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Cited by 213Impact of Technology on AdolescentsSexuality, Behavior, and TechnologyChild Development and Digital Technology

Comparing generalized and specific problematic smartphone/internet use: longitudinal relationships between smartphone application-based addiction and social media addiction and psychological distress

Open access
Chen, I-Hua, Pakpour, Amir H., Leung, Hildie, Potenza, Marc N., Su, Jian-An, Lin, Chung-Ying, Griffiths, Mark D.·2020·Journal of Behavioral Addictions
DOI 10.1556/2006.2020.00023PMC PMC8939406
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Abstract

Background and aims: The literature has proposed two types of problematic smartphone/internet use: generalized problematic use and specific problematic use. However, longitudinal findings on the associations between the two types of problematic use and psychological distress are lacking among East-Asians. The present study examined temporal associations between both generalized and specific problematic use of the smartphone/internet, and psychological distress. Methods: Hong Kong University students ( N = 308; 100 males; mean age = 23.75 years; SD ± 5.15) were recruited with follow-ups at three, six, and nine months after baseline assessment. All participants completed the Smartphone Application-Based Addiction Scale (for generalized problematic smartphone/internet use), the Bergen Social Media Addiction Scale (for specific problematic smartphone/internet use), and the Hospital Anxiety and Depression Scale (for psychological distress) in each assessment. Latent growth modeling (LGM) was constructed to understand temporal associations between generalized/specific problematic use and psychological distress. Results: The LGM suggested that the intercept of generalized problematic use was significantly associated with the intercept of psychological distress (standardized coefficient [ β ] = 0.32; P < 0.01). The growth of generalized problematic use was significantly associated with the growth of psychological distress ( β = 0.51; P < 0.01). Moreover, the intercept of specific problematic use was significantly associated with the intercept of psychological distress ( β = 0.28; P < 0.01) and the growth of psychological distress ( β = 0.37; P < 0.01). Conclusion: The initial level of problematic use of smartphone/internet increased the psychological distress among university students. Helping young adults address problematic use of the smartphone/internet may prevent psychological distress.

AI snapshot

Written from the paper’s full text.

TL;DR

In a longitudinal sample of Hong Kong university students, both generalized and specific problematic smartphone/internet use were positively associated with psychological distress over nine months. Initial social media addiction predicted both initial and growth in distress, while growth in generalized problematic use predicted growth in distress.

Key findings

  • Generalized problematic use: intercept associated with psychological distress intercept (β = 0.32, P < 0.01); growth associated with growth of psychological distress (β = 0.51, P < 0.01).
  • Specific problematic use (social media): intercept associated with psychological distress intercept (β = 0.28, P < 0.01) and with growth of psychological distress (β = 0.37, P < 0.01).
  • SABAS, BSMAS, and HADS scores were significantly correlated across all four time points (r = 0.174 to 0.854; all P < 0.01).
  • The LGM models supported the direction from problematic use to psychological distress more than the reverse direction; the reverse-direction models had fit concerns, including a Heywood case in the third model and an RMSEA 90% CI of 0.110 in the fourth model.

Methods

  • Longitudinal online survey of Hong Kong university students: N = 308 at baseline (mean age = 23.75 years, SD = 5.15); follow-ups at three, six, and nine months; 114 completed all follow-ups, 58 completed two, and 40 completed one.
  • Measures: Smartphone Application-Based Addiction Scale (SABAS) for generalized problematic smartphone/internet use, Bergen Social Media Addiction Scale (BSMAS) for specific problematic use, and Hospital Anxiety and Depression Scale (HADS) for psychological distress.
  • Analysis: latent growth modeling (LGM) within structural equation modeling, adjusting for age and gender; full information maximum likelihood (FIML) for missing data; four models tested problematic use → distress and distress → problematic use.

Limitations

  • The paper states: no data on when participants began using social media/smartphones; mental illness was self-reported and not confirmed by psychiatric interview or records; convenience sampling of university students, mostly from one university, limits generalizability; missing data appeared not to be missing at random, with completers differing from non-completers in age and hours of smartphone/social media use; Hong Kong-specific findings may not generalize; impactful life events between assessments were not collected; all data were self-reported and subject to recall and social desirability biases; only one specific form of problematic use (social media) was assessed.
  • Evident in the text: attrition was substantial (114 of 308 completed all follow-ups), and the reverse-direction LGM models had fit problems, including a Heywood case and an RMSEA confidence interval exceeding the acceptable cutoff in one model.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1556/2006.2020.00023

Cites

43 of 43 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 34 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    The growth of generalized problematic smartphone/internet use was significantly associated with the growth of psychological distress (β = 0.51, P < 0.01).

