Exploring mediational roles for self-stigma in associations between types of problematic use of internet and psychological distress in youth with ADHD

Kuan-Ying Lee; Chao-Ying Chen; Ji-Kang Chen; Chih-Ching Liu; Kun-Chia Chang; Xavier C C Fung; Jung-Sheng Chen; Yu-Chia Kao; Marc N Potenza; Amir H Pakpour; Chung-Ying Lin

doi:10.1016/j.ridd.2022.104410

Exploring mediational roles for self-stigma in associations between types of problematic use of internet and psychological distress in youth with ADHD

Res Dev Disabil. 2023 Feb:133:104410. doi: 10.1016/j.ridd.2022.104410. Epub 2023 Jan 3.

Authors

Affiliations

¹ Department of Child and Adolescent Psychiatry, Jianan Psychiatric Center, Ministry of Health and Welfare, Tainan, Taiwan.
² School of Physical Therapy and Graduate Institute of Rehabilitation Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan; New Taipei City Tucheng Hospital (Chang Gung Medical Foundation), Department of Pediatric Internal Medicine, New Taipei City, Taiwan.
³ Department of Social Work, Chinese University of Hong Kong, New Territories, Hong Kong.
⁴ Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan.
⁵ Department of General Psychiatry, Jianan Psychiatric Center, Ministry of Health and Welfare, Tainan, Taiwan; Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
⁶ Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
⁷ Department of Medical Research, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan.
⁸ Department of Pediatrics, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan. Electronic address: yukanomail2006@yahoo.com.tw.
⁹ Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; Connecticut Mental Health Center, New Haven, CT, USA; Connecticut Council on Problem Gambling, Wethersfield, CT, USA; Child Study Center, Yale School of Medicine, New Haven, CT, USA; Department of Neuroscience, Yale University, New Haven, CT, USA; Wu Tsai Institute, Yale University, New Haven, CT, USA.
¹⁰ Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden.
¹¹ Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan. Electronic address: cylin36933@gmail.com.

PMID: 36603311
DOI: 10.1016/j.ridd.2022.104410

Abstract

Background: Several studies have linked the problematic use of the Internet (PUI) to psychological distress. Youth with attention deficit hyperactivity disorder (ADHD) are considered a particular disadvantaged population with a high risk of developing PUI, psychological distress, and self-stigma. Nonetheless, the interrelationships of PUI, self-stigma, and psychological distress in adolescents with ADHD are not well understood.

Aims: This study investigated whether self-stigma mediates relationships between different forms of PUI, such as problematic gaming (PG), problematic social media use (PSMU), problematic smartphone use (PSPU), and psychological distress (i.e., depression, anxiety, and stress), in children with ADHD.

Methods and procedures: We recruited 100 youth with ADHD (mean age=10.80 [SD=3.07] years; 84 boys) from psychiatric outpatient clinics in Taiwan. All participants were assessed for PUI (via Internet Gaming Disorder-Short Form for PG, Bergan Social Medica Addiction Scale for PSMU, and Smartphone Application-Based Addiction Scale for PSPU), self-stigma (via Self-Stigma Short-Scale), and psychological distress (via Depression, Anxiety, Stress Scale).

Outcomes and results: The results of path and bootstrapping analyses indicated that self-stigma mediated the associations between PSMU and PSPU, but not PG, and depression, anxiety, and stress.

Conclusions and implications: This study expands the extant literature by revealing that self-stigma mediates the association between specific forms of PUI and psychological distress in adolescents with ADHD. Interventions aimed at reducing self-stigma and PUI, particularly PSMU and PSPU, may help decrease psychological distress among adolescents with ADHD.

Keywords: ADHD; Addictive behavior; Impulsive behavior; Internet addiction disorder; Online; Psychological distress; Self-stigma.

MeSH terms

Adolescent
Anxiety / psychology
Anxiety Disorders
Attention Deficit Disorder with Hyperactivity* / psychology
Behavior, Addictive* / psychology
Child
Humans
Internet
Male
Psychological Distress*
Social Media*