Int J Adolesc Med Health 2015; aop
Short Communication Lauren A. Jelenchick, Skyler T. Hawk and Megan A. Moreno*
Problematic internet use and social networking site use among Dutch adolescents Abstract: Problematic Internet use (PIU), defined as Internet use that is risky, excessive, or impulsive in nature and leads to adverse life consequences, is an emerging health concern among adolescents worldwide. Social networking site (SNS) use is among the most popular and common Internet use activities for youth; however, risks of SNS use for PIU remain unexplored. The purpose of this study was to determine the prevalence of adolescents at risk for PIU within a national school-based sample of Dutch adolescents and to explore associations between SNS use and PIU. Adolescents were recruited from six public schools in the Netherlands to complete a survey, which included SNS use questions and the Problematic and Risky Internet Use Screening Scale (PRIUSS). Logistic regression models were used to test associations between risk for PIU and demographic or SNS use variables. A total of 474 adolescents participated (98% response rate), and 11% (n = 51) of adolescents were at risk for PIU. Risk for PIU was significantly associated with gender (p = 0.015), increased age (p = 0.034), and posting on SNS more than four times a day (p= 0.003). Risk for PIU was not associated with number of SNS profiles, SNS preference or the number of online friends. Findings illustrate high risk groups for PIU includes males and older teens. Findings also illuminate that risk for PIU related to SNS was not associated with a specific SNS or number of SNSs used but was related to one’s personal investment in SNSs by posting four or more times a day. Keywords: media; problematic internet use; screening.
*Corresponding author: Megan A. Moreno, MD, MSEd, MPH, Seattle Children’s Research Institute, Division of Adolescent Medicine, Center for Child Health Behavior and Development, Seattle, WA, USA, Phone: 206-884-1424, Fax: 206-884-7801, E-mail: [email protected]; and University of Washington, Seattle, WA, USA Lauren A. Jelenchick: University of Minnesota School of Medicine, Medical Scientist Training Program, Minneapolis, MN, USA Skyler T. Hawk: Chinese University of Hong Kong, Shatin, New Territories, Hong Kong Utrecht University, Utrecht, Netherlands; and University of Minnesota School of Medicine, Medical Scientist Training Program, Minneapolis, MN, USA
DOI 10.1515/ijamh-2014-0068 Received October 10, 2014; accepted November 22, 2014
Introduction Problematic Internet use (PIU), defined as “Internet use that is risky, excessive or impulsive in nature leading to adverse life consequences, specifically physical, emotional, social or functional impairment,” is an emerging health concern among adolescents (1). Prevalence estimates of PIU vary across adolescent populations: between 4% and 13% in Europe, with significant differences between countries (2). Among European adolescents, PIU has been associated with negative health outcomes, such as depression and conduct problems (3, 4). Previous studies have shown that risk for PIU rises with increased participation in specific online activities such as social networking site (SNS) use (3, 4). SNSs are globally popular among adolescents; over 70% of European adolescents report daily use (5). European adolescents who report high levels of SNS use have been found to have diminished capacities in academic performance, social competency, as well as increased internalizing behavior problems (5). Despite the proposed relationship between SNS use and adverse outcomes, there is little known regarding the aspects of SNS use that may predispose an adolescent to PIU. Thus, there were two objectives to the current study: first, to determine the prevalence and predictors of risk for PIU among Dutch adolescents, and second, to explore associations with specific aspects of SNSs that may predispose an adolescent to risk.
Methods Setting and subjects This cross-sectional survey study was conducted between October 2012 and March 2014 in accordance with the Ethical Guidelines for Human Research of Utrecht University. Six public high schools were
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2 Jelenchick et al.: Problematic internet use and social media
selected for participation in the study to represent northern, middle, and southern provinces of the Netherlands.
Procedure The research team obtained consent from each school prior to seeking consent from students and their parents. Survey instructions were provided both verbally and in writing during students’ homeroom class; a trained research assistant remained present throughout survey completion. The survey took students an average of 15–20 min to complete.
Measures The survey contained standard demographics and SNS use questions including: on which SNS sites participants had profiles, most frequently used SNS, number of friends linked to their SNS profile, and frequency of posting on SNS. The Problematic and Risky Internet Use Screening Scale (PRIUSS), a validated adolescent screening instrument (6), was included to assess PIU. A PRIUSS score > 25 indicates that the adolescent is at-risk for PIU. Cronbach’s alpha coefficient for the scale was 0.92.
