = 0.005 ) and significantly positive ( p = 0.004), respectively. Conclusions: Conclusions: The obtained results are consistent with sensitization and tolerance theories, which suggest that high-symptom groups are expected to experience frustration and disappointment until achieving excessive dopamine release, at which point their hedonic experience is expected to improve in additional play. Conversely, low-symptom groups experience no such fall-and-rise pattern. This result is consistent with the outcome that members of the latter group play the game for the direct experience such that their hedonic experience is more directly related to events occurring in the game than to the increasingly-elusive pursuit of excessive dopamine release. We also find that high-symptom groups spend substantially more time and money to support VG use and are much more likely to engage in VG use at the expense of other important activities, such as work, sleep, and eating. Clinicaltrial:
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Background and Aims Use of technological gadgets has rapidly been increasing among adolescents, which may result in health issues and technology addiction. This study focuses on the prevalence of usage of technological gadgets and health-related complications among secondary school-going children of Bangladesh. Methods A total of 1803 secondary school students from 21 different districts of Bangladesh participated in the study. The children were asked questions relating to their access to electronic gadgets, time spent on outdoor activities, and whether they experienced any health-complications as an after-effect of the usage. A binary logistic regression model was adapted considering time spent on gadgets as an independent variable and health problems (physical and mental) as the dependent variable. Results Among all the gadgets, 67.11% of the participants were reported to use mobile phones on a daily basis. Due to the ongoing COVID-19 pandemic, 24.48% of respondents used electronic gadgets for attending online classes. The participants were reported to use gadgets significantly more (P < .05) in 2020 as compared to 2019. Children showed less tendency to spend time in outdoor activities. More than 50% of the participants spend time doing outdoor activities for less than 1 hour daily. An association between gadget use and health problems like headache, backache, visual disturbance, and sleeping disturbance has been observed in our study. Conclusion This study demonstrates that different socio-demographic factors have influence on the use of gadgets by children, and this use has greatly been affecting both the physical and mental health of the secondary school-going students of Bangladesh.
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Background: Internet gaming disorder (IGD) is an entity of clinical attention prominent among schoolgoing students. The reported nature and extent of Internet gaming varies widely, as does the extent of its effects. Aim: This study aimed to assess the prevalence of IGD and factors associated with it. Methods: After institution ethics approval, individual assent, and parental consent, a cross‑sectional study was conducted among 142 students of a school in western Maharashtra. A specially designed sociodemographic pro forma and IGD Scale were administered to the students. Data thus generated were statistically analyzed and compared with published literature. Results: The prevalence of IGD was 10.6% among 13–19‑year‑old students. It was significantly higher among male students (15.3%) than female students (3.5%). Multivariate logistic regression found IGD to be significantly associated with male gender and lower age at first gameplay. Conclusions: IGD affects a tenth of our schoolgoing population with a male preponderance. Lower age at first gameplay had an adverse association.
Article
With a novel multilingual approach, this cross-cultural meta-analysis study investigated the associations between personality traits and Internet addiction. Articles were identified and retrieved by searching through general and language-specific databases, and thereafter reviewed for inclusion based on the selection criteria. Random effects models with the Hartung-Knapp-Sidik-Jonkman method were used to examine the associations of Internet addiction with seven personality traits: Openness, Conscientiousness, Extraversion, Agreeableness, Neuroticism, Psychoticism, and Lie (OCEAN-PL). Forest plots with summary statistics were produced to inspect the between-study heterogeneity. Subgroup analysis was performed to further determine the contributions of moderators (geographic region, population subgroup, scales for assessing personality traits and Internet addiction, and language of publication) to the observed between-study heterogeneity. Funnel plots and Egger's test were used to detect possible small-study effects. A sample of 34,438 participants from 37 studies (24 from Asia) were included for data analysis. The major languages of publications of the selected articles were English and Asian languages. According to the pooled results, Internet addiction was associated positively with Neuroticism and Psychoticism, but negatively with Conscientiousness, Extraversion, Agreeableness, and Lie. Geographic region and language of publication significantly moderated the associations of Internet addiction with Agreeableness and Neuroticism, and Openness and Extraversion, respectively. No significant small-study effect was present for all OCEAN-PL personality traits, except Neuroticism. In conclusion, the Internet addiction group is relatively more neurotic and psychotic, and less conscientious, extraverted, agreeable, and untruthful than the nonaddiction group. A multilingual approach is useful for improving the search strategies for systematic reviews, cross-cultural meta-analyses in particular.
