Abstract 4366436: Internet Addiction and Early-Life Risk Indicators for Cardiometabolic and Mental Health Disorders

Internet addiction is associated with a range of psychological risk factors such as childhood trauma and depression. Studies have also suggested sex differences in internet and other behavioral addictions. However, it remains unclear how childhood trauma, depression and internet addiction inter-relate differently between the sexes. A total of 1749 adolescents and young adults aged 12–27 participated in a survey of sociodemographic characteristics and standardized assessments to evaluate internet addiction (Internet Addiction Test), childhood trauma (Childhood Trauma Questionnaire) and depression (Beck Depression Inventory). Mediation and path analyses were used to examine the relationship between childhood trauma, depression and internet addiction. Internet-addicted females relative to males showed more severe depression but the control participants showed the opposite. Childhood trauma was associated with depression for both internet-addicted males and females; however, internet-addicted females but not males showed significant associations between depression and the severity of internet addiction as well as between childhood trauma and the severity of internet addiction. Further, in females, depression mediated the correlations between all types of childhood trauma and the severity of internet addiction. A path analysis suggested that sexual abuse and emotional neglect contributed most significantly to internet addiction when all types of childhood trauma were examined in one model. The findings suggest sex differences in the relationship between childhood trauma, depression and internet addiction. Childhood trauma contributes to internet addiction through depression only in females. The findings may guide future prevention and intervention strategies of internet addiction.

Background and ObjectivesCOVID‐19‐related quarantine and stress have likely escalated the crisis of Internet addiction. This study aimed to determine the impact of the COVID‐19 pandemic on Internet use and related risk factors among the general public in China.MethodsA large‐sample cross‐sectional online survey was conducted from March 24 to April 30, 2020, in China, and 20,472 participants completed the survey. We investigated the prevalence and severity of Internet addiction based on the Internet Addiction Test (IAT), and explored the risk factors related to increases in time spent on Internet use and severity of Internet addiction, as well as severe Internet addiction.ResultsThe overall prevalence of Internet addiction was 36.7% among the general population during the pandemic, and that of severe Internet addiction was 2.8%, according to IAT scores. Time spent on recreational Internet use had significantly increased during the pandemic, and almost half of participants reported increases in the severity of Internet addiction. Risk factors for increases in time spent on Internet use and severity of Internet addiction and severe Internet addiction included having fewer social supporters, perceiving pressure and impact on mental health status due to COVID‐19, and being over‐engaged in playing videogames.Discussion and ConclusionsThe COVID‐19 pandemic adversely impacted Internet use and increased the prevalence and severity of Internet addiction among the general population in China, especially in vulnerable populations.Scientific SignificanceThis study provides evidence for policymakers to refine public health policies to control the pandemic and make efforts to provide population‐specific prevention and interventions for people at risk of developing Internet addiction. (Am J Addict 2021;00:00–00)

The primary aim of this study was to examine associations between problematic Internet use, depression and sleep disturbance, and explore whether there were differential effects of problematic Internet use and depression on sleep disturbance. A total of 1772 adolescents who participated in the Shantou Adolescent Mental Health Survey were recruited in 2012 in Shantou, China. The Chinese version of the Internet Addiction Test (IAT) was used to evaluate the prevalence and severity of Internet addiction. The Chinese version of the Pittsburgh Sleep Quality Index (PSQI), a 10-item version of the Center for Epidemiologic Studies Depression Scale (CESD-10), and other socio-demographic measures were also completed. Multiple regression analysis was used to test the mediating effect of problematic Internet use and depression on sleep disturbance. Among the participants, 17.2% of adolescents met the criteria for problematic Internet use, 40.0% were also classified as suffering from sleep disturbance, and 54.4% of students had depressive symptoms. Problematic Internet use was significantly associated with depressive symptoms and sleep disturbance. The correlation between depressive symptoms and sleep disturbance was highly significant. Both problematic Internet use (β = 0.014; Sobel test Z = 12.7, p < 0.001) and depression (β = 0.232; Sobel test Z = 3.39, p < 0.001) had partially mediating effects on sleep disturbance and depression was of greater importance for sleep disturbance than problematic Internet use. There is a high prevalence of problematic Internet use, depression and sleep disturbance among high school students in southern China, and problematic Internet use and depressive symptoms are strongly associated with sleep disturbance. This study provides evidence that problematic Internet use and depression have partially mediating effects on sleep disturbance. These results are important for clinicians and policy makers with useful information for prevention and intervention efforts.

