Document Type : Original Article
Authors
1 Health Information Technology Department, School of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
2 Master of Arts in Clinical Psychology, Abadan Faculty of Medical Sciences, Abadan, Iran
3 Student Research Committee, Abadan Faculty of Medical Sciences, Abadan, Iran
Abstract
BACKGROUND: Internet addiction (IA) is a severe problem, especially in academic communities.
The association between IA and unfavorable emotional conditions (e.g., anxiety, stress, and
depression) can harm students’ relationships and academic and career performance. The present
study evaluated (a) the prevalence of IA in a sample of medical sciences university students; (b) the
association between IA and depression, anxiety, stress, and sleep disorders; and (c) the association
between demographic characteristics and IA, depression, anxiety, and stress.
MATERIALS AND METHODS: In this descriptive cross‑sectional study, 268 students from Abadan
University of Medical Sciences were selected using Morgan Table. The participants responded to
the Young Internet Addiction Test, the Depression Anxiety Stress Scales‑42, and the Pittsburgh
Sleep Quality Index. Data were analyzed using descriptive statistics, Pearson correlation coefficient,
independent sample t‑test, one‑way ANOVA, and least significant difference.
RESULTS: The mean score of IA was 45.65 ± 35.40. IA was found to be significantly related to
depression, anxiety, stress, and sleep disorders (except for sleep disturbance) (P < 0.001). Males
were found to be more likely than females to suffer from IA, depression, anxiety, stress, and sleep
disorders. Furthermore, age was inversely related to IA, depression, and stress. Finally, medical
sciences students suffered from depression, anxiety, and stress more than students majoring in
other fields.
CONCLUSIONS: The simultaneous occurrence of IA and depression, anxiety, stress, and sleep
disorders in students indicates that IA is associated with other psychological problems. Therefore,
researchers and policymakers need to identify preventive measures to help internet‑addicted students.
Keywords
2018 (in millions) 2019. Available from: https://www.statista.
com/statistics/273018/number‑of‑internet‑users‑worldwide/.
2. Akin A, Iskender M. Internet addiction and depression, anxiety
and stress. IOJES 2011;3:138‑48.
3. Guillot CR, Bello MS, Tsai JY, Huh J, Leventhal AM, Sussman S.
Longitudinal associations between anhedonia and internet‑related
addictive behaviors in emerging adults. Comput Human Behav
2016;62:475‑9.
4. Alam SS, Hashim NM, Ahmad M, Wel CA, Nor SM, Omar NA.
Negative and positive impact of internet addiction on young
adults: Empericial study in Malaysia. Intangible Capital
2014;10:619‑38.
5. American Psychiatric Association. Diagnostic and Statistical
Manual of Mental Disorders (DSM‑5). Arlington, VA: American
Psychiatric Association; 2013.
6. World Health Organization. ICD‑10: International Statistical
Classification of Diseases and Related Health Problems. 5th ed.,
10th Rev. World Health Organization; 2016.
7. Kovács M, Makkos A, Pintér D, Juhász A, Darnai G, Karádi K,et al. Screening for problematic internet use may help identify
impulse control disorders in Parkinson’s disease. Behav Neurol
2019;2019:1‑8.
8. Younes F, Halawi G, Jabbour H, El Osta N, Karam L, Hajj A,
et al. Internet addiction and relationships with insomnia, anxiety,
depression, stress and self‑esteem in university students:
A cross‑sectional designed study. PLoS One 2016;11:e0161126.
9. Su W, Han X, Jin C, Yan Y, Potenza MN. Are males more likely
to be addicted to the internet than females? A meta‑analysis
involving 34 global jurisdictions. Comput Human Behav
2019;99:86‑100.
10. Liang L, Zhou D, Yuan C, Shao A, Bian Y. Gender differences
in the relationship between internet addiction and depression:
A cross‑lagged study in Chinese adolescents. Comput Human
Behav 2016;63:463‑70.
11. Najafi F, Kerman Saravi F, Navidian A, Malek Raeisi S. The
relationship between internet addiction, loneliness and sleep
quality among students of nursing and midwifery faculty. ZJRMS
2018;20:7‑1.
12. Mooi CS, Ali H, Theng CA, Salim HS. Psychological distress and
internet addiction among medical students from a Malaysian
public university: A comparison between gender. Malays J Med
Health Sci 2019;15:3‑8.
13. Yücens B, Üzer A. The relationship between internet addiction,
social anxiety, impulsivity, self‑esteem, and depression in a
sample of Turkish undergraduate medical students. Psychiatry
Res 2018;267:313‑8.
14. Lin IH, Ko CH, Chang YP, Liu TL, Wang PW, Lin HC, et al.
The association between suicidality and Internet addiction
and activities in Taiwanese adolescents. Compr Psychiatry
2014;55:504‑10.
