Patterns of internet use and mental health of high school students in Istria County,Croatia: cross-sectional study

Aim

To examine associations between different forms of internet use and a number of psychological variables related to mental health in adolescents.

Methods

A cross-sectional survey was carried out on a representative sample of students (N = 1539) from all high schools in the region of Istria in Croatia (14-19 years). The associations between four factors of internet use and nine mental health indicators were analyzed using canonical correlation analysis.

Results

The four canonical functions suggested a significant association between different types of internet use and specific indicators of mental health (P < 0.001). Problematic internet use, more typical among boys, was associated with general aggressive behavior and substance abuse (P < 0.001). Experiences of harassment, more typical among girls, were associated with health complaints, symptoms of depression, loneliness, and fear of negative evaluation (P < 0.001). Using the internet for communication and entertainment was associated with better relationships with peers (P < 0.001), while use of the internet for academic purposes was associated with conscientiousness (P < 0.001).

Conclusion

The results suggest that different patterns of internet use are significantly associated with specific sets of positive and negative mental health indicators. The data support the assumption that internet use can have both positive and adverse effects on the mental health of youth.New technologies, and especially the use of computers and the internet, are part of the everyday lives of young people and have a significant impact on their psychological development. Indeed, this mass use of new media technologies presents parents and society with a challenge to protect and support the positive development of children and youth. To date, a number of studies have examined the positive and negative aspects of using internet technologies.Literature points to several positive aspects of internet use (1,2): for information acquiring, communication, and social networking, entertainment, and online shopping. More specifically, adolescents use the internet as a useful source of information about school assignments, daily events, interests and hobbies, or health and sexuality concerns. In these instances, online activities aimed at connecting with peers have a significant place. Visiting social networking sites and using communication tools such as email, chat, forums, and discussion groups enables the creation of friendships and social groups and contributes to the development of personal identity (3). The use of computers and the internet (cyberspace) has also been argued to provide opportunities for new and faster learning, exercising one''s self-control, considering different opinions, expressing one''s attitudes and tolerance, and developing skills in critical thinking and decision-making (4). Best et al (5) found that use of online communication technologies contributed to increased self-confidence, better perception of social support, greater social capital, positive experimenting with one’s own identity, and greater opportunities for open self-disclosure. Conversely, adolescents who do not use the internet might trail behind in the development of such positive attitudes and traits and risk being rejected by their peers (6). Finally, Livingstone et al (7) found that a certain amount of risk exposure was useful in building resilience.In contrast to these positive influences of internet use, harmful effects of internet abuse range from exposure to inappropriate sexual content, pornography, and violence (2,7) to humiliation and cyber-bullying (6,8-10) and internet addiction (11,12). Research has confirmed the link between internet abuse and social isolation, depression and, anxiety (1,5,13,14), alcohol and drug abuse and gambling (15), and problems with physical health (16). Ybarra and Mitchell (17) found a connection between experiences of threats or humiliation in the virtual world and absences from school, lower school achievement, substance use disorders, delinquency and depression. Fekkes et al (18) point to the association between victimizing experiences and a number of physical, emotional, and behavioral problems, such as headaches, tension, fatigue, loss of appetite, enuresis, and sleeping problems. Slonje and Smith (19) define such experiences as a product of cyber-bullying and argue that this can be viewed as another form of aggressive behavior. Gender has emerged as a significant predictor of the manner in which the internet is used. Specifically, girls tend to experience victimizing experiences, while boys more frequently demonstrate antisocial behavior (20,21).Although many studies have identified both positive and negative correlates of internet use, there have been only a few studies using complex multivariate analyses to identify broader patterns of internet use and adolescent mental health (22,23). Less is known about how adolescents exhibiting different personalities and different emotional and behavioral patterns engage in internet use and what might be the consequences of this engagement. The aim of this study was to determine the specific patterns of internet use and mental health among adolescents. The following hypotheses were tested:H1: Problematic internet use is associated with externalized symptoms and other negative indicators of mental health. Exposure to victimizing and disturbing content on the internet is associated with internalized symptoms and negative indicators of mental health.H2: Prosocial internet use (aimed at connecting with peers and entertainment) and internet use for school purposes are associated with positive aspects of mental health.H3: Problematic internet use is present more often in young men, while exposure to disturbing content on the internet is more frequently experienced by young women.