    “The growth of generalized problematic use was significantly associated with the growth of psychological distress (β = 0.51; P < 0.01).”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Missing data in SABAS, BSMAS, and HADS scores were missing at random.
  • Findingown data

    SABAS, BSMAS, and HADS scores were significantly correlated across all four time points (r = 0.174 to 0.854; p < 0.01).

    “Table 3 demonstrates the significant correlations between the SABAS score, BSMAS score, and HADS score in the four assessed time points (r = 0.174 to 0.854; p-values < 0.01).”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: Missing data in SABAS, BSMAS, and HADS scores were missing at random.
  • Findingown data

    The intercept of specific problematic smartphone/internet use was significantly associated with the intercept of psychological distress (β = 0.28, P < 0.01).

    “Moreover, the intercept of specific problematic use was significantly associated with the intercept of psychological distress (β = 0.28; P < 0.01)”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Missing data in SABAS, BSMAS, and HADS scores were missing at random.
  • Findingown data

    The intercept of generalized problematic smartphone/internet use was significantly associated with the intercept of psychological distress (β = 0.32, P < 0.01).

    “The LGM suggested that the intercept of generalized problematic use was significantly associated with the intercept of psychological distress (standardized coefficient [β] = 0.32; P < 0.01).”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Missing data in SABAS, BSMAS, and HADS scores were missing at random.
  • Findingown data

    The intercept of specific problematic smartphone/internet use was significantly associated with the growth of psychological distress (β = 0.37, P < 0.01).

    “and the growth of psychological distress (β = 0.37; P < 0.01).”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Missing data in SABAS, BSMAS, and HADS scores were missing at random.
  • Classified as probably not a substantial claim. 21
  • May combine two claims. 12
  • The quote only partly states this claim. 1

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Participants who completed all follow-ups comprised fewer males than those who only participated at baseline.

    “The participants who completed all the follow-ups comprised fewer males (21.1%) than those who only participated at baseline (41.7%).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Generalized problematic smartphone/internet use has been associated with several comorbid disorders including attention deficit/hyperactivity disorder, depression, and substance abuse.

    “Such problematic smartphone/internet use has been associated with several comorbid disorders including attention deficit/hyperactivity disorder (Karaka, Canan, Saleh, & Potenza, 2017), depression (Sariyska, Reuter, Lachmann, & Montag, 2015) and substance abuse (Rücker, Akre, Berchtold, & Suris, 2015).”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites Karaka, Canan, Saleh, & Potenza, 2017

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    • cites Sariyska, Reuter, Lachmann, & Montag, 2015

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    • cites Rücker, Akre, Berchtold, & Suris, 2015

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  • Classified as probably not a substantial claim.

    Premisecitation

    Applications on smartphones can be a source of problematic behavior among a minority of individuals.

    “Therefore, the present study takes the similar view to Chen et al. (2020) that applications on smartphones can be a source of problematic behavior among a minority of individuals.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Chen et al. (2020)

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    Premisecitation

    The psychometric properties of the BSMAS have been established in English, Italian, Persian, Portuguese, Taiwanese, and Hong Kong versions.

    “Additionally, the psychometric properties of the BSMAS have been established using English (Andreassen et al., 2016), Italian (Monacis et al., 2017), Persian (Lin, Broström, Nilsen, Griffiths, & Pakpour, 2017), Portuguese (Pontes, Andreassen, & Griffiths, 2016), Taiwanese (Chen et al., 2020; Leung et al., 2019), and Hong Kong versions (Yam et al., 2019).”
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    • cites Andreassen et al., 2016

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    • cites Monacis et al., 2017

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    • cites Lin, Broström, Nilsen, Griffiths, & Pakpour, 2017; Pontes, Andreassen, & Griffiths, 2016; Chen et al., 2020; Leung et al., 2019; Yam et al., 2019

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  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    Of 308 baseline participants, 114 completed all follow-up assessments, 58 completed two follow-ups, and 40 completed one follow-up.

    “Following this process, 308 Hong Kong students completed the baseline assessment; 114 Hong Kong students completed all the follow-up assessments; 58 completed two follow-ups; and 40 completed one follow-up.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Premisecitation

    Smartphone addiction may be generalized because of the many different activities that can be engaged in using smartphones.

