There is a general consensus that Internet addiction (IA) is mainly related to social aspects of the Web, especially among adolescents. The empirical link between poor social skills and IA is well documented; however, theoretical explanations for this relationship are less developed. One possibility is that people with poor social skills are especially prone to develop a preference for online social interaction (POSI), which, in turn, predicts problematic usage. This hypothesis has been tested for loneliness and social anxiety, but not for self-esteem (SE; one of the main antecedents of IA). Furthermore, the mediating role of the perceived relevance of some Internet features (e.g., anonymity) in the relationship between SE and POSI has never been investigated. A cross-sectional study was conducted with 257 adolescents. Using mediation analyses, we found evidence among females for the mediating role of (a) POSI in the relationship between SE and IA, and (b) the subjective relevance of some Internet features in the association between SE and POSI. No significant effects were found for males.

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BACKGROUND:The effect of pulmonary rehabilitation (PR) on the EuroQol Group's 5-dimension questionnaire (EQ-5D) in COPD has been poorly investigated. In addition, conflicting results were reported about the visual analog scale component of EQ-5D (EQ-VAS). The purpose of this study was to evaluate the responsiveness of EQ-VAS to PR and its relationship with clinical and functional parameters in subjects with COPD, as well as to define the minimal clinically important difference (MCID) estimate for the EQ-VAS after PR. METHODS: A total of 468 in-patients with stable moderate-to-severe COPD, allocated to a 3-wk PR program, were retrospectively evaluated. EQ-VAS was assessed before and after PR, and its relationship with baseline pulmonary function, changes in 6-min walk test, and baseline, and transitional dyspnea index (BDI/TDI) after PR were evaluated. Using an anchor-based approach and receiver operating characteristic curves, the EQ-VAS change cutoff that identified subjects achieving the known MCID for TDI after PR was identified. RESULTS: Four hundred and thirty-nine subjects (94%, mean FEV 1 55.3% predicted) completed pre-and post-PR EQ-VAS scores. After PR, EQ-VAS increased from 58 ؎ 17 to 72 ؎ 15 (⌬EQ-VAS 14 ؎ 12, P < .001). ⌬EQ-VAS was negatively related to baseline FEV 1 (r ‫؍‬ ؊0.32, P < .001) and positively to TDI (r ‫؍‬ 0.50, P < .001) and 6-min walk distance (r ‫؍‬ 0.46, P < .001) changes. Receiver operating characteristic curves identified an EQ-VAS change cutoff of 8 as the best discriminating value to identify the MCID for TDI (0.78 sensitivity and 0.81 specificity; area under curve: 0.845, P < .001). CONCLUSIONS: Our study shows that, in in-patients with stable moderate-to-severe COPD, EQ-VAS is a valid and reliable tool to assess the responsiveness to PR, with an estimated MCID of 8 points. The EQ-VAS can be a practical alternative to more timeconsuming measures of health-related quality of life.

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The 15-item Generalized Problematic Internet Use Scale 2 (GPIUS2) is one of the few theory-driven instruments to measure problematic Internet use (PIU). Since PIU has emerged in several cultural contexts, it seems relevant to evaluate the psychometric properties of the scale across various cultures. The aim of the present study was to test the psychometric properties (i.e., dimensionality, reliability, and validity) of the Italian version of the GPIUS2. The sample consisted of 371 participants (128 males and 243 females), and their age ranged from 14 to 33 years (M=18.07 years, SD=5.58). The GPIUS2 and the Internet Addiction Test (IAT) were administered individually in both high school and college classes. With regard to scale dimensionality, the best-fit measurement model includes four first-order factors: preference for online social interaction, mood regulation, deficient self-regulation, and negative outcomes (Satorra-Bentler scaled chi-square [S-Bχ(2)]/df=2.27; comparative fit index [CFI]=0.94; Tucker-Lewis index [TLI]=0.93; root mean square error of approximation [RMSEA]=0.05). With regard to reliability, internal-consistency Cronbach's alpha ranged from 0.78 to 0.89. Convergent validity is demonstrated with significant correlations between GPIUS2 (total score and all the subscale scores) and IAT score. Results showed that GPIUS2 scores significantly discriminated between high school and undergraduate students. The overall findings of the present study provide evidence that the Italian version of the GPIUS2 appears to be an adequate measure of generalized PIU cognitions, behaviors, and outcomes. Suggestions for further research are provided.

IntroductionFollowing the theoretical frameworks of the dual-factor model of Facebook use and the Self Determination Theory, the present study hypothesizes that the satisfaction of unmet needs through Social Networking Sites (SNSs) may represent a pathway towards problematic use of Internet communicative services (GPIU) for socially anxious people.MethodsFour hundred undergraduate students (females = 51.8%; mean age = 22.45 + 2.09) completed three brief scales measuring the satisfaction via SNSs of the need to belong, the need for self-presentation and the need for assertiveness, the Generalized Problematic Internet Use Scale 2 and the Social Interaction Anxiety Scale. Structural equation modeling was performed separately for males and females.ResultsA direct effect of social anxiety on GPIU was found among both genders. Socially anxious males and females tend to use SNSs for self-presentation purposes, as well as for the opportunity to be more assertive. The association between social anxiety and GPIU was partially mediated by the need for self-presentation only among males.ConclusionsThe present results extend our understanding of the development of problematic use of Internet communicative services, based on the framework of the dual factor model of Facebook use and the Self Determination Theory. The fulfillment of an unmet need for self-presentation (i.e. the desire to create a positive impression of one's self in others) through SNSs could be one of the possible pathways to GPIU for socially anxious males.

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