Maintenance Notice

Due to necessary scheduled maintenance, the JMIR Publications website will be unavailable from Wednesday, July 01, 2020 at 8:00 PM to 10:00 PM EST. We apologize in advance for any inconvenience this may cause you.

Who will be affected?

Accepted for/Published in: Journal of Medical Internet Research

Date Submitted: Jan 30, 2026
Date Accepted: Jul 27, 2026

The final, peer-reviewed published version of this preprint can be found here:

Social Connectedness Buffering the Interaction Between Problematic Internet Use and Psychopathological Symptoms Among Adolescents: Undirected and Bayesian Network Analyses

Xu J, Bao W, Zhou K, Cao Q, Hu M, Li J, Chen X, Xu J

Social Connectedness Buffering the Interaction Between Problematic Internet Use and Psychopathological Symptoms Among Adolescents: Undirected and Bayesian Network Analyses

J Med Internet Res 2026;28:e92473

DOI: 10.2196/92473

Social Connectedness Buffering the Interaction Between Problematic Internet Use and Psychopathological Symptoms Among Adolescents: Undirected and Bayesian Network Analyses

  • Jiaqi Xu; 
  • Wenxin Bao; 
  • Kexin Zhou; 
  • Qiyuan Cao; 
  • Min Hu; 
  • Jing Li; 
  • Xiacan Chen; 
  • Jiajun Xu

ABSTRACT

Background:

Problematic Internet use (PIU) in adolescents often co-occurs with psychopathological symptoms. Social connectedness (SC) is a potential protective factor for both PIU and psychopathological symptoms, but how SC interacts with the PIU-psychopathology system remains unclear.

Objective:

This study aimed to delineate the factor-level comorbidity network linking PIU with psychopathological symptoms among adolescents with moderate-to-severe PIU, and to clarify how offline and online SC functions in this system. We further explored potential directional pathways to identify early prevention targets.

Methods:

This multi-center study included 9407 adolescents aged 12-18 years from four provinces in China. PIU, depression, anxiety, irritability, repetitive thoughts and behaviors, anger, aggression, and social connectedness were assessed. We estimated an undirected factor-level symptom network and a directed acyclic graph (DAG) derived from a Bayesian network structure to characterize associations and conditional dependency structure among SC, PIU, and eight psychopathological symptoms.

Results:

The integrative symptom network encompassing PIU, internalizing and externalizing symptoms, and social connectedness (PIU-IES) showed great stability and accuracy. Anxiety, anger, and depression were identified as central bridging symptoms that reinforce the interplay between PIU and other psychopathological symptoms. Offline SC exhibited the highest number of negative edges and the highest bridge expected influence value, followed by online SC. In the DAG network, offline SC was positioned as an upstream contextual factor with pathways to both externalizing (aggression, irritability) and internalizing (depression, anxiety) symptoms.

Conclusions:

PIU and psychopathological symptoms exhibit a mutual reinforcement relationship, which could be alleviated by offline SC. Offline SC is a key protective bridge and a plausible upstream factor of the PIU-IES network. Strengthening offline SC may therefore represent a promising intervention and prevention target to mitigate PIU-related comorbidity and reduce the risk of more severe clinical outcomes.


 Citation

Please cite as:

Xu J, Bao W, Zhou K, Cao Q, Hu M, Li J, Chen X, Xu J

Social Connectedness Buffering the Interaction Between Problematic Internet Use and Psychopathological Symptoms Among Adolescents: Undirected and Bayesian Network Analyses

J Med Internet Res 2026;28:e92473

DOI: 10.2196/92473

Download PDF


Request queued. Please wait while the file is being generated. It may take some time.

© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.