The relationship between social frailty and cognitive impairment among older adults: the role of various types of internet use.

Introduction: This study aimed to explore the role of internet use in the relationship between social frailty and cognitive function among Korean older adults. Methods: A nationally representative survey of community-dwelling older adults in Korea was used in the analysis (N = 8,639). Results: All types of internet use were significantly associated with cognitive impairment and played a significant role in the relationship between social frailty and cognitive impairment. The advantage of internet use for information searching (OR 0.40, 95% CI 0.35-0.46) was the greatest for cognitive function, followed by internet use for instrumental use (OR 0.59, 95% CI 0.53-0.66). Internet use for entertainment exhibited the greatest influence in the relationship between social frailty and cognitive impairment, with interpersonal communication ranking second in significance. Internet use regulates the relationship between social frailty and cognitive impairment in older adults. The influences of internet use vary depending on the type of online activity and the levels of social frailty. Discussion: This highlights the importance of considering various forms of internet use when developing non-pharmacological interventions to mitigate the impact of social frailty on cognitive decline.

The Worldwide Prevalence of Internet Addiction among Medical Students: A Systematic Review and Meta-Analysis.

BACKGROUND: The internet helps us obtain necessary information, facilitates social communication, and provides access to entertainment content. The internet can also lead to the behavioral addictive condition termed internet addiction (IA) if used excessively. As active internet users, medical students are susceptible to IA, which is known to lead to depression and improper medical care delivery, poor academic performance, worse sleep quality, and undesirable financial issues. This systematic review and meta-analysis aimed to assess medical students' pooled IA prevalence. METHODS: The analysis included thirteen cross-sectional studies involving 4787 medical students. Cumulative, subgroup, and meta-regression meta-analyses were applied, using the random-effects model and the restricted maximum likelihood method. RESULTS: The cumulative meta-analysis revealed a rise in the proportion of IA from 0.08 to 0.29, with minor fluctuations between 2015 and 2022. The IA prevalence in lower-middle-income countries was approximately three times higher than in high-income ones. Age and gender were not associated with IA among medical students. CONCLUSIONS: The worldwide prevalence of IA was 0.29, with a 95% CI between 0.19 and 0.41. Considering negative IA implications for medical students' well-being, policymakers and all stakeholders should pay special attention to addressing IA within the medical student community.

Problematic Use of Smartphones and Social Media on Sleep Quality of High School Students in Mexico City.

BACKGROUND: Smartphones, internet access, and social media represent a new form of problematic behavior and can affect how teens sleep. METHODS: A cross-sectional design was employed to examine the prevalence and association of problematic internet use and problematic smartphone use with sleep quality in a non-probability sample of 190 high school students in Mexico. The internet-related experiences questionnaire (IREQ), the mobile-related experiences questionnaire (MREQ), and the Pittsburgh Sleep Quality Index (PSQI) were used. RESULTS: The study revealed that 66% of participants exhibited some form of problematic internet use, primarily in the form of social media use; 68% had some form of problematic smartphone use, and 84% reported poor sleep quality. The PSQI score was most accurately predicted by problematic smartphone use (MREQ), followed by enrollment in the morning school shift, participation in sports, the father's education level, and knowledge that "smartphone use disturbs sleep", which together explained 23% of the variation in sleep quality. CONCLUSIONS: Excessive smartphone use may negatively affect sleep quality in adolescents. We recommended that interventions be implemented to educate adolescents about appropriate and healthy use of technology, in parallel with the promotion of preventive sleep habits.

Beyond the Screen: A Comprehensive Analysis of Emotional Skills and Social Networking in French Young Adults.

