Internet addiction and psychological distress: Evidence from path analyses in Greek adolescents at different developmental stages
Published:
Dec 28, 2025
Keywords:
internet addiction, adolescence, depression, anxiety, stress
Abstract
As internet use among adolescents increases, internet addiction has become a crucial public mental health issue, putting adolescents at risk of psychological distress. Research indicates a bidirectional association between internet addiction and adolescents’ development of depressive symptoms. Although current evidence shows that anxiety can predict internet addiction, which subsequently predicts depression, the underlying mechanisms of the relationship between internet addiction and mental distress remain unclear, while the role of age differences in internet addiction warrant further research. The present cross-sectional study explores how internet addiction and stress mediate the relationship between anxiety and depression, and how the association between depression and internet addiction varies with the developmental stage of adolescence. A convenient sample of 215 Greek adolescents, aged from 11 to 20 years, were sourced from internet forums, including social media, and completed the Internet Addiction Test (IAT-20) and the Depression, Anxiety and Stress Scale-21 (DASS-21). Middle stage adolescents (ages 15-17), showed increased levels of internet addiction (Mdn = 52) compared to early (Mdn = 44) and late (Mdn = 49.5) stage adolescents. The results from path analyses revealed that internet addiction and stress serially mediate the relationship between anxiety and depression. Furthermore, depression was found to be moderated by the stage of adolescence with the strongest relationship observed in early adolescence (ages 11-14). These findings contribute to a more thorough understanding of how internet addiction is related to psychological distress among adolescents that may assist clinicians with designing age-specific interventions to address both internet addiction and psychological distress.
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Parpoula, C., Yotsidi, V., & Adamopoulou, F.-E. (2025). Internet addiction and psychological distress: Evidence from path analyses in Greek adolescents at different developmental stages. Psychology: The Journal of the Hellenic Psychological Society, 30(2), 354–376. https://doi.org/10.12681/psy_hps.43972
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References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Publishing. https://doi.org/10.1176/appi.books.9780890425596
Anderson, E. L., Steen, E., & Stavropoulos, V. (2017). Internet use and problematic Internet use: A systematic review of longitudinal research trends in adolescence and emergent adulthood. International Journal of Adolescence and Youth, 22(4), 430–454. https://doi.org/10.1080/02673843.2016.1227716
Andreou, E., & Svoli, H. (2013). The association between Internet user characteristics and dimensions of Internet addiction among Greek adolescents. International Journal of Mental Health and Addiction, 11, 139–148. https://doi.org/10.1007/s11469-012-9404-3
Beard, K. W., & Wolf, E. M. (2001). Modification in the proposed diagnostic criteria for Internet addiction. Cyberpsychology & Behavior: The Impact of the Internet, Multimedia and Virtual Reality on Behavior and Society, 4(3), 377–383. https://doi.org/10.1089/109493101300210286
Bernardi, S., & Pallanti, S. (2009). Internet addiction: Α descriptive clinical study focusing on comorbidities and dissociative symptoms. Comprehensive Psychiatry, 50(6), 510–516. https://doi.org/10.1016/j.comppsych.2008.11.011
Best, P., Manktelow, R., & Taylor, B. (2014). Online communication, social media and adolescent wellbeing: A systematic narrative review. Children and Youth Services Review, 41, 27–36. https://doi.org/10.1016/j.childyouth.2014.03.001
Bickham, D. S. (2021). Current Research and Viewpoints on Internet Addiction in Adolescents. Current Pediatrics Reports, 9(1), 1–10. https://doi.org/10.1007/s40124-020-00236-3
Bisen, S. S., & Deshpande, Y. M. (2018). Understanding internet addiction: A comprehensive review. Mental Health Review Journal, 23(3), 165–184. https://doi.org/10.1108/MHRJ-07-2017-0023
Borca, G., Bina, M., Keller, P. S., Gilbert, L. R., & Begotti, T. (2015). Internet use and developmental tasks: Adolescents’ point of view. Computers in Human Behavior, 52, 49–58. https://doi.org/10.1016/j.chb.2015.05.029
Byun, S., Ruffini, C., Mills, J. E., Douglas, A. C., Niang, M., Stepchenkova, S., Lee, S. K., Loutfi, J., Lee, J. K., Atallah, M., & Blanton, M. (2009). Internet addiction: Metasynthesis of 1996-2006 quantitative research. Cyberpsychology & Behavior: The Impact of the Internet, Multimedia and Virtual Reality on Behavior and Society, 12(2), 203–207. https://doi.org/10.1089/cpb.2008.0102
Cai, Z., Mao, P., Wang, Z., Wang, D., He, J., & Fan, X. (2023). Associations between problematic Internet use and mental health outcomes of students: A meta-analytic review. Adolescent Research Review, 8(1), 45–62. https://doi.org/10.1007/s40894-022-00201-9
