Abstract
Internet addiction (IA) is prevalent among adolescents and imposes a serious public health threat. Familial risk and protective factors may co-exist and interact with each other to determine IA. We conducted a cross-sectional survey among 9,618 Secondary 1 to 4 students in Hong Kong, China. About 16% of the surveyed students were classified as Internet addicted; nearly one third of them perceived that at least one of their family members had IA (FMIA). We found that FMIA was a risk factor (multivariate odds ratio [OR] = 2.04), and perceived family support was a protective factor (multivariate OR = 0.97) of IA. We also found a significant risk-enhancement moderation effect between these risk and protective factors, that is, the risk effect of FMIA increased with perceived family support. The finding highlights that family-based interventions, which modify familial risk and protective factors, should be effective for adolescent IA, but caution is required about potential risk-enhancement moderations between such factors.
|
Ary, D. V., Duncan, T. E., Biglan, A., Metzler, C. W., Noell, J. W., Smolkowski, K. (1999). Development of adolescent problem behavior. Journal of Abnormal Child Psychology, 27, 141-151. doi:10.1023/A:1021963531607 Google Scholar | Crossref | Medline | ISI | |
|
Bahr, S. J., Hoffmann, J. P., Yang, X. (2005). Parental and peer influences on the risk of adolescent drug use. The Journal of Primary Prevention, 26, 529-551. doi:10.1007/s10935-005-0014-8 Google Scholar | Crossref | Medline | |
|
Ball, D. (2008). Addiction science and its genetics. Addiction, 103, 360-367. doi:10.1111/j.1360-0443.2007.02061.x Google Scholar | Crossref | Medline | ISI | |
|
Bandura, A. (1977). Social learning theory. Englewood Cliffs, NJ: Prentice Hall. Google Scholar | |
|
Block, J. J. (2008). Issues for DSM-V: Internet addiction. The American Journal of Psychiatry, 165, 306-307. doi:10.1176/appi.ajp.2007.07101556 Google Scholar | Crossref | Medline | ISI | |
|
Bremer, J. (2005). The internet and children: Advantages and disadvantages. Child & Adolescent Psychiatry Clinics of North American, 14, 405-428. doi:10.1016/j.chc.2005.02.003 Google Scholar | Crossref | Medline | ISI | |
|
Brooks-Gunn, J., Furstenberg, F. F. (1989). Adolescent sexual behavior. American Psychologist, 44, 249-257. Google Scholar | Crossref | Medline | ISI | |
|
Carter, P. M., Bingham, C. R., Zakrajsek, J. S., Shope, J. T., Sayer, T. B. (2014). Social norms and risk perception: Predictors of distracted driving behavior among novice adolescent drivers. Journal of Adolescent Health, 54, S32-S41. doi:10.1016/j.jadohealth.2014.01.008 Google Scholar | Crossref | Medline | ISI | |
|
Cash, H., Rae, C. D., Steel, A. H., Winkler, A. (2012). Internet addiction: A brief summary of research and practice. Current Psychiatry Reviews, 8, 292-298. doi:10.2174/157340012803520513 Google Scholar | Crossref | Medline | |
|
Cestac, J., Paran, F., Delhomme, P. (2014). Drive as I say, not as I drive: Influence of injunctive and descriptive norms on speeding intentions among young drivers. Transportation Research Part F: Traffic Psychology and Behaviour, 23, 44-56. doi:10.1016/j.trf.2013.12.006 Google Scholar | Crossref | ISI | |
|
Chambers, R. A., Taylor, J. R., Potenza, M. N. (2003). Developmental neurocircuitry of motivation in adolescence: A critical period of addiction vulnerability. The American Journal of Psychiatry, 160, 1041-1052. Retrieved from http://ajp.psychiatryonline.org/ Google Scholar | |
|
