title: Pathological Internet Use and Risk-Behaviors among European Adolescents.
abstract: Risk-behaviors are a major contributor to the leading causes of morbidity among adolescents and young people; however, their association with pathological Internet use (PIU) is relatively unexplored, particularly within the European context. The main objective of this study is to investigate the association between risk-behaviors and PIU in European adolescents. This cross-sectional study was conducted within the framework of the FP7 European Union project: Saving and Empowering Young Lives in Europe (SEYLE). Data on adolescents were collected from randomized schools within study sites across eleven European countries. PIU was measured using Young's Diagnostic Questionnaire (YDQ). Risk-behaviors were assessed using questions procured from the Global School-Based Student Health Survey (GSHS). A total of 11,931 adolescents were included in the analyses: 43.4% male and 56.6% female (M/F: 5179/6752), with a mean age of 14.89 ± 0.87 years. Adolescents reporting poor sleeping habits and risk-taking actions showed the strongest associations with PIU, followed by tobacco use, poor nutrition and physical inactivity. Among adolescents in the PIU group, 89.9% were characterized as having multiple risk-behaviors. The significant association observed between PIU and risk-behaviors, combined with a high rate of co-occurrence, underlines the importance of considering PIU when screening, treating or preventing high-risk behaviors among adolescents.
authors.affiliation: National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institutet, Stockholm SE-17177, Sweden. tony.durkee@ki.se.
authors.forename: Tony
authors.initials: T
authors.lastname: Durkee
authors.affiliation: National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institutet, Stockholm SE-17177, Sweden. vladimir.carli@ki.se.
authors.forename: Vladimir
authors.initials: V
authors.lastname: Carli
authors.affiliation: Department of Clinical Neuroscience, Karolinska Institutet, Stockholm SE-17177, Sweden. birgitta.floderus@ki.se.
authors.forename: Birgitta
authors.initials: B
authors.lastname: Floderus
authors.affiliation: Department of Medicine and Health Science, University of Molise, Campobasso 86100, Italy. camillaw@gmail.com.|Department of Child and Adolescent Psychiatry, New York State Psychiatric Institute, Columbia University, New York, NY 10032, USA. camillaw@gmail.com.
authors.forename: Camilla
authors.initials: C
authors.lastname: Wasserman
authors.affiliation: Department of Medicine and Health Science, University of Molise, Campobasso 86100, Italy. marco.sarchiapone@gmail.com.|National Institute for Migration and Poverty, Via San Gallicano, Roma 25/A, Italy. marco.sarchiapone@gmail.com.
authors.forename: Marco
authors.initials: M
authors.lastname: Sarchiapone
authors.affiliation: Feinberg Child Study Centre, Schneider Children's Medical Centre, Tel Aviv University, Tel Aviv 49202, Israel. asapter@gmail.com.
authors.forename: Alan
authors.initials: A
authors.lastname: Apter
authors.affiliation: Vadaskert Child and Adolescent Psychiatric Hospital, Budapest 1021, Hungary. judit.agnes.balazs@gmail.com.|Institute of Psychology, Eötvös Loránd University, Budapest 1064, Hungary. judit.agnes.balazs@gmail.com.
authors.forename: Judit A
authors.initials: JA
authors.lastname: Balazs
authors.affiliation: Department of Psychiatry, Center for Biomedical Research in the Mental Health Network (CIBERSAM), University of Oviedo, Oviedo 33006, Spain. bobes@uniovi.es.
authors.forename: Julio
authors.initials: J
authors.lastname: Bobes
authors.affiliation: Section for Disorders of Personality Development, Clinic of Child and Adolescent Psychiatry, Centre of Psychosocial Medicine, University of Heidelberg, Heidelberg 69115, Germany. romuald.brunner@uni-heidelberg.de.
authors.forename: Romuald
authors.initials: R
authors.lastname: Brunner
authors.affiliation: National Suicide Research Foundation, Western Rd., Cork, Ireland. pcorcoran@ucc.ie.
authors.forename: Paul
authors.initials: P
authors.lastname: Corcoran
authors.affiliation: Department of Clinical Psychology, Iuliu Hatieganu University of Medicine and Pharmacy, Str. Victor Babes Nr. 8, Cluj-Napoca 400000, Romania. doina_octaviancosman@yahoo.com.
authors.forename: Doina
authors.initials: D
authors.lastname: Cosman
authors.affiliation: Research Division for Mental Health, University for Medical Information Technology (UMIT), Klagenfurt, Innsbruck 6060, Austria. Christian.haring@tilak.at.
authors.forename: Christian
authors.initials: C
authors.lastname: Haring
authors.affiliation: Department of Child and Adolescent Psychiatry, New York State Psychiatric Institute, Columbia University, New York, NY 10032, USA. ch42@cumc.columbia.edu.|Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA. ch42@cumc.columbia.edu.
authors.forename: Christina W
authors.initials: CW
authors.lastname: Hoven
authors.affiliation: Section for Disorders of Personality Development, Clinic of Child and Adolescent Psychiatry, Centre of Psychosocial Medicine, University of Heidelberg, Heidelberg 69115, Germany. Michael.kaess@uni-heidelberg.de.
authors.forename: Michael
authors.initials: M
authors.lastname: Kaess
authors.affiliation: Department of Psychiatry, Centre Hospitalo-Universitaire de Nancy, Université de Lorraine, Nancy, Vandoeuvre-lès-Nancy 54500, France. jp.kahn@chu-nancy.fr.
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Kahn
authors.affiliation: Department of Clinical Psychology, Iuliu Hatieganu University of Medicine and Pharmacy, Str. Victor Babes Nr. 8, Cluj-Napoca 400000, Romania. nemes_bogdan@yahoo.com.
authors.forename: Bogdan
authors.initials: B
authors.lastname: Nemes
authors.affiliation: Slovene Center for Suicide Research, Andrej Marušič Institute, University of Primorska, Koper 6000, Slovenia. vita.postuvan@upr.si.
authors.forename: Vita
authors.initials: V
authors.lastname: Postuvan
authors.affiliation: Department of Psychiatry, Center for Biomedical Research in the Mental Health Network (CIBERSAM), University of Oviedo, Oviedo 33006, Spain. pilaralejandra.saiz@gmail.com.
authors.forename: Pilar A
authors.initials: PA
authors.lastname: Saiz
authors.affiliation: Centre of Behavioral and Health Sciences, Estonian-Swedish Mental Health &amp; Suicidology Institute, Tallinn University, Tallinn 10120, Estonia. peeterv@suicidology.ee.
authors.forename: Peeter
authors.initials: P
authors.lastname: Värnik
authors.affiliation: National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institutet, Stockholm SE-17177, Sweden. danuta.wasserman@ki.se.
authors.forename: Danuta
authors.initials: D
authors.lastname: Wasserman
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D016739:Behavior, Addictive / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology*; D003430:Cross-Sectional Studies; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D012309:Risk-Taking; D013334:Students / Q000523:psychology*; D011795:Surveys and Questionnaires
keywords: Internet addiction; SEYLE; adolescents; multiple risk-behaviors; pathological Internet use; risk-behavior; unhealthy lifestyles