Investigating the Relationships between Internet Addiction and Suicidal Ideation in Adolescent Girls
-
Zeynab Akbari
,
Fatemeh Serjouie
,
Jafar Sarani Yaztappeh
,
Mohammad Hossein Turkzadeh
,
Faeze Ziaei
,
Ali Bagheri
,
Maryam Sate Zohd
,
Amir Sam Kianimoghadam
Abstract
Objective: Suicidal ideation (SI) signifies a psychiatric crisis, and individuals with SI are at a significantly higher risk of suicide attempts compared to those without. According to previous research, three factors that affect SI in adolescent girls are externalization problems, alexithymia, and perceived social support (PSS). As a result, the present research aimed to examine whether internet addiction (IA) is associated with SI through the mediating roles of PSS, externalizing problems, and alexithymia among adolescent girls in Tehran, Iran.
Method: The current correlational study employed a structural equation modeling approach. Model fit indices such as the Chi-square to degrees of freedom ratio (CMIN/DF), normed fit index (NFI), root mean square error of approximation (RMSEA), Tucker-Lewis index (TLI), and goodness-of-fit index (CFI) were reported to assess the model’s adequacy.
A total of 441 adolescent girls were selected from high school and between the ages of 11 and 19 using a convenience sampling method. Participants completed the Multidimensional Scale of Perceived Social Support (MSPSS), the Beck Scale for Suicidal Ideation (BSSI), the Cell-Phone Over-Use Scale (COS), the Youth Self-Report (YSR), and the Toronto Alexithymia Scale-20 (TAS-20) in a written manner. Data analysis was done using SPSS 25 and AMOS 22.
Results: Results revealed a significant positive correlation between IA and SI (P < 0.001). The study's most significant findings indicate that PSS, externalizing problems, and alexithymia significantly mediate the relationship between SI and IA. The coefficient of determination for the SI variable was 0.33, which means that predictor variables can explain 33% of the variance in SI (IA, PSS, alexithymia, and externalizing problems).
Conclusion: IA showed direct and indirect effects on SI. Using these findings, we can elucidate the mechanism of how IA affects individual SI, providing critical information for the development and implementation of targeted strategies and interventions to reduce SI among Iranian adolescent girls. Psychological interventions that address the role of externalizing behaviors, alexithymia, and PSS in adolescents with IA may help reduce SI.
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2. Mahase E. Nearly one in three American teenage girls had suicidal thoughts in 2021, finds CDC. Bmj. 2023;380:380.
3. LaVome Robinson W, Droege JR, Hipwell AE, Stepp SD, Keenan K. Brief report: Suicidal ideation in adolescent girls: Impact of race. J Adolesc. 2016;53:16-20.
4. Nazarzadeh M, Bidel Z, Ayubi E, Asadollahi K, Carson KV, Sayehmiri K. Determination of the social related factors of suicide in Iran: a systematic review and meta-analysis. BMC Public Health. 2013;13:4.
5. Cen Y, He J, Zhong Y, Zhou J, Zeng J, Huang G, et al. The mediating role of sleep problems and depressed mood between psychological abuse/neglect and suicidal ideation in adolescent childhood: a multicentred, large sample survey in Western China. BMC Psychiatry. 2024;24(1):64.
6. De-Sola Gutiérrez J, Rodríguez de Fonseca F, Rubio G. Cell-Phone Addiction: A Review. Front Psychiatry. 2016;7:175.
7. Cheng YS, Tseng PT, Lin PY, Chen TY, Stubbs B, Carvalho AF, et al. Internet Addiction and Its Relationship With Suicidal Behaviors: A Meta-Analysis of Multinational Observational Studies. J Clin Psychiatry. 2018;79(4): 17r11761.
8. Duprat IP, Alves VdM, Oliveira JMd, Fischer FM. Association between internet addiction and suicidal ideation in university students. Research, Society and Development. 2021;10(6):art. e10810615505 [12].
9. Ivie EJ, Pettitt A, Moses LJ, Allen NB. A meta-analysis of the association between adolescent social media use and depressive symptoms. J Affect Disord. 2020;275:165-74.
10. Twenge JM, Campbell WK. Media Use Is Linked to Lower Psychological Well-Being: Evidence from Three Datasets. Psychiatr Q. 2019;90(2):311-31.
11. O'Reilly M, Dogra N, Hughes J, Reilly P, George R, Whiteman N. Potential of social media in promoting mental health in adolescents. Health Promot Int. 2019;34(5):981-91.
