The impact of the COVID-19 pandemic on internet usage profiles in individuals: the mediating role of ADHD symptoms

Abstract

Aims: Attention deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder characterized by attention deficit, impulsivity, and hyperactivity. This disorder may have had an impact on individuals’ internet usage profiles, particularly due to the pandemic measures. The aim of the study was to determine the prevalence of ADHD and to examine the factors affecting internet addiction in this disorder. Methods: This clinical study was designed as a cross-sectional and descriptive study and was conducted on 250 participants living in the city center of Sakarya and selected by random sampling method. The sociodemographic data form, Addiction Profile Index internet (APIINT) form, Adult ADHD Self-Report Scale (ASRS), Epidemic Anxiety Assessment Scale (EAAS) were applied to the participants online via e-mail via Google forms. Results: Of the participants, 14 (5.6%) stated that they were diagnosed with ADHD in childhood and 20 (8%) in adulthood. The number of patients who reported that they were diagnosed with any psychiatric disorder in adulthood (other than ADHD) was 50 (20%). With the APIINT scale score, the APIINT total score mean values ​​were found to be significantly higher in the groups diagnosed with ADHD in childhood, diagnosed with ADHD in adulthood and suspected ADHD with ASRS compared to the group without ADHD diagnosis (p=0.001). Conclusion: Internet use has intensified during the pandemic, and it has been observed that this situation may be related to the level of anxiety about the pandemic. Internet addiction was found to be higher in those with ADHD than in the non-ADHD group. The study is valuable in that it examines the changes in people’s media and technology usage habits during the pandemic, but studies with larger samples, face-to-face interviews, and follow-up data are needed to better understand the subject.

Keywords

• ADHD
• internet addiction
• COVID-19
• media
• technology

Ethical Statement

Ethics committee approval was obtained from Sakarya University Faculty of Medicine Non-Interventional Ethics Committee with the date and decision number 2020/309. The research was conducted in accordance with the 1964 Helsinki Declaration.

COVID-19 pandemisinin bireylerde internet kullanım profillerine etkisi: DEHB belirtilerinin aracı rolü

Abstract

Amaç DEHB (Dikkat Eksikliği ve Hiperaktivite Bozukluğu); dikkat eksikliği, dürtüsellik ve hiperaktiviteyle seyreden sık görülen bir nörogelişimsel bozukluktur. Bu bozukluk özellikle pandemi dönemi tedbirlerinin de etkisiyle bireylerin internet kullanım profilleri üzerine etki etmiş olabilir. Çalışmanın amacı DEHB’in prevelansını saptamak ve bu bozuklukta görülen internet bağımlılığını etkileyen faktörleri incelemektir. Gereç ve Yöntem Bu klinik araştırma kesitsel ve tanımlayıcı bir çalışma olarak dizayn edilmiş olup Sakarya il merkezinde yaşayan ve gelişigüzel örneklem yöntemi ile seçilen 250 katılımcı üzerinde gerçekleştirilmiştir. Katılımcılara sosyodemografik veri formu, Bağımlılık Profil İndeksi İnternet (BAPİNT) Formu, Yetişkin DEHB Öz Bildirim Ölçeği (ASRS), Salgın Hastalık Kaygı Değerlendirme Ölçeği (SHKDÖ), Google Formlar aracılığıyla elektronik posta yolu ile çevrimiçi olarak uygulanmıştır. Bulgular Katılımcıların 14 (%5,6)‘ü çocukluk çağında, 20 (%8)’si ise erişkin çağda DEHB tanısı aldığını belirtmiştir. Erişkin dönemde (DEHB dışında) herhangi bir psikiyatrik bozukluk tanısı aldığını bildiren hasta sayısı ise 50 (%20)’dir. BAPİNT ölçeği puanı ile Çocukluk çağında DEHB tanısı olan, yetişkinlikte DEHB tanısı olan ve ASRS ile DEHB olduğu düşünülen gruplarda BAPİNT total skor ortalama değerleri, DEHB tanısı olmayan gruba göre anlamlı düzeyde daha yüksek olarak saptanmıştır (p=0,001). Sonuç İnternet kullanımı pandemi döneminde yoğunlaşmıştır ve bu durumun salgın hastalık kaygı düzeyiyle ilişkili olabileceği gözlemlenmiştir. DEHB olanlarda internet bağımlılığının DEHB olmayan grubu göre daha fazla olduğu bulunmuştur. Çalışma, pandemi sürecinde insanların medya ve teknoloji kullanım alışkanlıklarındaki değişikliklerini incelemesi yönüyle değerlidir ancak konunun daha iyi anlaşılması için daha yüksek örneklemli, görüşmelerin yüz yüze gerçekleştirildiği ve takip verileri içeren çalışmalara ihtiyaç vardır.