Chen, S. H., Weng, L., Su, Y., Wu, H., Yang, P. (2003). Development of Chinese internet addiction scale and its psychometric study. Chinese Journal of Psychology, 45, 279-294. Retrieved from http://118.145.16.229:81/Jweb_xlxb/EN/article/downloadArticleFile.do?attachType=PDF&id=13754 Google Scholar | |
|
Cheung, L. M., Wong, W. S. (2011). The effects of insomnia and Internet addiction on depression in Hong Kong Chinese adolescents: An exploratory cross-sectional analysis. Journal of Sleep Research, 20, 311-317. Google Scholar | Crossref | Medline | ISI | |
|
Chou, C. (2001). Internet heavy use and addiction among Taiwanese college students: An online interview study. CyberPsychology & Behavior, 4, 573-585. Google Scholar | Crossref | Medline | |
|
Chou, C., Condron, L., Belland, J. C. (2005). A review of the research on Internet addiction. Educational Psychology Review, 17, 363-388. Google Scholar | Crossref | ISI | |
|
Chou, K. L. (2000). Assessing Chinese adolescents’ social support: The multidimensional scale of perceived social support. Personality and Individual Differences, 28, 299-307. doi:10.1016/S0191-8869(99)00098-7 Google Scholar | Crossref | ISI | |
|
Education Commission . (2004). Education statistics. Retrieved from http://www.e-c.edu.hk/eng/reform/edu_stat_eng.pdf Google Scholar | |
|
Ferguson, K., Xie, B. (2012). Adult support and substance use among homeless youths who attend high school. Child & Youth Care Forum, 41, 427-445. doi:10.1007/s10566-012-9175-9 Google Scholar | Crossref | ISI | |
|
Fishbein, M., Ajzen, I. (2010). Predicting and changing behavior: The reasoned action approach. New York, NY: Psychology Press. Google Scholar | |
|
Flay, B. R., Hu, F. B., Siddiqui, O., Day, L. E., Hedeker, D., Petraitis, J., . . . Sussman, S. (1994). Differential influence of parental smoking and friends’ smoking on adolescent initiation and escalation of smoking. Journal of Health and Social Behavior, 35, 248-265.Retrieved from http://hsb.sagepub.com/ Google Scholar | |
|
Foster, S. E., Jones, D. J., Olson, A. L., Gaffney, C. A., Zens, M. S., Forehand, R., Bau, J. J. (2007). Family socialization of adolescent’s self-reported cigarette use: The role of parents’ history of regular smoking and parenting style. Journal of Pediatric Psychology, 32, 481-493. doi:10.1093/jpepsy/jsl030 Google Scholar | Crossref | Medline | ISI | |
|
Fu, K. W., Chan, W. S., Wong, P. W., Yip, P. S. (2010). Internet addiction: Prevalence, discriminant validity and correlates among adolescents in Hong Kong. The British Journal of Psychiatry, 196, 486-492. doi:10.1192/bjp.bp.109.075002 Google Scholar | Crossref | Medline | ISI | |
|
García-Rodríguez, O., Suárez-Vázquez, R., Santonja-Gómez, F. J., Secades-Villa, R., Sánchez-Hervás, E. (2011). Psychosocial risk factors for adolescent smoking: A school-based study. International Journal of Clinical and Health Psychology, 11, 23-33. Retrieved from http://www.journals.elsevier.com/international-journal-of-clinical-and-health-psychology/ Google Scholar | |
|
Ghassemzadeh, L., Shahraray, M., Moradi, A. (2008). Prevalence of internet addiction and comparison of internet addicts and non-addicts in Iranian high schools. CyberPsychology & Behavior, 11, 731-733. doi:10.1089/cpb.2007.0243 Google Scholar | Crossref | Medline | |
|
Gunuc, S., Dogan, A. (2013). The relationships between Turkish adolescents’ internet addiction, their perceived social support and family activities. Computers in Human Behavior, 29, 2197-2207. doi:10.1016/j.chb.2013.04.011 Google Scholar | Crossref | ISI | |
|
