Identification of central symptoms in Internet addictions and depression among adolescents in Macau: A network analysis

Hong Cai; Wei Bai; Sha Sha; Ling Zhang; Ines H I Chow; Si-Man Lei; Grace K I Lok; Teris Cheung; Zhaohui Su; Brian J Hall; Robert D Smith; Yu-Tao Xiang

doi:10.1016/j.jad.2022.01.068

Identification of central symptoms in Internet addictions and depression among adolescents in Macau: A network analysis

J Affect Disord. 2022 Apr 1:302:415-423. doi: 10.1016/j.jad.2022.01.068. Epub 2022 Jan 20.

Authors

Hong Cai¹, Wei Bai¹, Sha Sha², Ling Zhang², Ines H I Chow¹, Si-Man Lei³, Grace K I Lok⁴, Teris Cheung⁵, Zhaohui Su⁶, Brian J Hall⁷, Robert D Smith⁸, Yu-Tao Xiang⁹

Affiliations

¹ Unit of Psychiatry, Department of Public Health and Medicinal Administration, and Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China; Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China; Institute of Advanced Studies in Humanities and Social Sciences, University of Macau, Macao SAR, China.
² The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders Beijing Anding Hospital and the Advanced Innovation Center for Human Brain Protection, Capital Medical University, School of Mental Health, Beijing, China.
³ Faculty of Education, University of Macau, Macao SAR, China.
⁴ Kiang Wu Nursing College of Macau, Macau SAR, China.
⁵ School of Nursing, Hong Kong Polytechnic University, Hong Kong SAR, China.
⁶ Center on Smart and Connected Health Technologies, Mays Cancer Center, School of Nursing, UT Health San Antonio, San Antonio, Texas, United States.
⁷ Center for Global Health Equity, New York University (Shanghai), Shanghai, China; School of Global Public Health, New York University, NY, United States.
⁸ Unit of Psychiatry, Department of Public Health and Medicinal Administration, and Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China.
⁹ Unit of Psychiatry, Department of Public Health and Medicinal Administration, and Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China; Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China; Institute of Advanced Studies in Humanities and Social Sciences, University of Macau, Macao SAR, China. Electronic address: ytxiang@gmail.com.

PMID: 35065088
DOI: 10.1016/j.jad.2022.01.068

Abstract

Background: Internet addiction (IA) and depression are common among adolescents and often are co-occurring. This study examined the network structures of IA and depressive symptoms (depression hereafter) in adolescents.

Methods: A total of 1,009 adolescents were recruited. IA and depression were measured using the Internet Addiction Test (IAT) and the 9 items-Patient Health Questionnaire (PHQ-9), respectively. A network analysis was conducted to identify central symptoms and bridge symptoms using centrality indices. Network stability was evaluated using the case-dropping procedure. The Network Comparison Test (NCT) was conducted to examine whether network characteristics differed by gender.

Results: Network analysis revealed that nodes IAT-15 ("Preoccupation with the Internet"), IAT-2 ("Neglect chores to spend more time online"), PHQ-6 ("Guilty"), and IAT-16 ("Request an extension for longer time spent online") were the most central symptoms within the model of coexisting IA and depression. The most important bridge symptom was node IAT-11 ("Anticipation for future online activities"), followed by IAT-12 ("Fear that life is boring and empty without the Internet") and IAT-19 ("Spend more time online over going out with others"). Gender did not significantly influence the network structure. The IA and depression network model showed a high degree of stability.

Conclusion: The central symptoms along with key bridge symptoms identified could be potentially targeted when treating and preventing IA and depression among adolescents.

Keywords: Adolescents; Depression; Internet addiction; Network analysis.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Behavior, Addictive* / diagnosis
Behavior, Addictive* / epidemiology
Depression / diagnosis
Depression / epidemiology
Fear
Humans
Internet
Internet Addiction Disorder* / epidemiology
Macau
Surveys and Questionnaires