The objective of this study was to evaluate the relationship between attention deficit-hyperactivity/impulsivity symptoms and Internet addiction. In total, 535 elementary school students (264 boys, 271 girls; mean age, 11.0 +/- 1.0 years) were recruited. The presence or severity of Internet addiction was assessed by the Young's Internet Addiction test. Parents and teachers of the children completed the DuPaul's attention deficit hyperactivity disorder (ADHD) rating scale (ARS; Korean version, K-ARS) and Child Behavior Checklists. Children with the highest and lowest quartiles in K-ARS scores were defined to be in ADHD and non-ADHD groups, respectively. Five children (0.9%) met criteria for a definite Internet addiction and 75 children (14.0%) met criteria for a probable Internet addiction. K-ARS scores had significant positive correlations with Young's Internet Addiction test scores. The Internet addiction group had higher total scores of K-ARS and ADHD-related subcategories in the Child Behavior Checklists than the non-addiction group. The ADHD group had higher Internet addiction scores compared with the non-ADHD group. Therefore, significant associations have been found between the level of ADHD symptoms and the severity of Internet addiction in children. In addition, current findings suggest that the presence of ADHD symptoms, both in inattention and hyperactivity-impulsivity domains, may be one of the important risk factors for Internet addiction.

BackgroundUganda is experiencing a dual burden of over- and undernutrition, with overweight prevalence increasing while underweight remains common. Potential weight-related factors, particularly physical activity, sleep, and rural/urban status, are not currently well understood or commonly assessed in Ugandan youth. ObjectiveThe purpose of this study was to pilot test a survey measuring weight-related factors in rural and urban Ugandan schoolchildren. MethodsA cross-sectional survey measured sociodemographics, physical activity, sleep patterns, and dietary factors in 148 rural and urban schoolchildren aged 11-16 in central Uganda. Height and weight were objectively measured. Rural and urban youth were compared on these factors using χ2 and t tests. Regression was used to identify correlates of higher body mass index (BMI) percentile in the full sample and nonstunted youth. FindingsYouth were on average 12.1 ± 1.1 years old; underweight (10%) was more common than overweight (1.4%). Self-reported sleep duration and subjective sleep quality did not differ by rural/urban residence. Rural children overall had higher BMI percentile and marginally higher stunting prevalence. In adjusted analyses in both the full and nonstunted samples, higher BMI percentile was related to living in a rural area, higher frequency of physical activity, and higher subjective sleep quality; it was negatively related to being active on weekends. In the full sample, higher BMI percentile was also related to female gender, whereas in nonstunted youth, higher BMI was related to age. BMI percentile was unrelated to sedentary time, performance of active chores and sports, and dietary factors. ConclusionsThis study is one of the first to pilot test a survey assessing weight-related factors, particularly physical activity and sleep, in Ugandan schoolchildren. BMI percentile was related to several sociodemographic, sleep, and physical activity factors among primarily normal-weight school children in Uganda, providing a basis for understanding weight status in the context of the nutrition transition.

Problematic Internet use: a distinct disorder, a manifestation of an underlying psychopathology, or a troublesome behaviour?

Internet addiction severity and risk for psychopathology, serious mental illness, and suicidalities: a cross-sectional study

Acculturation Determines BMI Percentile and Noncore Food Intake in Hispanic Children1–3

Introduction: The global burden of disease due to mental health problems is on a rise. One of the vulnerable groups are college going youths. The objective of the current study was to examine the frequency and pattern of mental health problems, perceived stress, and internet addiction and explore their relationship with each other among students reporting voluntarily during stress management program. Material and method: A cross-sectional study among 139 undergraduate students was conducted as a part of a program titled "Stress, drugs and internet among college students" during orientation program for undergraduate students of a management college in Kathmandu Valley. Mental Health Screening Questionnaire (MHS), Young's Internet addiction test (YIAT), perceived stress scale (PSS) were used for mental health problems, internet addiction and stress respectively. Results: As per mental health screening questionnaire, 64.7% (90/139) and 7.2% (10/139) participants reported somewhat difficulty and very much or extreme difficulty. There was mild internet addiction among 45.3% and moderate internet addiction among 18.7%. There was significant positive correlation of the MHS score (indicative of number of mental health problems) with the total YIAT score (ρ= 0.404, p&lt; 0.01) and PSS scores (ρ= 0.301, p&lt; 0.01). Also, severity of internet addiction and perceived stress levels were positively associated with each other (ρ= 0.303, p&lt; 0.01). Conclusion: There is significant burden of mental health problems, stress and problematic internet use among the undergraduate students in Nepal. There is also a significant positive correlation of the MHS score (indicative of number of mental health problems) with the Young’s internet addiction test score and perceived stress scale scores.