12. Boyd SI, Moore A, Moghaddas S, Hamilton JL. Perceived functions and importance of digital media use and adolescent depression and suicidal ideation. J Adolesc. 2024;96(5):1001-11.
13. Zadravec Šedivy N, Podlogar T, Kerr DCR, De Leo D. Community social support as a protective factor against suicide: A gender-specific ecological study of 75 regions of 23 European countries. Health Place. 2017;48:40-6.
14. Wang S, Zhang D. The impact of perceived social support on students’ pathological internet use: The mediating effect of perceived personal discrimination and moderating effect of emotional intelligence. Comput Human Behav. 2020;106:106247.
15. Hu H, Yang X, Mo PKH, Zhao C, Kuang B, Zhang G, et al. How mobile phone addiction is associated with suicidal ideation in university students in China: Roles of depression and online social support. Front Psychol. 2022;13:1001280.
16. Ma Y, Li Y, Xie X, Zhang Y, Ammerman BA, Lewis SP, et al. The role of depressive symptoms and social support in the association of internet addiction with non-suicidal self-injury among adolescents: a cohort study in China. BMC Psychiatry. 2023;23(1):322.
17. Vaux A. Social support: Theory, research, and intervention: Praeger publishers; 1988.
18. Achenbach TM, Ivanova MY, Rescorla LA, Turner LV, Althoff RR. Internalizing/Externalizing Problems: Review and Recommendations for Clinical and Research Applications. J Am Acad Child Adolesc Psychiatry. 2016;55(8):647-56.
19. Cao F, Su L, Liu T, Gao X. The relationship between impulsivity and Internet addiction in a sample of Chinese adolescents. Eur Psychiatry. 2007;22(7):466-71.
20. Shapira NA, Goldsmith TD, Keck PE, Jr., Khosla UM, McElroy SL. Psychiatric features of individuals with problematic internet use. J Affect Disord. 2000;57(1-3):267-72.
21. Park HS, Kim SH, Bang SA, Yoon EJ, Cho SS, Kim SE. Altered regional cerebral glucose metabolism in internet game overusers: a 18F-fluorodeoxyglucose positron emission tomography study. CNS Spectr. 2010;15(3):159-66.
22. Zhang Y, Liu Z, Zhao Y. Impulsivity, Social Support and Depression Are Associated With Latent Profiles of Internet Addiction Among Male College Freshmen. Front Psychiatry. 2021;12:642914.
23. Fontana A, Benzi IMA, Cipresso P. Problematic internet use as a moderator between personality dimensions and internalizing and externalizing symptoms in adolescence. Curr Psychol. 2022:17:1-10.
24. Kelly EV, Newton NC, Stapinski LA, Slade T, Barrett EL, Conrod PJ, et al. Suicidality, internalizing problems and externalizing problems among adolescent bullies, victims and bully-victims. Prev Med. 2015;73:100-5.
25. Suárez-Relinque C, Del Moral G, León-Moreno C, Callejas-Jerónimo JE. Emotional Loneliness, Suicidal Ideation, and Alexithymia in Adolescents Who Commit Child-to-Parent Violence. J Interpers Violence. 2023;38(3-4):4007-33.
26. Iskric A, Ceniti AK, Bergmans Y, McInerney S, Rizvi SJ. Alexithymia and self-harm: A review of nonsuicidal self-injury, suicidal ideation, and suicide attempts. Psychiatry Res. 2020;288:112920.
27. Buyukbayraktar CG. Predictive relationships between social anxiety, internet addiction and alexithymia in adolescents. Journal of education and learning. 2020;9(2):222-31.
28. Beck AT, Steer RA, Ranieri WF. Scale for Suicide Ideation: psychometric properties of a self-report version. J Clin Psychol. 1988;44(4):499-505.
29. Esfahani M, Hashemi Y, Alavi K. Psychometric assessment of beck scale for suicidal ideation (BSSI) in general population in Tehran. Med J Islam Repub Iran. 2015;29:268.
30. Jenaro C, Flores N, Gómez-Vela M, González-Gil F, Caballo C. Problematic internet and cell-phone use: Psychological, behavioral, and health correlates. Addiction research & theory. 2007;15(3):309-20.
31. GOLMOHAMMADIAN M, Yyaseminejad P. Normalization, validity and reliability of Cell-phone Over-use Scale (COS) among university students. 2011.
