Reciprocal Relationships Between Problematic Social Media Use, Problematic Gaming, and Psychological Distress Among University Students: A 9-Month Longitudinal Study

doi:10.3389/fpubh.2022.858482

. 2022 Apr 8:10:858482.

doi: 10.3389/fpubh.2022.858482. eCollection 2022.

Reciprocal Relationships Between Problematic Social Media Use, Problematic Gaming, and Psychological Distress Among University Students: A 9-Month Longitudinal Study

Ching-Wen Chang¹, Ru-Yi Huang^{2

3}, Carol Strong⁴, Yi-Ching Lin⁵, Meng-Che Tsai^{6

7}, I-Hua Chen⁸, Chung-Ying Lin^{9

10

11

4}, Amir H Pakpour^{12

13}, Mark D Griffiths¹³

Affiliations

¹ Graduate Institute of Social Work, National Taiwan Normal University, Taipei, Taiwan.
² Department of Family and Community Medicine, E-Da Hospital, Kaohsiung, Taiwan.
³ School of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung, Taiwan.
⁴ Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
⁵ Department of Early Childhood and Family Education, National Taipei University of Education, Taipei, Taiwan.
⁶ Department of Pediatrics, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan.
⁷ Department of Medical Humanities and Social Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
⁸ Chinese Academy of Education Big Data, Qufu Normal University, Qufu, China.
⁹ College of Medicine, Institute of Allied Health Sciences, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan.
¹⁰ Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
¹¹ Biostatistics Consulting Center, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan.
¹² Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden.
¹³ International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, United Kingdom.

PMID: 35462841
PMCID: PMC9024175
DOI: 10.3389/fpubh.2022.858482

Reciprocal Relationships Between Problematic Social Media Use, Problematic Gaming, and Psychological Distress Among University Students: A 9-Month Longitudinal Study

Ching-Wen Chang et al. Front Public Health. 2022.

. 2022 Apr 8:10:858482.

doi: 10.3389/fpubh.2022.858482. eCollection 2022.

Authors

Ching-Wen Chang¹, Ru-Yi Huang^{2

3}, Carol Strong⁴, Yi-Ching Lin⁵, Meng-Che Tsai^{6

7}, I-Hua Chen⁸, Chung-Ying Lin^{9

10

11

4}, Amir H Pakpour^{12

13}, Mark D Griffiths¹³

Affiliations

¹ Graduate Institute of Social Work, National Taiwan Normal University, Taipei, Taiwan.
² Department of Family and Community Medicine, E-Da Hospital, Kaohsiung, Taiwan.
³ School of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung, Taiwan.
⁴ Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
⁵ Department of Early Childhood and Family Education, National Taipei University of Education, Taipei, Taiwan.
⁶ Department of Pediatrics, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan.
⁷ Department of Medical Humanities and Social Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
⁸ Chinese Academy of Education Big Data, Qufu Normal University, Qufu, China.
⁹ College of Medicine, Institute of Allied Health Sciences, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan.
¹⁰ Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
¹¹ Biostatistics Consulting Center, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan.
¹² Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden.
¹³ International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, United Kingdom.

PMID: 35462841
PMCID: PMC9024175
DOI: 10.3389/fpubh.2022.858482

Abstract

Background: The causal relationships between two specific types of problematic use in internet-related activities [i.e., problematic social media use (PSMU) and problematic gaming (PG)] and psychological distress remain controversial. The present study investigated the temporal relationships between PSMU, PG, and psychological distress (i.e., anxiety, depression) in university students.

Methods: Hong Kong and Taiwan university students [N = 645; n_male = 266; mean = 20.95 years (SD = 5.63)] were recruited for a survey study, with follow-ups at 3, 6, and 9 months after baseline assessment. The Bergen Social Media Addiction Scale, Internet Gaming Disorder Scale-Short Form, and the Hospital Anxiety and Depression Scale were used to assess studied variables. Demographics including age, physical characteristics (i.e., height, weight, and body mass index), and cigarette use were compared between participants who completed all the follow-ups and those who dropped out. Random intercept cross-lagged models were constructed to understand the reciprocal relationships between PSMU, PG, and psychological distress.

Results: No significant differences were found in age, physical characteristics, and cigarette use between participants who completed all the follow-ups and those who dropped out. Findings indicated that a high level of PSMU significantly increased the level of anxiety and a high level of anxiety significantly increased the level of PSMU. A high level of PSMU significantly increased the level of depression but the level of depression did not significantly affect the level of PSMU. A high level of PG significantly increased the level of anxiety, but the level of anxiety did not significantly affect the level of PG. A high level of depression significantly increased the level of PG, but the level of depression did not significantly affect the level of PG.

Conclusion: The patterns of the causal relationship between PIU and psychological distress variables differ. A reciprocal relationship was only found between the level of PSMU and the level of anxiety. Moreover, the longitudinal design found no differences in the waves in terms of gaming by the participants.