As digital connectivity has become an integral part of daily life, internet addiction has emerged as a significant concern, particularly among adolescents. Therefore, this study aims to estimate the prevalence of internet addiction among adolescents, assess its severity, investigate the associations between sociodemographic factors and internet addiction levels, and examine the correlation between adolescents' age and the severity of internet addiction. This descriptive cross-sectional study involved 200 adolescents from private education institutes in Sargodha, Pakistan. A structured questionnaire was developed to collect data on sociodemographic indicators, and the validated Internet Addiction Test (IAT) questionnaire was adopted to assess the occurrence and severity of internet addiction. The data were analyzed using IBM® SPSS® software. The results revealed that among the 200 participants, 42% were male and 58% female, with nearly half (47.5%) being aged 13–15 years. Most (57.00%) owned a personal mobile device, whereas 47.5% had a laptop. Furthermore, 39.5% of the participants used the internet for one hour or less per day, whereas 30% reported using it for 2–4 hours daily. Only 8 participants stated that they did not use any social media applications. The study highlights significant internet addiction patterns. Many participants stayed online longer than intended (12.5% always, 16.5% often), whereas 34.5% neglected household chores. Internet dependency was evident, with 14.5% preferring online excitement over intimacy and 26.0% receiving complaints about excessive internet use. Sleep disturbances affected 25.0% of the study participants, whereas academic impacts were reported by 14.5% of the participants. The IAT results revealed that 8.5% of the participants had full control, 54.0% had mild, 36.0% had moderate, and 1.5% had severe addiction. Chi-square analysis revealed no significant associations between addiction severity and sex, age, or device ownership (p &gt; 0.05), but the duration of internet use per day was significantly associated with addiction severity (p = 0.030). Age was weakly but significantly correlated with internet addiction (p = 0.04). The study concluded that a significant proportion of adolescents experienced moderate to severe internet addiction. These findings highlight the urgent need to implement measures to promote healthy digital practices among adolescents.

The objective of this article is to fully understand Internet addiction, we aimed to compare the attachment styles and psychopathologies associated with problematic Internet use with those related to alcohol use. Through the participation of 141 male participants, the present study assessed problematic Internet and alcohol use, attachment, psychopathology, and demographic data via the use of self-rating questionnaires. We explored the significant predictors among avoidant and anxious attachments, depression, anxiety, and phobia to explain problematic Internet and alcohol use. The results showed that anxious attachment, depression, and anxiety could explain problematic alcohol use. In contrast, both anxious and avoidant attachment as well as depression and phobia explained problematic Internet use. Additionally, depression moderated the effects of avoidant attachment on problematic Internet use. We demonstrated that the interaction of attachment and psychopathology predicts problematic Internet use originating from an earlier stage of life than that associated with problematic alcohol use.

Introduction: The Internet and new technologies have become an indispensable resource in our era, although, if not used properly, they can have serious consequences. This study analyses problematic Internet use, cyberbullying and mental health (anxiety and depression), at an international level, in university populations in Spain, Portugal and Brazil, as well as differences according to age and gender. Method: A stratified study sample of 1957 university students from Spain, Portugal and Brazil was used, with a mean age of 21.4 years (SD=3.28) and 62.3% female. Results: Brazilian university students have higher scores on depression, problematic internet use, mobile phone addiction and cyberbullying than Spanish and Portuguese university students, with no differences between the latter two countries. However, anxiety is similar in all 3 countries. Being a female university student implies higher scores on depression, anxiety and more problematic mobile phone use, but less problematic internet use and less cyberaggression than men. With respect to age, younger university students show higher scores on anxiety, more problematic internet and mobile phone use and more cyber aggression. However, age does not show differences in depression and cyber-victimization. Conclusions: Brazil is the country with the highest mental health difficulties and risks associated with internet use. Female university students are more likely to have mental health difficulties. Younger university students score higher on all variables except depression and cybervictimisation.