Cao, F., & Su, L. (2007). Internet addiction among Chinese adolescents: Prevalence and psychological features. Child: Care, Health and Development, 33(3), 275–281. https://doi.org/10.1111/j.1365-2214.2006.00715.x
Caplan, S. E. (2005). A social skill account of problematic Internet use. Journal of Communication, 55(4), 721–736. https://doi.org/10.1111/j.1460-2466.2005.tb03019.x
Caplan, S. E. (2007). Relations among loneliness, social anxiety, and problematic Internet use. Cyberpsychology & Behavior: The Impact of the Internet, Multimedia and Virtual Reality on Behavior and Society, 10(2), 234–242. https://doi.org/10.1089/cpb.2006.9963
Caplan, S. E. (2010). Theory and measurement of generalized problematic Internet use: A two-step approach. Computers in Human Behavior, 26(5), 1089–1097. https://doi.org/10.1016/j.chb.2010.03.012
Carli, V., Durkee, T., Wasserman, D., Hadlaczky, G., Despalins, R., Kramarz, E., Wasserman, C., Sarchiapone, M., Hoven, C. W., Brunner, R., & Kaess, M. (2013). The association between pathological internet use and comorbid psychopathology: A systematic review. Psychopathology, 46(1), 1–13. https://doi.org/10.1159/000337971
Cerniglia, L., Zoratto, F., Cimino, S., Laviola, G., Ammaniti, M., & Adriani, W. (2017). Internet addiction in adolescence: Neurobiological, psychosocial and clinical issues. Neuroscience and Biobehavioral Reviews, 76(Pt A), 174–184. https://doi.org/10.1016/j.neubiorev.2016.12.024
Chadha, Y., Patil, R., Toshniwal, S., & Sinha, N. (2024). Internet addiction management: A comprehensive review of clinical interventions and modalities. Cureus, 16(3), e55466. https://doi.org/10.7759/cureus.55466
Chang, K., & Kuhlman, K.R. (2022). Adolescent-onset depression is associated with altered social functioning into middle adulthood. Scientific Reports, 12(1), 17320. https://doi.org/10.1038/s41598-022-22131-1
Chen, C. Y., Chen, I. H., Pakpour, A. H., Lin, C. Y., & Griffiths, M. D. (2021). Internet-related behaviors and psychological distress among schoolchildren during the COVID-19 school hiatus. Cyberpsychology, Behavior and Social Networking, 24(10), 654–663. https://doi.org/10.1089/cyber.2020.0497
Cheng, C., & Li, A. Y. (2014). Internet addiction prevalence and quality of (real) life: A meta-analysis of 31 nations across seven world regions. Cyberpsychology, Behavior and Social Networking, 17(12), 755–760. https://doi.org/10.1089/cyber.2014.0317
Chi, X., Liu, X., Guo, T., Wu, M., & Chen, X. (2019). Internet addiction and depression in Chinese adolescents: A moderated mediation model. Frontiers in Psychiatry, 10, 816. https://doi.org/10.3389/fpsyt.2019.00816
Çikrıkci, Ö. (2016). The effect of internet use on well-being: Meta-analysis. Computers in Human Behavior, 65, 560–566. https://doi.org/10.1016/j.chb.2016.09.021
Çimşir, E., & Akdoğan, R. (2023). Inferiority feelings and internet addiction among Turkish university students in the context of COVID-19: The mediating role of emotion dysregulation. Current Psychology, 43, 4245–4254. https://doi.org/10.1007/s12144-023-04661-7
Davis, R. A. (2001). A cognitive–behavioral model of pathological Internet use. Computers in Human Behavior, 17(2), 187–195. https://doi.org/10.1016/S0747-5632(00)00041-8
Demming, C. L., Jahn, S., & Boztuğ, Y. (2017). Conducting mediation analysis in marketing research. Marketing: ZFP – Journal of Research and Management, 39(3), 76–93. https://www.jstor.org/stable/26426855
Dermani, E., & Perdikaris, P. (2022). Internet addiction and psychological impact on adolescents: A scoping review. International Journal of Biological and Pharmaceutical Sciences Archive, 4(2), 73–87. https://doi.org/10.53771/ijbpsa.2022.4.2.0096
Douglas, A. C., Mills, J. E., Niang, M., Stepchenkova, S., Byun, S., Ruffini, C., Lee, S. K., Loutfi, J., Lee, J.-K., Atallah, M., & Blanton, M. (2008). Internet addiction: Meta-synthesis of qualitative research for the decade 1996-2006. Computers in Human Behavior, 24(6), 3027–3044. https://doi.org/10.1016/j.chb.2008.05.009
Du, W., Fan, Z., Li, D., & Wu, M. (2024). Internet use behavior and adolescent mental health: The mediating effects of self-education expectations and parental support. Psychology Research and Behavior Management, 17, 1163–1176. https://doi.org/10.2147/PRBM.S449353
Duffy, C. J., Cunningham, E. G., & Moore, S. M. (2005). Brief report: The factor structure of mood states in an early adolescent sample. Journal of Adolescence, 28(5), 677–680. https://doi.org/10.1016/j.adolescence.2005.08.013
Duong, X. L., Liaw, S. Y., & Augustin, J. P. M. (2020). How has Internet addiction been tracked over the last decade? A literature review and 3C paradigm for future research. International Journal of Preventive Medicine, 11, 175. https://doi.org/10.4103%2Fijpvm.IJPVM_212_20
Durkee, T., Kaess, M., Carli, V., Parzer, P., Wasserman, C., Floderus, B., Apter, A., Balazs, J., Barzilay, S., Bobes, J., Brunner, R., Corcoran, P., Cosman, D., Cotter, P., Despalins, R., Graber, N., Guillemin, F., Haring, C., Kahn, J.-P., ... Wasserman, D. (2012). Pathological internet use among adolescents. Addiction, 107(12), 2210–2222. https://doi.org/10.1111/j.1360-0443.2012.03946.x
Erikson, E. H. (1986). Identity, youth and crisis. W.W. Norton & Company, Inc.