Keywords: anxiety; depression; longitudinal study; problematic gaming; problematic social media use.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

**Figure 1**
Cross-lagged model of PSMU and anxiety using lagged bidirectional model. Covariates include gender and age. Anxiety was assessed using the Hospital Anxiety and Depression Scale; PSMU, problematic social media use was assessed using the Bergen Social Media Addiction Scale. RI, random intercept; W1, wave 1; W2, wave 2; W3, wave 3. All the estimates are standardized coefficients. *p < 0.05; **p < 0.01.

**Figure 2**
Cross-lagged model of PSMU and depression using lagged bidirectional model. Covariates include gender and age. Depression was assessed using the Hospital Anxiety and Depression Scale; PSMU, problematic social media use was assessed using the Bergen Social Media Addiction Scale. RI, random intercept; W1, wave 1; W2, wave 2; W3, wave 3. All the estimates are standardized coefficients. *p < 0.05; **p < 0.01.

**Figure 3**
Cross-lagged model of PG and anxiety using lagged bidirectional model. Covariates include gender and age. Anxiety was assessed using the Hospital Anxiety and Depression Scale; PG, problematic gaming was assessed using the Internet Gaming Disorder Scale-Short Form. RI, random intercept; W1, wave 1; W2, wave 2; W3, wave 3. All the estimates are standardized coefficients. *p < 0.05; **p < 0.01.

**Figure 4**
Cross-lagged model of PG and depression using lagged bidirectional model. Covariates include gender and age. Depression was assessed using the Hospital Anxiety and Depression Scale; PG, problematic gaming was assessed using the Internet Gaming Disorder Scale-Short Form. RI, random intercept; W1, wave 1; W2, wave 2; W3, wave 3. All the estimates are standardized coefficients. *p < 0.05; **p < 0.01.

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References

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1. Oluwole LO, Obadeji A, Dada MU. Surfing over masked distress: internet addiction and psychological well-being among a population of medical students. Asian J Soc Health Behav. (2021) 4:56–61. 10.4103/shb.shb_76_20 - DOI

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[1] Mihajlov M, Vejmelka L. Internet addiction: a review of the first twenty years. Psychiatr Danub. (2017) 29:260–72. 10.24869/psyd.2017.260 - DOI - PubMed

[2] Mihajlov M, Vejmelka L. Internet addiction: a review of the first twenty years. Psychiatr Danub. (2017) 29:260–72. 10.24869/psyd.2017.260 - DOI - PubMed

[3] Cheng C, Li AY. Internet addiction prevalence and quality of (real) life: a meta-analysis of 31 nations across seven world regions. Cyberpsychol Behav Soc Netw. (2014) 17:755–60. 10.1089/cyber.2014.0317 - DOI - PMC - PubMed

[4] Cheng C, Li AY. Internet addiction prevalence and quality of (real) life: a meta-analysis of 31 nations across seven world regions. Cyberpsychol Behav Soc Netw. (2014) 17:755–60. 10.1089/cyber.2014.0317 - DOI - PMC - PubMed

[5] Cole SH, Hooley JM. Clinical and personality correlates of MMO gaming. Soc Sci Comput Rev. (2013) 31:424–36. 10.1177/0894439312475280 - DOI

[6] Cole SH, Hooley JM. Clinical and personality correlates of MMO gaming. Soc Sci Comput Rev. (2013) 31:424–36. 10.1177/0894439312475280 - DOI

[7] Hyun GJ, Han D H, Lee YS, Kang KD, Yoo SK, Chung US, et al. . Risk factors associated with online game addiction: a hierarchical model. Comput Hum Behav. (2015) 48:706–13. 10.1016/j.chb.2015.02.008 - DOI

[8] Hyun GJ, Han D H, Lee YS, Kang KD, Yoo SK, Chung US, et al. . Risk factors associated with online game addiction: a hierarchical model. Comput Hum Behav. (2015) 48:706–13. 10.1016/j.chb.2015.02.008 - DOI

[9] Oluwole LO, Obadeji A, Dada MU. Surfing over masked distress: internet addiction and psychological well-being among a population of medical students. Asian J Soc Health Behav. (2021) 4:56–61. 10.4103/shb.shb_76_20 - DOI

[10] Oluwole LO, Obadeji A, Dada MU. Surfing over masked distress: internet addiction and psychological well-being among a population of medical students. Asian J Soc Health Behav. (2021) 4:56–61. 10.4103/shb.shb_76_20 - DOI

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Reciprocal Relationships Between Problematic Social Media Use, Problematic Gaming, and Psychological Distress Among University Students: A 9-Month Longitudinal Study

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Reciprocal Relationships Between Problematic Social Media Use, Problematic Gaming, and Psychological Distress Among University Students: A 9-Month Longitudinal Study

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