With the increasing prevalence of digital technology, adolescent internet addiction (IA) has become a global concern. Excessive internet use, especially among adolescents, has been linked to various negative outcomes such as poor academic performance, social isolation, and mental health issues. Conducted among adolescents of Arab origin, our study addressed the limitations of the literature, which predominantly focuses on Western, educated, industrialized, rich, and democratic populations. This study aimed to differentiate between essential and nonessential internet use and how they relate to IA in early and middle adolescents, as well as the relationship between subjective happiness with the amount of time spent on nonessential internet use and IA. A cross-sectional survey was conducted among 377 students from 16 schools in Qatar. The survey measured essential and nonessential internet use, subjective happiness with nonessential use, and IA symptoms using the Internet Addiction Diagnostic Questionnaire, as well as participant demographics. To explore age-specific associations, participants were categorized into early (age 11-13 years) and middle (age 14-17 years) adolescents. Factorial analysis, multiple regression, and logistic regression were used for statistical analysis. Nonessential internet use significantly predicted IA in both early (P<.001) and middle (P<.001) adolescents, with early adolescents showing a stronger association. Subjective happiness with nonessential internet use negatively predicted IA only in middle adolescents (P<.001) as greater dissatisfaction led to a higher IA risk. Essential internet use did not predict IA in either group. Differentiating between essential and nonessential internet use is crucial in understanding IA. This study highlights the importance of developmental differences in shaping IA symptoms. The findings suggest that interventions aimed at addressing IA should be age specific and focus on addressing nonessential use specifically rather than considering internet use and screen time in general as a single entity. Cultural and regional factors also play a role in shaping internet use patterns and IA in the Middle East, necessitating context-specific, culturally sensitive approaches to IA prevention.

Background and aimsWhile the association between health anxiety and maladaptive Internet use is a well-established finding, no studies have been performed to examine the possible effect of abnormal illness behavior (AIB). AIB is a maladaptive manner of experiencing, evaluating, or acting in response to health and illness that is disproportionate to evident pathology. The aim of this study was to investigate the association between AIB and Internet addiction (IA) severity in a sample of Italian University students. The possible effect of alexithymia, anxiety, and depression was also taken into account.MethodsParticipants were 115 men and 163 women (mean age = 23.62 ± 4.38 years); AIB was measured via the Illness Behavior Questionnaire (IBQ), and IA severity by the Internet Addiction Test (IAT).ResultsThe most powerful IBQ factor predicting IA severity scores was disease conviction. Irritability was the only emotional IBQ factor associated with IA severity. Nevertheless, disease conviction and alexithymia remained the only significant predictors of IAT scores when hierarchical regression analysis was executed.Discussion and conclusionsOur results support previous findings showing that those characterized by health anxiety are more prone to an excessive and maladaptive use of Internet. Moreover, this study showed that irritability was the only emotional aspect of AIB predicting IA severity. This finding is consistent with the cognitive model of hypochondria, which states that cognitive factors (dysfunctional beliefs and assumptions) play a major role in the explanation of this psychopathological condition.

The purpose of this study was to examine the association of Internet overuse with excessive daytime sleepiness (EDS). A total of 2336 high school students in South Korea (boys, 57.5%; girls, 42.5%) completed the structured questionnaire. The severity of Internet addiction was evaluated using Young's Internet addiction test. The proportions of boys who were classified as Internet addicts and possible Internet addicts were 2.5% and 53.7%, respectively. For girls, the corresponding proportions were 1.9% and 38.9%, respectively. The prevalence of EDS was 11.2% (boys, 11.2%; girls, 11.1%). When Internet addicts were compared with non-addicts, they consisted of more boys, drank alcohol more, and considered their own health condition as poor. But smoking was not related with Internet addiction. The prevalence rate of EDS for Internet addicts was 37.7%, whereas that for possible Internet addicts and non-addicts was 13.9% and 7.4%, respectively. The prevalence of insomnia, witnessed snoring, apnea, teeth grinding, and nightmares was highest in Internet addicts, middle in possible addicts, and lowest in non-addicts. With adjustment for duration of Internet use, duration of sleep time, age, gender, smoking, taking painkillers due to headache, insomnia symptoms, witnessed apnea, and nightmares, the odds of EDS were 5.2-fold greater (95% confidence interval [CI]: 2.7-10.2) in Internet addicts and 1.9-fold greater (95%CI: 1.4-2.6) in possible Internet addicts compared to non-addicts. Internet addiction is strongly associated with EDS in adolescents. Clinicians should consider examining Internet addiction in adolescent cases of EDS.