Handley, E. D., Chassin, L. (2008). Stress-induced drinking in parents of adolescents with externalizing symptomatology: The moderating role of parent social support. The American Journal on Addictions, 17, 469-477. doi:10.1080/10550490802408795 Google Scholar | Crossref | Medline | ISI | |
|
Hawkins, J. D., Catalano, R. F., Miller, J. Y. (1992). Risk and protective factors for alcohol and other drug problems in adolescence and early adulthood: Implications for substance abuse prevention. Psychological Bulletin, 112, 64-105. doi:10.1037/0033-2909.112.1.64 Google Scholar | Crossref | Medline | ISI | |
|
Hirschi, T. (1969). The causes of delinquency. Berkeley: University of California Press. Google Scholar | |
|
Hong Kong Census and Statistics Department . (2012). Population census 2011. Retrieved from http://www.census2011.gov.hk/en/main-table/A120.html Google Scholar | |
|
Jablonska, B., Lindberg, L. (2007). Risk behaviours, victimisation and mental distress among adolescents in different family structures. Social Psychiatry and Psychiatric Epidemiology, 42, 656-663. Google Scholar | Crossref | Medline | ISI | |
|
Johnson, G. M., Shontz, F. C., Locke, T. P. (1984). Relationships between adolescent drug use and parental drug behaviors. Adolescence, 19, 295-299. Retrieved from https://www.questia.com/library/p4790/adolescence/ Google Scholar | |
|
Kandel, D. B. (1980). Drug and drinking behavior among youth. Annual Review of Sociology, 6, 235-285. Google Scholar | Crossref | ISI | |
|
Ko, C. H., Yen, C. F., Yen, C. N., Yen, J. Y., Chen, C. C., Chen, S. H. (2005). Screening for internet addiction: An empirical study on cut-off points for the Chen Internet Addiction Scale. The Kaohsiung Journal of Medical Sciences, 21, 545-551. doi:10.1016/S1607-551X(09)70206-2 Google Scholar | Crossref | Medline | |
|
Ko, C. H., Yen, J. Y., Chen, C. S., Yeh, Y. C., Yen, C. F. (2009). Predictive values of psychiatric symptoms for internet addiction in adolescents: A 2-year prospective study. Archive of Pediatric & Adolescent Medicine, 163, 937-943. doi:10.1001/archpediatrics.2009.159 Google Scholar | Crossref | Medline | |
|
Ko, C. H., Yen, J. Y., Yen, C. F., Chen, C. S., Weng, C. C., Chen, C. C. (2008). The association between Internet addiction and problematic alcohol use in adolescents: The problem behavior model. CyberPsychology & Behavior, 11, 571-576. Google Scholar | Crossref | Medline | |
|
Ko, C. H., Yen, J. Y., Yen, C. F., Lin, H. C., Yang, M. J. (2007). Factors predictive for incidence and remission of internet addiction in young adolescents: A prospective study. CyberPsychology & Behavior, 10, 545-551. doi:10.1089/cpb.2007.9992 Google Scholar | Crossref | Medline | |
|
Kuss, D. J., Griffiths, M. D., Binder, J. F. (2013). Internet addiction in students: Prevalence and risk factors. Computers in Human Behavior, 29, 959-966. doi:10.1016/j.chb.2012.12.024 Google Scholar | Crossref | ISI | |
|
Landis, J. R., Koch, G. G. (1977). The measurement of observer agreement for categorical data. Biometrics, 33, 159-174. Google Scholar | Crossref | Medline | ISI | |
|
Larzelere, R. E., Patterson, G. R. (1990). Parental management: Mediator of the effect of socioeconomic status on early delinquency. Criminology, 28, 301-324. Google Scholar | Crossref | ISI | |
|
Li, W., Garland, E. L., Howard, M. O. (2014). Family factors in internet addiction among Chinese youth: A review of English- and Chinese-language studies. Computers in Human Behavior, 31, 393-411. doi:10.1016/j.chb.2013.11.004 Google Scholar | Crossref | ISI | |
|
