Latent Profiles and Transitions of Bedtime Procrastination Among Chinese College Students: The Predictive Roles of Anxiety, Depression, Problematic Smartphone Use and Self-Control.

Background: Bedtime procrastination (BP) has become an important factor affecting individual well-being. This study aimed to assess the stability and changes in BP and examine risk and protective factors. Methods: The study recruited 1423 respondents. Latent profile analysis was used to identify subgroups of BP and latent transition analysis to determine transition probabilities for each subgroup. Logistic regression examined associations between identified classes and related factors. Results: Three subgroups of BP were identified. In terms of stability and changes, the moderate bedtime procrastination group showed the highest stability (66%), followed by the severe bedtime procrastination group (62.4%), and the mild bedtime procrastination group had a 52% probability of switching to moderate bedtime procrastination. In terms of influencing factors, more problematic phone use (PSU) (OR: 1.08; 95% CI = 1.05-1.12), more depression (OR: 1.17; 95% CI = 1.06-1.29) and anxiety (OR: 1.16; 95% CI = 1.05-1.28) are all factors that aggravate the transition from mild to moderate sleep procrastination. Similarly, PSU (OR: 1.15; 95% CI = 1.12-1.19), anxiety (OR: 1.10; 95% CI = 1.06-1.14), and depression (OR: 1.10; 95% CI = 1.06-1.14) increased the risk of severe bedtime procrastination. Self-control emerged as a protective factor against BP. Conclusion: This study identified three subgroups of BP at two time points and the rule of transition for each subgroup. Our findings indicate that BP were relatively stable, with some changes over time. The results also highlight the important function that PSU, depression, anxiety, and self-control can play in preventing and intervening in BP.

Testing the Associations Between Attachment Anxiety, Relational Aggression and Depressive Symptoms in Romantic Relationships: Actor-Partner Interdependence Model and Actor-Partner Interdependence Mediator Model.

Emerging adulthood is a pivotal period for romantic relationships, yet the specific mechanisms through which attachment anxiety influences relationship dynamics and psychological outcomes in this phase are poorly understood. Particularly, in the context of romantic dyads, understanding how partners' behaviors and emotional patterns reciprocally influence each other remains underexplored. This study utilizes the Actor-Partner Interdependence Model and Actor-Partner Interdependence Mediator Model to explore the relationship between attachment anxiety,relational aggression (both perpetration and victimization), and depressive symptoms among emerging adults. A sample of 138 mixed-sex emerging adulthood couples from China, was recruited (Mage = 21.40, SD = 2.54; 50% female, 62.6% reporting that this relationship was ongoing for more than a year). Attachment anxiety significantly predicted relational aggression in both partners, with male attachment anxiety also significantly predicted female relational aggression. Significant indirect effects of both partners' relational aggression perpetration and victimization on their own and each other's relationship between attachment anxiety and depressive symptoms. These findings contribute to understanding the intricate dynamics of attachment anxiety and relational aggression in romantic relationships during emerging adulthood, emphasizing the need for targeted interventions to mitigate these risks.

Association between problematic social networking use and anxiety symptoms: a systematic review and meta-analysis.

A growing number of studies have reported that problematic social networking use (PSNU) is strongly associated with anxiety symptoms. However, due to the presence of multiple anxiety subtypes, existing research findings on the extent of this association vary widely, leading to a lack of consensus. The current meta-analysis aimed to summarize studies exploring the relationship between PSNU levels and anxiety symptoms, including generalized anxiety, social anxiety, attachment anxiety, and fear of missing out. 209 studies with a total of 172 articles were included in the meta-analysis, involving 252,337 participants from 28 countries. The results showed a moderately positive association between PSNU and generalized anxiety (GA), social anxiety (SA), attachment anxiety (AA), and fear of missing out (FoMO) respectively (GA: r = 0.388, 95% CI [0.362, 0.413]; SA: r = 0.437, 95% CI [0.395, 0.478]; AA: r = 0.345, 95% CI [0.286, 0.402]; FoMO: r = 0.496, 95% CI [0.461, 0.529]), and there were different regulatory factors between PSNU and different anxiety subtypes. This study provides the first comprehensive estimate of the association of PSNU with multiple anxiety subtypes, which vary by time of measurement, region, gender, and measurement tool.