    “However, smartphone addiction may be generalized because of the many different activities that can be engaged in using smartphones (e.g., gambling, gaming, social networking, and working) (Kuss & Griffiths, 2017).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Kuss & Griffiths, 2017

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  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    Participants who completed all follow-ups were younger and spent less time on smartphones and social media than those who only participated at baseline.

    “The participants who completed all follow-ups were younger (22.39 years) and spent less time on smartphones (4.10 hours/day) and social media (2.26 hours/day) than those who only participated at baseline (mean age = 25.19 years; time on smartphone = 5.90 hours/day; time on social media = 3.59 hours/day).”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Premisecitation

    Two different forms of problematic use of digital technologies have been proposed: generalized internet addictions and specific internet addictions.

    “Two different forms of problematic use of digital technologies have been proposed: generalized internet addictions and specific internet addictions (i.e., generalized problematic smartphone/internet use and specific problematic smartphone/internet use) (Brand, Young, & Laier, 2014; Davis, 2001; Griffiths, 1998, 2000; Montag et al., 2015).”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites Brand, Young, & Laier, 2014

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    • cites Davis, 2001

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    • cites Griffiths, 1998, 2000; Montag et al., 2015

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    Premisecitation

    The construct validity of the HADS has been confirmed in Hong Kong adolescents.

    “The construct validity of the HADS has been confirmed in Hong Kong adolescents (Chan, Leung, Fong, Leung, & Lee, 2010) with acceptable Cronbach's alphas (0.79 for anxiety and 0.67 for depression).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Chan, Leung, Fong, Leung, & Lee, 2010

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  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The psychometric properties of the SABAS have been established in English, Hungarian, Persian, Taiwanese, and Hong Kong versions.

    “The psychometric properties of the SABAS have been established using English (Csibi et al., 2018), Hungarian (Csibi et al., 2016), Persian (Lin et al., 2018), Taiwanese (Chen et al., 2020; Leung et al., 2019), and Hong Kong versions (Yam et al., 2019).”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites Csibi et al., 2018

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    • cites Csibi et al., 2016

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    • cites Lin et al., 2018; Chen et al., 2020; Leung et al., 2019; Yam et al., 2019

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  • Classified as probably not a substantial claim.

    Premisecitation

    Prior research suggests a relationship between different types of problematic smartphone/internet use and poor mental health.

    “Although prior research suggests a relationship between different types of problematic smartphone/internet use and poor mental health (Pontes et al., 2015; Rücker et al. 2015)”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Pontes et al., 2015

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    • cites Rücker et al. 2015

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  • May combine two claims.

    Premisecitation

    Strong relationships exist between smartphone addiction and social media addiction, most likely because social media use is primarily engaged in via smartphones.

    “Despite such polarized views, strong relationships exist between smartphone addiction and social media addiction, most likely because social media use is primarily engaged in via smartphones (Kuss & Griffiths, 2017; Sha, Sariyska, Riedl, Lachmann & Montag, 2019).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Kuss & Griffiths, 2017

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    • cites Sha, Sariyska, Riedl, Lachmann & Montag, 2019

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    Study design and conductown data

    The internal consistency of the HADS was acceptable across all assessments in the present study (α = 0.84-0.85; ω = 0.84-0.85).

    “The internal consistency of the HADS was acceptable across all the assessments in the present study: α = 0.85 and ω = 0.85 at baseline; α = 0.84 and ω = 0.84 at first follow-up; α = 0.85 and ω = 0.85 at second follow-up; α = 0.85 and ω = 0.85 at third follow-up.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Data on when participants began using social media or smartphones were not collected.

    “data on when participants began using social media or smartphones were not collected.”
    Quote in the paperNot a substantial claim

  • The quote only partly states this claim.

    Interpretationown data

    The magnitude of the association between the intercept of specific problematic social media use and the growth of psychological distress was moderate (0.37; Cohen, 1988).

    “However, the magnitude of the association was of note (0.37, a moderate effect size; Cohen, 1988).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Cohen, 1988

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  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Griffiths (2000, 2005) proposed salience, mood modification, tolerance, withdrawal, conflict, and relapse as the six main criteria for addiction, and these have been modeled to assess generalized or specific problematic smartphone/internet use.

