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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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          Abstract

          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.

          Methods

          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.

          Results

          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.

          Discussion

          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 references 60

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          A cognitive-behavioral model of pathological Internet use

           R.A. Davis (2001)
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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.
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              Television viewing, computer game playing, and Internet use and self-reported time to bed and time out of bed in secondary-school children.

              To investigate the relationship between the presence of a television set, a gaming computer, and/or an Internet connection in the room of adolescents and television viewing, computer game playing, and Internet use on the one hand, and time to bed, time up, time spent in bed, and overall tiredness in first- and fourth-year secondary-school children on the other hand. A random sample of students from 15 schools in Flanders, Belgium, yielded 2546 children who completed a questionnaire with questions about media presence in bedrooms; volume of television viewing, computer game playing, and Internet use; time to bed and time up on average weekdays and average weekend days; and questions regarding the level of tiredness in the morning, at school, after a day at school, and after the weekend. Children with a television set in their rooms went to bed significantly later on weekdays and weekend days and got up significantly later on weekend days. Overall, they spent less time in bed on weekdays. Children with a gaming computer in their rooms went to bed significantly later on weekdays. On weekdays, they spent significantly less time in bed. Children who watched more television went to bed later on weekdays and weekend days and got up later on weekend days. They spent less time in bed on weekdays. They reported higher overall levels of being tired. Children who spent more time playing computer games went to bed later on weekdays and weekend days and got up later on weekend days. On weekdays, they actually got up significantly earlier. They spent less time in bed on weekdays and reported higher levels of tiredness. Children who spent more time using the Internet went to bed significantly later during the week and during the weekend. They got up later on weekend days. They spent less time in bed during the week and reported higher levels of tiredness. Going out was also significantly related to sleeping later and less. Concerns about media use should not be limited to television. Computer game playing and Internet use are related to sleep behavior as well. Leisure activities that are unstructured seem to be negatively related to good sleep patterns. Imposing more structure (eg, end times) might reduce impact.
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                Author and article information

                Journal
                jba
                JBA
                Journal of Behavioral Addictions
                J Behav Addict
                Akadémiai Kiadó (Budapest )
                2062-5871
                2063-5303
                26 December 2017
                December 2017
                : 6
                : 4
                : 554-563
                Affiliations
                [ 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
                Article
                10.1556/2006.6.2017.085
                6034947
                29280394
                © 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.

                Page count
                Figures: 0, Tables: 4, Equations: 0, References: 60, Pages: 10
                Funding
                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).
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