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Background: Digital competence can help children and adolescents engage with technology for acquiring new knowledge and for broadening social contact and support, while reducing the risk of inappropriate media use. This study investigated the effects of digital competence on the risk of gaming addiction among children and adolescents. We explored whether students with good digital competence were protected from the adverse effects of media use and the risk of gaming addiction. Methods: 1956 students (690 primary and 1266 secondary) completed a digital competence assessment and a self-report questionnaire on their mental health status, use of digital devices, and experiences of cyberbullying. Multiple regression analyses with further mediation and moderation analyses were performed to investigate the association of digital competence with gaming addiction and mental health in children and adolescents. Findings: Regression analyses showed that children and adolescents with better digital competence were less likely to develop gaming addiction (β = -0.144, p < 0.0001) and experienced less cyberbullying behaviour as perpetrators (β = -0.169, p < 0.0001) and as victims (β = -0.121, p < 0.0001). Digital competence was found to mediate the relationship between digital device usage time and gaming addiction. Interpretation: Digital competence is associated with less gaming addiction and could potentially lead to better mental wellbeing by reducing the risks of gaming addiction and cyberbullying. Education that promotes digital competence is essential to maximize the benefits of media use, while reducing the potential adverse effects from the inappropriate use of digital devices.
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This study examines how usage of social media influence political polarization. Using data from the students of different public and private universities of Lahore, this study investigates the association between usage of social media and political polarization and proposes that political engagement and political loyalty can be potential mediators between the relationship of social media usage and political polarization (issue based, leadership based, and party based). Correlation research design was used to collect the data. A sample of 350 students were taken through purposive sampling technique. Smart Partial least square 3.2.7 has been used to analyze and test the conceptual model. Findings show that usage of social media has significant direct effect on political engagement and political loyalty. In addition to this, social media usage is a significant predictor of political polarization. Results further show that indirect effect of social media usage on polarization was mediated by political engagement and party loyalty. We observed that more usage of social media helps the participants to engage in politics and identify themselves with a certain political party. This study has highlighted the role of social media in motivating the users towards political participation. This high-level users' participation on social networking sites is creating ideological divergence. The implications of these findings have been discussed in detail.
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Background and aims: Internet Gaming Disorder, a subtype of Internet Addiction, is now classified in Section 3 of the DSM-5. Cognitive behavioral therapy (CBT) has been suggested in treating Internet addiction as this modality has been shown to be an effective treatment for similar impulse control disorders. Given the daily and necessary use of the Internet and technology in general compared to other compulsive syndromes, a specialized form of CBT has been developed called Cognitive-Behavioral Therapy for Internet Addiction (CBT-IA). CBT-IA is a comprehensive three phase approach that includes behavior modification to control compulsive Internet use, cognitive restructuring to identify, challenge, and modify cognitive distortions that lead to addictive use, and harm reduction techniques to address and treat co-morbid issues associated with the disorder. Methods: As the first model of its kind, this study examines 128 clients to measure treatment outcomes using CBT-IA. Clients were evaluated using the Internet Addiction Test (IAT) to classify subjects and were administered twelve weekly sessions of CBT-IA. Treatment outcomes were measured at the end of the twelve weeks, one-month, three months and at six month post-treatment. Results: RESULTS showed that over 95% of clients were able to manage symptoms at the end of the twelve weeks and 78% sustained recovery six months following treatment. Discussion and conclusions: RESULTS found that CBT-IA was effective at ameliorating symptoms associated with Internet addiction after twelve weekly sessions and consistently over one-month, three months, and six months after therapy. Further research implications such as investigating long-term outcome effects of the model with larger client populations and treatment differences among the subtypes of Internet addiction or with other cultural populations using CBT-IA are discussed.