32. Zimet GD, Powell SS, Farley GK, Werkman S, Berkoff KA. Psychometric characteristics of the Multidimensional Scale of Perceived Social Support. J Pers Assess. 1990;55(3-4):610-7.
33. Besharat MA. Multidimensional scale of perceived social support: Questionnaire, instruction and scoring. 2019.
34. Ivanova MY, Achenbach TM, Rescorla LA, Dumenci L, Almqvist F, Bilenberg N, et al. The generalizability of the Youth Self-Report syndrome structure in 23 societies. J Consult Clin Psychol. 2007;75(5):729-38.
35. Bagby RM, Taylor GJ, Parker JD. The Twenty-item Toronto Alexithymia Scale--II. Convergent, discriminant, and concurrent validity. J Psychosom Res. 1994;38(1):33-40.
36. Besharat MA. Reliability and factorial validity of a Farsi version of the 20-item Toronto Alexithymia Scale with a sample of Iranian students. Psychol Rep. 2007;101(1):209-20.
37. Peng C, Wang M, Cheng J, Tan Y, Huang Y, Rong F, et al. Association between internet addiction and suicidal ideation, suicide plans, and suicide attempts among Chinese adolescents with and without parental migration. Comput Human Behav. 2021;125:106949.
38. Sedgwick R, Epstein S, Dutta R, Ougrin D. Social media, internet use and suicide attempts in adolescents. Curr Opin Psychiatry. 2019;32(6):534-41.
39. Xie Y, Yang Q, Lei F. The Relationship of Internet Gaming Addiction and Suicidal Ideation among Adolescents: The Mediating Role of Negative Emotion and the Moderating Role of Hope. Int J Environ Res Public Health. 2023;20(4):3375.
40. Pan PY, Yeh CB. Internet Addiction among Adolescents May Predict Self-Harm/Suicidal Behavior: A Prospective Study. J Pediatr. 2018;197:262-7.
41. Lin H-Y, Tai Y-M. The Association between Internet Addiction and Suicide Ideation: Comparison between Soldiers and College Students in Taiwan. Taiwanese Journal of Psychiatry. 2024;38(1):38-45.
42. Kang M, Xu B, Chen C, Wang D. Internet addiction and suicidal ideation among Chinese college students: the mediating role of psychotic-like experiences. Front Public Health. 2023;11:1276496.
43. Chu C, Buchman-Schmitt JM, Stanley IH, Hom MA, Tucker RP, Hagan CR, et al. The interpersonal theory of suicide: A systematic review and meta-analysis of a decade of cross-national research. Psychol Bull. 2017;143(12):1313-45.
44. Liu Y, Duan L, Shen Q, Ma Y, Chen Y, Xu L, et al. The mediating effect of internet addiction and the moderating effect of physical activity on the relationship between alexithymia and depression. Sci Rep. 2024;14(1):9781.
45. Yang X, Ma H, Zhang L, Xue J, Hu P. Perceived Social Support, Depressive Symptoms, Self-Compassion, and Mobile Phone Addiction: A Moderated Mediation Analysis. Behav Sci (Basel). 2023;13(9):769.
2. Mahase E. Nearly one in three American teenage girls had suicidal thoughts in 2021, finds CDC. Bmj. 2023;380:380.
3. LaVome Robinson W, Droege JR, Hipwell AE, Stepp SD, Keenan K. Brief report: Suicidal ideation in adolescent girls: Impact of race. J Adolesc. 2016;53:16-20.
4. Nazarzadeh M, Bidel Z, Ayubi E, Asadollahi K, Carson KV, Sayehmiri K. Determination of the social related factors of suicide in Iran: a systematic review and meta-analysis. BMC Public Health. 2013;13:4.
5. Cen Y, He J, Zhong Y, Zhou J, Zeng J, Huang G, et al. The mediating role of sleep problems and depressed mood between psychological abuse/neglect and suicidal ideation in adolescent childhood: a multicentred, large sample survey in Western China. BMC Psychiatry. 2024;24(1):64.
6. De-Sola Gutiérrez J, Rodríguez de Fonseca F, Rubio G. Cell-Phone Addiction: A Review. Front Psychiatry. 2016;7:175.
7. Cheng YS, Tseng PT, Lin PY, Chen TY, Stubbs B, Carvalho AF, et al. Internet Addiction and Its Relationship With Suicidal Behaviors: A Meta-Analysis of Multinational Observational Studies. J Clin Psychiatry. 2018;79(4): 17r11761.