(1) Background: This study investigates the influence of social networks on young adults, focusing on both positive and negative impacts. It considers problematic social networking site use (PSNSU), emotional intelligence, empathy, and the phenomenon of Fear of Missing Out (FoMO). (2) Methods: A comprehensive online survey was conducted with 442 participants aged 18 to 30 years that used various psychometric tools to assess emotional intelligence, empathy, internet and social media use, and FoMO. (3) Results: The study revealed that young adults display low competencies in emotional intelligence and empathy, with a tendency towards problematic internet and social media use. High FoMO scores were observed, correlating with negative internet use outcomes. Gender differences in these aspects were also explored. (4) Conclusions: The findings suggest a complex interaction between social network use, emotional skills, and FoMO that impacts young adults' mental health and social behaviors. This study highlights the need for a nuanced understanding of these relationships and their implications for well-being and social interaction in the digital age.

Dose-Response Associations of Internet Use Time and Internet Addiction With Depressive Symptoms Among Chinese Children and Adolescents: Cross-Sectional Study.

Background: Children's lives are increasingly mediated by digital technologies, yet evidence regarding the associations between internet use and depression is far from comprehensive and remains unclear. Objective: This study aimed to investigate the dose-response association between internet use, including use time and addiction behaviors, and depressive symptoms among children and adolescents in Zhejiang Province. Methods: Data were collected from a school-based health survey China Common Disease and Risk Factor Surveillance Among Students, encompassing 21,336 students in Zhejiang Province. The daily internet use time, internet addiction (IA) behaviors, and depressive symptoms were assessed with questionnaires. Logistic regression models were used to explore the associations of internet use time and IA behaviors with depressive symptoms among children and adolescents. Restricted cubic spline curves were used to determine the dose-response associations. Results: A total of 6225 (29.2%) students had depressive symptoms. Compared to those reporting no internet use, boys using the internet for >2 hours/day (odds ratio [OR] 1.53, 95% CI 1.34-1.74) and girls using internet for 1.1-2 hours/day (OR 1.22, 95% CI 1.06-1.39) and >2 hours/day (OR 1.70, 95% CI 1.50-1.93) were at higher risks of depressive symptoms. A significant J-shaped association was identified between internet use time and depressive symptoms among children and adolescents, especially in boys and primary school students (nonlinear P values were .006, .003, and <.001, respectively). Increased IA behaviors were associated with a higher odd of depressive symptoms (1 IA behavior: OR 2.01, 95% CI 1.83-2.21; 2 IA behaviors: 2.91, 95% CI 2.57-3.29; and ≥3 IA behaviors: 4.72, 95% CI 4.26-5.22). A positive nonlinear association between the number of IA behaviors and depressive symptoms was found in total population, girls, and primary school students (nonlinear P values were .02, .002, .007, respectively). Conclusions: Findings suggested that excessive internet use time and IA behaviors were significantly associated with an increased risk of depressive symptoms, highlighting the importance of interventions to regulate and educate about adequate internet use during childhood and adolescence.

Mediating Effects of Information Access on Internet Use and Multidimensional Health Among Middle-Aged and Older Adults: Nationwide Cross-Sectional Study.

