The Internet activities, gratifications, and health consequences related to compulsive Internet use

Background: The proliferation of the Internet and Internet related applications has consequently increased the concern for compulsive internet use (CIU), particularly among adolescents. CIU shares similar qualities and definitions with other substance and behavioral addictions, which are often characterized by 1) preoccupation, 2) mood alterations, 3) tolerance, and 4) withdrawal. CIU has been linked with several mental health issues, such as depression, anhedonia, and ADHD and behavioral consequences, such as substance use, alcohol use, hostility, and suicidal ideation. Understanding the risks and consequences associated with CIU may play an important factor not only in CIU prevention but in the prevention of other associated mental and behavioral problems. ❧ Methods: This dissertation was guided by the Uses and Gratifications Theory. Study 1 assessed CIU and Internet activities using latent class analysis among a sample of continuation high school students participating in Project Towards No Drugs Abuse in Los Angeles, CA, USA. Study 2 and Study 3 used data from the Happiness and Health Study, a study surveying regular, youths attending high schools in Los Angeles, CA, USA. Study 2 assessed pleasure derived from Internet use and its association with CIU using multi-level modeling. Study 3 assessed the longitudinal association between CIU and substance use using latent transition analysis. ❧ Results: Study 1 found that generalized Internet use and use of the Internet for specific activities were associated with greater CIU. Study 2 found certain gratifications were associated with CIU onset but not with changes in CIU. These relationships are moderated by anhedonia and gender cross-sectionally but not longitudinally. Over time, baseline CIU and identifying as “Hispanic” and “Other” ethnicity were the only variables that significantly predicted changes in CIU one year later. Study 3 found Internet Addiction (IA) was an independent behavioral consequence as well as a consequence associated with substance use behaviors among subsets of adolescents. IA was a relatively stable behavior among adolescents exhibiting IA only, whereas those who exhibited IA and substance use problems were more likely to change behaviors at follow-up. ❧ Conclusion: These findings contribute to our understanding of factors that may be associated with CIU etiology and consequence. These results suggest the importance of CIU prevention at an early age and provide insight on how best to tailor CIU prevention and intervention programs, as well as substance use programs, most effectively.背景：互联网及其相关应用的普及，使得网络成瘾（compulsive internet use, CIU）相关问题愈发受到社会关注，青少年群体尤为突出。网络成瘾与其他物质成瘾及行为成瘾具有相似的核心特征与界定标准，通常表现为以下四类典型症状：1）沉迷专注，2）情绪改变，3）耐受性增强，4）戒断反应。现有研究证实，网络成瘾与多种心理健康问题密切相关，包括抑郁、快感缺失（anhedonia）及注意缺陷多动障碍（ADHD）；同时还会引发一系列不良行为后果，如物质滥用、饮酒、敌意情绪及自杀意念。明确网络成瘾相关的风险因素与不良结局，不仅是网络成瘾预防的核心环节，也可为其他与之关联的心理及行为问题的防控提供支撑。 ❧ 研究方法：本研究以使用与满足理论（Uses and Gratifications Theory）为理论框架。研究1针对美国加利福尼亚州洛杉矶市「迈向无药物滥用项目（Project Towards No Drugs Abuse）」中的继续教育高中学生样本，采用潜类别分析（latent class analysis）评估网络成瘾情况及互联网使用活动。研究2与研究3的数据均来自「幸福与健康研究（Happiness and Health Study）」，该调查面向美国加利福尼亚州洛杉矶市的普通高中在校青少年开展。研究2采用多层模型（multi-level modeling）分析互联网使用带来的愉悦感及其与网络成瘾的关联。研究3采用潜转移分析（latent transition analysis）探究网络成瘾与物质滥用之间的纵向关联。 ❧ 研究结果：研究1发现，泛化互联网使用以及针对特定活动的互联网使用，均与更严重的网络成瘾程度显著相关。研究2发现，特定的使用动机与网络成瘾的初始发生存在关联，但与网络成瘾程度的后续变化无关；上述关联在横断面分析中受快感缺失程度与性别的调节，但在纵向分析中未观察到该调节效应。随着时间推移，基线时的网络成瘾程度、自我标识为「西班牙裔」及「其他族裔」是唯一能显著预测一年后网络成瘾程度变化的变量。研究3发现，网络成瘾（Internet Addiction, IA）既是一种独立的行为后果，也会在部分青少年亚群体中成为物质滥用行为的继发后果。仅表现出网络成瘾症状的青少年，其网络成瘾行为相对稳定；而同时存在网络成瘾与物质滥用问题的青少年，在随访阶段更易出现行为模式的转变。 ❧ 研究结论：本研究结果有助于深化对网络成瘾病因及不良结局相关影响因素的认知。研究结果证实了及早开展网络成瘾预防工作的重要性，并为如何更精准地定制网络成瘾预防与干预方案、以及物质滥用干预方案提供了科学参考与实践思路。