Fisoun, V., Floros, G., Geroukalis, D., Ioannidi, N., Farkonas, N., Sergentani, E., Angelopoulos, N., & Siomos, K. (2012). Internet addiction in the island of Hippocrates: The associations between Internet abuse and adolescent off-line behaviours. Child and Adolescent Mental Health, 17(1), 37–44. https://doi.org/10.1111/j.1475-3588.2011.00605.x
Garett, R., Liu, S., & Young, S.D. (2018). The relationship between social media use and sleep quality among undergraduate students. Information, Communication and Society, 21(2), 163–173. https://doi.org/10.1080/1369118X.2016.1266374
Gioia, F., Rega, V., & Boursier, V. (2021). Problematic Internet use and emotional dysregulation among young people: A literature review. Clinical Neuropsychiatry, 18(1), 41–54. https://doi.org/10.36131/cnfioritieditore20210104
González-Bueso, V., Santamaría, J. J., Fernández, D., Merino, L., Montero, E., & Ribas, J. (2018). Association between Internet gaming disorder or pathological video-game use and comorbid psychopathology: A comprehensive review. International Journal of Environmental Research and Public Health, 15(4), 668. https://doi.org/10.3390/ijerph15040668
Ha, J. H., Kim, S. Y., Bae, S. C., Bae, S., Kim, H., Sim, M., Lyoo, I. K., & Cho, S. C. (2007). Depression and Internet addiction in adolescents. Psychopathology, 40(6), 424–430. https://doi.org/10.1159/000107426
Hayes, A. F. (2013). Introduction to mediation, moderation, and conditional process analysis: A regression-based approach. Guilford Press. https://doi.org/10.1111/jedm.12050
Hinton, P. R., McMurray, I., & Brownlow, C. (2014). SPSS Explained (2nd ed.). Routledge. https://doi.org/10.4324/9781315797298
Ho, R. C., Zhang, M. W., Tsang, T. Y., Toh, A. H., Pan, F., Lu, Y., Cheng, C., Yip, P. S., Lam, L. T., Lai, C., Watanabe, H., & Mak, K. (2014). The association between internet addiction and psychiatric co-morbidity: A meta-analysis. BMC Psychiatry, 14, 183. https://doi.org/10.1186/1471-244X-14-183
Holden, C. (2010). Behavioral addictions debut in proposed DSM-V. Science, 327(5968), 935. https://doi.org/10.1126/science.327.5968.935
Hussain, Z., & Griffiths, M. D. (2018). Problematic social networking site use and comorbid psychiatric disorders: A systematic review of recent large-scale studies. Frontiers in Psychiatry, 9, 686. https://doi.org/10.3389/fpsyt.2018.00686
Jang, K. S., Hwang, S. Y., & Choi, J. Y. (2008). Internet addiction and psychiatric symptoms among Korean adolescents. The Journal of School Health, 78(3), 165–171. https://doi.org/10.1111/j.1746-1561.2007.00279.x
Kaess, M., Durkee, T., Brunner, R., Carli, V., Parzer, P., Wasserman, C., Sarchiapone, M., Hoven, C., Apter, A., Balazs, J., Balint, M., Bobes, J., Cohen, R., Cosman, D., Cotter, P., Fischer, G., Floderus, B., Iosue, M., Haring, C., … Wasserman, D. (2014). Pathological Internet use among European adolescents: Psychopathology and self-destructive behaviours. European Child & Adolescent Psychiatry, 23(11), 1093–1102. https://doi.org/10.1007/s00787-014-0562-7
Karacic, S., & Oreskovic, S. (2017). Internet addiction through the stage of adolescence: A questionnaire study. JMIR Mental Health, 4(2), e11. https://doi.org/10.2196/mental.5537
Kawabe, K., Horiuchi, F., Ochi, M., Oka, Y., & Ueno, S. (2016). Internet addiction: Prevalence and relation with mental states in adolescents. Psychiatry and Clinical Neurosciences, 70(9), 405–412. https://doi.org/10.1111/pcn.12402
Ko, C. H., Yen, J. Y., Chen, C. S., Yeh, Y. C., & Yen, C. F. (2009a). Predictive values of psychiatric symptoms for Ιnternet addiction in adolescents: Α 2-year prospective study. Archives of Pediatrics & Adolescent Medicine, 163(10), 937–943. https://doi.org/10.1001/archpediatrics.2009.159