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Background This study evaluates the association between Internal Addiction (IA) and psychiatric co-morbidity in the literature. Methods Meta-analyses were conducted on cross-sectional, case–control and cohort studies which examined the relationship between IA and psychiatric co-morbidity. Selected studies were extracted from major online databases. The inclusion criteria are as follows: 1) studies conducted on human subjects; 2) IA and psychiatric co-morbidity were assessed by standardised questionnaires; and 3) availability of adequate information to calculate the effect size. Random-effects models were used to calculate the aggregate prevalence and the pooled odds ratios (OR). Results Eight studies comprising 1641 patients suffering from IA and 11210 controls were included. Our analyses demonstrated a significant and positive association between IA and alcohol abuse (OR = 3.05, 95% CI = 2.14-4.37, z = 6.12, P < 0.001), attention deficit and hyperactivity (OR = 2.85, 95% CI = 2.15-3.77, z = 7.27, P < 0.001), depression (OR = 2.77, 95% CI = 2.04-3.75, z = 6.55, P < 0.001) and anxiety (OR = 2.70, 95% CI = 1.46-4.97, z = 3.18, P = 0.001). Conclusions IA is significantly associated with alcohol abuse, attention deficit and hyperactivity, depression and anxiety.
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AimsTo investigate the longitudinal patterns (stability and change) of problematic computer game use and its interdependencies with psychosocial wellbeing in different age groups. DesignThree-wave, annual panel study using computer-assisted telephone surveys. SettingGermany. ParticipantsA total of 112 adolescents aged between 14 and 18 years, 363 younger adults between 19-39 years and 427 adults aged 40years and older (overall n=902). MeasurementsProblematic game use was measured with the Gaming Addiction Short Scale (GAS), which covers seven criteria including salience, withdrawal and conflict. Additionally, gaming behaviour and psychosocial wellbeing (social capital and support, life satisfaction and success) were measured in all three panel waves. FindingsThe generally low GAS scores were very stable in yearly intervals [average autocorrelation across waves and age groups: r=0.74, confidence interval (CI)=0.71, 0.77]. Only nine respondents (1%, CI=0.5, 1.9) consistently exhibited symptoms of problematic game use across all waves, while no respondent could be classified consistently as being addicted according to the GAS criteria. Changes in problematic gaming were not related consistently to changes in psychosocial wellbeing, although some cross-lagged effects were statistically significant in younger and older adult groups. Conclusions Within a 2-year time-frame, problematic use of computer games appears to be a less stable behaviour than reported previously and not related systematically to negative changes in the gamers' lives.
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In the 2000s, online games became popular, while studies of Internet gaming addiction emerged, outlining the negative consequences of excessive gaming, its prevalence, and associated risk factors. The establishment of specialized treatment centers in South-East Asia, the US, and Europe reflects the growing need for professional help. It is argued that only by understanding the appeal of Internet gaming, its context, and neurobiologic correlates can the phenomenon of Internet gaming addiction be understood comprehensively. The aim of this review is to provide an insight into current perspectives on Internet gaming addiction using a holistic approach, taking into consideration the mass appeal of online games, the context of Internet gaming addiction, and associated neuroimaging findings, as well as the current diagnostic framework adopted by the American Psychiatric Association. The cited research indicates that the individual's context is a significant factor that marks the dividing line between excessive gaming and gaming addiction, and the game context can gain particular importance for players, depending on their life situation and gaming preferences. Moreover, the cultural context is significant because it embeds the gamer in a community with shared beliefs and practices, endowing their gaming with particular meaning. The cited neuroimaging studies indicate that Internet gaming addiction shares similarities with other addictions, including substance dependence, at the molecular, neurocircuitry, and behavioral levels. The findings provide support for the current perspective of understanding Internet gaming addiction from a disease framework. The benefits of an Internet gaming addiction diagnosis include reliability across research, destigmatization of individuals, development of efficacious treatments, and the creation of an incentive for public health care and insurance providers. The holistic approach adopted here not only highlights empirical research that evidences neurobiologic correlates of Internet gaming addiction and the establishment of a preliminary diagnosis, but also emphasizes the necessity of an indepth understanding of the meaning, context, and practices associated with gaming.
