Abstract
Background: The increase in problematic Internet use (PIU) among medical students and resident doctors during the coronavirus disease 2019 (COVID-19) pandemic may be leading to significant impairments in everyday functioning, including sleeping patterns, anxiety, depressive symptoms, and overall well-being. The Compulsive Internet Use Scale (CIUS) has been developed to assess the severity of PIU, however, it has not been elucidated whether this scale is also applicable to medical students and resident doctors. The first aim of this study was to explore the psychometric properties of the Lithuanian version of the CIUS. The second aim was to examine associations between subjectively reported mental health symptoms and PIU during the COVID-19 pandemic.Methods: A total of 524 medical students and resident doctors (78.60% women, mean age 24 [SD 3] years old) participated in an online survey between December 2020 and February 2021. Participants completed the CIUS, the Pittsburgh Sleep Quality Index (PSQI) questionnaire, the Patient Health Questionnaire-9 (PHQ-9), the Generalized Anxiety Disorder Assessment-7 (GAD-7), and the WHO—Five Well-Being Index questionnaire (WHO-5).Results: The confirmatory factor analysis (CFA) suggested brief versions (CIUS-5, CIUS-7, and CIUS-9) rather than the original (CIUS-14) version of the CIUS questionnaire as reliable and structurally stable instruments that can be used to measure compulsive Internet use severity in the sample of medical students and resident doctors. The most prevalent online behaviors were social media use (90.1%), online shopping (15.6%), and online gaming/gambling (11.3%). Students with higher CIUS scores reported significantly lower academic achievements during the 6 months (r = 0.12–0.13; p < 0.006), as well as more severe depressive and anxiety symptoms, worsened sleep quality, and lower sense of well-being (r = 0.21–0.41; p's < 0.001). Both, during workdays (d = 0.87) and weekend (d = 0.33), students spent more time online than resident doctors (p's < 0.001).Conclusion: The brief, 5-, 7-, and 9-item versions of the Lithuanian CIUS are reliable and valid self-report screening instruments for evaluating the severity of PIU symptoms among the medical student population. Symptoms of PIU during the COVID-19 period were associated with worsened self-reported mental health and everyday functioning.
Highlights
During the last few decades, Internet use has grown but has transformed from a tool to collect and share information to a way of connecting with others and the world around us
Of those invited to participate, significantly more responses were received from the medical student group than the resident doctors (20.8 vs. 16.9%, respectively; p < 0.05); and the respondents were younger when compared with non-respondents (p < 0.05)
There was an inverse correlation between Problematic Internet use (PIU) as measured by the Compulsive Internet Use Scale (CIUS) and academic achievements among the whole study group (r = −0.345; p < 0.001)
Summary
During the last few decades, Internet use has grown but has transformed from a tool to collect and share information to a way of connecting with others and the world around us. Problematic Internet use (PIU) is defined as the excessive and compulsive use of online activities and services which have addictive potential associated with marked functional impairment (Király et al, 2015; Ioannidis et al, 2016, 2019). The increase in problematic Internet use (PIU) among medical students and resident doctors during the coronavirus disease 2019 (COVID-19) pandemic may be leading to significant impairments in everyday functioning, including sleeping patterns, anxiety, depressive symptoms, and overall well-being. The Compulsive Internet Use Scale (CIUS) has been developed to assess the severity of PIU, it has not been elucidated whether this scale is applicable to medical students and resident doctors. The second aim was to examine associations between subjectively reported mental health symptoms and PIU during the COVID-19 pandemic
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