Wu Anise M S, Li Jibin, Lau Joseph T F, Mo Phoenix K H, Lau Mason M C
Department of Psychology, Faculty of Social Sciences, University of Macau, Macao, China.
Centre for Health Behaviours Research, School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; Department of Clinical Research, Sun Yat-sen University Cancer Center, Guangzhou, China.
Compr Psychiatry. 2016 Oct;70:41-52. doi: 10.1016/j.comppsych.2016.06.011. Epub 2016 Jun 16.
Internet addiction (IA) is a risk factor while some psychosocial factors can be protective against depression among adolescents. Mechanisms of IA onto depression in terms of mediations and moderations involving protective factors are unknown and were investigated in this study.
A representative cross-sectional study was conducted among Hong Kong Chinese secondary school students (n=9518).
Among males and females, prevalence of depression at moderate or severe level (CES-D≥21) was 38.36% and 46.13%, and that of IA (CIAS>63) was 17.64% and 14.01%, respectively. Adjusted for socio-demographics, depression was positively associated with IA [males: adjusted odds ratio (AOR)=4.22, 95% CI=3.61-4.94; females: AOR=4.79, 95% CI=3.91-5.87] and negatively associated with psychosocial factors including self-esteem, positive affect, family support, and self-efficacy (males: AOR=0.76-0.94; females: AOR=0.72-0.92, p<.05). The positive association between IA and depression was partially mediated by the protective psychosocial factors (mainly self-esteem) across sexes. Through significant moderations, IA also reduced magnitude of protective effects of self-efficacy and family support among males and that of positive affect among both sexes against depression.
The high IA prevalence contributes to increased risk of prevalent depression through its direct effect, mediation (reduced level of protective factors) and moderation (reduced magnitude of protective effects) effects. Understanding to mechanisms between IA and depression through protective factors is enhanced. Screening and interventions for IA and depression are warranted, and should cultivate protective factors, and unlink negative impact of IA onto levels and effects of protective factors.
网络成瘾（IA）是一个风险因素，而一些心理社会因素可能对青少年抑郁症具有保护作用。关于IA通过涉及保护因素的中介和调节作用对抑郁症产生影响的机制尚不清楚，本研究对此进行了调查。
在香港的中国中学生（n = 9518）中进行了一项具有代表性的横断面研究。
在男性和女性中，中度或重度抑郁症（CES - D≥21）的患病率分别为38.36%和46.13%，IA（CIAS>63）的患病率分别为17.64%和14.01%。在对社会人口统计学因素进行调整后，抑郁症与IA呈正相关[男性：调整后的优势比（AOR）= 4.22，95%置信区间（CI）= 3.61 - 4.94；女性：AOR = 4.79，95% CI = 3.91 - 5.87]，与自尊、积极情绪、家庭支持和自我效能等心理社会因素呈负相关（男性：AOR = 0.76 - 0.94；女性：AOR = 0.72 - 0.92，p <.05）。IA与抑郁症之间的正相关在两性中部分由保护性心理社会因素（主要是自尊）介导。通过显著的调节作用，IA还降低了男性自我效能和家庭支持以及两性积极情绪对抑郁症的保护作用强度。
高IA患病率通过其直接作用、中介作用（降低保护因素水平）和调节作用（降低保护作用强度）导致普遍抑郁症风险增加。通过保护因素对IA与抑郁症之间机制的理解得到了加强。对IA和抑郁症进行筛查和干预是必要的，并且应该培养保护因素，并消除IA对保护因素水平和作用的负面影响。