The Vicious Cycle between Loneliness and Problematic Smartphone Use among Adolescents: A Random Intercept Cross-Lagged Panel Model.

Despite extensive research on the psychological impacts of digital technology, the nuanced dynamics between adolescent loneliness and problematic smartphone use, particularly across different educational levels and genders, remain underexplored. This study aims to fill this gap by employing a Random Intercept Cross-Lagged Panel Model to dissect the bidirectional relationship between loneliness and problematic smartphone use among adolescents, with a focus on the moderating roles of educational levels and gender. Engaging 3132 students from various educational institutions in China, the research conducted a three-wave longitudinal analysis across 2022-2023. The final number of participants included 1120 adolescents (53.5% female; age in 2022: M = 14.57 years, SD = 1.57). Results reveal that loneliness significantly predicts problematic smartphone use, but not vice versa, highlighting a unidirectional influence. The study uncovers crucial differences across educational levels and gender, emphasizing the stronger effect of loneliness on problematic smartphone use among junior high students and female adolescents. These findings underscore the complexity of adolescent loneliness and its relationship with digital behavior, suggesting a need for tailored interventions considering both gender and developmental stages.

The Long-Term Effect of Early-Life Uncertainty on Mental Health in Adolescence and Adulthood: A Meta-Analysis.

Turbulent changes in early life are a hidden source of childhood trauma, increasing potential risks for mental illness. Many studies have identified the link between childhood uncertainty and mental health. However, research on the long-term effect of early-life uncertainty (EU) on mental health has not been systematically synthesized. This meta-analysis aims to provide a quantitative estimate of the association between EU and subsequent mental health outcomes. Eight electronic databases and gray literature were searched. Twenty-eight studies met our inclusion criteria: samples of non-clinical adolescents or adults and clear and valid assessments. Random-effect models were used to calculate the pooled effect sizes of EU on internalizing problems, externalizing problems, and well-being. Meta-regression and subgroup analysis were used to explore potential moderators. Results indicated small to moderate associations involving EU and internalizing problem (r = .28; 95% confidence interval [CI] [0.228, 0.326]) and externalizing problem (r = .16; 95% CI [0.102, 0.220]). EU was not significantly associated with well-being (r = -.41; 95% CI [-0.738, 0.071]). Furthermore, moderator analyses found that composite uncertain experiences in childhood had a stronger negative effect than single experiences. EU was a stronger predictor of mental health problems in adults than in adolescents. Cross-sectional studies would amplify the correlation between EU and mental illness compared to longitudinal studies. In the future, childhood uncertain and unpredictable risks should receive more attention. More research needs to focus on positive psychological indicators and samples from non-Western countries.

Psychosocial Correlates of Motivation for Abstinence Among People Who Used Drugs After Community Rehabilitation Treatment in China: A Structural Equation Modelling.

Background: Enhancing abstinence motivation of drugs is an effective strategy for the rehabilitation of people who used drugs and prevention of drug use relapse. However, little is known about its risk and protective factors. This study aimed to examine the potential intrapersonal (ie, impulsivity, depression, anxiety, sleep quality) and interpersonal factors (ie, perceived social support) of abstinence motivation among people who completed the community rehabilitation treatment. Methods: A total of 222 participants (mean age = 43; male = 89.2%) were recruited from eleven communities located in Wenzhou, China. Data were collected using a self-reported questionnaire in counselling room settings between April and June 2021. Results: The proportions of participants with depression, anxiety, and poor sleep quality were 38.8%, 19.5%, and 21.2%, respectively. Age and family history of physical disease were significant background factors of abstinence motivation. Impulsivity, depressive symptoms, anxiety symptoms, and poor quality of sleep were negatively associated with abstinence motivation. Perceived social support from family and important others was positively associated with abstinence motivation. Structural equation modeling fitted the data well in which impulsivity and perceived social support were both associated with abstinence motivation indirectly through mental health problems. Conclusion: The identified psychosocial factors should be addressed in community rehabilitation treatment and follow-up service to enhance abstinence motivation and the long-term effectiveness of the treatment.

