The effects of self-esteem and parental phubbing on adolescent internet addiction and the moderating role of the classroom environment: a hierarchical linear model analysis.

BACKGROUND: With the advent of the new media era, the understanding of adolescent internet addiction needs to be enriched. It is also necessary to distinguish the related factors of adolescent internet addiction at different levels to clarify the mechanisms of this phenomenon. METHODS: This study used hierarchical linear model analysis to explore the effects of student-level factors and school-level factors on adolescent internet addiction, along with cross-level moderating effects. A total of 1,912 students between the 4th and 8th grades in China participated in the study. Participants completed the Self-Esteem Scale, Parents Phubbing Scale, Classroom Environment Scale, and the Diagnostic Questionnaire of Internet Addiction. RESULTS: Correlational analyses revealed that internet addiction was found to be negatively correlated with both self-esteem and the teacher-student relationship (p < 0.01), while father phubbing, mother phubbing, and learning burden were shown to positively correlate with internet addiction (p < 0.01). Hierarchical linear model analysis suggested that student-level variables, including self-esteem, and mother phubbing, were significant predictors of internet addiction (ß = -0.077, p < 0.001 and ß = 0.028, p < 0.01, respectively). At the school level, learning burden significantly and negatively predicted internet addiction (ß = 0.073, p < 0.05). Furthermore, the relationship between self-esteem and internet addiction was significantly moderated by learning burden (ß = -0.007, p < 0.05). Meanwhile, the teacher-student relationship also had a significant moderating effect on the association between mother phubbing and internet addiction (ß = -0.005, p < 0.01). CONCLUSIONS: This study revealed the relationships between self-esteem, parental phubbing, and classroom environment with adolescent internet addiction, and these findings could provide insights into reducing adolescent internet addiction from the perspective of individuals, families, and schools.

Effects of indoor temperature and its fluctuation on blood pressure and its variability.

Cardiovascular diseases (CVDs) are the number one health threat globally. Adverse indoor thermal environments are associated with excess mortality caused by CVDs in the cold season. While many studies have focused on the impact of indoor temperature on CVDs, none has considered the fluctuation of indoor temperature. To quantify the effect of indoor temperature on blood pressure and the effect of indoor temperature fluctuation on blood pressure variability (BPV), 172 middle-aged and elderly people in areas that experience both hot summers and cold winters in China completed a household survey regarding their characteristics and living habits. A hierarchical linear model (HLM) was used to analyze the impact of indoor temperature on home blood pressure. A multiple linear model was used to analyze the effect of indoor temperature fluctuation on day-to-day home blood pressure variability. The results showed that there was a significant negative correlation between morning temperature below 18 °C and blood pressure, especially systolic blood pressure (SBP). At the same time, morning temperature fluctuations have an independent influence on BPV, and a deviation of morning temperature fluctuation greater than 1.1 °C significantly increased BPV. Morning temperature and its fluctuation threshold for the rise of SBP and its variability of middle-aged and elderly people were clarified, which can provide a basis for the design, operation, and evaluation of residential thermal environmental health performance for the middle-aged and elderly population in this area, thereby reducing the cardiovascular health risk of the corresponding population.

The primary drivers of private-sphere pro-environmental behaviour in five European countries during the Covid-19 pandemic.

Nowadays, when fighting climate change and other global environmental issues is of utmost urgency, the understanding of what drives pro-environmental behaviour has become a hot topic in both academic and practical circles. Some earlier studies unravelled the complexity of the underlying factors of pro-environmental conduct, yet more studies are needed to understand the socio-cultural premises of such behaviour in different countries. The main aim of this paper is to offer a comprehensive analysis of the importance of pro-environmental behaviour drivers across five countries in Europe, namely Greece, Poland, Portugal, Sweden, and the United Kingdom. The survey using computer-assisted web interviews (N = 2502) was implemented in July 2020, the first summer of the Covid-19 pandemic. Hierarchical linear models were employed to analyse individuals' behaviour, defined as self-perceived declaration of the willingness to contribute to environmental conservation. The results showed that attitudinal and value-related factors are more significant than demographics. Biospheric values and relationship to nature generally affect pro-environmental behaviour positively. Similarly, the experience of Covid-19 exerted a positive influence. In terms of country-level predictors, greenhouse gas emissions were found to have affected pro-environmental behaviour negatively, while the share of renewable energy sources influenced it positively. The cumulative country Covid-19-related mortality at the time of investigation did not have discernible impact. Based on the results it is suggested that, in order to foster PEB, a stronger emphasis on environmental education and attitudes towards nature should be employed.