Statistical analysis Statistical analyses were performed using SAS software version 9.2 (SAS Institute, Cary, NC, USA). All p-values were 2-sided, and p < 0.05 was used to indicate statistical significance except in cases of multiple comparison, for which we applied a Bonferroni correction. χ2 and nonparametric Spearman’s rank correlation tests were used to assess associations between SNS use and gender and age. Associations between age, gender, and SNS use variables, and the probability of being at-risk for PIU were evaluated using logistic regression analysis. Interaction variables and additional covariates (country of birth, living situation) were included in an exploratory fashion using forward selection. Odds ratios (ORs) and the corresponding 95% confidence intervals (CIs) were computed to compare the proportions of participants at-risk for PIU between the predictor variable levels.
Results Demographic and descriptive variables A total of 474 participants completed the survey (98% response rate). The sample was 47% female and the mean age was 14.3 years (standard deviation, SD = 1.8, range = 11–18). The majority of participants (n = 442, 94%) reported having a least one SNS profile, and most used two or more (n = 260, 58.69%). Profiles were most common on Facebook (n = 364, 77.2%) or Twitter (n = 337, 76.1%); a minority of participants reported no SNS profiles (n = 29, 6%). Participants reported posting most frequently on Facebook (n = 166,
38.5%) or Twitter (n = 188, 43.6%). SNS use patterns, including number of profiles and most used site, differed by age (Figure 1) but not gender. Specifically, older participants reported posting less frequently (r = –0.27, p < 0.0001), but a greater number of online friends (r = 0.28, p =0.001).
Risk for problematic Internet use A total of 11% (n = 51) of the sample scored at-risk for PIU. The final model evaluating risk for PIU included age (p = 0.034), gender (p = 0.015), and SNS posting frequency (p = 0.003). There were no significant associations between other demographic covariates, markers of SNS use, or interaction variables. Specifically, there was a 22% increase in risk with each increasing year in age (OR= 1.22, 95% CI: 1.02–1.48), and males were over twice as likely to be at-risk compared to females (OR= 2.26, 95% CI: 1.17–4.3). Further, as compared with those who posted to SNSs less than once per week, there were no significant differences in risk for PIU among those posting 1–2 times per week (OR= 0.59, 95% CI: 0.16–2.25), 3–4 times per week (OR = 0.87, 95% CI: 0.23–3.34), once per day (OR = 1.70, 95% CI: 0.58–5.01), or 2-3 times per day (OR = 2.07, 95% CI: 0.59–7.25). SNS users who reported posting four or more times per day were almost five times as likely to be at risk for PIU (OR = 4.59, 95% CI: 1.92–11.0) compared to those posting less than once a week.
Discussion In this study of Dutch adolescents, risk for PIU was highest among males and older adolescents. The overall prevalence of PIU was consistent with other European adolescent populations (2). Risk for PIU was not associated with number of SNS profiles, SNS preference or the number of online friends. However, posting to a SNS four or more times a day was positively associated with risk for PIU. These findings suggest that an adolescent who routinely posts four or more times per day to a SNS may be using that SNS at the expense of being present in the offline world. This investment in SNS use, and prioritization of online social interactions over offline, is supported in previous work that proposed conceptual components of PIU (1). This study is strengthened by the large sample of adolescents recruited within a single European country. Limitations include a reliance on self-reported data, a correlational design with concurrent measurements, and an oversampling of 13 year olds. Despite these limitations, findings support clinicians’ and educators’ efforts to educate adolescents about healthy Internet use and the
Brought to you by | provisional account Unauthenticated Download Date | 6/10/15 8:05 AM
Jelenchick et al.: Problematic internet use and social media 3
A. Number of SNS Profiles 100% 80% 3+ profiles
60%
2 profiles 40%
1 profiles 0 profiles
20% 0% 11–12
13–14
15–16
17–18
B. Most frequently used SNS site. 100% 80% 60%
Other SNS Twitter
40%
Facebook 20% 0%
11–12
13–14
15–16
17–18
C. Posting frequency on preferred SNS site. 100% 80% 4+/day
60%
1+/day 40%
1+/week
Short Communication Lauren A. Jelenchick, Skyler T. Hawk and Megan A. Moreno*
