Hökby Sebastian, Hadlaczky Gergö, Westerlund Joakim, Wasserman Danuta, Balazs Judit, Germanavicius Arunas, Machín Núria, Meszaros Gergely, Sarchiapone Marco, Värnik Airi, Varnik Peeter, Westerlund Michael, Carli Vladimir
National Centre for Suicide Research and Prevention of Mental Ill-Health, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden.
JMIR Ment Health. 2016 Jul 13;3(3):e31. doi: 10.2196/mental.5925.
Adolescents and young adults are among the most frequent Internet users, and accumulating evidence suggests that their Internet behaviors might affect their mental health. Internet use may impact mental health because certain Web-based content could be distressing. It is also possible that excessive use, regardless of content, produces negative consequences, such as neglect of protective offline activities.
The objective of this study was to assess how mental health is associated with (1) the time spent on the Internet, (2) the time spent on different Web-based activities (social media use, gaming, gambling, pornography use, school work, newsreading, and targeted information searches), and (3) the perceived consequences of engaging in those activities.
A random sample of 2286 adolescents was recruited from state schools in Estonia, Hungary, Italy, Lithuania, Spain, Sweden, and the United Kingdom. Questionnaire data comprising Internet behaviors and mental health variables were collected and analyzed cross-sectionally and were followed up after 4 months.
Cross-sectionally, both the time spent on the Internet and the relative time spent on various activities predicted mental health (P<.001), explaining 1.4% and 2.8% variance, respectively. However, the consequences of engaging in those activities were more important predictors, explaining 11.1% variance. Only Web-based gaming, gambling, and targeted searches had mental health effects that were not fully accounted for by perceived consequences. The longitudinal analyses showed that sleep loss due to Internet use (ß=.12, 95% CI=0.05-0.19, P=.001) and withdrawal (negative mood) when Internet could not be accessed (ß=.09, 95% CI=0.03-0.16, P<.01) were the only consequences that had a direct effect on mental health in the long term. Perceived positive consequences of Internet use did not seem to be associated with mental health at all.
The magnitude of Internet use is negatively associated with mental health in general, but specific Web-based activities differ in how consistently, how much, and in what direction they affect mental health. Consequences of Internet use (especially sleep loss and withdrawal when Internet cannot be accessed) seem to predict mental health outcomes to a greater extent than the specific activities themselves. Interventions aimed at reducing the negative mental health effects of Internet use could target its negative consequences instead of the Internet use itself.
International Standard Randomized Controlled Trial Number (ISRCTN): 65120704; http://www.isrctn.com/ISRCTN65120704?q=&filters=recruitmentCountry:Lithuania&sort=&offset= 5&totalResults=32&page=1&pageSize=10&searchType=basic-search (Archived by WebCite at http://www.webcitation/abcdefg).
青少年和青年是最频繁使用互联网的人群之一，越来越多的证据表明他们的互联网行为可能会影响其心理健康。使用互联网可能会影响心理健康，因为某些基于网络的内容可能令人苦恼。也有可能无论内容如何，过度使用都会产生负面影响，例如忽视线下的保护性活动。
本研究的目的是评估心理健康如何与以下因素相关：（1）上网时间；（2）在不同基于网络的活动上花费的时间（社交媒体使用、游戏、赌博、色情内容使用、学业、新闻阅读和定向信息搜索）；（3）参与这些活动所感知到的后果。
从爱沙尼亚、匈牙利、意大利、立陶宛、西班牙、瑞典和英国的国立学校中随机抽取2286名青少年作为样本。收集了包括互联网行为和心理健康变量的问卷数据，并进行横断面分析，4个月后进行随访。
横断面分析显示，上网时间和在各种活动上花费的相对时间均能预测心理健康（P<.001），分别解释了1.4%和2.8%的方差。然而，参与这些活动的后果是更重要的预测因素，解释了11.1%的方差。只有基于网络的游戏、赌博和定向搜索对心理健康有影响，且这些影响不能完全由感知到的后果来解释。纵向分析表明，因使用互联网导致的睡眠不足（β=0.12，95%CI=0.05 - 0.19，P=.001）以及无法上网时的戒断反应（负面情绪）（β=0.09，95%CI=0.03 - 0.16，P<.01）是长期对心理健康有直接影响的唯一后果。互联网使用的感知积极后果似乎与心理健康完全无关。
一般来说，互联网使用量与心理健康呈负相关，但特定的基于网络的活动在影响心理健康的一致性、程度和方向上存在差异。互联网使用的后果（尤其是无法上网时的睡眠不足和戒断反应）似乎比特定活动本身更能预测心理健康结果。旨在减少互联网使用对心理健康负面影响的干预措施可以针对其负面后果而非互联网使用本身。
国际标准随机对照试验编号（ISRCTN）：65120704；http://www.isrctn.com/ISRCTN65120704?q=&filters=recruitmentCountry:Lithuania&sort=&offset= 5&totalResults=32&page=1&pageSize=10&searchType=basic-search（由WebCite存档于http://www.webcitation/abcdefg）