Pro-sociality and happiness across national cultures: A hierarchical linear model.

Research from both Empirical studies and Positive Psychology has indicated that pro-sociality has a universal effect on happiness; however, this does not take into account the national or cultural differences of a given country. The hierarchical linear model (HLM) is employed in this study to investigate the link between pro-sociality and happiness at the individual level, as well as the effect of four national cultures (i.e., power distance, individualism versus collectivism, masculinity versus femininity, and uncertainty avoidance) at the country/territory level on this relationship. This study utilizes the public World Value Survey dataset, which adopts random probability representative adult samples from 32 countries or territories (N = 53,618; Mage = 44.10, SD = 16.51). Results suggest that pro-sociality is associated with happiness, even when accounting for demographics and the country/territory code. Additionally, the country/territory level displays variations in happiness, which can be partially explained by masculinity versus femininity (positively) and uncertainty avoidance (negatively). Moreover, the connection between pro-sociality and happiness is not influenced by national cultures. This research provides evidence for the universal happiness reward of pro-sociality. Implications, restrictions, and potential future research directions are discussed.

Predictors of loss due to pharmaceutical fraud: evidence from the U.S.

BACKGROUND: Globally and in the U.S. in particular, pharmaceutical fraud account for a large number out of all crimes in health care, which result into severe costs to the society. The Academy of Managed Care Pharmacists (Fraud, waste, and abuse in prescription drug benefits. 2019. Posted May 20. https://www.amcp.org/policy-advocacy/policy-advocacy-focus-areas/where-we-stand-position-statements/fraud-waste-and-abuse-prescription-drug-benefits .) estimate that pharmacy fraud is 1% of costs, therefore estimating that pharmacy fraud costs at $3.5 billion, given that pharmacy costs are $358 billion (Statista. Prescription drug expenditure in the United States from 1960 to 2020. 2021. https://www.statista.com/statistics/184914/prescription-drug-expenditures-in-the-us-since-1960/ ). AIM: This exploratory study aims to demonstrate a fraudster's profile as well as to estimate average consequences in terms of costs and identify the loss predictors' hierarchy in the pharmaceutical industry in the U.S. MATERIALS AND METHODS: Data from the Corporate Prosecution Registry and mixed-effects models are utilized for this purpose. The dataset covers years 2001-2020 and 75 cases, falling into one of the following broad sub-categories: misbranding, counterfeit, off-label use of drugs/deceptive marketing; violation of the Food, Drug and Cosmetic Act. RESULTS: The main factors positively associated with loss due to pharmaceutical fraud are: (i) duration of , and (ii) the scheme and scheme being executed at a U.S. public company. Surprisingly, presence of collusion negatively and significantly effects the cost. Potential factors include: (a) principal perpetrator being a white American and/or male, and (b) number of employees at individual and organizational level respectively. CONCLUSION: This study empirically justifies considering loss, due to pharmaceutical fraud, from a multi-level perspective. Identified profiles of a typical fraudster helped to elaborate on specific practical recommendations aimed at pharmaceutical fraud prevention in the U.S.

Effect of income inequality, community infrastructure and individual stressors on adult depression.

This paper considers the impact of variables at three different levels-city, community and individual-on the depression of adults aged 45 years and above in China. Evidence shows that community factors, such as infrastructure and elderly centres, are critical to reduce depression but the effect of city-level factors such as lowering income inequality and improving public health investment is different for the segments of poor and non-poor as well as the rural and urban residents. This highlights the need to consider targeted policy mix options to avoid resource misallocation. Lastly, Chinese females' depression has worsened over time with ageing, particularly those who drink alcohol or are less educated are prone to depression prompting the need for specialist women health centres.

Neck Stabilization Exercises Enhance Respiratory Function after Stroke: Respiratory Function Index Change Trajectory Analyzed Using a Hierarchical Linear Model.

