Previously submitted to: Journal of Medical Internet Research (no longer under consideration since Mar 21, 2022)
Date Submitted: Sep 6, 2020
Open Peer Review Period: Sep 9, 2020 - Nov 4, 2020
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Problematic internet use in Chinese rural adolescents and its association with adverse life experiences and resilience: A nationwide cross-sectional study
ABSTRACT
Background:
Problematic internet use (PIU) is a growing public health and social issue among adolescents, however, its prevalence in rural adolescents remains to be investigated. Adverse life experiences (ALEs) and resilience have been reported to be important influence factors of PIU, but little is known about the interaction effects of ALEs and resilience on PIU, or gender differences in these effects.
Objective:
This study aimed to provide the first prevalence report of PIU in Chinese rural adolescents based on a nationwide sample, and to examine the association among ALEs, resilience and PIU, as well as the gender difference within these relationships.
Methods:
A school-based survey was conducted in rural areas from five provinces in China in 2014-2015. A total of 15950 students aged 11-22 years finished a complete self-report questionnaire, including demographic characteristics, measurements of PIU, stressful life events, child neglect and maltreatment, and resilience. ALEs were defined as having experienced stressful life events and/or child neglect and maltreatment. Univariate and multivariable logistic regression analyses were used.
Results:
There were 2734 adolescents assessed with PIU in our sample, with a prevalence rate of 17.1%. Multiple adjusted odds ratios for PIU was significantly increased with higher ALEs scores (5-6: OR=1.28, 95% CI=1.11-1.48; 7-8: OR=1.66, 95% CI=1.43-1.92) and significantly decreased with higher resilience level (Mild: OR=0.83, 95% CI=0.74-0.93; Moderate: OR=0.68, 95% CI=0.60-0.77; High: OR=0.59; 95% CI=0.52-0.67). Moderate resilience had significantly protective effect on PIU in adolescents with high ALEs scores (OR=0.63, 95% CI=0.41-0.97). A significant interaction effect was found between ALEs and resilience on PIU only in girls (P=0.021) but not in boys (P=0.081), however, this gender difference showed no significance (P=0.305).
Conclusions:
This study suggests a relative high prevalence of PIU among Chinese rural adolescents. More ALEs and lower resilience are associated with higher risk for PIU, and resilience can moderate the association between ALEs and PIU. Strategies combining ALEs prevention and resilience promotion both in girls and boys would yield better to decrease PIU problems in adolescents.
Citation
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