Sleep health and associated factors among undergraduates during the COVID-19 in China: A two-wave network analysis.

Using network analysis, the current study investigated the pathways that underlie selected components of sleep health and their changes over time. Undergraduates (N = 1423; 80.60% female) completed a two-wave survey, sleep health (i.e. chronotypologies (CTs), sleep procrastination (SP), sleep quality (SQ)), psychological distress (PD), emotion regulation (ER), self-control (SC), problematic smartphone use (PSU) were measured. CTs, SP, and SQ formed a spatially contiguous pattern that remained unchanged in both waves. ER and PD node increased its strength, betweenness, and closeness in the network, while the link between the two was strengthened at T2. PSU was connected to SP, but not to CTs and SQ during both waves. In the context of the network approach, SP had the highest strength, and its associations with other dimensions of individual sleep may represent key factors in understanding the influence of exposure to the COVID-19 outbreak on sleep health.

Are "night owls" or "morning larks" more likely to delay sleep due to problematic smartphone use? a cross-lagged study among undergraduates.

Sleep is an important physiological process, but staying up late has become a worldwide problem, particularly among university students. Sleep procrastination has been found to associated with sleep biorhythms and problematic smartphone use ("PSU") in previous studies. This two-wave study examines the longitudinal reciprocal relationship between PSU and sleep procrastination, together with the moderating role of sleep biorhythms. Participants comprised 1,423 Chinese university students. The results revealed that PSU and sleep procrastination are reciprocally related. Additionally, sleep biorhythms moderated this relationship, as PSU at T1 significantly predicted sleep procrastination at T2 for the morning larks group but not the night owls group. Accordingly, both PSU and sleep biorhythms should be considered when developing interventions for sleep procrastination.

Prospective association between perceived stress and anxiety among nursing college students: the moderating roles of career adaptability and professional commitment.

BACKGROUND: Anxiety may stay with nursing students throughout their internship and even persist afterwards. Although many studies have explored the effects of perceived stress on anxiety, the relationship between pre-internship perceived stress and post-internship anxiety levels has not been clarified. In addition, none had focused on the moderating roles of career adaptability and professional commitment between perceived stress and anxiety. This study aims to investigate the influence of pre-internship perceived stress on the post-internship anxiety level of nursing college students, and to analyze the moderating effects of career adaptability and professional commitment on their relationships. METHODS: A longitudinal study design was employed. Full-time nursing college students from a Chinese medical university were recruited by convenient sampling. All surveys were conducted via Wen Juan Xing ( www.wjx.cn ), a widely used web-based survey platform in China. Two waves of surveys were collected in the pre-internship and post-internship periods, with an interval of one year. Among 823 nursing students recruited, 692 students completed all two waves of the survey (response rate: 84.08%). Participants completed a series of questionnaires examining general demographic characteristics, perceived stress, anxiety, career adaptability, and professional commitment both before and after the internship. The bias-corrected bootstrap technique of the Hayes PROCESS macro (Model 2) was used to test the moderation effect. RESULTS: Pre-internship perceived stress was positively associated with post-internship anxiety (ß = 0.474, p < 0.001). Career adaptability would mitigate the effect of perceived stress on anxiety (ß = -0.009, p < 0.01, 95% CI = [-0.013, -0.004]), and this influence became stronger for nursing college students with higher levels of career adaptability. Instead, the professional commitment would enhance the effect of perceived stress on anxiety (ß = 0.004, p < 0.05, 95% CI = [0.001, 0.009]). CONCLUSIONS: Adequate career adaptability was key to alleviating anxiety among nursing interns. Nursing educators and clinical nursing managers should pay attention to cultivating the career adaptability of nursing college students in order to help them successfully achieve identity transformation and career development. Meanwhile, it is crucial to guide them to develop appropriate professional commitment.

