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Association between problematic Internet use, sleep disturbance, and suicidal behavior in Chinese adolescents
Open accessAbstract
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”
From Social media, internet use and suicide attempts in adolescents (2019) · cites this paper as Guo, 2018
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“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
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“Although the underlying mechanism of the association between PIU and suicidal behavior is still unclear, evidence suggests that individuals with additive disorder share similar personality characteristics and reward-related neurocircuitry or genetic traits with those who possess psychiatric disorder (Hammond, Mayes, &…”
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Metadata
- 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)
- 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
- 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
- gold
- doi.org
- 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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