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Background Internet addiction disorder (IAD) is a novel concept under scrutiny for a definite inclusion in the psychiatric taxonomy, after showing correlations with overt expressions of psychopathology. This study aims to assist the scientific dialogue concerning IAD while presenting comparative data on adolescent psychopathology before and during a major economic crisis that has affected Greece from 2010 onwards. Methods This is a cross-sectional study of a high school student population, aged 12–18, on IAD which follows-up a 2006 survey, and is carried out 5 years later at the same school classes. A comparison on psychopathological symptoms between the two samples is carried out to confirm any underlying correlations with IAD while providing some first insight on any effects of the economic crisis on adolescent psyche. Results Results indicate that Internet addiction is increased in this population paralleling the increase in Internet availability at home. Adolescents affected with IAD present with more psychopathological symptoms. A comparison between the 2006 and 2011 samples reveals lower rates of general psychopathology but similar burden of reported symptoms. Conclusions Those findings are discussed in the framework of adolescent coping to adversity, individual reactions to major crises, as well as the general debate regarding the value of IAD as a distinct diagnosis. The effects of the economic crisis may have triggered an adaptive response in the adolescent population although IAD as a distinct nosological entity is clearly linked to more symptoms of overt psychopathology. Directions are offered for further research in countries affected by crises.
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To investigate prevalence and patterns of psychiatric disorders in young subjects with Internet addiction (IA). Subjects were taken from a sample of patients, aged 10-18 years old, referred to Istanbul Medical Faculty, Child and Adolescent Psychiatry Department due to a variety of behavioral and emotional problems alongside problematic Internet use. Inclusion criteria included IQ ≥70 and score ≥80 on Young's Internet Addiction Scale (YIAS). Psychiatric comorbidity was assessed using the Turkish version of the Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime Version. Subjects were 45 boys (75%) and 15 girls (25%) with an age range of 10-18 years old (mean age, 13.38 ± 1.79 years). A total of 60% (n = 36) had been using Internet for ≥5 years. Mean hours/week spent on the Internet was 53.7 (range, 30-105 h) and the average YIAS score was 85. All subjects (100%) had at least one and 88.3% (n = 53) had at least two comorbid psychiatric disorders. The frequency of diagnostic groups were as follows: behavioral disorder, n = 52 (86.7%); anxiety disorder, n = 43 (71.7%); mood disorder, n = 23 (38.3%); elimination disorder, n = 16 (26.7%); tic disorder, n = 10 (16.7%); and substance use disorder, n = 4 (6.7%). The most common psychiatric disorders were attention-deficit hyperactivity disorder (n = 53; 83.3%), social phobia (n = 21; 35.0%) and major depressive disorder (n = 18; 30.0%). High rates of psychiatric comorbidity, particularly behavioral, anxiety and mood disorders were found in young subjects with IA. Because the presence of psychiatric disorders may affect the management /prognosis of IA, assessment should include that for other psychiatric disorders.
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Background It has been reported that Internet addiction is associated with substance dependence. Eating disorders have high rates of co-morbidity with substance use disorders. The relationship between Internet addiction and eating disorders was reported in a previous study. Aims To examine the hypothesis that Internet addiction is closely associated with bulimia. The hypothesis that depression mediates the relationship between Internet addiction and bulimia symptoms was also tested. Methods 2,036 Chinese college students were assessed on Internet addiction, eating behaviors and depression. Binge eating, compensatory behaviors, weight concern, menarche and weight change were also reported. Multiple regression analysis was used to test the mediating effect of depression. Results Internet addicts showed significantly higher scores on most subscales on EDI-1 than the controls. They reported significantly more binge eating, weight concern and weight change than the controls. Among all of the participants, depression was found to be a partial mediator in the relationship between Internet addiction and bulimia. Conclusion This survey provides evidence of the co-morbidity of Internet addiction and bulimia.