A cross-lagged study of the associations among problematic smartphone use, depressive symptoms, and suicidal ideation in chinese university students.

The present study aimed to investigate the longitudinal and reciprocal relationships among problematic smartphone use (PSU), depressive symptoms (DS), and suicidal ideation (SI) in Chinese university students. Using a cross-lagged design, the Mobile Phone Addiction Inventory Scale, the Center for Epidemiologic Studies Depression Scale, and the Self-Rating Idea of Suicide Scale as research instruments, 194 university students completed a questionnaire four consecutive times. June of Year 1, December of Year 2, June of Year 2, and December of Year 3 of their college study. We refer to these as the Time 1 (T1), Time 2 (T2), Time 3 (T3), and Time 4 (T4) assessments, respectively. The levels of PSU and DS fluctuated significantly over time. DS at T1 was significantly predicted to influence SI at T2 (ß = 0.17, p < .05); DS at T3 was significantly predicted by PSU and by SI at T2 (respectively, ß = 0.30, p < .05; ß = 0.21, p < .05); DS at T2 significantly predicted PSU at T3 (ß = 0.14, p < .05); and DS at T3 significantly predicted SI at T4 (ß = 0.14, p < .05) in the cross-lagged pathway. DS at T3 fully mediated the relationship between PSU at T2 and SI at T4 (indirect effect: ß = 0.133, 95% CI = [0.063, 0.213]). The results suggest that there is a reciprocal relationship between PSU and DS and, furthermore, that DS plays an important mediating role between PSU and SI. Our results suggest the importance of early identification and treatment of SI. Timely reduction of PSU and improvement of DS among university students may help prevent SI.

Longitudinal relationships among career adaptability, resilience, and career commitment in chinese nursing undergraduates: testing differences in career interest between cross-lagged models.

PURPOSE: Various physiological and psychological negative situations experienced by nurses as a result of COVID-19 pandemic have been shown to increase their perception of organizational difficulty and decrease their career commitment, thereby accelerating the turnover rate of nurses. Resilience and career adaptability have important influences on career commitment, so there is a need to evaluate the relationships between them and the underlying mechanisms. PATIENTS AND METHODS: Using a cross-lagged design, the Career Adaptability Scale, the Chinese version of career commitment, and Davidson's Resilience Scale as research methods, we studied 692 nursing students for two consecutive years to evaluate the relationship among career adaptability, resilience, and career commitment. RESULTS: Career adaptability at T1 substantially and positively predicts the career commitment at T2. Career adaptability and resilience are mutually predictive. No interaction is found between resilience and career commitment over time. There is a substantial difference in the cross-lagged relationship among career adaptability, resilience, and career commitment for low- and high-career interest. CONCLUSION: Our results show the importance of developing career commitment early on. Developing career adaptability, enhancing resilience, and increasing career interest in nursing students might help to increase career commitment.

Risk and Protective Factors Associated With Smartphone Addiction and Phubbing Behavior Among College Students in China.

Both smartphone addiction and phubbing are emerging behavioral problems. The present study investigates potential risk and protective factors of smartphone addiction and phubbing behavior, including demographic factors, personal factors, and interpersonal factors among Chinese college students. A total of 866 college students (Mage = 21.01, SD = 1.60) completed self-reported questionnaires in classroom settings. Collected data were analyzed by using Pearson's correlation and hierarchical linear regression analyses. The risk factors for smartphone addiction were phubbing behavior, depression, and social anxiety, while the protective factors were self-control and sense of security. In addition, the risk factors for phubbing behavior included female sex and smartphone addiction, while the protective factors included sense of security and interpersonal adaptability. Our findings help to enhance understanding of the general and specific risks and protective factors for smartphone addiction and phubbing behavior, which can benefit intervention development for related behavior prevention and reduction.