    “Griffiths (2000, 2005) has proposed salience, mood, modification, tolerance, withdrawal conflict, and relapse as the six main criteria for addiction and these have been modeled to assess generalized or specific problematic smartphone/internet use.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Griffiths (2000, 2005)

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  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationown data

    The present study's findings echo the current evidence concerning the associations between problematic smartphone/internet use and mental health.

    “The present study's findings echo the current evidence concerning the associations between problematic smartphone/internet use and mental health (Bányai et al., 2017; Csibi et al., 2018; Monacis et al., 2017; Sha et al., 2019).”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites Bányai et al., 2017

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    • cites Csibi et al., 2018

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    • cites Monacis et al., 2017

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    Study design and conductown data

    The RMSEA fit index was close to the suggested cutoff, but its 90% CI covered acceptable cutoff scores and did not exceed 0.10, except for the fourth model (Fig. 2b; 90% CI of RMSEA = 0.110).

    “The fit index of RMSEA (0.083–0.092) was close to the suggested cutoff. However, its 90% CI covers acceptable cutoff scores and does not exceed the worst value for RMSEA (i.e., 0.10), except for the fourth model (Fig. 2b; 90% CI of RSMEA = 0.110).”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Only one type of specific smartphone/internet problematic use (i.e., social media use) was assessed.

    “only one type of specific smartphone/internet problematic use (i.e., social media use) was assessed.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationown data

    The finding that the initial level of specific problematic use in social media was associated with the growth of psychological distress, while this association was not found with generalized problematic smartphone/internet use, supports scholars who distinguish generalized problematic smartphone/internet use from specific problematic use.

    “This finding supports those scholars who distinguish generalized problematic smartphone/internet use from specific problematic use (Brand et al., 2014; Davis, 2001; Griffiths, 1998, 2000; Montag et al., 2015).”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites Brand et al., 2014

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    • cites Davis, 2001

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    • cites Griffiths, 1998, 2000

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    Study design and conductown data

    Missing data in the present study appeared not to be missing at random, and significant differences were found between those completing the survey only once, those completing twice, those completing three times, and those completing all four assessments in age, hours spent on using smartphone per day, and hours spent on using social media per day.

    “although missing data in the present study appeared not to be missing at random, significant differences were found between those completing the survey only once, those completing twice, those completing three times, and those completing all four assessments in age, hours spent on using smartphone per day, and hours spent on using social media per day.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Interpretationown data

    The results of the present study provided insights into the debate concerning whether problematic smartphone/internet use should be considered as an independent diagnosis or a negative consequence of other disorders.

    “the results of the present study provided insights into the debate concerning whether problematic smartphone/internet use should be considered as an independent diagnosis or a negative consequence of other disorders (Pies, 2009).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Pies, 2009

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  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Generalized problematic smartphone/internet use has been associated with other dysfunctions including impaired family functioning, lowered life satisfaction, problematic family interaction, poor emotional wellbeing, and decreased academic performance.

    “Generalized problematic smartphone/internet use has been associated with other dysfunctions including impaired family functioning, lowered life satisfaction, problematic family interaction, poor emotional wellbeing, and decreased academic performance (Rücker et al. 2015; Wartberg, Kriston, Kammerl, Petersen, & Thomasius, 2015).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Rücker et al. 2015

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    • cites Wartberg, Kriston, Kammerl, Petersen, & Thomasius, 2015

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  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    All data were self-reported using Google Forms and are subject to biases including memory recall and social desirability.

    “all data were self-reported using Google Forms and are subject to biases including memory recall and social desirability.”
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    Study design and conductown data

    There was a Heywood case in the third model (Fig. 2a; a standardized coefficient is larger than 1).

    “Moreover, there is a Heywood case in the third model (Fig. 2a; a standardized coefficient is larger than 1).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductnone given

    Only university students (with the majority from one university) were recruited using convenience sampling.

    “only university students (with the majority from one university) were recruited using convenience sampling.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductnone given

    Participants who self-reported having any mental illness were excluded, but such diagnoses were not confirmed by formal psychiatric interviews or data from medical records.

    “although participants who self-reported having any mental illness were excluded, such diagnoses were not confirmed by formal psychiatric interviews or data from medical records.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationown data

    The present study corroborates and extends prior findings that problematic smartphone/internet use is associated with (and may further impact) psychological distress among individuals with problematic smartphone/internet use.