Keywords

• DEHB
• internet bağımlılığı
• COVID- 19
• medya
• teknoloji

References

1. Ceylan MF, Şener Ş, Bayraktar AC, Kavutçu M. Changes in oxidative stress and cellular immunity serum markers in attention-deficit/hyperactivity disorder. Psychiatr Clin Neurosci. 2012;66(3):220-226. doi: 10.1111/j.1440-1819.2012.02330.x
2. Rowland AS, Lesesne CA, Abramowitz A. The epidemiology of attention-deficit/hyperactivity disorder (ADHD): a public health view. Ment Retard Dev Disabil Res Rev. 2002;8(3):162-170. doi:10.1002/mrdd. 10036
3. Schuch V, Utsumi DA, Costa TVMM, Kulikowski LD, Muszkat M. Attention deficit hyperactivity disorder in the light of the epigenetic paradigm. Fronti Psychiatry. 2015;6:126. doi:10.3389/fpsyt.2015.00126
4. Mahone EM, Crocetti D, Ranta ME, et al. A preliminary neuroimaging study of preschool children with ADHD. Clin Neuropsychol. 2011;25(6): 1009-1028. doi:10.1080/13854046.2011.580784
5. Guan L, Wang B, Chen Y, et al. a high-density single-nucleotide polymorphism screen of 23 candidate genes in attention deficit hyperactivity disorder: suggesting multiple susceptibility genes among Chinese Han population. Molecul Psychiatry. 2008;14(5):546-554. doi: 10.1038/sj.mp.4002139
6. Kuss DJ, Griffiths MD, Karila L, Billieux J. Internet addiction: a systematic review of epidemiological research for the last decade. Curr Pharm Des. 2014;20(25):4026-4052. doi:10.2174/13816128113199990617
7. Abdullah MQ. The relationship between internet addiction and temperament among children and adolescents. Psychol Behav Sci Inter J. 2017;5(5):1-7. doi:10.19080/pbsij.2017.05.555674
8. Mohamed KO, Soumit SM, Elseed AA, Allam WA, Soomit AM, Humeda HS. Prevalence of internet addiction among medical students and its impact on psychological distress: a cross-sectional study. Cureus. 2024; 16(2):e53543. doi:10.21203/rs.3.rs-3173993/v1