BACKGROUND: With the exacerbation of population aging, the health issues of middle-aged and older adults have increasingly become a focus of attention. The widespread use of the internet has created conditions for promoting the health of this demographic. However, little is known about the effects of information access in promoting the relationship between internet use and the health of middle-aged and older adults. OBJECTIVE: This study aims to examine the relationship between internet use and multidimensional health in middle-aged and older adults, as well as the mediating effect of information access. Moreover, this study will explore the relationship between other dimensions of internet use (purposes and frequency) and health. METHODS: Data were sourced from the China General Social Survey conducted in 2018. Health outcomes, including self-rated, physical, and mental health, were assessed using the 5-level self-rated health scale, the 5-level basic activities of daily living scale, and the 5-level depression scale, respectively. The ordinal logistic regression model was used to examine the relationship between internet use and health among middle-aged and older adults. Additionally, the Karlson-Holm-Breen decomposition method was used to examine the mediation effect of information access. To address endogeneity issues, the two-stage least squares approach was applied. RESULTS: In our sample, nearly half (n=3036, 46.3%) of the respondents use the internet. Regression analyses revealed that internet use was positively associated with self-rated health (odds ratio [OR] 1.55, 95% CI 1.39-1.74; P<.001), physical health (OR 1.39, 95% CI 1.25-1.56; P<.001), and mental health (OR 1.33, 95% CI 1.19-1.49; P<.001) of middle-aged and older adults. Various dimensions of internet use positively contribute to health. In addition, information access significantly mediated the relationship between internet use and self-rated health (ß=.28, 95% CI 0.23-0.32), physical health (ß=.40, 95% CI 0.35-0.45), and mental health (ß=.16, 95% CI 0.11-0.20). Furthermore, there were significant differences in the relationship between internet use and health among advantaged and disadvantaged groups. CONCLUSIONS: The study showed that different dimensions of internet use are associated with better self-rated health, better physical health, and better mental health in middle-aged and older adults. Information access mediates the relationship between internet use and health. This result emphasizes the significance of promoting internet access as a means to enhance the health of middle-aged and older adults in China.

Health literacy and the use of digital tools in older patients with cancer and their younger counterparts: A multicenter, nationwide study.

OBJECTIVES: To evaluate health literacy (HL), assess the use of digital tools/sources, and identify factors associated with low or moderate HL in older (aged ≥65) and younger (18-64) patients with cancer. METHODS: A cross-sectional multicenter study including patients with cancer was conducted in 26 centers in France. HL was assessed using the Functional, Communicative and Critical Health Literacy (FCCHL) scale. Factors associated with low/moderate HL (score

Nomophobia (no-mobile-phone phobia) among the undergraduate medical students.

Nomophobia (no-mobile-phone phobia) is the fear and anxiety of being without a mobile phone. This study pioneers the investigation of nomophobia in Afghanistan using the Nomophobia Questionnaire (NMP-Q), addressing a crucial gap in the field. We collected statistical data from 754 undergraduate medical students, comprising men (56.50 %) and women (43.50 %), and analyzed the dimensions of nomophobia. While results revealed that all but two participants were nomophobic, they identified three significant dimensions affecting the level of nomophobia among participants: (a) gender, (b) age, and (c) marital status. The study's contributions are precious, given the peculiarity of Afghan political turmoil, security, and human rights issues, especially for women. For example, the study's data collection was abruptly halted in December 2022 due to the Taliban regime's decision to make it illegal for women to enroll in universities as students. Therefore, while examining the characteristics of nomophobia across societies is imperative, it is also vital to investigate what is true of one society, Afghanistan, at one point in time and space. The study concludes by emphasizing the need to broaden participants' scope in future studies to better understand the prevalence of nomophobia across broader societal contexts and forces.

The effect of loneliness on interpersonal sensitivity among nursing undergraduates: a chain mediation role of problematic internet use and bedtime procrastination.

BACKGROUND: Loneliness was associated with interpersonal sensitivity, but the factors contributing to this relationship in nursing students remain unclear. This study investigated the relationship between loneliness and interpersonal sensitivity among nursing undergraduates, with a specific focus on the mediating roles played by problematic internet use and bedtime procrastination. METHOD: This study was conducted as a cross-sectional survey at a university in China between November and December 2022. Data were collected using a self-administered online questionnaire that included demographic characteristics, the Three-Item Loneliness Scale (T-ILS), the Chinese Version of Short Form of Interpersonal Sensitivity Measure (IPSM-CS), the 6-item short form of the Problematic Internet Use Questionnaire (PIUQ-SF-6), and the Bedtime Procrastination Scale (BPS). Pearson correlation analysis was employed to explore the relationships among loneliness, interpersonal sensitivity, problematic internet use, and bedtime procrastination. Structural equation modeling (SEM) was conducted using AMOS software to examine the mediating role of problematic internet use and bedtime procrastination between loneliness and interpersonal sensitivity. RESULTS: Loneliness was positively related to interpersonal sensitivity among nursing undergraduates (ß = 0.44, P < 0.001). There was a significant chain mediation role of problematic internet use and bedtime procrastination in the relationship between loneliness and interpersonal sensitivity. CONCLUSIONS: The study contributed to deepening the understanding of the relationship between loneliness and interpersonal sensitivity and provided valuable insights into the improvement of interpersonal sensitivity in nursing undergraduates.