Ko, C. H., Yen, J. Y., Liu, S. C., Huang, C. F., & Yen, C. F. (2009b). The associations between aggressive behaviors and Ιnternet addiction and online activities in adolescents. The Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine, 44(6), 598–605. https://doi.org/10.1016/j.jadohealth.2008.11.011
Ko, C. H., Yen, J. Y., Yen, C. F., Chen, C. S., & Chen, C. C. (2012). The association between Internet addiction and psychiatric disorder: A review of the literature. European Psychiatry: The journal of the Association of European Psychiatrists, 27(1), 1–8. https://doi.org/10.1016/j.eurpsy.2010.04.011
Ko, C. H., Yen, J. Y., Yen, C. F., Lin, H. C., & Yang, M. J. (2007). Factors predictive for incidence and remission of Internet addiction in young adolescents: A prospective study. CyberPsychology & Behavior, 10(4), 545–551. https://doi.org/10.1089/cpb.2007.9992
Krossbakken, E., Pallesen, S., Mentzoni, R. A., King, D. L., Molde, H., Finserås, T. R., & Torsheim, T. (2018). A cross-lagged study of developmental trajectories of video game engagement, addiction, and mental health. Frontiers in Psychology, 9, 2239. https://doi.org/10.3389/fpsyg.2018.02239
Kuss, D. J., & Griffiths, M. D. (2012). Internet gaming addiction: A systematic review of empirical research. International Journal of Mental Health and Addiction, 10(2), 278–296. https://doi.org/10.1007/s11469-011-9318-5
Kwon, J. H., Chung, C. S., & Lee, J. (2011). The effects of escape from self and interpersonal relationship on the pathological use of Internet games. Community Mental Health Journal, 47, 113–121. https://doi.org/10.1007/s10597-009-9236-1
Kyriazos, T. A., Stalikas, A., Prassa, K., & Yotsidi, V. (2018). Can the Depression Anxiety Stress Scales Short be shorter? Factor structure and measurement invariance of DASS-21 and DASS-9 in a Greek, non-clinical sample. Psychology, 9, 1095-1127. https://doi.org/10.4236/psych.2018.95069
Lam, L. T., & Peng, Z. W. (2010). Effect of pathological use of the Internet on adolescent mental health: A prospective study. Archives of Pediatrics & Adolescent Medicine, 164(10), 901–906. https://doi.org/10.1001/archpediatrics.2010.159
Lam, L. T., Peng, Z., Mai, J., & Jing, J. (2009). The association between internet addiction and self-injurious behaviour among adolescents. Injury prevention. Journal of the International Society for Child and Adolescent Injury Prevention, 15(6), 403–408. https://doi.org/10.1136/ip.2009.021949
Lau, J. T. F., Walden, D. L., Wu, A. M. S., Cheng, K. M., Lau, M. C. M., & Mo, P. K. H. (2018). Bidirectional predictions between Internet addiction and probable depression among Chinese adolescents. Journal of Behavioral Addictions, 7(3), 633–643. https://doi.org/10.1556/2006.7.2018.87
Li, M., Deng, Y., Ren, Y., Guo, S., & He, X. (2014). Obesity status of middle school students in Xiangtan and its relationship with Internet addiction. Obesity, 22(2), 482–487. https://doi.org/10.1002/oby.20595
Lian, S. L., Sun, X. J., Niu, G. F., Yang, X. J., Zhou, Z. K., & Yang, C. (2021). Mobile phone addiction and psychological distress among Chinese adolescents: The mediating role of rumination and moderating role of the capacity to be alone. Journal of Affective Disorders, 279, 701–710. https://doi.org/10.1016/j.jad.2020.10.005
Lim, M. S., & Choi, S. B. (2017). Stress caused by social media network applications and user responses. Multimedia Tools and Applications, 76, 17685–17698. https://doi.org/10.1007/s11042-015-2891-z
