The mediating role of Internet addiction in depression, social anxiety, and psychosocial well-being among adolescents in six Asian countries: a structural equation modelling approach.
OBJECTIVE
This study examines the associations of Internet addiction with social anxiety, depression, and psychosocial well-being among Asian adolescents. A self-medication model conceptualizing Internet addiction as a mediating role in relating depression and social anxiety to negative psychosocial well-being was tested.


METHODS
A cross-sectional survey.


METHODS
In the Asian Adolescent Risk Behavior Survey (AARBS), 5366 adolescents aged 12-18 years from six Asian countries (China, Hong Kong, Japan, South Korea, Malaysia, and Philippines) completed a questionnaire with items of the Internet Addiction Test (IAT), Social Anxiety Scale for Adolescents (SAS-A), Center for Epidemiological Studies Depression Scale (CESD), Self-Rated Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA-SR) in the 2012-2013 school year. Structural equation modelling was used to examine the mediating role of Internet addiction in depression, social anxiety, and subjective psychosocial well-being.


RESULTS
Significant differences on the scores of IAT, SAS-A, CESD, and HoNOSCA-SR across the six countries were found. The proposed self-medication model of Internet addiction received satisfactory goodness-of-fit with data of all countries. After the path from social anxiety to Internet addiction had been discarded in the revised model, there was a significant improvement of the goodness-of-fit in the models for Japan, South Korea, and the Philippines.


CONCLUSIONS
Depression and social anxiety reciprocally influenced, whereas depression associated with poorer psychosocial well-being directly and indirectly through Internet addiction in all six countries. Internet addiction mediated the association between social anxiety and poor psychosocial well-being in China, Hong Kong, and Malaysia.
Department of Psychology, Chinese University of Hong Kong, Hong Kong.
C M
CM
Lai
Department of Psychology, University of Hong Kong, Hong Kong. Electronic address: kkmak@graduate.hku.hk.
K K
KK
Mak
Department of Children and Women's Health, Osaka University Graduate School of Medicine, Japan.
H
H
Watanabe
Department of Bio and Brain Engineering, Korea Advanced Institute of Science and Technology, Republic of Korea.
J
J
Jeong
Department of Education, Seoul National University, Republic of Korea.
D
D
Kim
Department of Psychiatry, Selayang Hospital, Malaysia.
N
N
Bahar
Department of Psychiatry, National University Hospital at Manila, Philippines.
M
M
Ramos
Department of Psychology, National Taiwan University, Taiwan.
S H
SH
Chen
Department of Psychology, University of Hong Kong, Hong Kong.
C
C
Cheng
D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D001007:Anxiety / Q000453:epidemiology*; D001208:Asia / Q000453:epidemiology; D016739:Behavior, Addictive / Q000523:psychology*; D002648:Child; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology*; D005260:Female; D006801:Humans; D020407:Internet / Q000706:statistics & numerical data*; D008297:Male; D008960:Models, Psychological; D012919:Social Behavior; D011795:Surveys and Questionnaires
Adolescents; Asian; Depression; Internet addiction; Social anxiety; Structural equation modelling