Lin, M. P., Ko, H. C., Wu, J. Y. (2008). The role of positive/negative outcome expectancy and refusal self-efficacy of internet use on internet addiction among college students in Taiwan. CyberPsychology & Behavior, 11, 451-457. doi:10.1089/cpb.2007.0121 Google Scholar | Crossref | Medline | |
|
Liu, C. Y., Kuo, F. Y. (2007). A study of internet addiction through the lens of the interpersonal theory. CyberPsychology & Behavior, 10, 799-804. doi:10.1089/cpb.2007.9951 Google Scholar | Crossref | Medline | |
|
Liu, Q. X., Fang, X. Y., Deng, L. Y., Zhang, J. T. (2012). Parent–adolescent communication, parental internet use and internet-specific norms and pathological internet use among Chinese adolescents. Computers in Human Behavior, 28, 1269-1275. doi:10.1016/j.chb.2012.02.010 Google Scholar | Crossref | ISI | |
|
Livingstone, S. (2003). Children’s use of the internet: Reflections on the emerging research agenda. New Media & Society, 5, 147-166. doi:10.1177/1461444803005002001 Google Scholar | SAGE Journals | ISI | |
|
Lopez-Fernandez, O., Honrubia-Serrano, M. L., Gibson, W., Griffiths, M. D. (2014). Problematic internet use in British adolescents: An exploration of the addictive symptomatology. Computers in Human Behavior, 35, 224-233. doi:10.1016/j.chb.2014.02.042 Google Scholar | Crossref | ISI | |
|
McMillan, S. J., Morrison, M. (2006). Coming of age with the internet: A qualitative exploration of how the internet has become an integral part of young people’s lives. New Media & Society, 8, 73-95. doi:10.1177/1461444806059871 Google Scholar | SAGE Journals | ISI | |
|
McPherson, K. E., Kerr, S., Morgan, A., McGee, E., Cheater, F. M., McLean, J., Egan, J. (2013). The association between family and community social capital and health risk behaviours in young people: An integrative review. BMC Public Health, 13, 971. doi:10.1186/1471-2458-13-971 Google Scholar | Crossref | Medline | ISI | |
|
Mulia, N., Schmidt, L., Bond, J., Jacobs, L., Korcha, R. (2008). Stress, social support and problem drinking among women in poverty. Addiction, 103, 1283-1293. doi:10.1111/j.1360-0443.2008.02234.x Google Scholar | Crossref | Medline | ISI | |
|
Oei, T. P., Raylu, N. (2004). Familial influence on offspring gambling: A cognitive mechanism for transmission of gambling behavior in families. Psychological Medicine, 34, 1279-1288. doi:10.1017/S0033291704003150 Google Scholar | Crossref | Medline | ISI | |
|
Pabayo, R., Alcantara, C., Kawachi, I., Wood, E., Kerr, T. (2013). The role of depression and social support in non-fatal drug overdose among a cohort of injection drug users in a Canadian setting. Drug and Alcohol Dependence, 132, 603-609. doi:10.1016/j.drugalcdep.2013.04.007 Google Scholar | Crossref | Medline | ISI | |
|
Park, S., Kim, H., Kim, H. (2009). Relationships between parental alcohol abuse and social support, peer substance abuse risk and social support, and substance abuse risk among South Korean adolescents. Adolescence, 44, 87-99. Retrieved from https://www.questia.com/library/p4790/adolescence/ Google Scholar | |
|
Park, S. K., Kim, J. Y., Cho, C. B. (2008). Prevalence of internet addiction and correlations with family factors among South Korean adolescents. Adolescence, 43, 895-909. Retrieved from https://www.questia.com/library/p4790/adolescence/ Google Scholar | |
|
Poli, R., Agrimi, E. (2012). Internet addiction disorder: Prevalence in an Italian student population. Nordic Journal of Psychiatry, 66, 55-59. doi:10.3109/08039488.2011.605169 Google Scholar | Crossref | Medline | ISI | |
|