15. Kim JH, Lau CH, Cheuk KK, Kan P, Hui HL, Griffiths SM. Brief
report: Predictors of heavy Internet use and associations with
health‑promoting and health risk behaviors among Hong Kong
university students. J Adolesc 2010;33:215‑20.
16. Tan Y, Chen Y, Lu Y, Li L. Exploring associations between
problematic internet use, depressive symptoms and sleep
disturbance among southern Chinese adolescents. Int J Environ
Res Public Health 2016;13:313.
17. Cheng SH, Shih CC, Lee IH, Hou YW, Chen KC, Chen KT, et al.
A study on the sleep quality of incoming university students.
Psychiatry Res 2012;197:270‑4.
18. Lin PH, Lee YC, Chen KL, Hsieh PL, Yang SY, Lin YL. The
relationship between sleep quality and internet addiction among
female college students. Front Neurosci 2019;13:599.
19. Internet World stats. TOP 20 COUNTRIES WITH THE HIGHEST
NUMBER OF INTERNET USERS 2019. Available from: https://
www.internetworldstats.com/top20.htm.
20. Statista. Number of Internet Users in the Middle East as
of April 2019, by Country (in Millions) 2019. Available
from: https://www.statista.com/statistics/603061/
number‑of‑internet‑users‑in‑middle‑east‑countries/.
21. MohammadkhaniP, AlkasirE, PourshahbazA, Jafarian DehkordiF,
Soleimani Sefat E. Internet addiction in high school students and
its relationship with the symptoms of mental disorders. IRJ
2017;15:141‑8.
22. Gholamian B, Shahnazi H, Hassanzadeh A. The prevalence
of internet addiction and its association with depression,
anxiety, and stress, among high‑school students. Int J Pediatr
2017;5:4763‑70.
23. Ahmadi K. Internet addiction among Iranian adolescents:
A nationwide study. Acta Med Iran 2014;52:467‑72.
24. Veisani Y, Jalilian Z, Mohamadian F. Relationship between
internet addiction and mental health in adolescents. J Educ Health
Promot 2020;9:303.
25. Kheyri F, Azizifar A, Valizadeh R, Veisani Y, Aibod S, Cheraghi F,
et al. Investigation the relationship between internet dependence
with anxiety and educational performance of high school
students. J Educ Health Promot 2019;8:213.
26. Salehi M, Norozi Khalili M, Hojjat SK, Salehi M, Danesh A.
Prevalence of internet addiction and associated factors among
medical students from mashhad, iran in 2013. Iran Red Crescent
Med J 2014;16:e17256.
27. Sahraian A, Hedayati SB, Mani A, Hedayati A. Internet addiction
based on personality characteristics in medical students. Shiraz
E Med J 2016;17:1‑7.
28. Rafiee F, Zare Z, Adib‑Hajbaghery M, Zade S. Internet addiction
and psychological strain in nursing and midwifery students. Nurs
Midwifery Stud 2020;9:36‑42.
29. Vahidi Far H, Nabavi Zadeh H, MA. Assessment of internet
addiction among college students in North Khorasan University
of Medical Sciences in Bojnoord, Iran. J N Khorasan Univ Med
Sci 2014;5:1088‑1.
30. Ahangarzadeh Rezaei S, Moradi Y. Internet addiction study
at Urmia university students medical sciences. J Urmia Nurs
Midwifery Fac 2015;13:434‑9.
31. TehranTimes. Iran Ranks 12th in Internet User Growth:
R e p o r t : T e h r a n T i m e s ; 2 0 1 9 . A v a i l a b l e f r o m :
https://www.tehrantimes.com/news/437110/
Iran‑ranks‑12th‑in‑internet‑user‑growth‑report.
32. Young KS. Caught in the net: How to recognize the signs of
internet addiction--and a winning strategy for recovery. New
York: John Wiley & Sons; 1998.
33. Lovibond PF, Lovibond SH. The structure of negative emotional
states: Comparison of the Depression Anxiety Stress Scales (DASS)
with the Beck Depression and Anxiety Inventories. Behav Res
Ther 1995;33:335‑43.
34. Demirbatir RE. Undergraduate music student’s depression,
anxiety and stress levels: A study from Turkey. Procedia Soc
Behav Sci 2012;46:2995‑9.
35. Buysse DJ, Reynolds CF 3rd, Monk TH, Berman SR, Kupfer DJ. The
Pittsburgh Sleep Quality Index: A new instrument for psychiatric
practice and research. Psychiatry Res 1989;28:193‑213.
36. Farrahi Moghaddam J, Nakhaee N, Sheibani V, Garrusi B,
Amirkafi A. Reliability and validity of the Persian version
of the Pittsburgh Sleep Quality Index (PSQI‑P). Sleep Breath
2012;16:79‑82.
