Background Both eating disorders and excessive internet use represent significant health issues for contemporary adolescents. Yet, the link between them has seldom been investigated. We aim to study this association through their common underlying psychological factors: internalising problems and externalising problems. Methods A representative sample of 7,083 adolescents (Mage = 13.48 years; SDage = 1.32; 50.3% girls) from Slovakia was obtained from the Health Behaviour in School-aged Children (HBSC) project in 2018. Study variables included the Excessive Internet Use Scale (EIU) and the Strength and Difficulties Questionnaire (SDQ). Eating disorders symptoms (EDS) were assessed by SCOFF and selected items from the Eating Disorder Screen for Primary Care (ESP). Data were analysed separately for boys and girls with Structural Equation Modelling. Results There was a partial correlation between EDS and EIU (r = 0.36 for boys and r = 0.29 for girls) after controlling for the internalising and externalising of problems. Internalising and externalising problems were positively associated with EDS, while EIU was only associated with externalising problems. The results were comparable for both genders. Conclusion The study provides evidence that, during adolescence, EDS and EIU are related and have a tendency to occur together. Also, they are related even when controlled for their shared underlying psychological factors, namely the emotional and attentional/behavioural difficulties.

Background: This study investigates both offline and online bullying perpetration and victimization in association with problematic internet use (PIU) and problematic smartphone use (PSU), while also considering the related psychosocial difficulties. Methods: A total of 3939 adolescents (49.4% boys, aged 13-15 years) from a representative sample of schools in Slovakia was obtained from the Health Behavior in School-aged Children (HBSC) project in 2018. Due to the lack of similar complex research and the expected mutual associations among the constructs, we compared exploratory network models that provided separate estimates for boys and girls. Results: The constructs formed similarly clustered networks for both genders, with a few notable differences. Unlike PIU, PSU was not associated with bullying experiences in boys or girls; however, PSU and PIU were partially related in girls. Bullying experiences formed a strong cluster in both networks. Two strong bridges were identified, and they are potential candidates for intervention in both boys and girls: first, traditional bullying victimization connected the cluster of bullying experiences to psychosocial difficulties; and, second, frequently missing sleep or meals due to internet use (behavioral salience) that is connected to the bullying cluster with PIU. Conclusions: The findings offer an indication for the preventive and interventive work of practitioners who deal with adolescents, as well as complex gender comparisons for the mutual relations of problematic internet and smartphone use, bullying experiences, and the psychosocial difficulties of youth. This study provides evidence that problematic digital media can play a role in bullying experiences irrespective of whether bullying happens offline or online. Key practitioner message• Existing research found isolated relationships among psychosocial difficulties, problematic internet use (PIU), problematic smartphone use (PSU), and bullying experiences; however, no studies offer complex models.• We applied network modeling to explore mutual relationships among individual symptoms.• PSU was not associated with bullying experiences in the network for either gender.• We identified traditional bullying victimization and the frequent missing of sleep and meals due to the internet as the most important intervention candidates for both genders. • The girls' network showed the symptoms of conflict and withdrawal (in PIU) as additional intervention candidates.

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BackgroundThe importance of studying the excessive use of social media in adolescents is increasing and so is the need for in-depth evaluations of the psychometric properties of the measurement tools. This study investigated the properties of the Social Media Disorder Scale (SMDS) in a large representative sample of Czech adolescents.MethodsWe analyzed the representative sample of 13,377 Czech adolescents (50.9% boys), 11–16 years old, who participated in the Health Behavior in School-aged Children (HBSC) survey (2017–18), using confirmatory factor analysis (CFA) and network models. Furthermore, we evaluated the measurement invariance and constructed the validity of the SMDS.ResultsWe found support for a single dominant factor but not for strict unidimensionality. Several residual correlations were identified. The strongest were for: problems–conflicts–deceptions; persistence–escape; and preoccupation–tolerance–withdrawal. Girls, particularly 13- and 15-year-olds, scored higher than boys in the same age group, and 13- and 15-year-olds achieved higher scores than 11-year-olds, although some items were not invariant between the groups. The SMDS was positively related to other online activities, screen time, and falling asleep late, but negatively related to well-being and mental health.Discussion and conclusionsThe SMDS showed solid psychometric properties and construct validity. However, small violations of measurement invariance were detected. Furthermore, the network analysis showed important residual relationships between the items.