Internet use, dietary habits and adolescent obesity: evidence from China.

The widespread use of Internet has substantially influenced adolescents' lifestyles. This paper systematically explored the impact of Internet use on adolescent obesity and unveiled the underlying mechanism in China. We discussed the relationship among Internet use, dietary habits and obesity, and estimated the impact using panel data collected by the China Health and Nutrition Survey. Results indicated that increased Internet use significantly raised the risk of obesity among adolescents by changing their dietary habits. With a longer time of Internet use, adolescents would increase more proportion of snacks, and choose food with higher fat and protein. This paper offers a new empirical evidence for understanding the mechanism of Internet use on adolescent obesity, and provides a reference for developing countries to guide adolescents toward moderate Internet use and lower the risk of obesity.

The association between Internet use and intrinsic capacity among older adults in China: The mediating role of social participation.

OBJECTIVE: This study aims to explore the relationship between Internet use and intrinsic capability among Chinese older adults, and the potential mediating role of social participation. METHODS: We verified the correlation between Internet use and intrinsic capacity using multiple linear regression and verified the mediating role of social participation using the Sobel and Bootstrap tests. RESULTS: The results of multiple linear regression show that there is a significant positive association between Internet use and intrinsic capacity (B = 0.717, p < .001); and social participation plays a mediating role, explaining a total of 20.5% of the association (indirect effect = 0.147, 95% CI: 0.067-0.227). CONCLUSION: Our findings suggest that Internet use significantly improves intrinsic capacity among Chinese older adults, with social participation playing a mediating role. Increasing Internet adoption rates and promoting social participation may help improve intrinsic capacity among older adults.

Mediating attentional control between depression and problematic Internet use in female adolescents: the role of attentional focusing and shifting.

PURPOSE: Female adolescents are more prone to depression compared with male adolescents, and depression is often associated with poor attentional control and problematic internet use (PIU). Attentional control includes both focusing and shifting functions. Focusing refers to the ability to direct attention to a task despite distractions. Shifting refers to the ability to flexibly switch attention between different tasks. This study examines the mediating role of attentional focusing and shifting between depression and PIU. METHODS: Female high school and college students (n = 476) in Taiwan participated in a survey administered at three time points over a seven-month period. The single- and two- mediator models examined their joint mediation effects. RESULTS: The results showed that the direct effect of depression on PIU was significant. The indirect effects also showed that attentional focusing was a negative partial mediator in the relationship between depression and PIU, while attentional shifting was not one. CONCLUSION: Informed by attentional theory and digital emotion regulation, addressing depression to mitigate its negative impact on attentional control and negative emotions is crucial. The potential impact, whether harmful or beneficial, of adolescents carefully selecting their online activities to reduce the risk of PIU remains contentious. Given the focus on Taiwanese adolescent girls during the COVID-19 pandemic, further research is needed to extend the applicability of the theory to other periods without being affected by COVID-19.

The impact of family climate on problematic internet use: Findings from one nationwide study in China.

