This 6 month prospective study systematically tested some multivariate models that advanced the understanding of the psychological mechanisms underlying Internet addiction and psychosocial ...maladjustment. On the basis of previous theories, avoidant coping and coping inflexibility were proposed as underlying mechanisms. Participants were 271 Chinese undergraduates (75% women, Mage=20.49) who took part in both phases of this study. Structural equation modeling was performed to obtain the best fit models for both the cross-sectional and the prospective data. The cross-sectional model testing revealed statistically significant mediating effects for both avoidant coping (β=0.149 95% CI 0.071-0.226, p=0.002) and coping flexibility (β=0.048 95% CI 0.013-0.081, p=0.032). The prospective model testing further showed that avoidant coping mediated the relationship between Internet addiction and Time 2 psychosocial maladjustment (β=0.141 95% CI 0.065-0.216, p=0.005), as well as that between coping flexibility and Time 2 psychosocial maladjustment (β=-0.096 95% CI -0.161 to -0.031, p=0.015). This study was the first to establish theory-driven models, which unveiled an inflexible, avoidant coping style as psychological mechanisms that explained the link between Internet addiction and psychosocial maladjustment.
This study evaluates the association between Internal Addiction (IA) and psychiatric co-morbidity in the literature.
Meta-analyses were conducted on cross-sectional, case-control and cohort studies ...which examined the relationship between IA and psychiatric co-morbidity. Selected studies were extracted from major online databases. The inclusion criteria are as follows: 1) studies conducted on human subjects; 2) IA and psychiatric co-morbidity were assessed by standardised questionnaires; and 3) availability of adequate information to calculate the effect size. Random-effects models were used to calculate the aggregate prevalence and the pooled odds ratios (OR).
Eight studies comprising 1641 patients suffering from IA and 11210 controls were included. Our analyses demonstrated a significant and positive association between IA and alcohol abuse (OR = 3.05, 95% CI = 2.14-4.37, z = 6.12, P < 0.001), attention deficit and hyperactivity (OR = 2.85, 95% CI = 2.15-3.77, z = 7.27, P < 0.001), depression (OR = 2.77, 95% CI = 2.04-3.75, z = 6.55, P < 0.001) and anxiety (OR = 2.70, 95% CI = 1.46-4.97, z = 3.18, P = 0.001).
IA is significantly associated with alcohol abuse, attention deficit and hyperactivity, depression and anxiety.
BACKGROUND: Sleep problems may have different influences on students' academic performance. We investigated the prevalence of sleep patterns, naps, and sleep disorders, and their associations with ...academic performance in Hong Kong adolescents.
METHODS: In 2007‐2008, 22,678 students aged 12‐18 (41.6% boys) completed a questionnaire on sociodemographic characteristics, sleep patterns and problems, and lifestyle factors including exercise, smoking, alcohol drinking, and academic performance.
RESULTS: The prevalence of having >8 hours of sleep was higher on holiday nights (86.4%) than on school‐day nights (27.4%). Sleeping after midnight was more common before holidays (49.3%) than before school days (19.9%). Symptoms of insomnia and obstructive sleep apnea (OSA) were reported by 21.5% and 34.4% of students. Having >2 hours of weekend sleep delay was associated with poor academic performance with an odds ratio (OR) (95% confidence interval) of 1.46 (1.29‐1.65). However, having 1‐2 hours and >2 hours of weekend wake‐up delay were both associated with less likelihood of poor academic performance with ORs of 0.64 (0.56‐0.73) and 0.69 (0.59‐0.80). Other factors associated with poor academic performance included >2 hours of sleep debt, OR of 1.17 (1.03‐1.33); having any insomnia symptoms in the past 30 days, OR of 1.27 (1.17‐1.37); and having any OSA symptoms at least weekly, OR of 1.23 (1.14‐1.32). Napping in the past 5 school days was only marginally associated with poor school performance with an OR of 1.08 (1.00‐1.16).
CONCLUSION: Poorer academic performance was associated with sleep debt, and symptoms of insomnia and OSA. Sleep compensation but not naps may be a protective factor of poor academic performance.
To cite this article: Lu Y, Mak K‐K, van Bever HPS, Ng TP, Mak A, Ho RC‐M. Prevalence of anxiety and depressive symptoms in adolescents with asthma: A meta‐analysis and meta‐regression. Pediatr ...Allergy Immunol 2012: 23: 707–715.