9. Ko CH, Yen JY, Lin PC. Association between urbanization and internet addiction. Curr Opin Psychiatry. 2022;35(3):219-225. doi:10.1097/yco.0000000000000780
10. Çınar S, Kanbay Y, Firat M, Özbay Ö. The mediating effect of social anxiety on the relationship between internet addiction and aggression in teenagers. Psychol Rep. 2022;127(3):1050-1064. doi:10.1177/00332941 221133006
11. Liu Z, Cheng H, Guan H, Yang X, Chen Z. Effect of paternal-maternal parenting styles on college students’ internet addiction of different genders: the mediating role of life satisfaction. Plos One. 2024;19(5): e0303554. doi:10.1371/journal.pone.0303554
12. Türkili S, Aslan E, Tot Ş, et al. Asistan hekimlerde korona virüs salgını nedeniyle yaşanılan zorluklar, kaygı düzeyi ve tükenmişlik sendromunun incelenmesi. Anat Clin J Med Sci. 2022;27(2):103-114.
13. Kaya AE, Oğur NB. The impact of the COVID-19 pandemic on the interest in antidepressants: an analysis of worldwide internet searches with Google trends data. Cureus. 2023;15(9):e45558. doi:10.7759/cureus. 45558
14. Kiatsakared P, Chen KY. The effect of flow experience on online game addiction during the COVID-19 pandemic: the moderating effect of activity passion. Sustainability. 2022;14(19):12364. doi:10.3390/su141912364
15. Mouratidis K, Papagiannakis A. COVID-19, internet, and mobility: The rise of telework, telehealth, e-learning, and e-shopping. Sustain Cities Soc. 2021;74:103182. doi:10.1016/j.scs.2021.103182
16. Hussain S, Sumiea EHH, Ahmad MH, Kumar S, Moshood TD. Factors affecting the public higher education institution (PHEI) acceptance of online meetings applications during COVID-19 pandemic: an empirical study. J Appl Res High Edu. 2022;15(4):1146-1166. doi:10.1108/jarhe-03-2022-0082
17. Gauxachs AS, Aiguabella JMA, Bosch MD. Coronavirus-driven digitalization of in-person communities. analysis of the catholic church online response in Spain during the pandemic. Religions. 2021;12(5):311. doi:10.3390/rel12050311
18. Luo R, Li Q, Meng G, et al. The association between intolerance of uncertainty and internet addiction during the second wave of the Coronavirus disease 2019 pandemic: a multiple mediation model considering depression and risk perception. Psych J. 2022;11(3):383-391. doi:10.1002/pchj.545
19. Petrović ZK, Peraica T, Kozarić-Kovačić D, Palavra IR. Internet use and internet-based addictive behaviours during Coronavirus pandemic. Curr Opin Psychiatry. 2022;35(5):324-331. doi:10.1097/yco. 0000000000000804
20. Tzang RF, Chang CH, Chang YC. Structural equation modeling (SEM): gaming disorder leading untreated attention-deficit/hyperactivity disorder to disruptive mood dysregulation. Int J Environ Res Public Health. 2022;19(11):6648. doi:10.3390/ijerph19116648
21. Werling AM, Walitza S, Drechsler R. Impact of the COVID-19 lockdown on screen media use in patients referred for ADHD to child and adolescent psychiatry: an introduction to problematic use of the internet in ADHD and results of a survey. J Neural Transmis. 2021;128(7):1033-1043. doi:10.1007/s00702-021-02332-0
22. Breaux R, Dvorsky MR, Marsh N, et al. Prospective impact of COVID-19 on mental health functioning in adolescents with and without ADHD: protective role of emotion regulation abilities. J Child Psychol Psychiatry. 2021;62(9):1132-1139. doi:10.1111/jcpp.13382
23. Gioia F, Rega V, Boursier V. Problematic internet use and emotional dysregulation among young people: a literature review. Clin Neuropsychiatry. 2021;18(1):41-54. doi:10.36131/cnfioritieditore20210104
24. Sun Y, Li Y, Bao Y, et al. Brief report: increased addictive internet and substance use behavior during the COVID-19 pandemic in China. Am J Addict. 2020;29(4):268-270. doi:10.1111/ajad.13066
25. Ögel K, Koç C, Başabak A, İşmen EM, Görücü S. Bağımlılık profil indeksi klinik formunun (BAPİ-K) geliştirilmesi: geçerlik ve güvenilirlik çalışması. Bağımlılık Derg. 2015;16(2):57-69.
26. Yazici E, Kose E, Turan C, Yazici AB. Outbreak Anxiety Scale: development, validity, and reliability. North Clin Istanb. 2021;8(5):443-453. doi:10.14744/nci.2021.69077
27. Heo S, Kim JH, Joung YS, et al. Clinical utility of the Korean version of the WHO adult attention-deficit/hyperactivity disorder self-report scale screener. Psychiatry Investigat. 2018;15(3):325-329. doi:10.30773/pi.2017.07.10
28. Evren C, Umut G, Bozkurt M, Teksin-Unal G, Ağaçhanlı R, Evren B. Psychometric properties of the turkish version of the adult ADHD Self-Report Scale (ASRS-v1.1) in a sample of inpatients with alcohol use disorder. Dusunen Adam J Psychiatr Neurol Scie. 2016;29(2):109-119. doi:10.5350/dajpn2016290202
29. Doğan S, Öncü B, Saraçoğlu Varol G, Kucukgoncu S. Validity and reliability of the Turkish version of the adult ADHD Self-Report Scale (ASRS-v1. 1). Anat J Psychiatr. 2009.
30. Jain A, Hussenet A. Profitability and polarization: TikTok’s dominance of the attention economy. J Stud Res. 2022;11:3. doi:10.47611/jsrhs.v11i3. 2963
31. Karakose T, Ozdemir TY, Papadakis S, Yirci R, Ozkayran SE, Polat H. Investigating the relationships between COVID-19 quality of life, loneliness, happiness, and internet addiction among K-12 teachers and school administrators-a structural equation modeling approach. Int J Environ Res Public Health. 2022;19(3):1052. doi:10.3390/ijerph19031052
32. Talaue GM, Kalanther I. Prevalence and associated factors of internet addiction among male students of Jubail University College, Saudi Arabia. Int J Cyber Behav Psychol Learn. 2023;13(1):1-16. doi:10.4018/ijcbpl.324087
33. Pan L, Li J, Hu Z, Wu H. The effect of COVID-19 perceived risk on internet addiction among college students in China: an empirical study based on the structural equation model. Int J Environ Res Public Health. 2022;19(20):13377. doi:10.3390/ijerph192013377
34. Song YX, Huang YC, Li YY, et al. Risk factors for poor progression of addictive internet use across different COVID-19 periods in China. Am J Add. 2023;32(6):593-605. doi:10.1111/ajad.13464
35. Chou WJ, Huang MF, Chang YP, Chen Y, Hu HF, Yen CF. Social skills deficits and their association with internet addiction and activities in adolescents with attention-deficit/hyperactivity disorder. J Behav Addict. 2016;6(1):42-50. doi:10.1556/2006.6.2017.005
36. Wong CK, Chen Y, Yen CF. Associations of parental bonding and adolescent internet addiction symptoms with depression and anxiety in parents of adolescents with attention deficit/hyperactivity disorder. Arch Clin Psychiatr (São Paulo). 2019;46(2):40-43. doi:10.1590/0101-60830000000190
37. Rupesh E, Singh S, Adgaonkar GW, Subramanyam AA, Kamath R. Study of internet addiction in children with attention-deficit hyperactivity disorder and normal control. Ind Psychiatr J. 2018;27(1):110-114. doi:10. 4103/ipj.ipj_47_17