37. Mihajlov M, Vejmelka L. Internet addiction: A review of the first
twenty years. Psychiatr Danub 2017;29:260‑72.
38. Tran BX, Huong LT, Hinh ND, Nguyen LH, Le BN, Nong VM,
et al. A study on the influence of internet addiction and online
interpersonal influences on health‑related quality of life in young
Vietnamese. BMC Public Health 2017;17:138.
39. Carli V, Durkee T, Wasserman D, Hadlaczky G, Despalins R,
Kramarz E, et al. The association between pathological internet
use and comorbid psychopathology: A systematic review.
Psychopathology 2013;46:1‑3.
40. González‑Bueso V, Santamaría JJ, Fernández D, Merino L,
Montero E, Ribas J. Association between internet gaming disorder
or pathological video‑game use and comorbid psychopathology:
A comprehensive review. Int J Environ Res Public Health
2018;15:668.
41. Orsal O, Orsal O, Unsal A, Ozalp SS. Evaluation of internet
addiction and depression among university students. Procedia
Soc Behav Sci 2013;82:445‑54.
42. Li G, Hou G, Yang D, Jian H, Wang W. Relationship between
anxiety, depression, sex, obesity, and internet addiction in Chinese
adolescents: A short‑term longitudinal study. Addict Behav
2019;90:421‑7.
43. Gupta S, Epari V, Pradhan S. Association of Internet Addiction
with Insomnia, Depression, Anxiety and Stress among University
Students-A Cross-Sectional Study. IJCH. 2018;30:342-7.
44. Dieris‑Hirche J, Bottel L, Bielefeld M, Steinbuechel T, Kehyayan A,
Dieris B, et al. Media use and internet addiction in adult depression: A case‑control study. Comput Human Behav
2017;68:96‑103.
45. Ko CH, Liu TL, Wang PW, Chen CS, Yen CF, Yen JY. The
exacerbation of depression, hostility, and social anxiety in the
course of Internet addiction among adolescents: A prospective
study. Compr Psychiatry 2014;55:1377‑84.
46. Seki T, Hamazaki K, Natori T, Inadera H. Relationship between
internet addiction and depression among Japanese university
students. J Affect Disord 2019;256:668‑72.
47. Do KY, Lee KS. Relationship between problematic internet use,
sleep problems, and oral health in Korean adolescents: A national
survey. Int J Environ Res Public Health 2018;15:1870.
48. Bhandari PM, Neupane D, Rijal S, Thapa K, Mishra SR,
Poudyal AK. Sleep quality, internet addiction and depressive
symptoms among undergraduate students in Nepal. BMC
Psychiatry 2017;17:106.
49. Thakur A, Peepre K, Vaswani A, Gupta K, Verma A, Singh D,
et al. Internet addiction, behavioural aspects, and health related
problems associated with it: A cross sectional study among
engineering students of Jabalpur district. Int J Res Med Sci
2018;6:253.
50. Gorgich EAC, Moftakhar L, Barfroshan S, Arbabisarjou A.
Evaluation of Internet Addiction and Mental Health Among
Medical Sciences Students in the Southeast of Iran. SEMJ.
2018;19:e55561.
51. Missaoui SG, Brahim T, Bouriga W, Abdelaziz AB. Prevalence
and consequences of internet addiction in a cohort of Tunisian
adolescents: a pilot study. J Child Adolesc Behav. 2015;3:257.
52. Sahin S, Ozdemir K, Unsal A, Temiz N. Evaluation of mobile
phone addiction level and sleep quality in university students.
Pak J Med Sci 2013;29:913‑8.
53. Kumar B, Shah MAA, Kumari R, Kumar A, Kumar J, Tahir A.
Depression, anxiety, and stress among final‑year medical
students. Cureus 2019;11:e4257.
54. Chinekesh A, Hosseini SA, Mohammadi F, Motlagh ME,
Baradaran Eftekhari M, Djalalinia S, et al. An explanatory model
for the concept of mental health in Iranian youth. F1000Res
2018;7:52.
55. Nemat Shahrbabaki B, Fallahi A, Pirakalathanan P. Expressed
Needs of Students for Prevention of Internet Addiction: A Content
Analysis Study. Health Scope. 2017;6:e15104.
56. Mao Y, Zhang N, Liu J, Zhu B, He R, Wang X. A systematic review
of depression and anxiety in medical students in China. BMC Med
Educ 2019;19:327.
57. Wickramasinghe DP, Almeida IS, Samarasekera DN. Depression
and stressful life events among medical students during
undergraduate career: Findings from a medical school in South
Asia. TAPS 2019;4:42‑7.
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