It remains unclear whether anxiety and depressive symptoms are more prevalent in adolescents with asthma when compared with healthy individuals. This meta‐analysis aimed to evaluate the difference in the aggregate prevalence of depressive and anxiety symptoms between adolescents with asthma and healthy controls and to explore the underlying moderators that potentially explain the heterogeneity of the effect size. A meta‐analysis of published work was performed using the random effects model. The differences in aggregate prevalence of depressive and anxiety symptoms between adolescents with asthma and healthy controls were determined. Meta‐regression and subgroup analysis were performed to identify factors that may contribute to heterogeneity. A total of eight studies were eligible for analysis. The aggregate prevalence of depressive and anxiety symptoms was significantly higher among 3546 adolescents with asthma than that of 24,884 controls (depression, 0.27; 95% CI, 0.18.6–0.39 vs. 0.13; 95% CI, 0.09–0.19; anxiety, 0.33; 95% CI, 0.19–0.52 vs. 0.21; 95% CI, 0.12–0.33). The risk of developing depression and anxiety is significantly higher among adolescents with asthma when compared with controls (depression: pooled odds ratio, 2.09; 95% CI, 1.65–2.64; p < 0.001; anxiety: pooled odds ratio, 1.83; 95% CI, 1.63–2.07; p < 0.001). Meta‐regression revealed that the proportions of Caucasian (p = 0.008) and smokers (p < 0.001) were significant moderators which explained the significant heterogeneity when comparing the risk of developing depressive symptoms among adolescent asthma patients vs. controls while age, gender, and severity of asthma were not significant. Family doctors, pediatricians, and healthcare providers should formulate strategies to detect depressive and anxiety symptoms in adolescents with asthma and offer psychological interventions to reduce the burden of psychiatric comorbidity.
This pilot study investigated the patterns of video and internet gaming habits and the prevalence and correlates of gaming addiction in Hong Kong adolescents. A total of 503 students were recruited ...from two secondary schools. Addictive behaviors of video and internet gaming were assessed using the Game Addiction Scale. Risk factors for gaming addiction were examined using logistical regression. An overwhelming majority of the subjects (94%) reported using video or internet games, with one in six (15.6%) identified as having a gaming addiction. The risk for gaming addiction was significantly higher among boys, those with poor academic performance, and those who preferred multiplayer online games. Gaming addiction was significantly associated with the average time spent gaming per week, frequency of spending money on gaming, period of spending money on gaming, perceived family disharmony, and having more close friends. These results suggest that effective educational and preventative programs or strategies are needed.
This study examined the psychometric properties of the Young's Internet Addiction Test (IAT) in 844 Hong Kong Chinese adolescents (37.7% boys) with mean age of 15.9 (standard deviation = 3.5) years.
...Demographic items, Internet use habits, IAT, and the Revised Chen Internet Addiction Scale (CIAS-R) were administered. 3 percent of the participants were classified as addicted and 31.6% as occasional problematic Internet users. Confirmatory factor analysis results indicated that the 18-item second-order three-factor model has the best fit with our data (Satorra-Bentler scaled χ(2) = 160.56, df = 132, p < .05, normed fit index = 0.95, non-normed fit index = 0.99, comparative fit index = 0.99, root mean square error of approximation = 0.02).
IAT demonstrated strong internal consistency (Cronbach's α = .93). Satisfactory concurrent and convergent validity of IAT were found moderately correlated with CIAS-R (r = .46) and the average online time per day (r = .40 for weekdays; r = .37 for weekends).
IAT has evidence of being a valid and reliable scale for screening Internet addiction in Chinese adolescents.
This study was designed to investigate the relation between health-related physical fitness and weight status in Hong Kong adolescents.
3,204 students aged 12-18 years participated in the Hong Kong ...Student Obesity Surveillance (HKSOS) project in 2006-2007. Anthropometric measures (height, weight) and health-related fitness (push-up, sit-up, sit-and-reach, 9-minute run) were assessed. Body mass index (BMI) was computed to classify participants into normal weight, underweight (Grade I, II/III), overweight, and obese groups. The associations of health-related physical fitness with BMI and weight status were examined by partial correlation coefficients and analysis of covariance, respectively.