Background and Objectives: This study aimed to assess the effect of neck stabilization exercise on respiratory function in stroke patients through longitudinal observation and determine whether there is a difference in its effect based on the side of paralysis in the patients. It is difficult to observe the amount of change observed in individuals and groups as most intergroup comparison studies only use mean values. To address these shortcomings, this study adopted a hierarchical linear model (HLM) in our trajectory analysis. Materials and Methods: We conducted neck stabilization training three times a week for four weeks in a single group of 21 stroke patients. To evaluate respiratory function, their forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), forced expiration ratio (FEV1/FVC), and peak cough flow (PCF) were measured. Data analysis was performed using HLM 8.0. Results: A significant increase was found in the respiratory function after neck stabilization training (p < 0.05). While neck stabilization training overall was longitudinally effective, the growth rate of respiratory function in left-sided paralytic patients was less than the whole group value. Conversely, the growth rate of respiratory function in right-sided paralytic patients was greater than the whole group value. Conclusions: This study demonstrated that neck stabilization training is longitudinally effective in improving respiratory function in stroke patients. Additionally, the growth rate of respiratory function was greater in patients with right side paralysis than in patients with left side paralysis.

Why Do We Require Registered Nurses in Nursing Homes? Using Longitudinal Hierarchical Linear Modeling.

AIMS: To examine the relationship between nurse staffing and quality of care of nursing home residents, longitudinally. BACKGROUND: Mixed results abound on the relationship between nurse staffing and quality of care of residents in nursing homes. Cross-sectional designs may underpin bias because the relationship between staffing and quality emerges over time, with latent unobserved variables. To offset this limitation, I used a longitudinal design in this study. DESIGN: I used repeated quarterly survey methods. METHODS: I measured staffing information with a formula developed by the Centers for Medicare & Medicaid Services. Outcome variables were 15 quality indicators and the Korean National Health Insurance Service 2015 nursing home evaluation manual. RESULTS AND FINDINGS: As registered nurse hours per resident day increased by 1, the percentage of residents with depression decreased by 3.88%, and the prevalence of residents with nasogastric tubes increased by 1.17% in 3 months. Prevalence of residents with bed rest decreased by 5.72%, and residents with restraints decreased by 1.092%. More registered nurses and fewer certified nursing assistants or qualified care workers yielded a statistically significant negative influence on aggressive behavior, depression, weight loss, and bed rest. The higher turnover of total nursing staff related to more use of antidepressants. CONCLUSIONS: Results supported registered nurses' exclusive impact on resident outcomes. More longitudinal research is required to confirm the influence of nurses on nursing home residents' outcomes. CLINICAL RELEVANCE: This study supported about the contributions of increased input of Registered Nurses, additional to previous longitudinal studies. The nursing homes in Korea should have mandatory Registered Nurse placement for optimal quality of care. CLINICAL RELEVANCE: This study supported about the contributions of increased input of Registered Nurses, additional to previous longitudinal studies. The nursing homes in Korea should have mandatory Registered Nurse placement for optimal quality of care.

Differentiating between mixed-effects and latent-curve approaches to growth modeling.

In psychology, mixed-effects models and latent-curve models are both widely used to explore growth over time. Despite this widespread popularity, some confusion remains regarding the overlap of these different approaches. Recent articles have shown that the two modeling frameworks are mathematically equivalent in many cases, which is often interpreted to mean that one's choice of modeling framework is merely a matter of personal preference. However, some important differences in estimation and specification can lead to the models producing very different results when implemented in software. Thus, mathematical equivalence does not necessarily equate to practical equivalence in all cases. In this article, we discuss these two common approaches to growth modeling and highlight contexts in which the choice of the modeling framework (and, consequently, the software) can directly impact the model estimates, or in which certain analyses can be facilitated in one framework over the other. We show that, unless the data are pristine, with a large sample size, linear or polynomial growth, and no missing data, and unless the participants have the same number of measurements collected at the same set of time points, one framework is often more advantageous to adopt. We provide several empirical examples to illustrate these situations, as well as ample software code so that researchers can make informed decisions regarding which framework will be the most beneficial and most straightforward for their research interests.

Social disparities in body mass index (BMI) trajectories among Chinese adults in 1991-2011.