Lin, C. Y., Potenza, M. N., Broström, A., & Pakpour, A. H. (2020). Internet gaming disorder, psychological distress, and insomnia in adolescent students and their siblings: An actor-partner interdependence model approach. Addictive Behaviors Reports, 13, 100332. https://doi.org/10.1016/j.abrep.2020.100332
Liu, T., & Potenza, M. N. (2007). Problematic Internet use: Clinical implications. CNS Spectrums, 12(6), 453–466. https://doi.org/10.1017/s1092852900015339
Loton, D., Borkoles, E., Lubman, D., & Polman, R. (2016). Video game addiction, engagement and symptoms of stress, depression and anxiety: The mediating role of coping. Internatinal Journal of Mental Health and Addiction, 14, 565–578. https://doi.org/10.1007/s11469-015-9578-6
Lovibond, P. F., & Lovibond, S. H. (1995). The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behaviour Research and Therapy, 33, 335-343. https://doi.org/10.1016/0005-7967(94)00075-U
Lukács, A. (2021). Predictors of severe problematic Internet use in adolescent students. Contemporary Educational Technology, 13(4), ep315. https://doi.org/10.30935/cedtech/10989
Ma, Y., & Gu, J. (2023) Internet and depression in adolescents: Evidence from China. Frontiers in Psychology, 14, 1026920. https://doi.org/10.3389/fpsyg.2023.1026920
Marciano, L., Ostroumova, M., Schulz, P. J., & Camerini, A. L. (2022). Digital media use and adolescents’ mental health during the Covid-19 pandemic: A systematic review and meta-analysis. Frontiers in Public Health, 9, 793868. https://doi.org/10.3389/fpubh.2021.793868
Matar Boumosleh, J., & Jaalouk, D. (2017). Depression, anxiety, and smartphone addiction in university students- A cross sectional study. PloS One, 12(8), e0182239. https://doi.org/10.1371/journal.pone.0182239
Mei, S., Yau, Y. H. C., Chai, J., Guo, J., & Potenza, M. N. (2016). Problematic Internet use, well-being, self-esteem and self-control: Data from a high-school survey in China, Addictive Behaviors, 61, 74-79. https://doi.org/10.1016/j.addbeh.2016.05.009
Morahan-Martin, J., & Schumacher, P. (2003). Loneliness and social uses of the Internet. Computers in Human Behavior, 19(6), 659–671. https://doi.org/10.1016/S0747-5632(03)00040-2
Moreno, M. A., Jelenchick, L., & Christakis, D. A. (2013). Problematic Internet use among older adolescents: A conceptual framework. Computers in Human Behavior, 29(4), 1879–1887. https://doi.org/10.1016/j.chb.2013.01.053
Moretta, T., Buodo, G., Demetrovics, Z., & Potenza, M. N. (2022). Tracing 20 years of research on problematic use of the internet and social media: Theoretical models, assessment tools, and an agenda for future work. Comprehensive Psychiatry, 112, 152286. https://doi.org/10.1016/j.comppsych.2021.152286
Morrison, C. M., & Gore, H. (2010). The relationship between excessive Internet use and depression: A questionnaire-based study of 1,319 young people and adults. Psychopathology, 43(2), 121–126. https://doi.org/10.1159/000277001
Ni, X., Yan, H., Chen, S., & Liu, Z. (2009). Factors influencing internet addiction in a sample of freshmen university students in China. Cyberpsychology & Behavior: The impact of the Internet, Multimedia and Virtual Reality on Behavior and Society, 12(3), 327–330. https://doi.org/10.1089/cpb.2008.0321
Noroozi, F., Hassanipour, S., Eftekharian, F., Eisapareh, K., & Kaveh, M. H. (2021). Internet addiction effect on quality of life: A systematic review and meta-analysis. The Scientific World Journal, 2021, 2556679. https://doi.org/10.1155/2021/2556679
Ostic, D., Qalati, S. A., Barbosa, B., Shah, S. M. M., Galvan Vela, E., Herzallah, A. M., & Liu, F. (2021). Effects of social media use on psychological well-being: A mediated model. Frontiers in Psychology, 12, 678766. https://doi.org/10.3389/fpsyg.2021.678766