8. Duprat IP, Alves VdM, Oliveira JMd, Fischer FM. Association between internet addiction and suicidal ideation in university students. Research, Society and Development. 2021;10(6):art. e10810615505 [12].
9. Ivie EJ, Pettitt A, Moses LJ, Allen NB. A meta-analysis of the association between adolescent social media use and depressive symptoms. J Affect Disord. 2020;275:165-74.
10. Twenge JM, Campbell WK. Media Use Is Linked to Lower Psychological Well-Being: Evidence from Three Datasets. Psychiatr Q. 2019;90(2):311-31.
11. O'Reilly M, Dogra N, Hughes J, Reilly P, George R, Whiteman N. Potential of social media in promoting mental health in adolescents. Health Promot Int. 2019;34(5):981-91.
12. Boyd SI, Moore A, Moghaddas S, Hamilton JL. Perceived functions and importance of digital media use and adolescent depression and suicidal ideation. J Adolesc. 2024;96(5):1001-11.
13. Zadravec Šedivy N, Podlogar T, Kerr DCR, De Leo D. Community social support as a protective factor against suicide: A gender-specific ecological study of 75 regions of 23 European countries. Health Place. 2017;48:40-6.
14. Wang S, Zhang D. The impact of perceived social support on students’ pathological internet use: The mediating effect of perceived personal discrimination and moderating effect of emotional intelligence. Comput Human Behav. 2020;106:106247.
15. Hu H, Yang X, Mo PKH, Zhao C, Kuang B, Zhang G, et al. How mobile phone addiction is associated with suicidal ideation in university students in China: Roles of depression and online social support. Front Psychol. 2022;13:1001280.
16. Ma Y, Li Y, Xie X, Zhang Y, Ammerman BA, Lewis SP, et al. The role of depressive symptoms and social support in the association of internet addiction with non-suicidal self-injury among adolescents: a cohort study in China. BMC Psychiatry. 2023;23(1):322.
17. Vaux A. Social support: Theory, research, and intervention: Praeger publishers; 1988.
18. Achenbach TM, Ivanova MY, Rescorla LA, Turner LV, Althoff RR. Internalizing/Externalizing Problems: Review and Recommendations for Clinical and Research Applications. J Am Acad Child Adolesc Psychiatry. 2016;55(8):647-56.
19. Cao F, Su L, Liu T, Gao X. The relationship between impulsivity and Internet addiction in a sample of Chinese adolescents. Eur Psychiatry. 2007;22(7):466-71.
20. Shapira NA, Goldsmith TD, Keck PE, Jr., Khosla UM, McElroy SL. Psychiatric features of individuals with problematic internet use. J Affect Disord. 2000;57(1-3):267-72.
21. Park HS, Kim SH, Bang SA, Yoon EJ, Cho SS, Kim SE. Altered regional cerebral glucose metabolism in internet game overusers: a 18F-fluorodeoxyglucose positron emission tomography study. CNS Spectr. 2010;15(3):159-66.
22. Zhang Y, Liu Z, Zhao Y. Impulsivity, Social Support and Depression Are Associated With Latent Profiles of Internet Addiction Among Male College Freshmen. Front Psychiatry. 2021;12:642914.
23. Fontana A, Benzi IMA, Cipresso P. Problematic internet use as a moderator between personality dimensions and internalizing and externalizing symptoms in adolescence. Curr Psychol. 2022:17:1-10.
24. Kelly EV, Newton NC, Stapinski LA, Slade T, Barrett EL, Conrod PJ, et al. Suicidality, internalizing problems and externalizing problems among adolescent bullies, victims and bully-victims. Prev Med. 2015;73:100-5.
25. Suárez-Relinque C, Del Moral G, León-Moreno C, Callejas-Jerónimo JE. Emotional Loneliness, Suicidal Ideation, and Alexithymia in Adolescents Who Commit Child-to-Parent Violence. J Interpers Violence. 2023;38(3-4):4007-33.
26. Iskric A, Ceniti AK, Bergmans Y, McInerney S, Rizvi SJ. Alexithymia and self-harm: A review of nonsuicidal self-injury, suicidal ideation, and suicide attempts. Psychiatry Res. 2020;288:112920.
27. Buyukbayraktar CG. Predictive relationships between social anxiety, internet addiction and alexithymia in adolescents. Journal of education and learning. 2020;9(2):222-31.
