Department of Preventive Medicine and Health Education, School of Public Health, Fudan University, Shanghai, China.
Key Laboratory of Public Health Safety, Fudan University, Shanghai, China.
J Med Internet Res. 2023 Jan 17;25:e43532. doi: 10.2196/43532.
The minority stress model postulates that men who have sex with men (MSM) often encounter multiple stressors because of their sexual minority status, which may lead to psychological problems and maladaptive coping such as addictive behaviors (eg, internet gaming disorder [IGD]). It was hypothesized that hopelessness and loneliness would be associated with IGD via self-control among MSM.
This study investigated the prevalence of IGD and its associations with variables related to minority stress (loneliness and hopelessness) among MSM who were university students. Mediation involving such associations via self-control was also explored.
With informed consent, 305 MSM attending universities in Sichuan, China participated in the study. The validated Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) checklist was used to assess IGD. Multivariable logistic regression adjusted for background factors and structural equation modeling were conducted.
The prevalence of IGD was 12.8% (n=39). Logistic regression found that IGD was positively associated with hopelessness and loneliness, and negatively associated with self-control. The structural equation modeling identified three significant paths between hopelessness/loneliness and IGD: (1) hopelessness → lower self-control → higher IGD (full mediation), (2) loneliness → lower self-control → higher IGD (partial mediation: effect size of 28%), and (3) a direct effect from loneliness to IGD.
IGD was prevalent among young MSM and warrants interventions that may try to reduce the level of psychosocial problems such as loneliness and hopelessness and improve self-control. According to the socioecological model, the promotion of social acceptance and reduction in stigma toward MSM are important in reducing loneliness and hopefulness among MSM. Self-control links up the relationships between psychosocial problems and IGD and should be given special attention. Longitudinal studies are warranted to confirm the findings and test new mediations between loneliness/hopelessness and MSM with IGD.
少数群体应激模型认为，男男性行为者（MSM）由于其性少数群体身份，经常会遇到多种应激源，这可能导致心理问题和适应不良的应对方式，如成瘾行为（例如，网络成瘾障碍 [IGD]）。有假设认为，无望和孤独感会通过 MSM 的自我控制与 IGD 相关。
本研究调查了大学生 MSM 中 IGD 的流行情况及其与少数群体应激（孤独和无望）相关变量之间的关联。还探讨了通过自我控制对这些关联的中介作用。
在知情同意的情况下，305 名在四川大学就读的 MSM 参加了这项研究。使用经过验证的《精神疾病诊断与统计手册》（第五版）检查表评估 IGD。进行多变量逻辑回归调整背景因素和结构方程建模。
IGD 的患病率为 12.8%（n=39）。逻辑回归发现，IGD 与无望和孤独感呈正相关，与自我控制呈负相关。结构方程建模确定了无望/孤独感与 IGD 之间的三个重要路径：（1）无望感→自我控制降低→IGD 增加（完全中介）；（2）孤独感→自我控制降低→IGD 增加（部分中介：效应大小为 28%）；（3）孤独感直接影响 IGD。
年轻的 MSM 中 IGD 较为普遍，需要采取干预措施，可能试图降低孤独和无望等心理社会问题的水平，并提高自我控制能力。根据社会生态学模型，促进对 MSM 的社会接受和减少对他们的污名化，对于减少 MSM 中的孤独和希望感非常重要。自我控制将心理社会问题与 IGD 之间的关系联系起来，应给予特别关注。需要进行纵向研究来证实这些发现，并测试新的中介作用，即孤独/无望感与 IGD 之间的关系。