Paakkari, L., Tynjälä, J., Lahti, H., Ojala, K., & Lyyra, N. (2021). Problematic social media use and health among adolescents. International Journal of Environmental Research and Public Health, 18(4), 1885. https://doi.org/10.3390/ijerph18041885
Pezirkianidis, C., Karakasidou, E., Lakioti, A., Stalikas, A., & Galanakis, M. (2018). Psychometric properties of the Depression, Anxiety, Stress Scales-21 (DASS-21) in a Greek sample. Psychology, 9, 2933-2950. https://doi.org/10.4236/psych.2018.915170
Pies, R. (2009). Should DSM-V designate “Internet addiction” a mental disorder?. Psychiatry (Edgmont), 6(2), 31–37. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2719452/
Preacher, K. J., & Hayes, A. F. (2008). Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behavior Research Methods, 40(3), 879–891. https://doi.org/10.3758/brm.40.3.879
Przepiorka, A., Blachnio, A., & Cudo, A. (2019). The role of depression, personality, and future time perspective in internet addiction in adolescents and emerging adults. Psychiatry Research, 272, 340–348. https://doi.org/10.1016/j.psychres.2018.12.086
Raudsepp, L., & Kais, K. (2019). Longitudinal associations between problematic social media use and depressive symptoms in adolescent girls. Preventive Medicine Reports, 15, 100925. https://doi.org/10.1016/j.pmedr.2019.100925
Rieselbach, M. M., Corley, R. P., Hewitt, J. K., & Rhee, S. H. (2023). Anxiety-specific associations with substance use: Evidence of a protective factor in adolescence and a risk factor in adulthood. Development and Psychopathology, 35(3), 1484–1496. https://doi.org/10.1017/S0954579422000232
Saikia, A. M., Das, J., Barman, P., & Bharali, M. D. (2019). Internet addiction and its relationships with depression, anxiety, and stress in urban adolescents of Kamrup district, Assam. Journal of Family & Community Medicine, 26(2), 108–112. https://doi.org/10.4103/jfcm.JFCM_93_18
Salmela-Aro, K. (2011). Stages of adolescence. In B.B. Brown, & M. J. Prinstein (Eds.), Encyclopedia of Adolescence (pp. 360-368). Academic press. https://doi.org/10.1016/B978-0-12-373951-3.00043-0
Sayed, M., Naiim, C. M., Aboelsaad, M., & Ibrahim, M. K. (2022). Internet addiction and relationships with depression, anxiety, stress and academic performance among Egypt pharmacy students: A cross-sectional designed study. BMC Public Health, 22(1), 1826. https://doi.org/10.1186/s12889-022-14140-6
Seo, M., Kang, H. S., & Yom, Y. H. (2009). Internet addiction and interpersonal problems in Korean adolescents. Computers, Informatics, Nursing, 27(4), 226–233. https://doi.org/10.1097/NCN.0b013e3181a91b3f
Shannon, H., Bush, K., Villeneuve, P. J., Hellemans, K. G., & Guimond, S. (2022). Problematic social media use in adolescents and young adults: Systematic review and meta-analysis. JMIR Mental Health, 9(4), e33450. https://doi.org/10.2196/33450
Shin, M., Juventin, M., Chu, J. T. W., Manor, Y., & Kemps, E. (2021). Online media consumption and depression in young people: A systematic review and meta-analysis. Computers in Human Behavior, 128, 107129. https://doi.org/10.1016/j.chb.2021.107129
Shklovski, I., Kiesler, S., & Kraut, R. (2006). The Internet and social interaction: A meta-analysis and critique of studies, 1995-2003. In R. Kraut, M. Brynin, & S. Kiesler (Eds.), Computers, Phones, and the Internet: Domesticating Information Technology (pp. 251–264). Oxford University Press. https://doi.org/10.1093/acprof:oso/9780195312805.003.0017
Siomos, K. E., Braimiotis, D., Floros, G. D., Dafoulis, V., & Angelopoulos, N. V. (2010a). Insomnia symptoms among Greek adolescent students with excessive computer use. Hippokratia, 14(3), 203–207.