BACKGROUND: With the growing attention paid to problematic internet use (PIU), this study aims to i) explore the prevalence of PIU based on a nationally representative sample and ii) propose and validate the theoretical model that correlates family climate with PIU. METHODS: One national cross-sectional study was conducted with probability sampling and stratified sampling. Overall, 21,854 sample were included and analyzed. Validated measures of family climate, loneliness, and PIU was distributed and collected from June 2022 to August 2022. RESULTS: The overall prevalence of PIU in the sample population is approximately 30.86 %. The model findings showed that family communication and family health had indirect effects of -0.12 and - 0.05 on PIU by the mediating effects of loneliness. The indirect effect explained 80.0 % of the total effect of family communication on PIU and 38.5 % of family health on PIU, highlighting the dominance effects of path family communication and PIU via loneliness. Extended family type (-0.047, p = 0.050), low family income (income≤3000 group, -0.127, p < 0.001) were identified as protective factors against PIU, while not living with family members (0.034, p = 0.021) was identified as risk factors of PIU. LIMITATIONS: The nature of cross-sectional data have the limitation of preventing examining the casual relationships of PIU and the loneliness and family climate, in which future longitudinal study design is needed. CONCLUSIONS: The high prevalence of PIU should be given adequate attention. Optimizing the family climate or family atmosphere by improving positive communication skills, providing family support and family health external resources can be served as effective strategies for controlling PIU.

Internet use, spatial variation and its determinants among reproductive age women in Ethiopia.

BACKGROUND: The Internet is the preferred source of health information for retrieving relevant information. In Ethiopia, the Internet penetration rate is improving year to year, but it is still at a low level compared to the rest of the world and neighboring African countries. Due to a lack of adequate information, it is important to assess Internet use, spatial variation, and determinants of Internet use among reproductive-age group women in Ethiopia. METHOD: Secondary data from EDHS 2016 were used to analyze 15,683 women aged 15-49 years. Spatial analysis was performed using ArcGIS 10.7. The Bernoulli model was used by applying Kuldorff's methods using SaTScan 10.1.2 software to analyze the purely spatial clusters of Internet use. A multilevel mixed-effect logistic regression was applied to estimate community variance to identify individual- and community-level factors associated with Internet use. All models were fitted in STATA version 17.0, and finally, the adjusted odds ratio (AOR) with a corresponding 95% confidence interval (CI) was reported. RESULT: The magnitude of Internet use was 4.97% ± 95% CI (4.63-5.32). The overall average age of women was 24.21 ± 8.06 years, with the age range 15-24 years constituting the larger group (39.2%). Women with secondary and above education [AOR = 6.47; 95% CI (5.04, 8.31)], unmarried [AOR = 2.60; 95% CI (1.89, 3.56)], rich [AOR = 1.95; 95% CI (1.00, 3.80)], own a mobile phone [AOR = 3.74; 95% CI (2.75, 5.09)], media exposure [AOR = 2.63; 95% CI (2.03, 3.42)], and urban [AOR = 1.80; 95% CI (1.08, 3.01)] had higher odds of Internet use. The spatial variation in Internet use was found to be nonrandom (global Moran's I = 0.58, p value < 0.001). Fifty-seven primary clusters were identified that were located in Addis Ababa city with a relative likelihood of 10.24 and a log-likelihood ratio of 425.16. CONCLUSIONS: Internet use among reproductive-age women in Ethiopia is 4.97 and has significant spatial variation across the country. Both community- and individual-level factors affect Internet use in Ethiopia. Therefore, educating women, improving access to media, encouraging women to use family planning, and supporting household wealth could improve women's Internet use.

Online social support and problematic Internet Use-a meta-analysis.

INTRODUCTION: The internet is a crucial platform for individuals to gain social support, enhancing their well-being. However, research indicated that while online social support (OSS) has positive aspects, it also carries potential drawbacks and can lead to problematic Internet use (PIU). This study aims to examine the complex relationship between OSS and PIU. METHODS: Adhering to the PRISMA guidelines, a systematic literature search was performed across five English and three Chinese databases. A total of 1966 articles were initially screened by title, followed by abstract, and finally, full text. And the random-effects model was used to synthesize the included 31 studies. RESULTS: 31 studies were identified, encompassing a total sample of 22,375 participants. Meta-analysis revealed a moderate and significant correlation between OSS and PIU (r = 0.293), and it was significantly moderated by gender and the measurement methods of PIU. Notably, the relationship was more pronounced in studies with a higher proportion of female participants; when PIU was measured by problematic social media use, the relationship with OSS was stronger than studies that measured PIU by general problematic Internet use or problematic mobile phone use. CONCLUSION: These findings contribute to a comprehensive understanding of the association between OSS and PIU, and carry implications for identifying and addressing the potential risks associated with social support provision in the digital realm.