    “The present study corroborates and extends prior findings (Bányai et al., 2017; Csibi et al., 2018; Monacis et al., 2017; Sha et al., 2019) that problematic smartphone/internet use is associated with (and may further impact) psychological distress among individuals with problematic smartphone/internet use.”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites Bányai et al., 2017

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    • cites Csibi et al., 2018

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    • cites Monacis et al., 2017

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    Study design and conductown data

    Data were collected from Hong Kong, and the extent to which the findings generalize to other populations warrants further investigation.

    “data were collected from Hong Kong and the extent to which the findings generalize to other populations also warrants further investigation.”
    Quote in the paperNot a substantial claim
29 of 29

  • The paper relies on this without support.

    Rarely has research used a longitudinal design to examine relationships between problematic smartphone/internet use and poor mental health in an East-Asian context.

    “rarely has research used a longitudinal design to examine such relationships in an East-Asian context.”

  • The paper relies on this without support.

    The direction between problematic use and psychological distress is still a matter of debate in the literature.

    “given that the direction between problematic use and psychological distress is still a matter of debate in the literature”

  • The paper relies on this without support.

    Missing data in SABAS, BSMAS, and HADS scores were missing at random.

    “A full information maximum likelihood (FIML) method was used to impute missing data in SABAS, BSMAS, and HADS scores for all the participants.”

  • The paper relies on this without support.

    The convenience sample of Hong Kong university students is representative of university students in general.

    “Convenience sampling was used and 400 students were invited to participate (response rate = 77%).”

  • The paper relies on this without support.

    The association between problematic use and psychological distress is not confounded by unmeasured variables.

    “two models were constructed adjusting for age and gender.”
5 of 5

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Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Female proportion is reported as the male proportion

    Minor

    The results say 32.5% of participants were female, but Table 1 identifies 100 of 308 participants (32.5%) as male.

1 of 1

Cites

Flagged first, then by citations

4 of the 47 references couldn’t be matched to a known paper.

Research works printed but not linked: 44

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  3. Andreassen, 2016, The relationship between addictive use of social media and video games and symptoms of psychiatric disorder: A large-scale cross-sectional study, Psychology of Addictive Behaviors, 30, 252, 10.1037/adb0000160 · DOI · Paper page
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Authors
Chen, I.-H., Pakpour, A. H., Leung, H., Potenza, M. N., Su, J.-A., Lin, C.-Y., & Griffiths, M. D.
Affiliations
  • Minnan Normal University (CN)
  • Qazvin University of Medical Sciences (IR)
  • City University of Hong Kong (HK)
  • Yale University (US)
  • Chang Gung University (TW)
  • Hong Kong Polytechnic University (HK)
  • Nottingham Trent University (GB)
Corresponding author
Lin, Chung-Ying
ORCID
Venue
Journal of Behavioral Addictions
Publisher
Akademiai Kiado Zrt.
Published
2020-06
Volume
9
Issue
2
Pages
410-419
ISSN
  • 2062-5871 (ISSN-L)
  • 2063-5303
DOI
10.1556/2006.2020.00023
PMC
PMC8939406
OpenAlex
W3037865145
Semantic Scholar
3d02484d45e179e134ee5e60f61ca2b7f9318e93
Cited by
213
References
47
Citations by year
2026: 23 · 2025: 38 · 2024: 35 · 2023: 33 · 2022: 47 · 2021: 32 · 2020: 5
FWCI
39.10
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Behavioral Addictions (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • Nottingham Trent University's Institutional Repository (Nottingham Trent Repository) (acceptedVersion)
  • Repository of the Academy's Library (Library of the Hungarian Academy of Sciences) (acceptedVersion)
  • CityU Scholars (submittedVersion, cc-by-nc)
  • PolyU Institutional Research Archive (Hong Kong Polytechnic University) (submittedVersion, cc-by-nc)
Funders
Hong Kong Polytechnic University
Topics
  • Social Sciences › Sociology and Political Science › Impact of Technology on Adolescents
  • Social Sciences › Psychology › Clinical Psychology › Sexuality, Behavior, and Technology
  • Social Sciences › Education › Child Development and Digital Technology
Keywords
smartphone addiction, problematic internet use, social media addiction, psychological distress, anxiety, depression, university students, young adults, longitudinal associations
MeSH terms
Smartphone, Psychological Distress, Internet Addiction Disorder, Adolescent, Adult, Anxiety, Depression, Female, Hong Kong, Humans, Longitudinal Studies, Male, Stress, Psychological, Students, Universities, Young Adult, Social Media

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