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Recurrent pain symptoms in adolescents with generalized and specific problematic Internet use: Associations analysis, confounding and mediating effects of comorbid psychosocial problems

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May 27, 2024 version files 5 MB

Abstract

Problematic Internet use (PIU) in adolescents is a global public health issue especially exacerbated by the restrictions caused by the COVID-19 epidemic. The authors assume a negative impact of PIU not only in relation to adolescents’ mental health and social behaviour but also relative to somatic components of their health, particularly concerning the occurrence of pain symptoms – recurrent headache (RH), recurrent abdominal pain (RAP), and recurrent back pain (RBP). The present study aims to identify the associations between different types of PIU (generalized PIU – PIUgen, problematic computer game use – PUgame, and problematic social media use – PUsocial), and pain symptoms (RH, RAP and RBP), and to determine the role of psychosocial factors in the emergence of these associations.

Methods: The research represents a one-stage observational study of 4,411 adolescents (53.6% girls; Mage = 14.53±1.52) in an unbiased school sample, held in three large cities of Central Siberia. The frequency and intensity of pain symptoms over the past three months were ascertained by completing a number of questionnaires. The following questionnaires were used to identify PIU and its types: the Chen Internet Addiction Scale (CIAS for PIUgen), the Game Addiction Scale for Adolescents (GASA for PUgame), and The Social Media Disorder Scale (SMDS for PUsocial). The psychological problems were assessed using The Strengths and Difficulties Questionnaire (SDQ). Logistic and linear regression, as well as mediation analysis, were used.

Results: Considering both the frequency and intensity of pain, along with the presence of psychosocial problems as a confounder, a direct association of RH with PUsocial only was revealed (OR = 1.68, CI = 1.33–2.11). Using the same criteria, RAP in this sample was associated with PIUgen and PUsocial (OR = 1.99, CI = 1.51–2.62 and 2.10, CI = 1.62–2.72, respectively). RBP, according to the obtained data, was also associated with PIUgen and PUsocial both in terms of pain frequency (OR = 1.99, CI = 1.53–2.57 and OR = 2.20, CI = 1.44–3.38, respectively) and intensity. PUgame was weakly associated only with RAP and showed no significant association with RH and RBP. The mediation analysis indicated that the revealed positive associations were largely mediated by psychosocial problems comorbid for PIUgen and PUsocial (but not PUgame).

Conclusions: The frequently reported association of recurrent pain symptoms with PIU in adolescents is largely mediated by comorbid psychosocial problems. The direct effect of excessive Internet use on somatic pain symptoms in adolescents is mild-to-moderate and depends on the content predominantly consumed.