Problematic Internet use and daily difficulties among adolescents with school refusal behaviors

Abstract

Problematic Internet use (PIU) is common and likely to coexist with mental health problems among adolescents with school refusal behavior. To date, no study has revealed to what extent PIU relates to the daily burden compared with other mental health problems. This study has examined the association between daily difficulties and PIU among adolescents with school refusal behaviors.This cross-sectional study involved all first-visit patients, regardless of diagnosis, aged 10 to 18 years at 2 child/adolescent psychiatric outpatient clinics in Yokohama City, Japan, from April 2016 to March 2018. The Questionnaire-Children with Difficulties (QCD) were obtained from parents. Simultaneously, the severity of PIU was evaluated using the Internet Addiction Test and depressive and anxiety symptoms were evaluated using the Patient Health Questionnaire-9 and General Anxiety Disorder-7 scale in the 2 weeks before the first-visit. From 684 first-visit patients, 227 with school refusal behaviors were enrolled in the study.PIU was observed in 40% of adolescents with school refusal behaviors. The QCD scores among patients with PIU were significantly lower than those in patients without PIU. Linear regression analysis revealed relationships between PIU and lower QCD scores throughout the day (except at night) and the total score of the day, after controlling for confounders such as depressive and anxiety symptoms.In conclusion, among adolescents with school refusal behaviors, PIU may affect their parent-assessed daily difficulties particularly experienced throughout the day.

A Systematic Review of the Association of Internet Gaming Disorder and Excessive Social Media Use With Psychiatric Comorbidities in Children and Adolescents: Is It a Curse or a Blessing?

“…These findings were further supported by a separate study conducted by Fujita et al, which assessed clinical depression symptoms using the Patient Health Questionnaire-9 (PHQ-9) scale and clinical anxiety in youth aged 10-18 years by using the General Anxiety Disorder-7 (GAD-7) scale [ 7 ]. The results indicated a positive correlation between PIU and both depression and anxiety symptoms [ 7 , 42 ].…”

“…Research has indicated a prevalence of internet addiction among students in the United States ranging from 5% to 25%, underscoring the need for thorough investigation and recognition of this phenomenon [ 6 ]. It is commonly assumed that children who spend extensive time online tend to become increasingly detached from reality [ 7 ]. Consequently, we were intrigued enough to explore whether the prevailing excessive use of the internet is genuinely detrimental to the mental health of children and adolescents, or, if, when utilized appropriately, it can potentially yield positive effects on their social and cognitive development.…”

Increasing important roles of child and adolescent psychiatrists in the treatment of gaming disorder: Current status in Japan

“…The Internet enables individuals with these psychological features to find a normalizing and comfortable place which in turn encourages them to remain there. Recent studies have suggested that hikikomori could at least partially be related to GD (35)(36)(37)(38). Because many children and adolescents use the Internet to play online games with both societal and parental approval, it is not surprising that there is a significant relationship between hikikomori and GD where controls are weak and cultural as well as individual predispositions exist.…”

“…Although GD is one of many behavioral addictions, almost all school-aged patients with GD have of necessity first visited child and adolescent psychiatry clinics rather than specialized clinics for addiction. At medical institutions having child and adolescent psychiatry services, there is evidence of an increasing number of children and adolescents presenting with various problems related to excessive gaming such as violence against family members ( 40 ), high bills which are consequent to some of the particular games’ rules and rewards systems ( 41 ), disturbed sleep-wake rhythm ( 42 ), school refusal ( 35 ), and various other mental health issues ( 43 ). Additionally, a secondary pathway exists through referrals from pediatric clinics, child consultation centers and school nurses for potential diagnoses of GD ( 40 , 44 ).…”

Digital Competence, Use, Actions and Time Dedicated to Digital Devices: Repercussions on the Interpersonal Relationships of Spanish Adolescents

“…In addition, in this regard, other research has highlighted the fact that, compared to adolescents in general, people with PIU experience more social recognition in the online world than offline [ 29 ]. In short, we can state that adolescents with PIU, in addition to having problems with depression and anxiety, also experience alterations in their own lifestyle, hygiene and sleep habits, loss of control, anger, symptoms of distress, family conflicts, and social isolation [ 30 , 31 , 32 , 33 ]. Therefore, the aims of this study are twofold: to analyze the use that young Spaniards make of the Internet and digital devices outside school, the time they use them, and their attitudes towards the use of digital devices.…”