Effects of Social Networking Service (SNS) Addiction on Mental Health Status in Chinese University Students: Structural Equation Modeling Approach Using a Cross-sectional Online Survey

Abstract

Background Although social networking services (SNSs) have become popular among young people, problematic SNS use has also increased. However, little is known about SNS addiction and its association with SNS use patterns and mental health status. Objective This study aims to test the mediating role of SNS addiction between SNS use patterns and mental health status among Chinese university students in Hong Kong (HK). Methods An online cross-sectional survey was conducted using a convenience sampling method. In total, 533 university students (323 [66.9%] female, mean age [SD]=20.87 [2.68] years) were recruited from February to March 2019. Multiple linear regression was used to assess the association between SNS use and SNS addiction. Structural equation modeling (SEM) was performed to examine the pathways and associations among SNS use, SNS addiction, psychosocial status, and mental health status (including anxiety and depressive symptoms). Results A longer time spent on SNSs per day (>3 h), a longer time spent on each SNS access (≥31 min), a higher frequency of SNS access (≤every 30 min), a longer duration of SNS use before sleeping (≥61 min), and a shorter duration from waking to first SNS use (≤5 min) were significantly associated with a higher level of SNS addiction (adjusted beta [aβ]=6.03, 95% CI 4.66-7.40; aβ=4.99, 95% CI 3.14-6.83; aβ=5.89, 95% CI 4.14-7.64; aβ=5.92, 95% CI 4.19-7.65; and aβ=3.27, 95% CI 1.73-4.82, respectively). SEM showed a significant mediating effect of SNS addiction in the relationship between SNS use and psychosocial status, and mental health status, including an indirect effect (β=0.63, 95% CI 0.37-0.93) and the total effect (β=0.44, 95% CI 0.19-0.72), while the direct effect was insignificant (β=–0.19, 95% CI –0.49 to 0.08). Conclusions SNS use patterns were associated with SNS addiction, and SNS addiction mediated the associations between SNS use, psychosocial status, and mental health status of Chinese university students in HK. The findings suggest that screening for and addressing excessive SNS use are needed to prevent SNS addiction and mental distress among young people.

Social networking use, mental health, and quality of life of Hong Kong adolescents during the COVID-19 pandemic

“…Using a representative sample of Hong Kong secondary school students, the present study provides meaningful theoretical and practical implications by differentiating the associations between different dosages of SNS use and adolescents' well-being, and by verifying the negative relationship between youths' social networking addiction and their mental health as well as their health-related quality of life, especially under the influence of the pandemic. In terms of theory, the present findings provide insights into the positive side of SNSs use by youths and their improved well-being, and thus contribute to the current literature, which has mainly highlighted the negative effects of SNSs usage on young people's mental health ( 79 – 81 ). Especially under the particular circumstances of the COVID-19 pandemic, appropriate use of SNSs can help young people to maintain their mental health through fulfilling their need to be socially connected and their desire to follow pandemic-related updates ( 82 ).…”

Interventions in Chinese Undergraduate Students’ Mental Health: Systematic Review

“…The interventions proposed in the included studies can be divided into two broad categories: social support and coping strategies. Social support was provided by government authorities [ 49 , 52 - 54 , 61 , 62 , 68 , 72 , 84 , 86 - 88 ]; university authorities [ 12 , 48 , 50 , 51 , 53 - 55 , 57 - 59 , 62 , 64 , 65 , 67 , 69 , 91 , 93 ]; students’ affairs counselors and teachers [ 54 , 75 , 83 - 85 , 87 , 93 ]; family members [ 52 , 54 , 57 , 83 , 94 ]; health care authorities and professionals [ 52 , 63 , 66 , 75 , 77 - 79 , 87 ]; researchers [ 70 , 85 ]; and media-, internet-, and smartphone-based interventions [ 26 , 53 , 55 , 56 , 60 , 71 , 73 , 75 , 77 , 80 , 81 ]. Positive coping strategies were adopted by undergraduate students themselves [ 52 , 82 , 83 , 85 , 86 ,…”

“…Previous studies proposed university authorities to make the following interventions in undergraduate students’ mental health concerns, including (1) developing a caring culture and ambience, which backs up undergraduate students to make life adjustments, promoting cultural and sports activities, facilitating the expansion of social networks, strengthening mental health education and counseling (eg, hotlines providing timely help for those in urgent need), early detection and effectively managing mental health concerns [ 12 ]; (2) screening for adverse childhood experiences and providing strength-based, trauma-informed interventions on fostering resilience [ 48 ]; (3) screening for anxiety disorders [ 50 , 57 ]; (4) screening and managing of emotional eating [ 51 ]; (5) organizing health education activities, and encouraging undergraduate students to arrange their time reasonably and find a proper approach to alleviate stress [ 53 ]; (6) encouraging timely, effective communication between family members [ 54 ]; (7) conducting interventions using cognitive behavioral approaches and screening for and addressing excessive social networking service use [ 55 ]; (8) developing psychological help-seeking interventions, strengthening the dissemination of mental health knowledge, and improving the level of mental health perception to improve help-seeking attitudes and increase the probability of seeking psychological help [ 57 ]; (9) being aware of undergraduate students’ coping strategies, organizing programs such as an online experience-sharing competition, encouraging students by offering rewards or financial aids, and supplying necessary food and health care materials [ 58 ]; (10) implementing various interventions such as sleep hygiene, mobile phone and internet use hygiene, mental health education courses, and professional psychological counseling [ 59 , 62 , 64 , 67 , 91 ]; (11) providing positive mental imagery training [ 65 ]; (12) offering relevant online mental health courses [ 67 ]; (13) adopting a web-based positive psychology intervention [ 69 ]; (14) establishing an early warning system for mental health concerns, guiding students to correctly understand their mental health status and individual differences in mental tolerance while encouraging them to seek help if necessary, developing targeted mental health education programs, and creating a new guidance mode to improve the communication between students and counselors [ 91 ]; and (15) promoting stress-coping strategies [ 93 ].…”

“…Evidence-based digital mental health interventions were found to be useful in improving mental health concerns [ 56 , 60 ], because depressed undergraduate students became less hostile when logging onto the internet, suggesting the internet as a useful medium to provide treatment for people with depression [ 71 ]. In the context of face-to-face intervention delivery hindered by the COVID-19 pandemic, internet-delivered interventions such as internet-delivered cognitive behavioral therapy can be considered to address effects of social networking service addiction on the mental health status of Chinese university students [ 55 ]. It is effective to use internet-based cognitive behavioral and mindfulness training programs, which can easily be integrated into existing service provision portfolios that promote mental health and reduce psychological distress to promote the mental health of undergraduate students [ 26 ].…”

“…Eleven of the 49 included studies described evidence-based internet-delivered digital mental health interventions such as internet-based cognitive behavioral and mindfulness training programs, online brief interventions, online sacramental ceremonies, internet-delivered cognitive behavioral therapy, and others [ 26 , 53 , 55 , 56 , 60 , 71 , 73 , 75 , 77 , 80 , 81 ]. These reported internet- or technology-based interventions can easily be incorporated into existing mental health service provision portfolios.…”