The aim of this study was to explore Internet addiction (IA) and its associated factors among Chinese adolescents. Ten thousand one hundred fifty-eight Chinese adolescents were selected in this study by using random cluster sampling. The prevalence rate of IA among Chinese adolescents was 10.4%. Multivariate logistic regression analyses showed gender, the only child, father-adolescent relationship, annual family income, academic performance, physical exercise, Rosenberg Self-esteem Scale (RSES) score, and Liebowitz Social Anxiety Scale (LSAS) score were significantly associated with IA among adolescents in social anxiety group (P < 0.05). In addition, gender, parental control, annual family income, academic performance, physical exercise, RSES score, and LSAS score were significantly associated with Internet addiction among adolescents in non-social anxiety group (P < 0.05). The mediating effects of social anxiety between multiple factors and IA were also significant. These findings can provide guidance aimed at reducing IA among Chinese adolescents.
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Allison, S. E., von Wahlde, L., Shockley, T., & Gabbard, G. O. (2006). The development of the self in the era of the internet and role-playing fantasy games. The American Journal of Psychiatry, 163(3), 381–385.
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed.). Washington.
Campbell, A. J., Cumming, S. R., & Hughes, I. (2006). Internet use by the socially fearful: addiction or therapy? Cyberpsychology & Behavior, 9(1), 69–81.
Festl, R., Scharkow, M., & Quandt, T. (2013). Problematic computer game use among adolescents, younger and older adults. Addiction, 108(3), 592–599.
Floros, G. D., Siomos, K., Fisoun, V., & Geroukalis, D. (2013). Adolescent online gambling: the impact of parental practices and correlates with online activities. Journal of Gambling Studies, 29(1), 131–150.
Gao, Z. C., Gao, F., & Wang, S. X. (2011a). Survey and analysis on anxiety and depression of the students with internet addiction in vocational college and social support. Medical Journal of West China, 23(9), 1824–1826 [in Chinese].
Gao, F., Gao, Z. C., & Wang, S. X. (2011b). Correlation between internet addiction disorder and family factors among vocational college students in Xi’an. Journal of Shanxi Medical University, 42, 297–299 [in Chinese].
Griffiths, M. D., Pontes, H. M., & Kuss, D. J. (2016). Online addictions: conceptualizations, debates, and controversies. Addicta: The Turkish Journal on Addictions, 3(2), 151–164.
Gultekin, B. K., & Dereboy, I. F. (2011). The prevalence of social phobia, and its impact on quality of life, academic achievement, and identity formation in university students. Turkish Journal of Psychiatry, 22(3), 150–158.
He, Y. L., & Zhang, M. Y. (2004). Psychometric investigation of Liebowitz Social Anxiety Scale. Journal of Diagnostics Concepts and Practice, 2, 29–33 [in Chinese].
Ho, R. C., Zhang, M. W., Tsang, T. Y., Toh, A. H., Pan, F., Lu, Y., et al. (2014). The association between internet addiction and psychiatric co-morbidity: a meta-analysis. BMC Psychiatry, 14, 183.
Huan, V., Ang, R., & Chye, S. (2014). Loneliness and shyness in adolescent problematic internet users: the role of social anxiety. Child & Youth Care Forum, 43, 539–551.
Karacic, S., & Oreskovic, S. (2017). Internet addiction and mental health status of adolescents in Croatia and Germany. Psychiatria Danubina, 29(3), 313–321.
Khan, M. A., Shabbir, F., & Rajput, T. A. (2017). Effect of gender and physical activity on internet addiction in medical students. Pakistan Journal of Medical Sciences, 33(1), 191–194.
Khazaal, Y., Billieux, J., Thorens, G., Khan, R., Louati, Y., Scarlatti, E., Theintz, F., Lederrey, J., van der Linden, M., & Zullino, D. (2008). French validation of the internet addiction test. Cyberpsychology & Behavior, 11(6), 703–706.
Kim, K., Ryu, E., Chon, M. Y., Yeun, E. J., Choi, S. Y., Seo, J. S., & Nam, B. W. (2006). Internet addiction in Korean adolescents and its relation to depression and suicidal ideation: a questionnaire survey. International Journal of Nursing Studies, 43(2), 185–192.