Problematic internet use and social networking site use among Dutch adolescents Abstract: Problematic Internet use (PIU), defined as Internet use that is risky, excessive, or impulsive in nature and leads to adverse life consequences, is an emerging health concern among adolescents worldwide. Social networking site (SNS) use is among the most popular and common Internet use activities for youth; however, risks of SNS use for PIU remain unexplored. The purpose of this study was to determine the prevalence of adolescents at risk for PIU within a national school-based sample of Dutch adolescents and to explore associations between SNS use and PIU. Adolescents were recruited from six public schools in the Netherlands to complete a survey, which included SNS use questions and the Problematic and Risky Internet Use Screening Scale (PRIUSS). Logistic regression models were used to test associations between risk for PIU and demographic or SNS use variables. A total of 474 adolescents participated (98% response rate), and 11% (n = 51) of adolescents were at risk for PIU. Risk for PIU was significantly associated with gender (p = 0.015), increased age (p = 0.034), and posting on SNS more than four times a day (p= 0.003). Risk for PIU was not associated with number of SNS profiles, SNS preference or the number of online friends. Findings illustrate high risk groups for PIU includes males and older teens. Findings also illuminate that risk for PIU related to SNS was not associated with a specific SNS or number of SNSs used but was related to one’s personal investment in SNSs by posting four or more times a day. Keywords: media; problematic internet use; screening.
*Corresponding author: Megan A. Moreno, MD, MSEd, MPH, Seattle Children’s Research Institute, Division of Adolescent Medicine, Center for Child Health Behavior and Development, Seattle, WA, USA, Phone: 206-884-1424, Fax: 206-884-7801, E-mail: [email protected]; and University of Washington, Seattle, WA, USA Lauren A. Jelenchick: University of Minnesota School of Medicine, Medical Scientist Training Program, Minneapolis, MN, USA Skyler T. Hawk: Chinese University of Hong Kong, Shatin, New Territories, Hong Kong Utrecht University, Utrecht, Netherlands; and University of Minnesota School of Medicine, Medical Scientist Training Program, Minneapolis, MN, USA
DOI 10.1515/ijamh-2014-0068 Received October 10, 2014; accepted November 22, 2014
Introduction Problematic Internet use (PIU), defined as “Internet use that is risky, excessive or impulsive in nature leading to adverse life consequences, specifically physical, emotional, social or functional impairment,” is an emerging health concern among adolescents (1). Prevalence estimates of PIU vary across adolescent populations: between 4% and 13% in Europe, with significant differences between countries (2). Among European adolescents, PIU has been associated with negative health outcomes, such as depression and conduct problems (3, 4). Previous studies have shown that risk for PIU rises with increased participation in specific online activities such as social networking site (SNS) use (3, 4). SNSs are globally popular among adolescents; over 70% of European adolescents report daily use (5). European adolescents who report high levels of SNS use have been found to have diminished capacities in academic performance, social competency, as well as increased internalizing behavior problems (5). Despite the proposed relationship between SNS use and adverse outcomes, there is little known regarding the aspects of SNS use that may predispose an adolescent to PIU. Thus, there were two objectives to the current study: first, to determine the prevalence and predictors of risk for PIU among Dutch adolescents, and second, to explore associations with specific aspects of SNSs that may predispose an adolescent to risk.
Methods Setting and subjects This cross-sectional survey study was conducted between October 2012 and March 2014 in accordance with the Ethical Guidelines for Human Research of Utrecht University. Six public high schools were
Brought to you by | provisional account Unauthenticated Download Date | 6/10/15 8:05 AM
2 Jelenchick et al.: Problematic internet use and social media
selected for participation in the study to represent northern, middle, and southern provinces of the Netherlands.
Procedure The research team obtained consent from each school prior to seeking consent from students and their parents. Survey instructions were provided both verbally and in writing during students’ homeroom class; a trained research assistant remained present throughout survey completion. The survey took students an average of 15–20 min to complete.
Measures The survey contained standard demographics and SNS use questions including: on which SNS sites participants had profiles, most frequently used SNS, number of friends linked to their SNS profile, and frequency of posting on SNS. The Problematic and Risky Internet Use Screening Scale (PRIUSS), a validated adolescent screening instrument (6), was included to assess PIU. A PRIUSS score > 25 indicates that the adolescent is at-risk for PIU. Cronbach’s alpha coefficient for the scale was 0.92.