Siomos, K., Dafoulis, V., Floros, G., Karagiannaki-Kastani, I., & Christianopoulos, K. (2010b). P01-203 - Presentation of a specialized outpatient unit for internet and PC addiction -first year of operations, results, recommendations for the future. European Psychiatry, 25(S1), 25-E409. https://doi.org/10.1016/S0924-9338(10)70409-0
Starr, L. R., Hammen, C., Connolly, N. P., & Brennan, P. A. (2014). Does relational dysfunction mediate the association between anxiety disorders and later depression? Testing an interpersonal model of comorbidity. Depression and Anxiety, 31(1), 77–86. https://doi.org/10.1002/da.22172
Statista (2024). Number of internet and social media users worldwide as of January 2024. Statista. Retrieved April 1, 2024, from https://www.statista.com/statistics/617136/digital-population-worldwide/
Statista (2023). Social media use during COVID-19 worldwide - Statistics & Facts. Statista. Retreived August 16, 2024, from https://www.statista.com/topics/7863/social-media-use-during-coronavirus-covid-19-worldwide/#topicOverview
Szabó M. (2010). The short version of the Depression Anxiety Stress Scales (DASS-21): Factor structure in a young adolescent sample. Journal of Adolescence, 33(1), 1–8. https://doi.org/10.1016/j.adolescence.2009.05.014
Szabó, M., & Lovibond, P. (2006). Anxiety, depression, and tension/stress in children. Journal of Psychopathology and Behavioral Assessment, 28(3), 195-205. http://dx.doi.org/10.1007/s10862-005-9008-3
Tan, Y., Chen, Y., Lu, Y., & Li, L. (2016). Exploring associations between problematic Internet use, depressive symptoms and sleep disturbance among Southern Chinese adolescents. International Journal of Environmental Research and Public Health, 13(3), 313. https://doi.org/10.3390/ijerph13030313
Tandon, A., Dhir, A., Talwar, S., Kaur, P., & Mäntymäki, M. (2021). Dark consequences of social media-induced fear of missing out (FoMO): Social media stalking, comparisons, and fatigue. Technological Forecasting and Social Change, 171, 120931. https://doi.org/10.1016/j.techfore.2021.120931
Tok, E. S., & Aldemir M. A. (2023). Relationship between loneliness, inadequacy, social anxiety and online social support with social media addiction. Psikiyatride Güncel Yaklaşımlar - Current Approaches in Psychiatry, 15(1), 373-382. https://doi.org/10.18863/pgy.1343828
Touloupis, T., & Teli, A. (2021). Internet addiction among adolescents: The role of social self-efficacy and general locus of control. In J. A. Jaworski (Ed.), Advances in sociology research (Vol. 36, pp. 81–112). Nova Science Publishers. https://doi.org/10.52305/GPAQ8046
Trumello, C., Vismara, L., Sechi, C., Ricciardi, P., Marino, V., & Babore, A. (2021). Internet addiction: The role of parental care and mental health in adolescence. International Journal of Environmental Research and Public Health, 18(24), 12876. https://doi.org/10.3390/ijerph182412876
Tsimtsiou, Z., Haidich, A. B., Kokkali, S., Dardavesis, T., Young, K. S., & Arvanitidou, M. (2014). Greek version of the Internet Addiction Test: A validation study. The Psychiatric Quarterly, 85(2), 187–195. https://doi.org/10.1007/s11126-013-9282-2
Tsimtsiou, Z., Haidich, A. B., Spachos, D., Kokkali, S., Bamidis, P., Dardavesis, T., & Arvanitidou, M. (2015). Internet addiction in Greek medical students: An online survey. Academic Psychiatry: The Journal of the American Association of Directors of Psychiatric Residency Training and the Association for Academic Psychiatry, 39(3), 300–304. https://doi.org/10.1007/s40596-014-0273-x
Tsitsika, A., Critselis, E., Louizou, A., Janikian, M., Freskou, A., Marangou, E., Kormas, G., & Kafetzis, D. (2011). Determinants of Internet addiction among adolescents: A case-control study. The Scientific World Journal, 11, 866–874. https://doi.org/10.1100/tsw.2011.85
Tsitsika, A., Janikian, M., Schoenmakers, T. M., Tzavela, E. C., Olafsson, K., Wójcik, S., Macarie, G. F., Tzavara, C. The EU NET ADB Consortium, & Richardson, C. (2014). Internet addictive behavior in adolescence: A cross-sectional study in seven European countries. Cyberpsychology, Behavior, and Social Networking, 17(8), 528–535. https://doi.org/10.1089/cyber.2013.0382
Vannucci, A., & McCauley Ohannessian, C. (2019). Social media use subgroups differentially predict psychosocial well-being during early adolescence. Journal of Youth and Adolescence, 48(8), 1469–1493. https://doi.org/10.1007/s10964-019-01060-9
Veisani, Y., Jalilian, Z., & Mohamadian, F. (2020). Relationship between internet addiction and mental health in adolescents. Journal of Education and Health Promotion, 9, 303. https://doi.org/10.4103/jehp.jehp_362_20
Villella, C., Martinotti, G., Di Nicola, M., Cassano, M., La Torre, G., Gliubizzi, M. D., Messeri, I., Petruccelli, F., Bria, P., Janiri, L., & Conte, G. (2011). Behavioural addictions in adolescents and young adults: Results from a prevalence study. Journal of Gambling Studies, 27(2), 203–214. https://doi.org/10.1007/s10899-010-9206-0
Wang, P., Wang, X., Wu, Y., Xie, X., Wang, X., Zhao, F., Ouyang, M., & Lei, L. (2018). Social networking sites addiction and adolescent depression: A moderated mediation model of rumination and self-esteem. Personality and Individual Differences, 127, 162-167. https://doi.org/10.1016/j.paid.2018.02.008
Weinstein, A., Dorani, D., Elhadif, R., Bukovza, Y., Yarmulnik, A., & Dannon, P. (2015). Internet addiction is associated with social anxiety in young adults. Annals of Clinical Psychiatry: Official Journal of the American Academy of Clinical Psychiatrists, 27(1), 4–9.