BACKGROUND: Obesity is a serious public health problem in China. The relationship between obesity and socio-economic status (SES) is changing and affected by uncertainty, particularly, in developing countries. The sex-related differences in body mass index (BMI) trajectories are controversial and require substantial empirical data for updating and enriching. METHODS: This study examined the relationship between SES and BMI in Chinese adults from a dynamic perspective using longitudinal data (1991-2011) from the China Health and Nutrition Survey (CHNS). Then, sex-related differences were determined. A hierarchical linear model was used. RESULTS: SES positively affected the male BMI changes, with faster BMI growth rates in the high-SES males over the past 20 years. By contrast, female BMI was only affected by BMI baseline and residential area. Specifically, greater BMI baseline led to greater BMI growth rate and earlier BMI decline. In the past 20 years, the BMI growth rate has been greater in the urban females than in the rural females. CONCLUSIONS: The relationship between SES and obesity is complex in China, and a substantial sex-related difference exists. We argue that this large sex-related difference is due to the rapid economic and social changes that have affected national health and increased the gender inequality and social role restrictions in females. We provide insights for further research and policy recommendations.

So what really is user experience? An experimental study of user needs and emotional responses as underlying constructs.

This driving simulator study extended knowledge on user experience using a strategy to mitigate distraction resulting from the use of in-vehicle information systems (IVISs). It examined the impact of system restrictions on users' needs, emotions and consequences of users' experience in terms of psychological reactance. In a repeated measures design, we asked 53 participants to perform secondary tasks with an IVIS while driving. Three versions of the system varied with respect to the number of operable functionalities. The more functionalities that were disabled while driving, the more negatively users rated the systems. Multilevel regression analyses of at least n = 155 data points revealed that drivers' need fulfilment predicted their emotions. Reactance depended on users' need fulfilment and emotions. Experienced autonomy mediated the relation between functional limitations and reactance. When developing interactive systems, one should focus on needs and be aware of potential unwanted consequences such as psychological reactance. Practitioner Summary: This driving simulator study highlights the importance of considering need fulfilment and users' emotions when developing an interactive system that provides high user experience. System restrictions could have negative consequences as users might show psychological reactance.

Intrinsic and extrinsic goals as moderators of stress and depressive symptoms in Chinese undergraduate students: A multi-wave longitudinal study.

BACKGROUND: Studies in western countries have examined the specific vulnerability hypothesis of Dykman's theory of goal-orientation predispositions to depression through two-time point designs. The purpose of this prospective longitudinal study was to investigate the moderating effects of intrinsic and extrinsic goals on stress and depressive symptoms in Chinese undergraduate students. METHODS: A total of 462 undergraduate students [46% female; mean age, 19.06 (range, 17-22) years] completed self-reported measures assessing intrinsic and extrinsic goals, depressive symptoms, and the occurrence of social and academic hassles. Every 3 months over the subsequent 12 months, the undergraduate students completed measures assessing depressive symptoms and the occurrence of daily hassles. RESULTS: Results of hierarchical linear modeling analyses indicated that undergraduate students with low levels of intrinsic goals reported greater depressive symptoms following the occurrence of social and academic hassles than did those with high levels of such goals. However, undergraduate students with high levels of extrinsic goals did not report greater depressive symptoms following the occurrence of social and academic hassles than did those possessing low levels. CONCLUSIONS: These findings suggest that intrinsic goals can protect undergraduate students experiencing high levels of social and academic hassles from depressive symptoms. The study findings provide new insight into the course of depressive symptoms among undergraduate students, and offer psychologist and psychiatrists ways to protect individuals from depressive symptoms by building up intrinsic goals.

Systematic review of restraint interventions for challenging behaviour among persons with intellectual disabilities: focus on effectiveness in single-case experiments.

BACKGROUND: This article is the first in a two-part series: we focus on the effectiveness of restraint interventions (RIs) for reducing challenging behaviour (CB) among persons with intellectual disabilities in this first article. In the second article, we focus on experiences with RIs for CB among people with intellectual disabilities. METHODS: A mixed-methods research synthesis involving statistical meta-analysis and qualitative meta-synthesis techniques was applied to synthesize 76 retrieved articles. This first article reports on the meta-analysis of 59 single-case experiments (SCEs) on effectiveness of RIs for CB among people with intellectual disabilities. RESULTS AND CONCLUSIONS: The RIs reported on in the SCEs were on average highly effective in reducing CB for people with intellectual disabilities, and this reduction in CB was statistically significant. However, the effects vary significantly over the included participants, and the published data and reported outcomes are rather unrepresentative of the everyday use of RIs among persons with intellectual disabilities.

Impact of job embeddedness on miners' safety performance: the role of perceived insider status and safety climate.