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Aim: In this study, the prevalence and risk factors of Internet addiction in high school students was investigated. Material and method: This cross-sectional study was performed in the Mersin Province in 2012. The study sample consisted of students attending high school in the central district of Mersin. The data were summarized by descriptive statistics and compared by a binary logistic regression. Results: Our study population included 1156 students, among whom 609 (52.7%) were male. The mean age of the students was 16.1 ± 0.9 years. Seventy-nine percent of the students had a computer at home, and 64.0% had a home Internet connection. In this study, 175 (15.1%) students were defined as Internet addicts. Whereas the addiction rate was 9.3% in girls, it was 20.4% in boys (P < 0.001). In this study, Internet addiction was found to have an independent relationship with gender, grade level, having a hobby, duration of daily computer use, depression and negative self-perception. Conclusion: According to our study results, the prevalence of Internet addiction was high among high school students. We recommend preventing Internet addiction among adolescents by building a healthy living environment around them, controlling the computer and Internet use, promoting book reading and providing treatment to those with a psychological problem.
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Objectives: Although there is growing international recognition of pathological technology use (PTU) in adolescence, there has been a paucity of empirical research conducted in Australia. This study was designed to assess the clinical features of pathological video gaming (PVG) and pathological Internet use (PIU) in a normative Australian adolescent population. A secondary objective was to investigate the axis I comorbidities associated with PIU and video gaming. Method: A total of 1287 South Australian secondary school students aged 12-18 years were recruited. Participants were assessed using the PTU checklist, Revised Children's Anxiety and Depression Scale, Social Anxiety Scale for Adolescents, revised UCLA Loneliness Scale, and Teenage Inventory of Social Skills. Adolescents who met the criteria for PVG or PIU or both were compared to normal adolescents in terms of axis I comorbidity. Results: The prevalence rates of PIU and PVG were 6.4% and 1.8%, respectively. A subgroup with co-occurring PIU and PVG was identified (3.3%). The most distinguishing clinical features of PTU were withdrawal, tolerance, lies and secrecy, and conflict. Symptoms of preoccupation, inability to self-limit, and using technology as an escape were commonly reported by adolescents without PTU, and therefore may be less useful as clinical indicators. Depression, panic disorder, and separation anxiety were most prevalent among adolescents with PIU. Conclusions: PTU among Australian adolescents remains an issue warranting clinical concern. These results suggest an emerging trend towards the greater uptake and use of the Internet among female adolescents, with associated PIU. Although there exists an overlap of PTU disorders, adolescents with PIU appear to be at greater risk of axis I comorbidity than adolescents with PVG alone. Further research with an emphasis on validation techniques, such as verified identification of harm, may enable an informed consensus on the definition and diagnosis of PTU.
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We developed a Korean translation of the Internet Addiction Test (KIAT), widely used self-report for internet addiction and tested its reliability and validity in a sample of college students. Two hundred seventy-nine college students at a national university completed the KIAT. Internal consistency and two week test-retest reliability were calculated from the data, and principal component factor analysis was conducted. Participants also completed the Internet Addiction Diagnostic Questionnaire (IADQ), the Korea Internet addiction scale (K-scale), and the Patient Health Questionnaire-9 for the criterion validity. Cronbach's alpha of the whole scale was 0.91, and test-retest reliability was also good (r = 0.73). The IADQ, the K-scale, and depressive symptoms were significantly correlated with the KIAT scores, demonstrating concurrent and convergent validity. The factor analysis extracted four factors (Excessive use, Dependence, Withdrawal, and Avoidance of reality) that accounted for 59% of total variance. The KIAT has outstanding internal consistency and high test-retest reliability. Also, the factor structure and validity data show that the KIAT is comparable to the original version. Thus, the KIAT is a psychometrically sound tool for assessing internet addiction in the Korean-speaking population.