More boys than girls were overweight or obese (18.0% vs 8.7%), but more girls than boys were underweight (22.3% vs 16.7%). Boys performed significantly (P < 0.001) better in sit-up (38.8 vs 31.6 times/min) and 9-minute run (1632.1 vs 1353.2 m), but poorer in sit-and-reach (27.4 vs 32.2 cm) than girls. All four physical fitness tests were significantly positively correlated with each other in both sexes, and BMI was only weakly correlated with sit up and sit-and-reach tests in boys. Decreasing performance (P for trend < 0.05) was observed from normal weight to overweight and obese for push-up, sit-up, and 9-minute run in both sexes. From normal weight to Grade I and Grade II/III underweight, decreasing performance (P for trend < 0.05) for sit-up and sit-and-reach in both sexes and for push-up in boys was observed.
The relations between BMI and health-related physical fitness in adolescents were non-linear. Overweight/obese and underweight adolescents had poorer performance in push-up and sit-up tests than normal weight adolescents. Different aspects of health-related physical fitness may serve as immediate indicators of potential health risks for underweight and overweight adolescents.
There has been increased research examining the psychometric properties on the Internet Addiction Test (IAT) in different populations. This population-based study examined the psychometric properties ...and measurement invariance of the IAT in adolescents from three Asian countries. In the Asian Adolescent Risk Behavior Survey (AARBS), 2,535 secondary school students (55.9% girls) aged 12-18 years from Hong Kong (n=844), Japan (n=744), and Malaysia (n=947) completed a survey in 2012-2013 school year. A nested hierarchy of hypotheses concerning the IAT cross-country invariance was tested using multigroup confirmatory factor analyses. Replicating past findings in Hong Kong adolescents, the construct of the IAT is best represented by a second-order three-factor structure in Malaysian and Japanese adolescents. Configural, metric, scalar, and partial strict factorial invariance was established across the three samples. No cross-country differences on Internet addiction were detected at the latent mean level. This study provided empirical support for the IAT as a reliable and factorially stable instrument, and valid to be used across Asian adolescent populations.
To compare the performance of Stunkard's current body size (CBS) with self-reported body mass index (BMI), waist circumference (WC) and waist to stature ratio (WSR) in predicting weight status in ...Chinese adolescents, and to determine the CBS cutoffs for overweight/obesity and underweight.
This cross-sectional study was conducted in a sample of 5,418 secondary school students (45.2% boys; mean age 14.7 years). Height and weight were measured by trained teachers or researchers. Subjects were classified as underweight, normal weight, or overweight/obese according to the International Obesity Task Force cutoffs. Subjects were asked to select the figure that best resembled their CBS on the Stunkard's figure rating scale. Self-reported height, weight, WC and WSR were also obtained. The performance of CBS, self-reported BMI, WC and WSR as a weight status indicator was analysed by sex-specific receiver operating characteristic curves. The optimal CBS cutoffs for underweight and overweight/obesity were determined based on the Youden Index.
Apart from self-reported BMI, CBS had the greatest area under curve (AUC) for underweight in boys (0.82) and girls (0.81). For overweight/obesity, CBS also had a greater AUC (0.85) than self-reported WC and WSR in boys, and an AUC (0.81) comparable to self-reported WC and WSR in girls. In general, CBS values of 3 and 5 appeared to be the optimal cutoffs for underweight and overweight/obesity, respectively, in different sex-age subgroups.
CBS is a potentially useful indicator to assess weight status of adolescents when measured and self-reported BMI are not available.
Aim: To assess the 5‐year secular changes in sports participation, sedentary activity, and physical self‐perceptions among Hong Kong adolescents.
Methods: A total of 2932 and 5692 secondary ...students, aged 13–18 participated in the Health Related Behavior General (HRBG) Survey in 1995–1996 and 2000–2001, respectively. Extracurricular sports participation at least weekly or as a team member (none, 1–2 events, 3 or more events), sedentary activities (0–1 h/day, 2 h/day or more) including television/video watching and homework were assessed. Additionally, physical self‐perceptions, physical fitness (fit/very fit, moderately fit, unfit/very unfit) and body weight (intention to lose weight, satisfied, intention to gain weight) were reported. Secular trends of sports participation, and sedentary activities and physical self‐perceptions were assessed.
Results: During the 5 years, the prevalence of sports participation (at least weekly or membership) decreased significantly in boys. The prevalence of both TV/video watching and homework for at least 2 h/day increased significantly in both sexes. The prevalence of being unfit/very unfit increased significantly in girls. No significant secular difference in weight perception was observed for both sexes.
Conclusions: Sports participation decreased and sedentary activities increased during the 5‐year period. Physical self‐perceptions did not change significantly, except an increase in being physically unfit was observed in girls.
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