The present study aims to explore the mechanism for the impact of job embeddedness on safety performance, the mediating role of perceived insider status and the cross-level moderating role of safety climate among miners. The questionnaire data used for analysis in this study were collected from 310 miners in 38 coal mine production teams in China. Bootstrap analysis was performed to explore the mediating role of perceived insider status, and multilevel linear analysis was performed to explore the cross-level moderating role of safety climate. The results showed that job embeddedness was positively related to miners' safety performance; perceived insider status mediating the relationship between job embeddedness and miners' safety performance; and safety climate moderating the relationship between perceived insider status and miners' safety performance across levels.

Unmet healthcare needs and the local extinction index: an analysis of regional disparities impacting South Korea's older adults.

Background: This study examines the factors affecting unmet healthcare experiences by integrating individual-and community-level extinction indices. Methods: Using spatial autocorrelation and multilevel modeling, the study utilizes data from the Community Health Survey and Statistics Korea for 218 local government regions from 2018 to 2019. Results: The analysis identifies significant clustering, particularly in non-metropolitan regions with a higher local extinction index. At the individual level, some factors affect unmet medical needs, and unmet healthcare needs increase as the local extinction index at the community level increases. Conclusion: The findings underscore the need for strategic efforts to enhance regional healthcare accessibility, particularly for vulnerable populations and local infrastructure development.

A longitudinal study of factors associated with cognitive frailty in middle-aged and elderly population based on the health ecology model.

BACKGROUND: Cognitive frailty (CF) is an important geriatric syndrome and is reversible. It is crucial to develop preventive interventions for CF. We aimed to explore the associations between CF and its associated factors in Chinese aged 45 years and above. METHODS: Based on the available data of 3 waves in China Health and Retirement Longitudinal Study from 2011 to 2015, 16,071 individuals aged 45 years and above from 3 waves were included. Based on the health ecology model, the associated factors were classified as downstream, midstream and upstream factors. Generalized hierarchical linear model including time level, individual level, and province level was applied to analyze the associations between factors and CF. RESULTS: Multilevel factors have different effects on physical and cognitive function. In the downstream, old age, female, underweight, chronic diseases, and depression were risk factors of reversible CF and potentially reversible CF, and overweight was their protective factor. In the midstream, short or long night sleep duration was their risk factor, and > 30 and ≤ 60 min afternoon naps, alcohol drinking, and participation in social activities were their protective factors. In the upstream, living in rural areas was their risk factor, and high educational level, household consumption and GDP per capita were their protective factors. CONCLUSIONS: Physical function and cognitive function are affected differently by multiple factors. The occurrence and development of physical frailty and cognitive impairment may have some common mechanisms. CF can be influenced by multilevel factors, and multilevel and comprehensive management of CF should be achieved. KEY POINTS: Cognitive frailty was correlated with multilevel factors, including downstream, midstream, and upstream factors. It is crucial to focus on individual interventions such as physiological factors, psychological factors and health behaviors, especially the elderly, women and those with depression. Socioeconomic status was associated with the lower prevalence of cognitive frailty.

Trajectories of sleep changes during the acute phase of traumatic brain injury: a 7-day actigraphy study.

BACKGROUND/PURPOSE: To examine trajectories of change in sleep during the acute phase of traumatic brain injury (TBI), and whether specific demographic and disease characteristics predicted the initial levels of sleep and the trajectories of change in sleep parameters. METHODS: This was a prospective observational study. Fifty-two patients with first-ever TBI were enrolled. Sleep parameters were measured using actigraphy for 7 consecutive days after admission. Hierarchical linear modeling was used for data analyses in 52 TBI patients and in a subgroup of mild TBI patients (n = 31). RESULTS: Participants had significant lower sleep efficiency, longer wake time after sleep onset, and longer 24-hour total sleep time (TST) than the normative data (all p < 0.05). Seventy-two percent of participants experienced prolonged 24-hour TST. Both daytime and 24-hour TST showed a significant downward trend across the study period. An initial Glasgow Coma Scale score < 11 significantly predicted the slope of change of daytime TST over time. Without initial loss of consciousness and age < 40 years were independent predictors of the change pattern of 24-hour TST over time. In the mild TBI subgroup, 24-hour TST significantly and gradually declined over time. Gender significantly predicted the trajectory of 24-hour sleep duration. CONCLUSION: Poor sleep efficiency and longer sleep duration are common symptoms in acute TBI patients. Both head injury severity and age predicted the trajectories of daytime and 24-hour sleep duration during the acute phase of TBI, whereas gender predicted the trajectories of 24-hour sleep duration in the mild TBI subgroup.

