The relationship between pathological internet use and psychiatric difficulties in adolescents during COVID-19 pandemic

Abstract

Objectives: Internet addiction has been attracting widespread interest due to the increase in screen time related to lectures, decrease in social activities and spending more time at home due to the education restriction all over the world. It was aimed to determine the psychiatric difficulties for before pandemic period and distance education period, separately and to evaluate the relationship between adolescents' pathological internet usage and difference in psychiatric difficulties.

Methods: Four hundred thirty-eight adolescents aged 11-17 years, secondary and high school students were included in the study. An online survey was created consists of “Young Internet Addiction Test-brief form” (IAT), “Strengths and Difficulties Questionnaire” (SDQ) and researcher form using Google forms application. Youths completed the SDQ retrospectively for two separate time points: during the school restriction period and before the pandemic.

Results: According to the results of our study, the number of changed areas (sleep, eating habits, leisure/social/physical activities) (B= 3.071, p < 0.001) and the change in SDQ-Peer relationship subscale score (B=1.193, p = 0.019) were among the factors significantly predict pathological internet use levels, respectively.

Conclusions: Studies enable understanding the relationship between pathological internet usage and psychiatric difficulties would be useful for the organization of preventive interventions in case similar outbreaks occurred in the future.

Keywords

• COVID-19
• pandemic
• internet addiction
• adolescent
• psychiatric difficulties

References

1. 1. Young, K. Understanding online gaming addiction and treatment issues for adolescents. Am J Fam Ther 2009;37:355-72.
2. 2. Alsehaima AO, Alanazi AA. Psychological and social risks to children of using the internet: literature review. J Child Adolesc Behav 2018;6:380.
3. 3. Liau AK, Khoo A, Ang PH. Factors influencing adolescents’ engagement in risky internet behavior. CyberPsychol Behav 2005;8:513-20.
4. 4. Livingstone S, Haddon L. Risky experiences for children online: charting European research on children and the internet. Children Soc 2008;22:314-23.
5. 5. Leung L. Stressful life events, motives for Internet use, and social support among digital kids. CyberPsychol Behav 2006;10:204-14.
6. 6. Yen JY, Ko CH, Yen CF, Wu HY, Yang MJ. The comorbid psychiatric symptoms of Internet addiction: attention deficit and hyperactivity disorder (ADHD), depression, social phobia, and hostility. J Adolesc Health 2007;41:93-8.
7. 7. Yoo HJ, Cho SC, Ha J, Yune SK, Kim SJ, Hwang J, et al. Attention deficit hyperactivity symptoms and internet addiction. Psychiatry Clin Neurosci 2004;58:487-94.
8. 8. Higuchi S, Mihara S, Kitayuguchi T, Miyakoshi H, Ohi M, Maezono M, et al. Prolonged use of internet and gaming among treatment seekers arising out of social restrictions related to COVID-19 pandemic. Psychiatry Clin Neurosci 2020;74:607-8.