Selya, A. S., Dierker, L. C., Rose, J. S., Hedeker, D., Mermelstein, R. J. (2012). Risk factors for adolescent smoking: Parental smoking and the mediating role of nicotine dependence. Drug and Alcohol Dependence, 124, 311-318. doi:10.1016/j.drugalcdep.2012.02.004 Google Scholar | Crossref | Medline | ISI | |
|
Shaw, M., Black, D. W. (2008). Internet addiction: Definition, assessment, epidemiology and clinical management. CNS Drugs, 22, 353-365. doi:10.2165/00023210-200822050-00001. Google Scholar | Crossref | Medline | ISI | |
|
Shek, D. T., Yu, L. (2012). Internet addiction phenomenon in early adolescents in Hong Kong. The Scientific World Journal, 2012, Article 104304. doi:10.1100/2012/104304 Google Scholar | Crossref | |
|
Siomos, K. E., Dafouli, E. D., Braimiotis, D. A., Mouzas, O. D., Angelopoulos, N. V. (2008). Internet addiction among Greek adolescent students. CyberPsychology & Behavior, 11, 653-657. doi:10.1089/cpb.2008.0088 Google Scholar | Crossref | Medline | |
|
Siomos, K., Floros, G., Fisoun, V., Evaggelia, D., Farkonas, N., Sergentani, E., . . . Geroukalis, D. (2012). Evolution of internet addiction in Greek adolescent students over a two-year period: The impact of parental bonding. European Child & Adolescent Psychiatry, 21, 211-219. doi:10.1007/s00787-012-0254-0 Google Scholar | Crossref | Medline | ISI | |
|
Tang, J., Yu, Y., Du, Y., Ma, Y., Zhang, D., Wang, J. (2014). Prevalence of internet addiction and its association with stressful life events and psychological symptoms among adolescent internet users. Addictive Behaviors, 39, 744-747. doi:10.1016/j.addbeh.2013.12.010 Google Scholar | Crossref | Medline | ISI | |
|
Tsai, H. F., Cheng, S. H., Yeh, T. L., Shih, C. C., Chen, K. C., Yang, Y. C., Yang, Y. K. (2009). The risk factors of internet addiction—A survey of university freshmen. Psychiatry Research, 167, 294-299. Google Scholar | Crossref | Medline | ISI | |
|
Urberg, K. A., Shyu, S. J., Liang, J. (1990). Peer influence in adolescent cigarette smoking. Addictive Behaviors, 15, 247-255. Google Scholar | Crossref | Medline | ISI | |
|
van den Eijnden, R. J., Meerkerk, G. J., Vermulst, A. A., Spijkerman, R., Engels, R. C. (2008). Online communication, compulsive Internet use, and psychosocial well-being among adolescents: A longitudinal study. Developmental Psychology, 44, 655-665. doi:10.1037/0012-1649.44.3.655 Google Scholar | Crossref | Medline | ISI | |
|
van den Eijnden, R. J., Spijkerman, R., Vermulst, A. A., van Rooij, T. J., Engels, R. C. (2010). Compulsive internet use among adolescents: Bidirectional parent-child relationships. Journal of Abnormal Child Psychology, 38, 77-89. doi:10.1007/s10802-009-9347-8 Google Scholar | Crossref | Medline | ISI | |
|
Wang, H., Zhou, X., Lu, C., Wu, J., Deng, X., Hong, L. (2011). Problematic internet use in high school students in Guangdong Province, China. PLoS ONE, 6, e19660. doi:10.1371/journal.pone.0019660 Google Scholar | Crossref | Medline | ISI | |
|
Wang, Y. H., Wu, A. M. S., Lau, J. T. F. (2016). The health belief model and presence of peers with Internet addiction as inter-related factors of Internet addiction among secondary school students in Hong Kong. BMC Public Health, 16, 272. doi:10.1186/s12889-016-2947-7 Google Scholar | Crossref | Medline | ISI | |
|
Webster, R. A., Hunter, M., Keats, J. A. (1994). Peer and parental influences on adolescents’ substance use: A path analysis. The International Journal of the Addictions, 29, 647-657. doi:10.3109/10826089409047405 Google Scholar | Crossref | Medline | |
|