Prospective Association between Smartphone Addiction and Perceived Stress and Moderation of Boredom during COVID-19 in China.

Smartphone addiction (SPA) is prevalent in college students and harms their healthy development, and perceived stress (PS) has been a well-documented risk factor of SPA. People often experienced boredom during COVID-19; however, its effect on behavioral/mental health during the pandemic has been rarely tested. We investigated the prospective association between SPA and PS before and during COVID-19, as well as the moderation of boredom. A total of 197 college students participated in four-wave surveys from December 2018 to June 2020 in China. The cross-lagged model was developed to investigate the prospective association between SPA and PS from T1 to T4. Boredom was added to the model at T4 as a moderator to explore the moderating role of boredom during COVID-19. The results showed that the pandemic changed PS's prediction on SPA. During COVID-19, boredom significantly affected SPA and PS and moderated the link from PS at T3 to PS at T4. The results suggest that the prospective associations between SPA and PS varied before and during COVID-19. Prevention of SPA should be conducted for new students and should be used to enhance their stress coping capacity. Intervention programs for eliminating boredom may be effective for reducing stress and SPA during COVID-19.

Do Attitudes, Mental Health Status, and Interpersonal Factors Predict COVID-19 Vaccine Hesitancy at the Early Phase of the Pandemic? A Longitudinal Study in Chinese College Students.

Purpose: The present study examined whether and how attitudes toward the COVID-19 vaccine (i.e., safety, efficacy, and price), mental health statuses (i.e., perceived stress and depression), and interpersonal factors (i.e., online social support, perceived social support) would predict COVID-19 vaccine hesitancy. Patients and methods: The two-wave longitudinal surveys were conducted in December 2019 and 2020 in Chinese medical college students (N = 194). Well- validated measures were used, including the Perceived Stress Scale, the Center for Epidemiologic Studies Depression Scale, the Online Social Support Questionnaire, and the Perceived Social Support Scale. Perceived safety, efficacy, price of COVID-19 vaccine, vaccine hesitancy, and actual intake were also measured. Results: Only 2.1% of participants had been vaccinated against COVID-19 in the early stages of the pandemic; 13.4% intended to get vaccinated in the next 3 months, and 66% intended to have it in the next 12 months upon follow-up. Multiple regression analyses revealed that perceived stress (ßm = -0.15, p < 0.05) and depression (ßm = -0.15, p < 0.05) were risk factors for positive attitudes toward the COVID-19 vaccine; online social support (ORm = 1.41, p < 0.01) and positive attitudes toward the COVID-19 vaccine (ORm = 1.83, p < 0.01) were protective factors of intention to get vaccinated in future. Conclusion: Findings suggest that intervention efforts should be made to reduce negative attitudes toward the COVID-19 vaccine among people with poor mental health and enhance online social support to promote COVID-19 vaccination.

The role of illness representations of internet gaming disorder (IGD) in help-seeking intention among undergraduates: A longitudinal study.

BACKGROUND AND AIMS: The Common-Sense Model asserts that illness representations of a health threat affect coping and behavioral reactions to it. Internet gaming disorder (IGD) is a newly defined mental disorder and leads to various health consequences. Little is known about illness representations of IGD and help-seeking for IGD among young adults who are at particular risk of IGD. OBJECTIVE: This study investigated the roles of illness representations in intention to seek help from professionals and important others (families and friends) for IGD in college students in China. METHODS: A two-wave longitudinal study was conducted with a convenience sample of college students in China (N = 591, 57.9% females, Meanage = 19.10). Descriptive analyses and logistic regression analyses were conducted. RESULTS: Approximately 10% of participants were classified as having probable IGD. However, over 70% endorsed self-diagnosed IGD. Less than 40% perceived resources of help-seeking, and most perceived shame for help-seeking. Less than 40% intended to seek help from professionals, and 26% from family and friends. Significant predictors of intention to seek professional help included probable IGD, perceived resources of help-seeking for IGD, consequence, timeline, and treatment. Significant predictors of intention to seek help from family and friends included probable IGD, self-diagnosed IGD, perceived resources of help-seeking for IGD, shame for help-seeking for IGD, timeline, treatment control, identity, concern, and emotional response. Females were more likely to seek both types of help. DISCUSSION AND CONCLUSIONS: Perceptions of IGD and help-seeking play significant roles in help-seeking intentions. These modifiable factors can be used to guide the development of health promotion and behavioral change programs to promote help-seeking for IGD.