9. 9. Putri A, Setiawati Y, Shieh YT, Lin SH. High-risk internet addiction in adolescents during pandemic COVID-19 and parent’s role. Periodic Epidemiol J 2022;10:11-20.
10. 10. Guessoum SB, Lachal J, Radjack R, Carretier E, Minassian S, Benoit L, Moro MR. Adolescent psychiatric disorders during the COVID-19 pandemic and lockdown. Psychiatry Res 2020;291:113264.
11. 11. Güvenir T, Özbek A, Baykara B, Arkar H, Şentürk B, İncekaş S. [Psychometric properties of the Turkish version of the strengths and difficulties questionnaire (SDQ)]. Çocuk ve Gençlik Ruh sağlığı Dergisi 2008;15:65-74. [Article in Turkish]
12. 12. Young KS. Internet addiction: a new clinical phenomenon and its consequences. Am Behav Sci 2004;48:402-15.
13. 13. Kutlu M, Savci M, Demir Y, Aysan F. Turkish adaptation of Young's Internet Addiction Test-Short Form: a reliability and validity study on university students and adolescents. Journal of Anatolian Psychiatry 2016;17(Suppl 1):69-77.
14. 14. Çakıroğlu S, Soylu N, Görmez V. Re-evaluating the digital gaming profiles of children and adolescents during the COVID-19 pandemic: a comparative analysis comprising 2 years of pre-pandemic data. Addicta 2021;8:51-7.
15. 15. Francisco R, Pedro M, Delvecchio E, Espada JP, Morales A, Mazzeschi C, et al. Psychological symptoms and behavioral changes in children and adolescents during the early phase of COVID-19 quarantine in three European countries. Front Psychiatry 2020;11:570164.
16. 16. Aközlü Z, Kolukısa T, Şahin ÖÖ, Topan A. Internet addiction and stressors causing internet addiction in primary school children during the COVID-19 pandemic: a descriptive and cross-sectional study from Turkey. Addicta 2021;8:65-72.
17. 17. Ozturk FO, Ayaz-Alkaya S. Internet addiction and psychosocial problems among adolescents during the COVID-19 pandemic: a cross-sectional study. Arch Psychiatr Nurs 2021;35:595-601.
18. 18. Matricciani L, Olds T, Williams M. A review of evidence for the claim that children are sleeping less than in the past. Sleep 2011;34:651-9.
19. 19. Łuszczki E, Bartosiewicz A, Pezdan-Śliż I, Kuchciak M, Jagielski P, Oleksy Ł, et al. Children’s eating habits, physical activity, sleep, and media usage before and during COVID-19 pandemic in Poland. Nutrients 2021;13:2447.
20. 20. Bates LC, Zieff G, Stanford K, Moore JB, Kerr ZY, Hanson ED, et al. COVID-19 impact on behaviors across the 24-hour day in children and adolescents: physical activity, sedentary behavior, and sleep. Children (Basel) 2020;7:138.
21. 21. Pietrobelli A, Pecoraro L, Ferruzzi A, Heo M, Faith M, Zoller T, et al. Effects of COVID-19 lockdown on lifestyle behaviors in children with obesity living in Verona, Italy: a longitudinal study. Obesity (Silver Spring) 2020;28:1382-5.
22. 22. Teixeira MT, Vitorino RS, da Silva JH, Raposo LM, Aquino LAD, Ribas SA. Eating habits of children and adolescents during the COVID-19 pandemic: the impact of social isolation. J Hum Nutr Diet 2021;34:670-8.
23. 23. Baptista AS, Prado IM, Perazzo MF, Pinho T, Paiva SM, Pordeus IA, et al. Can children’s oral hygiene and sleep routines be compromised during the COVID-19 pandemic? Int J Pediatr Dent 2021;31:12-9.
24. 24. Woods HC, Scott H. Sleepyteens: Social media use in adolescence is associated with poor sleep quality, anxiety, depression and low self-esteem. J Adolesc 2016;51:41-9.
25. 25. Arora T, Broglia E, Thomas GN, Taheri S. Associations between specific technologies and adolescent sleep quantity, sleep quality, and parasomnias. Sleep Med 2014;15:240-7.
26. 26. Stockwell S, Trott M, Tully M, Shin J, Barnett Y, Butler L, et al. Changes in physical activity and sedentary behaviors from before to during the COVID-19 pandemic lockdown: a systematic review. BMJ Open Sport Exerc Med 2021;7:e000960.
27. 27. Zalewska A, Gałczyk M, Sobolewski M, Białokoz-Kalinowska I. Depression as compared to level of physical activity and internet addiction among polish physiotherapy students during the COVID-19 pandemic. Int J Environ Res Public Health 2021;18:10072.
28. 28. Kim SE, Kim JW, Jee YS. Relationship between smartphone addiction and physical activity in Chinese international students in Korea. J Behav Addict 2015;4:200-5.
29. 29. Marks J, de la Haye K, Barnett LM, Allender S. Friendship network characteristics are associated with physical activity and sedentary behavior in early adolescence. PloS One 2015;10:e0145344.
30. 30. Guan H, Okely AD, Aguilar-Farias N, del Pozo Cruz B, Draper CE, El Hamdouchi A. Promoting healthy movement behaviors among children during the COVID-19 pandemic. Lancet Child Adolesc Health 2020;4:416-8.
31. 31. Ingram J, Maciejewski G, Hand CJ. Changes in diet, sleep, and physical activity are associated with differences in negative mood during COVID-19 lockdown. Front Psychol 2020;11:588604.
32. 32. Chen RN, Liang SW, Peng Y, Li XG, Chen JB, Tang S, et al. Mental health status and change in living rhythms among college students in China during the COVID-19 pandemic: A large-scale survey. J Psychosom Res 2020;137:110219.
33. 33. Nearchou F, Flinn C, Niland R, Subramaniam SS, Hennessy E. Exploring the impact of COVID-19 on mental health outcomes in children and adolescents: a systematic review. Int J Environ Res Public Health 2020;17:8479.
34. 34. Ozturk FO, Ekinci M, Ozturk O, Canan F. The relationship of affective temperament and emotional-behavioral difficulties to internet addiction in Turkish teenagers. ISRN Psychiatry 2013;2013:961734.
35. 35. Wang BQ, Yao NQ, Zhou X, Liu J, Lv ZT. The association between attention deficit/hyperactivity disorder and internet addiction: a systematic review and meta-analysis. BMC Psychiatry 2017;17:260.
36. 36. Yao MZ, Zhong ZJ. Loneliness, social contacts and Internet addiction: a cross-lagged panel study. Comput Hum Behav 2014;30:164-70.
37. 37. Hardie E, Tee MY. Excessive internet use: the role of personality, loneliness and social support networks in Internet Addiction. Aust J Emerging Technol Soc 2007;5:34-47.
38. 38. Fernandes B, Biswas UN, Mansukhani RT, Casarín AV, Essau CA. The impact of COVID-19 lockdown on internet use and escapism in adolescents. Revista de Psicología Clínica con Niños y Adolescentes 2020;7:59-65.
39. 39. Wu XS, Zhang ZH, Zhao F, Wang WJ, Li YF, Bi L, Sun YH. Prevalence of internet addiction and its association with social support and other related factors among adolescents in China. J Adolesc 2016;52:103-111.
40. 40. Tudorel OI, Vintilă M. The role of social support on Internet addiction. Revista de Asistenta Sociala 2018;1:73-78.
41. 41. Parajuli BR. Increased internet addiction during COVID-19 pandemics. Life Research 2022;5:1-2.
42. 42. Zhao Q, Huang Y, Li C. Does adolescents’ Internet addiction trigger depressive symptoms and aggressive behavior, or vice versa? The moderating roles of peer relationships and gender. Comput Hum Behav 2022;129:107143.
43. 43. Meng S, Dong P, Sun Y, Li Y, Chang X, Sun G, et al. Guidelines for prevention and treatment of internet addiction in adolescents during home quarantine for the COVID-19 pandemic. Heart Mind 2020;4:95-9.
44. 44. Tripathi A. Impact of internet addiction on mental health: an integrative therapy is needed. Integr Med Int 2017;4:215-22.
45. 45. Fegert JM, Vitiello B, Plener PL, Clemens V. Challenges and burden of the Coronavirus 2019 (COVID-19) pandemic for child and adolescent mental health: a narrative review to highlight clinical and research needs in the acute phase and the long return to normality. Child Adolesc Psychiatry Ment Health 2020;14:20.