title: Pathological Internet use among European adolescents: psychopathology and self-destructive behaviours.
abstract: Rising global rates of pathological Internet use (PIU) and related psychological impairments have gained considerable attention in recent years. In an effort to acquire evidence-based knowledge of this relationship, the main objective of this study was to investigate the association between PIU, psychopathology and self-destructive behaviours among school-based adolescents in eleven European countries. This cross-sectional study was implemented within the framework of the European Union project: Saving and Empowering Young Lives in Europe. A representative sample of 11,356 school-based adolescents (M/F: 4,856/6,500; mean age: 14.9) was included in the analyses. PIU was assessed using the Young's Diagnostic Questionnaire. Psychopathology was measured using the Beck Depression Inventory-II, Zung Self-Rating Anxiety Scale and Strengths and Difficulties Questionnaire. Self-destructive behaviours were evaluated by the Deliberate Self-Harm Inventory and Paykel Suicide Scale. Results showed that suicidal behaviours (suicidal ideation and suicide attempts), depression, anxiety, conduct problems and hyperactivity/inattention were significant and independent predictors of PIU. The correlation between PIU, conduct problems and hyperactivity/inattention was stronger among females, while the link between PIU and symptoms of depression, anxiety and peer relationship problems was stronger among males. The association between PIU, psychopathology and self-destructive behaviours was stronger in countries with a higher prevalence of PIU and suicide rates. These findings ascertain that psychopathology and suicidal behaviours are strongly related to PIU. This association is significantly influenced by gender and country suggesting socio-cultural influences. At the clinical and public health levels, targeting PIU among adolescents in the early stages could potentially lead to improvements of psychological well-being and a reduction of suicidal behaviours.
authors.affiliation: Section for Disorders of Personality Development, Clinic of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Kaess
authors.forename: Tony
authors.initials: T
authors.lastname: Durkee
authors.forename: Romuald
authors.initials: R
authors.lastname: Brunner
authors.forename: Vladimir
authors.initials: V
authors.lastname: Carli
authors.forename: Peter
authors.initials: P
authors.lastname: Parzer
authors.forename: Camilla
authors.initials: C
authors.lastname: Wasserman
authors.forename: Marco
authors.initials: M
authors.lastname: Sarchiapone
authors.forename: Christina
authors.initials: C
authors.lastname: Hoven
authors.forename: Alan
authors.initials: A
authors.lastname: Apter
authors.forename: Judit
authors.initials: J
authors.lastname: Balazs
authors.forename: Maria
authors.initials: M
authors.lastname: Balint
authors.forename: Julio
authors.initials: J
authors.lastname: Bobes
authors.forename: Renaud
authors.initials: R
authors.lastname: Cohen
authors.forename: Doina
authors.initials: D
authors.lastname: Cosman
authors.forename: Padraig
authors.initials: P
authors.lastname: Cotter
authors.forename: Gloria
authors.initials: G
authors.lastname: Fischer
authors.forename: Birgitta
authors.initials: B
authors.lastname: Floderus
authors.forename: Miriam
authors.initials: M
authors.lastname: Iosue
authors.forename: Christian
authors.initials: C
authors.lastname: Haring
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Kahn
authors.forename: George J
authors.initials: GJ
authors.lastname: Musa
authors.forename: Bogdan
authors.initials: B
authors.lastname: Nemes
authors.forename: Vita
authors.initials: V
authors.lastname: Postuvan
authors.forename: Franz
authors.initials: F
authors.lastname: Resch
authors.forename: Pilar A
authors.initials: PA
authors.lastname: Saiz
authors.forename: Merike
authors.initials: M
authors.lastname: Sisask
authors.forename: Avigal
authors.initials: A
authors.lastname: Snir
authors.forename: Airi
authors.initials: A
authors.lastname: Varnik
authors.forename: Janina
authors.initials: J
authors.lastname: Žiberna
authors.forename: Danuta
authors.initials: D
authors.lastname: Wasserman
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D001007:Anxiety / Q000523:psychology; D001289:Attention Deficit Disorder with Hyperactivity / Q000523:psychology; D016739:Behavior, Addictive / Q000523:psychology*; D019955:Conduct Disorder / Q000523:psychology; D003430:Cross-Sectional Studies; D003863:Depression / Q000523:psychology; D005060:Europe; D005260:Female; D006801:Humans; D020407:Internet / Q000706:statistics & numerical data*; D008297:Male; D011599:Psychopathology; D016728:Self-Injurious Behavior / Q000523:psychology*; D012737:Sex Factors; D059020:Suicidal Ideation; D013406:Suicide, Attempted / Q000523:psychology; D011795:Surveys and Questionnaires