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Objective: This study examined the psychometric properties of the Young's Internet Addiction Test (IAT) in 844 Hong Kong Chinese adolescents (37.7% boys) with mean age of 15.9 (standard deviation = 3.5) years. Methods: Demographic items, Internet use habits, IAT, and the Revised Chen Internet Addiction Scale (CIAS-R) were administered. 3 percent of the participants were classified as addicted and 31.6% as occasional problematic Internet users. Confirmatory factor analysis results indicated that the 18-item second-order three-factor model has the best fit with our data (Satorra-Bentler scaled χ(2) = 160.56, df = 132, p < .05, normed fit index = 0.95, non-normed fit index = 0.99, comparative fit index = 0.99, root mean square error of approximation = 0.02). Results: IAT demonstrated strong internal consistency (Cronbach's α = .93). Satisfactory concurrent and convergent validity of IAT were found moderately correlated with CIAS-R (r = .46) and the average online time per day (r = .40 for weekdays; r = .37 for weekends). Conclusion: IAT has evidence of being a valid and reliable scale for screening Internet addiction in Chinese adolescents.
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Background Internet addiction disorder (IAD) is now recognized internationally and is known to be linked with academic and social impairment. To date, we know little about its associated main biological factors. This study aimed to collect a carefully defined group of adolescents with IAD and an age- and gender-matched typically developing comparison group. We hypothesized that the young people with IAD would have higher rates of self-reported anxiety and depressive symptoms, have altered levels of peripheral blood dopamine, norepinephrine and serotonin. In addition, we hypothesized the hours spent online are correlated with the severity of depression and anxiety among these young people with IAD. Methodology/Principal Finding A cross-sectional study of 20 adolescents who met Beard’s criteria for IAD and 15 typically developing adolescents (comparison group) was conducted. All the participants completed the Self Rating Depression Scale (SDS), Self Rating Anxiety Scale (SAS), and the Screen for Child Anxiety Related Emotional Disorders (SCARED). Peripheral blood dopamine, serotonin and norepinephrine were assayed. The mean level of norepinephrine was lower in the IAD group than that in the typically developing participants, while dopamine and serotonin levels did not differ. The SDS, SAS and SCARED symptom scores were increased in the adolescents with IAD. A logistic regression analysis revealed that a higher SAS score and lower level of norepinephrine independently predicted IAD group membership. There was no significant correlation between hours spent online and scores of SAS/SDS in IAD group. Conclusions/Significance Increased self-reported anxiety and lower peripheral blood norepinephrine are independently associated with IAD.
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Internet addiction (IA) is an emerging social and mental health issue among youths. Analysis of risk factors, as well as their interactions, is crucial for understanding the development of IA. This study investigated the relationship between recent stressful life events, personality traits, perceived family functioning and IA in 892 college students. Subjects were classified into categories (non-addicted, mild IA or severe IA) using the Chen Internet Addiction Scale. Stressful life events, personality traits and family functioning were assessed using the Adolescent Self-Rating Life Events Checklist, the Eysenck Personality Questionnaire, and the Family Adaptability and Cohesion Scale, respectively. The results indicated that compared with non-addicted subjects, subjects with severe IA (9.98%) had lower family functioning, lower extraversion, higher neuroticism and psychoticism, and more stressful life events, and subjects with mild IA (11.21%) had higher neuroticism and more health and adaptation problems. Neuroticism and health and adaptation problems were potential predictors of IA. An interaction effect between psychoticism and total life stress on IA was also found. These findings highlight the role of personality traits and life stress and their interactions in college students' IA. Further research should explore the mechanisms underlying the interaction effect of psychoticism with life stress on IA. Copyright © 2013 John Wiley & Sons, Ltd.
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This study aims: a) to estimate the prevalence of internet addiction among adolescents of urban and rural areas in Greece, b) to examine whether the Internet Addiction Test cut-off point is applicable to them and c) to investigate the phenomenon's association with academic achievement. Participants were 2090 adolescents (mean age 16, 1036 males, 1050 females). Young's (1998) Internet Addiction Test and her Diagnostic Questionnaire were applied. School records' grades were retrieved. A 3.1% prevalence revealed, while boys {F (1, 1642) = 6.207, p < .05}, urban residents {F (1, 1642) = 5.53, p > .05} and academic track high school students {F (1, 1642) = 5.30, p < .05} were at higher risk. An Internet Addiction Test score of 51 points (sample's mean = 27.69, SD = 17.38) was proposed as the optimal cut-off point combining high sensitivity (98%) and specificity (91%). Finally, findings illustrated the syndrome's relation to worse academic achievement {F (1, 1725) = 0.93, p > .05}.