Association between children's home-schooling and parental psychological distress during the COVID-19 pandemic in Taiwan: Risk and protective factors in a multilevel approach.

BACKGROUND: The role home-schooling of children in parental mental health during the COVID-19 pandemic in Taiwan remains unknown. This study aimed to assess the association between parental psychological distress and home-schooling in a socio-ecological context during the peak of the first wave of the COVID-19 pandemic in Taiwan. METHODS: This was a prospective cohort study. In total, 902 parents (father: n = 206, mother: n = 696) who home-schooled children under 18 years of age were recruited by purposive sampling from 17 cities in Taiwan. Data were collected between 19 July and 30 September 2021 through a survey. Multilevel regression models were used to examine the association between parents' psychological distress and home-schooling considering the characteristics at the person and city levels. RESULTS: Parental psychological distress was positively associated with difficulty in setting up electronic devices and increased disputes between parents and children, and it was negatively associated with time management and increased time spent bonding with their children during home-schooling (Ps < 0.05). Parents who had a child with health conditions, lived in an extended family, worked from home, lived during the Level 3 alert level, and lived with a median/sporadic level of the COVID-19 community spread by city also reported greater psychological distress (Ps < 0.05). However, parents who had greater household family support reported less psychological distress (P < .05). CONCLUSIONS: Clinicians and policy makers must carefully consider parental mental health while home-schooling during the COVID-19 pandemic in a broader socio-ecological context. A focus is advised on the home-schooling experiences of parents and other risk and protective factors for parental psychological distress at the person and city levels, especially for those with children who require medical interventions and have a medical condition.

Regional integration and public healthcare environment: Evidence from China.

Introduction: Existing studies have focused on the impact of economic development and urban expansion on public healthcare environment but has ignored the importance of regional integration. Regional integration reflects the spatial distribution of the labor force, which significantly affects healthcare workforce and healthcare infrastructure development. Methods: Based on panel nested data for 137 cities in 16 major city clusters in China from 2001 to 2019, this paper assesses the impact of regional integration on the public healthcare environment through a hierarchical linear model (HLM). Results: Our findings indicate that a 1% increase in regional integration leads to a 6.6 and 1.9% improvement in healthcare workforce and healthcare infrastructure. The results of the mechanism analysis indicate that regional integration affects the public healthcare environment through improving transportation infrastructure and industrial upgrading. In addition, regional integration has a stronger effect on cities with lower levels of economic development and healthcare environments. Finally, the endogeneity test based on the difference-in-difference (DID) model and the robustness test based on high-dimensional fixed effects model conduct the consistent conclusions. Discussion: Policies to improve the public healthcare environment through promoting regional integration are proposed. Government should develop a more comprehensive regional cooperation plan to improve the public healthcare environment. Also, financial spending on improving the healthcare environment in peripheral cities should be increased. In addition, regional integration policy development needs to consider differences across regions.

Hierarchical Linear Model of Internet Addiction and Associated Risk Factors in Chinese Adolescents: A Longitudinal Study.

The risk effects of internet addiction have been documented in the literature; however, few longitudinal studies have considered the heterogeneity of the subjects. A hierarchical linear model was used here to explore the relationship between adolescents' internet addiction and associated risk factors (depression, anxiety, gender, and obesity) from the perspective of longitudinal analysis. A total of 1033 adolescents were investigated and followed up with every three months with the Self-Rating Depression Scale (SDS), Self-Rating Anxiety Scale (SAS), and Internet Addiction Test (IAT). The hierarchical linear model of internet addiction had only two levels. The first level of the model was the time variable (three time points) and the second level of the model was the individual adolescent (1033 adolescents). The results showed that (1) depression and anxiety, as associated risk factors, were significant positive predictors of adolescents' internet addiction considering the developmental trajectory courses of adolescent internet addiction, as well as the individual differences over time; (2) there were gender differences in the adolescents' internet addictions-specifically, the initial level of internet addiction among boys was significantly higher than that of girls, but the rate of decline was significantly faster than that of girls; and (3) there was no significant difference in obesity. The results demonstrated the importance of considering depression, anxiety, and gender in any intervention efforts to reduce adolescents' internet addictions, and we should pay attention to the cultivation of positive coping strategies for Chinese adolescents. The limitations of the study were also discussed.