Problematic internet use and shyness among Chinese adolescents: a moderated mediation model.

The potential adverse effects of problematic internet use (PIU) on individuals' offline personalities have been a significant concern in internet psychology. This study aimed to investigate the negative effects of PIU on shyness and the mediating role of self-regulation, as well as the moderating role of social comparison orientation. A total of 1,322 adolescents from China participated in the survey. The results indicated that: (1) PIU positively predicted shyness; (2) self-regulation partially mediated the relationship between PIU and shyness; (3) social comparison orientation moderated the mediation effect, specifically buffering the negative prediction of PIU on self-regulation, but exacerbating the negative predictive effect of self-regulation on shyness. The findings explored and verified the psychosocial effects of the internet, contributing to a deeper understanding of how PIU affects individual personality traits and offering insights into its role in broader social behavior patterns.

Clicks and checks: investigating the association between internet usage frequency and women's uptake of clinical breast examination in Ghana.

BACKGROUND: In resource-constrained settings, availability and access to mammography is a challenge. As such, the World Health Organization (WHO) recommends clinical breast examination (CBE) for women in such settings. Yet, CBE uptake remains low. We, therefore, aimed to contribute to the discourse on factors that influence women's screening practice by investigating the association between the frequency of internet use and women's uptake of CBE in Ghana. METHODS: This study was based on data from 15,013 women who participated in the 2022 Ghana demographic and health survey. We performed descriptive analysis, computed Pearson's chi-square test, and fitted multivariable logistic regression models. The findings from the regression model were presented in adjusted odds ratio (AOR) at a 95% confidence interval. RESULTS: Only 18.39% of women 15-49 years had their breasts examined by a healthcare provider. About 38.22% of the total sample often used the internet. Compared to women who did not use the internet at all, those who often used it had twice the odds of getting screened (COR = 2.86; 95%CI: 2.62-3.13). The odds of CBE uptake remained significantly higher among those who often used the internet (AOR = 1.26; 95%CI: 1.12-1.43) even after adjusting for the covariates. CONCLUSION: We conclude that CBE uptake is significantly high among women who frequently use the internet. This association persists even when considering other influential factors such as age, education level, marital status, and socioeconomic status. As such, it is imperative for the Ministry of Health in collaboration with the Ghana Health Service to recognize the potential of digital health interventions, including online health education campaigns and telehealth services, in reaching and engaging women to get their breast examined by a healthcare provider.

Depression fully mediates the effects of problematic internet use on nonsuicidal self-injury among adolescents during the COVID-19 outbreak.

The outbreak of the coronavirus disease 2019 (COVID-19) pandemic threatened adolescents' mental health and livelihoods, which can worsen their non-suicidal self-injury (NSSI) behaviors. With the significant increase of total online time use, adolescents become more prone to problematic internet use (PIU). This study examined whether depression mediated the relationship between PIU and NSSI among adolescence during the COVID-19 outbreak. Constructed with a cross-sectional design during the COVID-19 outbreak in Taiwan, 1060 participants were drawn from junior high schools through stratified and cluster sampling, and completed a set of comprehensive surveys. The mediation model demonstrated a good fit to the data, GFI = .96, CFI = .97, NFI = .97, NNFI = .95, IFI = .97, and SRMR = .02. The overall fit of the mediational model was adequate. The path from PIU to depression, ß = .41, p < .001, and the path from depression to NSSI, ß = .40, p < .001, were both significant. Moreover, the effect of PIU to NSSI decreased from .23 (p < .001) to .05 (p = .099) when depression was incorporated into the analysis. Moreover, results in bootstrapping analysis displayed that the indirect effect (PIU on NSSI via depression) was statistically significant (p < .001) and the direct effect (PIU on NSSI) was statistically non-significant (p = .134). The full mediation model was confirmed. The findings of the structure equation modeling and bootstrap analysis showed that PIU significantly and positively predicted NSSI, and that depression fully mediated this relationship.