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Background The orbitofrontal cortex (OFC) has consistently been implicated in the pathology of both drug and behavioral addictions. However, no study to date has examined OFC thickness in internet addiction. In the current study, we investigated the existence of differences in cortical thickness of the OFC in adolescents with internet addiction. On the basis of recently proposed theoretical models of addiction, we predicted a reduction of thickness in the OFC of internet addicted individuals. Findings Participants were 15 male adolescents diagnosed as having internet addiction and 15 male healthy comparison subjects. Brain magnetic resonance images were acquired on a 3T MRI and group differences in cortical thickness were analyzed using FreeSurfer. Our results confirmed that male adolescents with internet addiction have significantly decreased cortical thickness in the right lateral OFC (p<0.05). Conclusion This finding supports the view that the OFC alterations in adolescents with internet addiction reflect a shared neurobiological marker of addiction-related disorders in general.
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Internet addiction has become increasingly recognized as a mental disorder, though its neurobiological basis is unknown. This study used functional neuroimaging to investigate whole-brain functional connectivity in adolescents diagnosed with internet addiction. Based on neurobiological changes seen in other addiction related disorders, it was predicted that connectivity disruptions in adolescents with internet addiction would be most prominent in cortico-striatal circuitry. Participants were 12 adolescents diagnosed with internet addiction and 11 healthy comparison subjects. Resting-state functional magnetic resonance images were acquired, and group differences in brain functional connectivity were analyzed using the network-based statistic. We also analyzed network topology, testing for between-group differences in key graph-based network measures. Adolescents with internet addiction showed reduced functional connectivity spanning a distributed network. The majority of impaired connections involved cortico-subcortical circuits (∼24% with prefrontal and ∼27% with parietal cortex). Bilateral putamen was the most extensively involved subcortical brain region. No between-group difference was observed in network topological measures, including the clustering coefficient, characteristic path length, or the small-worldness ratio. Internet addiction is associated with a widespread and significant decrease of functional connectivity in cortico-striatal circuits, in the absence of global changes in brain functional network topology.
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Abstract Many researchers and professionals have reported nonsubstance addiction to online entertainments in adolescents. However, very few scales have been designed to assess problem Internet use in this population, in spite of their high exposure and obvious vulnerability. The aim of this study was to review the currently available scales for assessing problematic Internet use and to validate a new scale of this kind for use, specifically in this age group, the Problematic Internet Entertainment Use Scale for Adolescents. The research was carried out in Spain in a gender-balanced sample of 1131 high school students aged between 12 and 18 years. Psychometric analyses showed the scale to be unidimensional, with excellent internal consistency (Cronbach's alpha of 0.92), good construct validity, and positive associations with alternative measures of maladaptive Internet use. This self-administered scale can rapidly measure the presence of symptoms of behavioral addiction to online videogames and social networking sites, as well as their degree of severity. The results estimate the prevalence of this problematic behavior in Spanish adolescents to be around 5 percent.
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Background: Young's Internet Addiction Test (IAT) is one of the most widely used scales for assessing Internet addiction. Aims: The purpose of the current study was to investigate the value of IAT for subjects clinically diagnosed with Internet addiction. Methods: A total of 52 subjects, whose chief complaint and most serious behavioral problem was Internet addiction, were enrolled at an Internet-addiction clinic associated with a university hospital. The IAT was administered to assess the existence and severity of Internet addiction. Subjects were classified according to the severity guidelines of the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, text revision (DSM-IV-TR) and according to the duration of their Internet addiction. Results: The mean IAT score of our clinical subjects was 62.8 ± 18.2, which was below 70, the cut-off point indicating significant problems. The IAT detected only 42% of the clinical subjects as having significant problems with Internet addiction. No significant differences in IAT scores among those with mild, moderate and severe degrees of Internet addition were found, and no association between IAT scores and duration of illness was observed. Conclusions: IAT scores were not significant correlated with clinical severity and duration of illness in a clinical population. This instrument had limited clinical utility for evaluating the severity of Internet addiction. Considerable caution is required in interpretations of IAT scores.