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Cited by 114Impact of Technology on AdolescentsSuicide and Self-Harm StudiesSleep and related disorders

Association between problematic Internet use, sleep disturbance, and suicidal behavior in Chinese adolescents

Open access
Guo, Lan, Luo, Min, Wang, Wan-Xin, Huang, Guo-Liang, Xu, Yan, Gao, Xue, Lu, Ci-Yong, Zhang, Wei-Hong·2018·Journal of Behavioral Addictions
DOI 10.1556/2006.7.2018.115PMC PMC6376369
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Abstract

Background and aims: This large-scale study aimed to test (a) associations of problematic Internet use (PIU) and sleep disturbance with suicidal ideation and suicide attempts among Chinese adolescents and (b) whether sleep disturbance mediates the association between PIU and suicidal behavior. Methods: Data were drawn from the 2017 National School-based Chinese Adolescents Health Survey. A total of 20,895 students’ questionnaires were qualified for analysis. The Young’s Internet Addiction Test was used to assess PIU, and level of sleep disturbance was measured by the Pittsburgh Sleep Quality Index. Multilevel logistic regression models and path models were utilized in analyses. Results: Of the total sample, 2,864 (13.7%) reported having suicidal ideation, and 537 (2.6%) reported having suicide attempts. After adjusting for control variables and sleep disturbance, PIU was associated with an increased risk of suicidal ideation (AOR = 1.04, 95% CI = 1.03−1.04) and suicide attempts (AOR = 1.03, 95% CI = 1.02−1.04). Findings of the path models showed that the standardized indirect effects of PIU on suicidal ideation (standardized β estimate = 0.092, 95% CI = 0.082−0.102) and on suicide attempts (standardized β estimate = 0.082, 95% CI = 0.068−0.096) through sleep disturbance were significant. Conversely, sleep disturbance significantly mediated the association of suicidal behavior on PIU. Discussion and conclusions: There may be a complex transactional association between PIU, sleep disturbance, and suicidal behavior. The estimates of the mediator role of sleep disturbance provide evidence for the current understanding of the mechanism of the association between PIU and suicidal behavior. Possible concomitant treatment services for PIU, sleep disturbance, and suicidal behavior were recommended.

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  • PIU was associated with suicide attempts (adjusted OR 1.03, 95% CI 1.02-1.04, P<0.5) on multivariable, multilevel logistic regression.

    “PIU was associated with suicide attempts, (adjusted OR 1.03, 95% CI 1.02-1.04, P <0.5) on multivariable, multilevel logistic regression”

    From Social media, internet use and suicide attempts in adolescents (2019) · cites this paper as Guo, 2018

    Table 2 in the Results reports an adjusted odds ratio of 1.03 (95% CI 1.02–1.04) for suicide attempts in the multivariable multilevel model. The table note marks the result as p < .05, whereas the citing sentence prints P < 0.5; that threshold is imprecise, though the reported result also satisfies it. No page number is available in our copy. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • Severely addicted internet users had greater risk of suicide attempt (14.0%) than moderately addicted (4.3%) and average (1.5%) internet users.

    “Severely addicted internet users had greater risk of suicide attempt (14.0%) than moderately addicted (4.3%) and average (1.5%) internet users.”

    From Social media, internet use and suicide attempts in adolescents (2019) · cites this paper as Guo, 2018

    Methods > Measures defines the three Internet-use categories and suicide attempt, while Discussion reports a 2.6% overall suicide-attempt rate. Searches of our copy for 14.0%, 4.3%, 1.5%, and suicide-attempt rates by category did not locate the claimed group-specific percentages or establish their ordering. (LLM, conf=0.68)

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Authors
Guo, L., Luo, M., Wang, W.-X., Huang, G.-L., Xu, Y., Gao, X., Lu, C.-Y., & Zhang, W.-H.
Affiliations
  • Sun Yat-sen University (CN)
  • 1 Department of Medical statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People’s Republic of China
  • 3 Department of Drug Abuse Control, Center for ADR monitoring of Guangdong, Guangzhou, People’s Republic of China
  • Université Libre de Bruxelles (BE)
ORCID
Venue
Journal of Behavioral Addictions
Publisher
Akademiai Kiado Zrt.
Published
2018-11-26
Volume
7
Issue
4
Pages
965-975
ISSN
  • 2062-5871 (ISSN-L)
  • 2063-5303
DOI
10.1556/2006.7.2018.115
PMC
PMC6376369
OpenAlex
W2903186237
Cited by
114
References
60
Citations by year
2026: 9 · 2025: 18 · 2024: 15 · 2023: 14 · 2022: 21 · 2021: 13 · 2020: 18 · 2019: 6
FWCI
21.05
Type
journal article
Language
en
Open access
Locations
  • Journal of Behavioral Addictions (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • Repository of the Academy's Library (Library of the Hungarian Academy of Sciences) (acceptedVersion)
  • Dépôt institutionnel de l'Université libre de Bruxelles (Université Libre de Bruxelles) (submittedVersion, other-oa)
Funders
  • National Natural Science Foundation of China (81761128030)
  • Sun Yat-sen University
Topics
  • Social Sciences › Sociology and Political Science › Impact of Technology on Adolescents
  • Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
Keywords
problematic internet use, internet addiction, sleep disorders, suicidal ideation, suicide attempts, adolescents, mediation, Chinese adolescents
MeSH terms
Adolescent, Adolescent Behavior, China, Female, Health Surveys, Humans, Male, Schools, Sleep Wake Disorders, Students, Suicide, Attempted, Behavior, Addictive, Internet, Suicidal Ideation

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