Longitudinal relationships among perceived stress, suicidal ideation and sleep quality in Chinese undergraduates: A cross-lagged model.

BACKGROUND: Sleep quality is an important indicator of quality of life. It is of importance to investigate the risk factors and potential consequences of poor sleep quality, such as perceived stress and suicidal ideation. We therefore investigated the longitudinal and reciprocal relationships among perceived stress, suicidal ideation, and sleep quality. METHODS: A three-wave longitudinal survey was conducted from June 2019 to June 2020 at six-month intervals in undergraduate students (N = 197, 58.9% female) in China. The participants completed self-report questionnaires in classroom settings. RESULTS: While the levels of perceived stress were stable, levels of suicidal ideation and sleep quality fluctuated significantly over time. There were significant reciprocal relationships between perceived stress and suicidal ideation from T1 to T3. In addition, the reciprocal relationships between suicidal ideation and sleep quality from T1 to T2 were also significant. Suicidal ideation at T2 partially mediated the relationship between perceived stress at T1 and sleep quality at T3 (indirect effect: ß=0.06, 95% CI: 0.04 to 0.10, p<0.001), and suicidal ideation at T2 fully mediated the relationship between sleep quality at T1 and perceived stress at T3 (indirect effect: ß=0.48, 95% CI: 0.30, 0.70, p<0.001). LIMITATIONS: The subjects' educational background is single, and the measurement method is self-report measures. CONCLUSIONS: Suicidal ideation may play a significant role in explaining the longitudinal relationships between perceived stress and sleep quality. And suggest the importance of early identification and treatment of suicidal ideation among Chinese undergraduates.

How mobile phone addiction is associated with suicidal ideation in university students in China: Roles of depression and online social support.

Background: Recent studies have highlighted mobile phone addiction (MPA) as a potential risk of suicidal ideation. However, the mechanisms underlying that association require attention. Objective: This investigation aims to examine whether the relationship between MPA and suicidal ideation would be mediated by depression, and buffered by online social support (OSS) in university students. Methods: A convenient sample of 1,042 Chinese university students completed the measures of mobile phone addiction, depression, suicidal ideation, OSS in classroom settings. Moderated mediation analyses were performed to test the roles of depression and OSS in the association between MPA and suicidal ideation. Results: MPA was positively associated with suicidal ideation through depression (indirect effect =. 23, 95% CI: 0.18, 0.28, p < 0.001); OSS moderated the association between depression and suicidal ideation (B = - 0.09, 95% CI: -0.13, -0.04, p < 0.001). Specifically, the effect of depression on suicidal ideation was weaker in individuals with high (versus low) OSS. OSS moderated the association between MPA and suicidal ideation (B = 0.06, 95% CI: 0.02, 0.10, p = 0.001). The influence of MPA on suicidal ideation was non-significant among individuals with high OSS but negatively significant among students with low OSS. Conclusion: The results enrich the understanding of how MPA may increase suicidal ideation, and highlight the potential importance of reducing depression and enhancing OSS to prevent suicidal ideation in university students.

Longitudinal Effects of Stressful Life Events on Problematic Smartphone Use and the Mediating Roles of Mental Health Problems in Chinese Undergraduate Students.

