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      Insomnia partially mediated the association between problematic Internet use and depression among secondary school students in China


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          Background and aims

          This study aims to examine the mediating effects of insomnia on the associations between problematic Internet use, including Internet addiction (IA) and online social networking addiction (OSNA), and depression among adolescents.


          A total of 1,015 secondary school students from Guangzhou in China participated in a cross-sectional survey. Levels of depression, insomnia, IA, and OSNA were assessed using the Center for Epidemiological Studies-Depression Scale, Pittsburgh Sleep Quality Index, Young’s Diagnostic Questionnaire, and Online Social Networking Addiction Scale, respectively. Logistic regression models were fit to test the associations between IA, OSNA, insomnia, and depression. The mediation effects of insomnia were tested using Baron and Kenny’s strategy.


          The prevalence of depression at moderate level or above (CES-D ≥ 21), insomnia, IA, and OSNA were 23.5%, 37.2%, 8.1%, and 25.5%, respectively. IA and OSNA were significantly associated with depression (IA: AOR = 2.79, 95% CI: 1.71, 4.55; OSNA: AOR = 3.27, 95% CI: 2.33, 4.59) and insomnia (IA: AOR = 2.83, 95% CI: 1.72, 4.65; OSNA: AOR = 2.19, 95% CI: 1.61, 2.96), after adjusting for significant background factors. Furthermore, insomnia partially mediated 60.6% of the effect of IA on depression (Sobel Z = 3.562, p < .002) and 44.8% of the effect of OSNA on depression (Sobel Z = 3.919, p < .001), respectively.


          The high prevalence of IA and OSNA may be associated with increased risk of developing depression among adolescents, both through direct and indirect effects (via insomnia). Findings from this study indicated that it may be effective to develop and implement interventions that jointly consider the problematic Internet use, insomnia, and depression.

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          Most cited references58

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          A cognitive-behavioral model of pathological Internet use

          R.A. Davis (2001)
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            Problematic Social Media Use: Results from a Large-Scale Nationally Representative Adolescent Sample

            Despite social media use being one of the most popular activities among adolescents, prevalence estimates among teenage samples of social media (problematic) use are lacking in the field. The present study surveyed a nationally representative Hungarian sample comprising 5,961 adolescents as part of the European School Survey Project on Alcohol and Other Drugs (ESPAD). Using the Bergen Social Media Addiction Scale (BSMAS) and based on latent profile analysis, 4.5% of the adolescents belonged to the at-risk group, and reported low self-esteem, high level of depression symptoms, and elevated social media use. Results also demonstrated that BSMAS has appropriate psychometric properties. It is concluded that adolescents at-risk of problematic social media use should be targeted by school-based prevention and intervention programs.
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              Internet paradox. A social technology that reduces social involvement and psychological well-being?

              The Internet could change the lives of average citizens as much as did the telephone in the early part of the 20th century and television in the 1950s and 1960s. Researchers and social critics are debating whether the Internet is improving or harming participation in community life and social relationships. This research examined the social and psychological impact of the Internet on 169 people in 73 households during their first 1 to 2 years on-line. We used longitudinal data to examine the effects of the Internet on social involvement and psychological well-being. In this sample, the Internet was used extensively for communication. Nonetheless, greater use of the Internet was associated with declines in participants' communication with family members in the household, declines in the size of their social circle, and increases in their depression and loneliness. These findings have implications for research, for public policy and for the design of technology.

                Author and article information

                Journal of Behavioral Addictions
                J Behav Addict
                Akadémiai Kiadó (Budapest )
                26 December 2017
                December 2017
                : 6
                : 4
                : 554-563
                [ 1 ]State Key Laboratory of Oncology in South China, Department of Clinical Research, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center , Guangzhou, China
                [ 2 ]Faculty of Medicine, Centre for Health Behaviours Research, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong , Hong Kong, China
                [ 3 ] Shenzhen Research Institute (SZRI), The Chinese University of Hong Kong , Shenzhen, China
                [ 4 ]Department of Social Health Education, Center for Health Education in Guangdong Province , Guangzhou, China
                Author notes
                [* ]Corresponding author: Prof. Joseph T. F. Lau; The Jockey Club School of Public Health and Primary Care, Prince Wales Hospital, 5/F, Shatin, Hong Kong; Phone: +852 2637 6606; Fax: +852 2645 3098; E-mail: jlau@ 123456cuhk.edu.hk
                © 2017 The Author(s)

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium for non-commercial purposes, provided the original author and source are credited.

                : 13 July 2017
                : 06 November 2017
                : 03 December 2017
                Page count
                Figures: 0, Tables: 4, Equations: 0, References: 60, Pages: 10
                Funding sources: This study was supported by the Jockey Club School of Public Health and Primary Care Research Postgraduate Students’ Research Grants and CUHK research Postgraduate Student Grants for Overseas Academic Activities in the Chinese University of Hong Kong, and the study was also partially supported by National Science Foundation of China (no.: 81373021).
                FULL-LENGTH REPORT

                Evolutionary Biology,Medicine,Psychology,Educational research & Statistics,Social & Behavioral Sciences
                online social networking addiction,mediation,insomnia,depression,Internet addiction


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