28. Beck AT, Steer RA, Ranieri WF. Scale for Suicide Ideation: psychometric properties of a self-report version. J Clin Psychol. 1988;44(4):499-505.
29. Esfahani M, Hashemi Y, Alavi K. Psychometric assessment of beck scale for suicidal ideation (BSSI) in general population in Tehran. Med J Islam Repub Iran. 2015;29:268.
30. Jenaro C, Flores N, Gómez-Vela M, González-Gil F, Caballo C. Problematic internet and cell-phone use: Psychological, behavioral, and health correlates. Addiction research & theory. 2007;15(3):309-20.
31. GOLMOHAMMADIAN M, Yyaseminejad P. Normalization, validity and reliability of Cell-phone Over-use Scale (COS) among university students. 2011.
32. Zimet GD, Powell SS, Farley GK, Werkman S, Berkoff KA. Psychometric characteristics of the Multidimensional Scale of Perceived Social Support. J Pers Assess. 1990;55(3-4):610-7.
33. Besharat MA. Multidimensional scale of perceived social support: Questionnaire, instruction and scoring. 2019.
34. Ivanova MY, Achenbach TM, Rescorla LA, Dumenci L, Almqvist F, Bilenberg N, et al. The generalizability of the Youth Self-Report syndrome structure in 23 societies. J Consult Clin Psychol. 2007;75(5):729-38.
35. Bagby RM, Taylor GJ, Parker JD. The Twenty-item Toronto Alexithymia Scale--II. Convergent, discriminant, and concurrent validity. J Psychosom Res. 1994;38(1):33-40.
36. Besharat MA. Reliability and factorial validity of a Farsi version of the 20-item Toronto Alexithymia Scale with a sample of Iranian students. Psychol Rep. 2007;101(1):209-20.
37. Peng C, Wang M, Cheng J, Tan Y, Huang Y, Rong F, et al. Association between internet addiction and suicidal ideation, suicide plans, and suicide attempts among Chinese adolescents with and without parental migration. Comput Human Behav. 2021;125:106949.
38. Sedgwick R, Epstein S, Dutta R, Ougrin D. Social media, internet use and suicide attempts in adolescents. Curr Opin Psychiatry. 2019;32(6):534-41.
39. Xie Y, Yang Q, Lei F. The Relationship of Internet Gaming Addiction and Suicidal Ideation among Adolescents: The Mediating Role of Negative Emotion and the Moderating Role of Hope. Int J Environ Res Public Health. 2023;20(4):3375.
40. Pan PY, Yeh CB. Internet Addiction among Adolescents May Predict Self-Harm/Suicidal Behavior: A Prospective Study. J Pediatr. 2018;197:262-7.
41. Lin H-Y, Tai Y-M. The Association between Internet Addiction and Suicide Ideation: Comparison between Soldiers and College Students in Taiwan. Taiwanese Journal of Psychiatry. 2024;38(1):38-45.
42. Kang M, Xu B, Chen C, Wang D. Internet addiction and suicidal ideation among Chinese college students: the mediating role of psychotic-like experiences. Front Public Health. 2023;11:1276496.
43. Chu C, Buchman-Schmitt JM, Stanley IH, Hom MA, Tucker RP, Hagan CR, et al. The interpersonal theory of suicide: A systematic review and meta-analysis of a decade of cross-national research. Psychol Bull. 2017;143(12):1313-45.
44. Liu Y, Duan L, Shen Q, Ma Y, Chen Y, Xu L, et al. The mediating effect of internet addiction and the moderating effect of physical activity on the relationship between alexithymia and depression. Sci Rep. 2024;14(1):9781.
45. Yang X, Ma H, Zhang L, Xue J, Hu P. Perceived Social Support, Depressive Symptoms, Self-Compassion, and Mobile Phone Addiction: A Moderated Mediation Analysis. Behav Sci (Basel). 2023;13(9):769.
| Files | ||
| Issue | Vol 20 No 1 (2025) | |
| Section | Original Article(s) | |
| Keywords | ||
| Adolescent Alexithymia Behavioral Problems Internet Addiction Perceived Social Support Suicidal Ideation | ||
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How to Cite
1.
Akbari Z, Serjouie F, Sarani Yaztappeh J, Turkzadeh MH, Ziaei F, Bagheri A, Sate Zohd M, Kianimoghadam AS. Investigating the Relationships between Internet Addiction and Suicidal Ideation in Adolescent Girls. Iran J Psychiatry. 2024;20(1):46-56.