Ko, C. H., Yen, J. Y., Chen, C. C., Chen, S. H., & Yen, C. F. (2005). Gender differences and related factors affecting online gaming addiction among Taiwanese adolescents. The Journal of Nervous and Mental Disease, 193(4), 273–277.
Ko, C. H., Yen, J. Y., Yen, C. F., Chen, C. S., & Chen, C. C. (2012). The association between internet addiction and psychiatric disorder: a review of the literature. European Psychiatry, 27(1), 1–8.
Kuss, D. J., Griffiths, M. D., Karila, L., & Billieux, J. (2014). Internet addiction: a systematic review of epidemiological research for the last decade. Current Pharmaceutical Design, 20(25), 4026–4052.
Lai, C. M., Mak, K. K., Watanabe, H., Ang, R. P., Pang, J. S., & Ho, R. C. (2013). Psychometric properties of the internet addiction test in Chinese adolescents. Journal of Pediatric Psychology, 38(7), 794–807.
Lam, L. T., Peng, Z. W., Mai, J. C., & Jing, J. (2009). Factors associated with internet addiction among adolescents. Cyberpsychology & Behavior, 12(5), 551–555.
Lee, C. S., & McKenzie, K. (2015). Socioeconomic and geographic inequalities of internet addiction in Korean adolescents. Psychiatry Investigation, 12(4), 559–562.
Liebowitz, M. R. (1987). Social phobia. Modern Problems of Pharmacopsychiatry, 22, 141–173.
Lin, M. P., Ko, H. C., & Wu, J. Y. (2011). Prevalence and psychosocial risk factors associated with internet addiction in a nationally representative sample of college students in Taiwan. Cyberpsychology, Behavior & Social Networking, 14(12), 741–746.
Mancini, C., Van Ameringen, M., Bennett, M., Patterson, B., & Watson, C. (2005). Emerging treatments for child and adolescent social phobia: a review. Journal of Child and Adolescent Psychopharmacology, 15(4), 589–607.
Mohammadbeigi, A., Valizadeh, F., Mirshojaee, S. R., Ahmadli, R., Mokhtari, M., Ghaderi, E., et al. (2016). Self-rated health and internet addiction in Iranian medical sciences students; prevalence, risk factors and complications. International Journal of Biomedical Sciences, 12(2), 65–70.
Morris, T. L. (2001). Social phobia. In M. W. Vasey & M. R. Dadds (Eds.), The developmental psychopathology of anxiety (pp. 435–548). New York: Oxford University Press.
Mythily, S., Qiu, S., & Winslow, M. (2008). Prevalence and correlates of excessive internet use among youth in Singapore. Annals of the Academy of Medicine Singapore, 37(1), 9–14.
Ni, X., Yan, H., Chen, S., & Liu, Z. (2009). Factors influencing Internet addiction in a sample of freshmen university students in China. CyberPsychology & Behavior, 12(3), 327–330.
Niu, X. L., & Liu, C. L. (2012). Correlation between depressive symptoms and network addiction, social support, and C behavior among vocational college students. Chinese Journal of Public Health, 28(10), 1277–1279 [in Chinese].
Pantic, I., Milanovic, A., Loboda, B., Błachnio, A., Przepiorka, A., Nesic, D., Mazic, S., Dugalic, S., & Ristic, S. (2017). Association between physiological oscillations in self-esteem, narcissism and internet addiction: a cross-sectional study. Psychiatry Research, 258, 239–243.
Pontes, M. M., Kuss, D. J., & Griffiths, M. D. (2015). The clinical psychology of internet addiction: a review of its conceptualization, prevalence, neuronal processes, and implications for treatment. Neuroscience and Neuroeconomics, 4, 11–23.
Rosenberg, M. (1965). Society and the adolescent self-image. Princeton: Princeton University Press.
Sarosh, K. K., Maria-Paz, S., Carolyn, M. M., & Rynn, M. A. (2007). Social anxiety disorder in children and adolescents: epidemiology, diagnosis, and treatment. Paediatric Drugs, 9(4), 227–237.
Seyrek, S., Cop, E., Sinir, H., Ugurlu, M., & Senel, S. (2017). Factors associated with internet addiction: cross-sectional study of Turkish adolescents. Pediatrics International, 59(2), 218–222.