Background and Aims: This three-wave longitudinal study investigated the effects of stressful life events on problematic smartphone use and the mediating roles of mental health problems (i.e., depressive symptoms, poor sleep quality, and suicidal ideation) in Chinese undergraduate students. Methods: A total of 197 undergraduate students completed the three-wave surveys. Their severity of stressful life events, mental health problems, and problematic smartphone use were assessed. Results: Regression analyses revealed that stressful life events at T1 was significantly associated with problematic smartphone use at T3. Mediation analyses showed that mental health problems (i.e., depressive symptoms, poor sleep quality, and suicidal ideation) at T2 fully mediated the association between stressful life events at T1 and problematic smartphone use at T3 (B = 0.042, 0.034, and 0.022, respectively). Conclusions: The present study revealed that stressful life events and mental health problems (i.e., depressive symptoms, poor sleep quality, and suicidal ideation) are predictors of problematic smartphone use in Chinese college students.

Relationship Between Illness Representations and Symptoms of Internet Gaming Disorder Among Young People: Cross-Lagged Model.

BACKGROUND: The common-sense model of illness suggests that mental representations of health threats may affect one's behavioral reactions to them and health status. Internet gaming disorder is a newly defined mental disorder. Illness representations of internet gaming disorder may affect one's risk of internet gaming disorder. In turn, symptoms of internet gaming disorder may affect one's perceptions of the disorder. OBJECTIVE: This study aimed to investigate the relationships between illness representations and symptoms of internet gaming disorder in college students. METHODS: A 1-year longitudinal study was conducted with a convenience sample of Chinese college students (n=591; 342/591, 57.9% female). RESULTS: Of the participants, 10.1% (60/591) and 9.1% (54/591) were classified as having probable internet gaming disorder at baseline (T1) and follow-up (T2), respectively. The correlations between some dimensions of illness representations regarding internet gaming disorder (ie, consequence, timeline, personal control, treatment control, and concern) at T1 and symptoms of internet gaming disorder at T2 and between symptoms of internet gaming disorder at T1 and the dimensions of illness representations at T2 (ie, consequence, timeline, personal control, and emotional response) were statistically significant. The cross-lagged model fit the data well ((χ2/df=2.28, comparative fit index=.95, root mean square error of approximation=.06) and showed that internet gaming disorder at T1 was positively associated with unfavorable illness representations at T2. CONCLUSIONS: Individuals with more severe symptoms of internet gaming disorder had more pessimistic perceptions about the disorder. Such cognitive perceptions may affect one's emotional and behavioral reactions towards the disorder (eg, greater levels of depression and low self-control intention) and should be modified by educational programs and psychological interventions.

Effects of Online Social Support and Perceived Social Support on the Relationship Between Perceived Stress and Problematic Smartphone Usage Among Chinese Undergraduates.

PURPOSE: Recent research has identified a relationship between perceived stress and problematic smartphone usage. However, little is known about the underlying mediating and moderating mechanisms. The present study aimed to test the relationship between perceived stress and problematic smartphone usage as well as the mediating role of online social support and the moderating role of perceived social support among Chinese undergraduates. PATIENTS AND METHODS: A sample of 1123 college students participated in the study. The Perceived Stress Scale, Mobile Phone Addiction Index Scale, Online Social Support Questionnaire, and Perceived Social Support Scale were used. RESULTS: Perceived stress was significantly and positively associated with problematic smartphone usage, and online social support partially mediated the relationship between perceived stress and problematic smartphone usage. Moderated mediation analysis suggested that perceived social support moderated the association between perceived stress and online social support. This relationship became stronger for college students with lower levels of perceived social support. CONCLUSION: The results of this study can contribute to a better understanding of how perceived stress increases the risk of problematic smartphone usage. The importance of reducing online social support and enhancing perceived social support in preventing undergraduates' problematic smartphone usage is highlighted. The findings should be taken with caution given the convenience sampling and cross-sectional study design.