The Relationship between Internet Addiction, Internet Gaming and Anxiety among Medical Students in a Malaysian Public University during COVID-19 Pandemic

Abstract

The internet has become an important medium for learning and communication during the COVID-19 pandemic, particularly for university students. Nevertheless, an increase in internet usage could predispose people to internet addiction (IA) and internet gaming (IG). Equally, there is concern that anxiety levels have increased during the pandemic. The aim of this study is to determine the prevalence of IA and IG, and their associations with anxiety among medical students during the pandemic. Data were collected during the second wave of the “Conditional Movement Control Order” (CMCO) in Malaysia between 12 November and 10 December 2020. A total of 237 students participated through proportionate stratified random sampling in this cross-sectional study. They completed a set of online questionnaires which consisted of a sociodemographic profile, the Malay version of the internet addiction test (MVIAT), the Malay version of the internet gaming disorder-short form (IGDS9-SF) and the Malay version of the depression, anxiety and stress scale (DASS-21). The prevalence of IA and internet gaming disorder (IGD) were 83.5% and 2.5%, respectively. A multiple logistic regression showed that those in pre-clinical years had a greater risk of anxiety than those in clinical years [(AOR) = 2.49, p-value 0.01, 95% CI = 1.22–5.07]. In contrast, those who scored high on IA were protected against anxiety [AOR = 0.100, p-value 0.03, 95% CI = 0.01–0.76)]. In conclusion, IA was highly prevalent during the COVID-19 pandemic and its high usage might serve as a protective factor against anxiety among the medical students in this study sample.

Internet Addiction in Socio-Demographic, Academic, and Psychological Profile of College Students During the COVID-19 Pandemic in the Czech Republic and Slovakia

“…Finally, this study revealed that lower anxiety occurred in students with a higher rate of internet addiction in subscales such as Neglect Work and Lack of Control. These findings can be explained by the fact that higher score on internet addiction may be a protective factor against anxiety in students, which was revealed in a study by Ismail et al ( 93 ). On the other hand, there are inconsistent findings ( 94 , 95 ).…”

The Effects of Playing Video Games on Stress, Anxiety, Depression, Loneliness, and Gaming Disorder During the Early Stages of the COVID-19 Pandemic: PRISMA Systematic Review

“…84 With regard to adults, eight studies showed an increased risk of developing GD symptoms in association with age (i.e., being younger than 30 years), 77,79 gender (i.e., being male), 79,87 loneliness, 79,93 maladaptive self-regulation style, 79,88 high impulsivity, 79 depressive and anxiety symptoms before the COVID-19 pandemic, 79 psychological distress, 88,94 low physical activity, 79,94 being unemployed, 94 and being affected by COVID-19. 77 Another two studies reported no significant association between the prevalence of GD and anxiety 85 or being self-isolated or quarantined. 78…”

“…84 Finally, regarding young and middle-aged adults, a greater risk of developing GD symptoms has been observed in individuals reporting low physical activity, 79,94 unemployed, 94 and had been affected by COVID-19. 77 Instead, two studies reported no significant association between the prevalence of GD and anxiety 85 or being self-isolated or quarantined. 78…”

“…53 Gaming disorder. Nine studies reported the prevalence of GD during the early stages of the COVID-19 pandemic as follows: 11 percent among Vietnamese adolescents, 81 19 percent among Italian children and adolescents, 82 5.3 percent among Chinese children and adolescents, 83 16.6 percent among Spanish university students, 84 2.5 percent among medical students in Malaysia, 85 4.1 percent among Japanese middle-aged adults (8.5 percent among younger than 30), 77 15 percent among Chinese adolescents, 86 8.5 percent in college students from Nepal, 87 and 4.5 percent among Malaysian university students. 88 The 11 studies conducted on children and adolescent GD were associated with: age (i.e., being adolescent), 79,82,89 gender (i.e., being male), [82][83][84]86,[89][90][91][92] maladaptive coping regulatory styles, 86 poor social support, 83,86,89 depressive and anxiety symptoms before the COVID-19 pandemic, 76,92 poor mental health, 83 academic stress, 86 unhealthy parental care styles, [81][82][83] addictive gamer profile, 90,91 and excessive use of social networks.…”

“…Concerning the nationality, the majority of the studies recruited participants who were residents on the European continent, especially Italy 54,82,95 and the United Kingdom, 18,79,80 North America (i.e., the United States), 17,20,[78][79][80] and Asia. 15,83,85,86,[90][91][92] Most of the studies (n = 11) recruited young adults (i.e., 18-35 years), 5 studies children (i.e., younger than 12 years old), 10 studies adolescents (i.e., 12-18 years old), 5 studies middle-aged adults (i.e., 36-55 years old), while no studies recruited older adults (i.e., up to 55 years old).…”