Statistical analysis Statistical analyses were performed using SAS software version 9.2 (SAS Institute, Cary, NC, USA). All p-values were 2-sided, and p < 0.05 was used to indicate statistical significance except in cases of multiple comparison, for which we applied a Bonferroni correction. χ2 and nonparametric Spearman’s rank correlation tests were used to assess associations between SNS use and gender and age. Associations between age, gender, and SNS use variables, and the probability of being at-risk for PIU were evaluated using logistic regression analysis. Interaction variables and additional covariates (country of birth, living situation) were included in an exploratory fashion using forward selection. Odds ratios (ORs) and the corresponding 95% confidence intervals (CIs) were computed to compare the proportions of participants at-risk for PIU between the predictor variable levels.
Results Demographic and descriptive variables A total of 474 participants completed the survey (98% response rate). The sample was 47% female and the mean age was 14.3 years (standard deviation, SD = 1.8, range = 11–18). The majority of participants (n = 442, 94%) reported having a least one SNS profile, and most used two or more (n = 260, 58.69%). Profiles were most common on Facebook (n = 364, 77.2%) or Twitter (n = 337, 76.1%); a minority of participants reported no SNS profiles (n = 29, 6%). Participants reported posting most frequently on Facebook (n = 166,
38.5%) or Twitter (n = 188, 43.6%). SNS use patterns, including number of profiles and most used site, differed by age (Figure 1) but not gender. Specifically, older participants reported posting less frequently (r = –0.27, p < 0.0001), but a greater number of online friends (r = 0.28, p =0.001).
Risk for problematic Internet use A total of 11% (n = 51) of the sample scored at-risk for PIU. The final model evaluating risk for PIU included age (p = 0.034), gender (p = 0.015), and SNS posting frequency (p = 0.003). There were no significant associations between other demographic covariates, markers of SNS use, or interaction variables. Specifically, there was a 22% increase in risk with each increasing year in age (OR= 1.22, 95% CI: 1.02–1.48), and males were over twice as likely to be at-risk compared to females (OR= 2.26, 95% CI: 1.17–4.3). Further, as compared with those who posted to SNSs less than once per week, there were no significant differences in risk for PIU among those posting 1–2 times per week (OR= 0.59, 95% CI: 0.16–2.25), 3–4 times per week (OR = 0.87, 95% CI: 0.23–3.34), once per day (OR = 1.70, 95% CI: 0.58–5.01), or 2-3 times per day (OR = 2.07, 95% CI: 0.59–7.25). SNS users who reported posting four or more times per day were almost five times as likely to be at risk for PIU (OR = 4.59, 95% CI: 1.92–11.0) compared to those posting less than once a week.
Discussion In this study of Dutch adolescents, risk for PIU was highest among males and older adolescents. The overall prevalence of PIU was consistent with other European adolescent populations (2). Risk for PIU was not associated with number of SNS profiles, SNS preference or the number of online friends. However, posting to a SNS four or more times a day was positively associated with risk for PIU. These findings suggest that an adolescent who routinely posts four or more times per day to a SNS may be using that SNS at the expense of being present in the offline world. This investment in SNS use, and prioritization of online social interactions over offline, is supported in previous work that proposed conceptual components of PIU (1). This study is strengthened by the large sample of adolescents recruited within a single European country. Limitations include a reliance on self-reported data, a correlational design with concurrent measurements, and an oversampling of 13 year olds. Despite these limitations, findings support clinicians’ and educators’ efforts to educate adolescents about healthy Internet use and the
Brought to you by | provisional account Unauthenticated Download Date | 6/10/15 8:05 AM
Jelenchick et al.: Problematic internet use and social media 3
A. Number of SNS Profiles 100% 80% 3+ profiles
60%
2 profiles 40%
1 profiles 0 profiles
20% 0% 11–12
13–14
15–16
17–18
B. Most frequently used SNS site. 100% 80% 60%
Other SNS Twitter
40%
Facebook 20% 0%
11–12
13–14
15–16
17–18
C. Posting frequency on preferred SNS site. 100% 80% 4+/day
60%
1+/day 40%
1+/week