Weinstein, A., & Lejoyeux, M. (2010). Internet addiction or excessive internet use. The American Journal of Drug and Alcohol Abuse, 36(5), 277–283. https://doi.org/10.3109/00952990.2010.491880
Weinstein, A., Livny, A., & Weizman, A. (2017). New developments in brain research of internet and gaming disorder. Neuroscience and Biobehavioral Reviews, 75, 314–330. https://doi.org/10.1016/j.neubiorev.2017.01.040
Widyanto, L., & Griffiths, M. (2006). “Internet addiction”: A critical review. International Journal of Mental Health and Addiction, 4(1), 31–51. https://doi.org/10.1007/s11469-006-9009-9
Woods, H. C., & Scott, H. (2016). #Sleepyteens: Social media use in adolescence is associated with poor sleep quality, anxiety, depression and low self-esteem. Journal of Adolescence, 51, 41–49. https://doi.org/10.1016/j.adolescence.2016.05.008
Xanidis, N., & Brignell, C. M. (2016). The association between the use of social network sites, sleep quality and cognitive function during the day. Computers in Human Behavior, 55, 121-126. https://doi.org/10.1016/j.chb.2015.09.004
Xie, X., Cheng, H., & Chen, Z. (2023). Anxiety predicts internet addiction, which predicts depression among male college students: A cross-lagged comparison by sex. Frontiers in Psychology, 13, 1102066. https://doi.org/10.3389/fpsyg.2022.1102066
Yen, J. Y., Ko, C. H., Yen, C. F., Chen, S. H., Chung, W. L., & Chen, C. C. (2008). Psychiatric symptoms in adolescents with Internet addiction: Comparison with substance use. Psychiatry and Clinical Neurosciences, 62(1), 9–16. https://doi.org/10.1111/j.1440-1819.2007.01770.x
Yen, J. Y., Ko, C. H., Yen, C. F., Wu, H. Y., & Yang, M. J. (2007). The comorbid psychiatric symptoms of Internet addiction: Attention deficit and hyperactivity disorder (ADHD), depression, social phobia, and hostility. Journal of Adolescent Health, 41(1), 93–98. https://doi.org/10.1016/j.jadohealth.2007.02.002
Yfanti, T., Zygouris, N. C., Chondropoulos, I., & Stamoulis, G. I. (2020). Internet addiction and anxiety among Greek adolescents: An online survey. In M. Auer & T. Tsiatsos (Eds.), The challenges of the digital transformation in education: ICL 2018 (Advances in Intelligent Systems and Computing, Vol. 916). Springer, Cham. https://doi.org/10.1007/978-3-030-11932-4_75
Yotsidi, V., Nikolatou, E-K., Kourkoutas, E., & Kougioumtzis, G. A. (2023) Mental distress and well-being of university students amid COVID-19 pandemic: Findings from an online integrative intervention for psychology trainees. Frontiers in Psychology, 14, 1171225. https://doi: 10.3389/fpsyg.2023.1171225
Young, K. S. (1998). Internet addiction: The emergence of a new clinical disorder. CyberPsychology & Behavior, 1, 237-244. http://dx.doi.org/10.1089/cpb.1998.1.237
Young, K. S. (2004). Internet addiction: A new clinical phenomenon and its consequence. American Behavioral Scientist, 48, 402-415. https://doi.org/10.1177/0002764204270278
Young, K. S. (2017). The evolution of Internet addiction disorder. In C. Montag & M. Reuter (Eds.), Internet addiction. Springer. https://doi.org/10.1007/978-3-319-46276-9_1
Young, K. S., & Rogers, R. C. (1998). The relationship between depression and Internet addiction. CyberPsychology & Behavior, 1(1), 25–28. https://doi.org/10.1089/cpb.1998.1.25
Zhao, Q., Huang, Y., & Li, C. (2022). Does adolescents’ Internet addiction trigger depressive symptoms and aggressive behavior, or vice versa? The moderating roles of peer relationships and gender. Computers in Human Behavior, 129 (C), 107143. https://doi.org/10.1016/j.chb.2021.107143
Zhao, X., Lynch, J. G., & Chen, Q. (2010). Reconsidering Baron and Kenny: Myths and truths about mediation analysis. Journal of Consumer Research, 37(2), 197–206. https://doi.org/10.1086/651257
Zubair, U., Khan, M. K., & Albashari, M. (2023). Link between excessive social media use and psychiatric disorders. Annals of Medicine and Surgery, 85(4), 875–878. https://doi.org/10.1097/MS9.0000000000000112