Shepherd, R. M., & Edelmann, R. J. (2005). Reasons for internet use and social anxiety. Personality and Individual Differences, 39, 949–958.
Sinkkonen, H. M., Puhakka, H., & Merilainen, M. (2014). Internet use and addiction among Finnish adolescents (15-19 years). Journal of Adolescence, 37(2), 123–131.
Slade, T., & Andrews, G. (2001). DSM-IV and ICD-10 generalized anxiety disorder: discrepant diagnoses and associated disability. Social Psychiatry and Psychiatric Epidemiology, 36(1), 45–51.
Stavropoulos, V., Alexandraki, K., & Motti-Stefanidi, F. (2013). Recognizing internet addiction: prevalence and relationship to academic achievement in adolescents enrolled in urban and rural Greek high schools. Journal of Adolescence, 36(3), 565–576.
Tsitsika, A., Critselis, E., Kormas, G., Konstantoulaki, E., Constantopoulos, A., & Kafetzis, D. (2009). Adolescent pornographic internet site use: a multivariate regression analysis of the predictive factors of use and psychosocial implications. Cyberpsychology & Behavior, 12(5), 545–550.
Tsitsika, A., Critselis, E., Louizou, A., Janikian, M., Freskou, A., Marangou, E., Kormas, G., & Kafetzis, D. A. (2011). Determinants of internet addiction among adolescents: a case-control study. The Scientific World Journal, 11, 866–874.
Wang, H., Zhou, X., Lu, C., Wu, J., Deng, X., & Hong, L. (2011). Problematic Internet use in high school students in Guangdong Province, China. PLoS One, 6(5), e19660.
Weinstein, A., & Lejoyeux, M. (2010). Internet addiction or excessive internet use. The American Journal of Drug and Alcohol Abuse, 36(5), 277–283.
Winkler, A., Dörsing, B., Rief, W., Shen, Y., & Glombiewski, J. A. (2013). Treatment of internet addiction meta-analysis. Clinical Psychology Review, 33(2), 317–329.
Wu, H. R., & Zhu, K. J. (2004). Path analysis on related factors causing internet addiction disorder in college students. Chinese Journal of Public Health, 20, 1363–1364 [in Chinese].
Wu, P. H., Lai, Y. C., & Shih, C. L. (2013). Evaluation of the Rosenberg Self-esteem Scale using the rating scale model. Psychological Testing, 60, 263–289.
Yang, T., Yu, L., Oliffe, J. L., Jiang, S., & Si, Q. (2017). Regional contextual determinants of internet addiction among college students: a representative nationwide study of China. European Journal of Public Health, 27(6), 1032–1037.
Yen, J. Y., Ko, C. H., Yen, C. F., Wu, H. Y., & Yang, M. J. (2007a). The comorbid psychiatric symptoms of internet addiction: attention deficit and hyperactivity disorder (ADHD), depression, social phobia, and hostility. The Journal of Adolescent Health, 41(1), 93–98.
Yen, J. Y., Yen, C. F., Chen, C. C., Chen, S. H., & Ko, C. H. (2007b). Family factors of internet addiction and substance use experience in Taiwanese adolescents. Cyberpsychology & Behavior., 10(3), 323–329.
Yeun, Y. R., & Han, S. J. (2016). Effects of psychosocial interventions for school-aged children’s internet addiction, self-control and self-esteem: meta-analysis. Healthcare Informatics Research, 22(3), 217–230.
Young, K. S. (1999). The research and controversy surrounding internet addiction. Cyberpsychology & Behavior, 2(5), 381–383.
We would like to particularly thank the students who gave of their time to participate in the project.
This study was funded by National Natural Science Foundation of China (no.81202224) and the Anhui Provincial Natural Science Foundation (no.1208085QH148).
Conflict of Interest
The authors declare that they have no conflicts of interest.
All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000.
Informed consent was obtained from all participants for being included in the study.
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Dong, B., Zhao, F., Wu, XS. et al. Social Anxiety May Modify the Relationship Between Internet Addiction and Its Determining Factors in Chinese Adolescents. Int J Ment Health Addiction 17, 1508–1520 (2019). https://doi.org/10.1007/s11469-018-9912-x