Windle, M. (1992). A longitudinal study of stress buffering for adolescent problem behaviors. Developmental Psychology, 28, 522-530. doi:10.1037/0012-1649.28.3.522. Google Scholar | Crossref | ISI | |
|
Wood, M. D., Read, J. P., Mitchell, R. E., Brand, N. H. (2004). Do parents still matter? Parent and peer influences on alcohol involvement among recent high school graduates. Psychology of Addictive Behaviors, 18, 19-30. doi:10.1037/0893-164X.18.1.19 Google Scholar | Crossref | Medline | ISI | |
|
Wu, A. M. S., Li, J., Lau, J. T. F., Mo, P. K. H. (2016). Potential impact of Internet addiction and protective psychosocial factors onto depression among Hong Kong Chinese adolescents – direct, mediation and moderation effects. Comprehensive Psychiatry, 70, 41-52. doi: 10.1016/j.comppsych.2016.06.011. Google Scholar | Crossref | Medline | ISI | |
|
Wu, X., Chen, X., Han, J., Meng, H., Luo, J., Nydegger, L., Wu, H. (2013). Prevalence and factors of addictive internet use among adolescents in Wuhan, China: Interactions of parental relationship with age and hyperactivity-impulsivity. PLoS ONE, 8, e61782. doi:10.1371/journal.pone.0061782 Google Scholar | Crossref | Medline | ISI | |
|
Xu, F. Z., Zhang, W. X. (2011). Relationship between adolescents’ alienation and pathological internet use: Testing the moderating effect of family functioning and peer acceptance. Acta Psychologica Sinica, 43, 410-419. Google Scholar | |
|
Xu, J., Shen, L. X., Yan, C. H., Hu, H., Yang, F., Wang, L., . . . Shen, X. M. (2012). Personal characteristics related to the risk of adolescent internet addiction: A survey in Shanghai, China. BMC Public Health, 12, 1106. doi:10.1186/1471-2458-12-1106 Google Scholar | Crossref | Medline | ISI | |
|
Xu, J., Shen, L. X., Yan, C. H., Hu, H., Yang, F., Wang, L., . . . Shen, X. M. (2014). Parent-adolescent interaction and risk of adolescent internet addiction: A population-based study in Shanghai. BMC Psychiatry, 14, 112. doi:10.1186/1471-244X-14-112 Google Scholar | Crossref | Medline | ISI | |
|
Yang, S. C., Tung, C. J. (2007). Comparison of Internet addicts and non-addicts in Taiwanese high school. Computers in Human Behavior, 23, 79-96. Google Scholar | Crossref | ISI | |
|
Yeh, Y. C., Ko, H. C., Wu, J. Y., Cheng, C. P. (2008). Gender differences in relationships of actual and virtual social support to Internet addiction mediated through depressive symptoms among college students in Taiwan. CyberPsychology & Behavior, 11, 485-487. doi:10.1089/cpb.2007.0134 Google Scholar | Crossref | Medline | |
|
Yen, J. Y., Yen, C. F., Chen, C. C., Chen, S. H., Ko, C. H. (2007). Family factors of internet addiction and substance use experience in Taiwanese adolescents. CyberPsychology & Behavior, 10, 323-329. doi:10.1089/cpb.2006.9948 Google Scholar | Crossref | Medline | |
|
Yu, L., Shek, D. T. (2013). Internet addiction in Hong Kong adolescents: A three-year longitudinal study. Journal of Pediatric & Adolescent Gynecology, 26, S10-S17. doi:10.1016/j.jpag.2013.03.010 Google Scholar | Crossref | Medline | ISI | |
|
Zhong, X., Zu, S., Sha, S., Tao, R., Zhao, C., Yang, F., . . . Sha, P. (2011). The effect of family-based intervention model on internet-addicted Chinese adolescents. Social Behavior & Personality, 39, 1021-1034. doi:10.2224/sbp.2011.39.8.1021 Google Scholar | Crossref | ISI | |
|
Zimet, G. D., Dahlem, N. W., Zimet, S. G., Farley, G. K. (1988). The multidimensional scale of perceived social support. Journal of Personality Assessment, 52, 30-41. doi:10.1207/s15327752jpa5201_2 Google Scholar | Crossref | ISI |