Preventive Interventions for Internet Addiction in Young Children: Systematic Review.

BACKGROUND: In this digital age, children typically start using the internet in early childhood. Studies highlighted that young children are vulnerable to internet addiction due to personal limitations and social influence (eg, family and school). Internet addiction can have long-term harmful effects on children's health and well-being. The high risk of internet addiction for vulnerable populations like young children has raised questions about how best to prevent the problem. OBJECTIVE: This review study aimed to investigate the existing interventions and explore future directions to prevent or reduce internet addiction risks in children younger than 12 years. METHODS: The systematic review was conducted following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. We searched for relevant literature from 4 research databases (Scopus, Web of Science, PubMed, and PsycINFO). We included 14 primary studies discussing the interventions to prevent or reduce internet addiction risks in young children and their efficacy outcomes. RESULTS: The preventive interventions identified were categorized into four approaches as follows: (1) children's education, (2) parenting strategy, (3) strategic physical activity, and (4) counseling. Ten interventions showed promising efficacy in preventing or reducing internet addiction risks with small-to-medium effect sizes. Interventions that enhance children's competencies in having appropriate online behaviors and literacy were more likely to show better efficacy than interventions that force children to reduce screen time. Interventions that shift children's focus from online activities to real-world activities also showed promising efficacy in reducing engagement with the internet, thereby preventing addictive behaviors. We also identified the limitations of each approach (eg, temporariness, accessibility, and implementation) as valuable considerations in developing future interventions. CONCLUSIONS: The findings suggest the need to develop more sustainable and accessible interventions to encourage healthy online behaviors through education, appropriate parenting strategies, and substitutive activities to prevent children's overdependence on the internet. Developing digital tools and social support systems can be beneficial to improve the capability, efficiency, and accessibility of the interventions. Future interventions also need to consider their appropriateness within familial context or culture and provide adequate implementation training. Last, policy makers and experts can also contribute by making design guidelines to prevent digital product developers from making products that can encourage overuse in children.

Rates and psychological stress predictors of problematic internet use (PIU) during the COVID-19 pandemic in a racially diverse sample of young adults.

BACKGROUND: Problematic internet use (PIU), which includes social media misuse (SMM) and gaming misuse (GM), is uncontrollable and associated with significant psychological impairment. PIU is a coping behavior for COVID-19-related stress. We explored distress-related predictors of PIU in a young adult racially diverse sample during the pandemic. METHODS: Analyses used cross-sectional survey data (N = 1956). Psychological diagnoses, financial distress, COVID-19-related emotions, psychological distress, distress tolerance, social support, loneliness, SMM and GM were measured. Hierarchical multiple regressions identified predictors of PIU. Race-stratified exploratory analyses sought to understand if predictors held true across racial groups. RESULTS: Low distress tolerance was associated with SMM and GM, as were depression symptoms, with racial differences observed. SMM was associated with younger age, and GM was associated with male gender. PTSD symptoms predicted more GM. SMM and GM rates varied between racial groups. COVID-19-related adjustment challenges and stress predicted SMM and GM respectively, with racial differences observed. CONCLUSION: Individual psychological distress and low distress tolerance markedly increased PIU risk. Clinicians should screen for stress-related PIU risk factors and bolster distress tolerance in vulnerable patients. Comparing PIU to different forms of coping in a larger sample would further clarify groups differences in stress coping behaviors.