Uso Problemático de Internet, Sintomatología Depresiva e Ideación Suicida en Universitarios Durante el Confinamiento por COVID-19
PDF (English)

Palabras clave

Problematic Internet use
Depression
Suicidal ideation
Confinement
COVID-19 Uso problemático de Internet
Depresión
Ideación suicida
Confinamiento
COVID-19

Cómo citar

Villanueva-Silvestre, V., Vázquez-Martínez, A., Isorna-Folgar, M., & Villanueva- Blasco, V. J. (2022). Uso Problemático de Internet, Sintomatología Depresiva e Ideación Suicida en Universitarios Durante el Confinamiento por COVID-19. Psicothema, 34(Número 4), 518–527. Recuperado a partir de https://reunido.uniovi.es/index.php/PST/article/view/19110

Resumen

Antecedentes: El objetivo fue estimar la tasa de PIU en universitarios españoles durante el confinamiento, considerando sexo y edad, y analizar su relación con depresión e ideación suicida. Método: Participaron 921 estudiantes universitarios (55% mujeres) de 18 a 30 años (M = 24.8 años; SD = 3). Resultados: Los resultados mostraron que el 21% presentaron PIU; 25.1% depresión moderada; 2.1% depresión severa; y 6.6% ideación suicida. El grupo de 18 a 21 años presentó la mayor tasa de PIU (37.8%). Se observó una correlación positiva entre PIU y depresión (r = .38; p < .001), con una puntuación media significativamente mayor en el PHQ-9 (t(241.813) = -8.21; p < .001; d = .78) en universitarios con PIU (M = 9.8; SD = 5.1) frente a los que no la tienen (M = 6.4; SD = 4.1). La tasa de depresión severa fue seis veces mayor (χ2(3) = 73.25; p < .001) en los universitarios con PIU (6.2%) en comparación con los que no tenían PIU (0.8%). El 3.6% de los universitarios con PIU presentó ideación suicida. Conclusiones: Estos hallazgos establecen la asociación entre PIU y depresión e ideación suicida en población universitaria, brindando aportes novedosos para las políticas de prevención.

PDF (English)

Citas

Afrin, D., Islam, M. U., Rabbiand, F., & Hossain, A. (2017). The school- level factors associated with internet addiction among adolescents: A cross-sectional study in Bangladesh. Journal of Addiction and Dependence, 3(2), 170-174. https://doi.org/10.15436/2471-061X.17.1686

Ahorsu, D. K., Imani, V., Lin, C.Y., Timpka, T., Broström, A., Updegraff, J. A., Årestedt, K., Griffiths, M. D., & Pakpour, A. H. (2022). Associations between fear of COVID-19, mental health, and preventive behaviours across pregnant women and husbands: an actor-partner interdependence modelling. International Journal of Mental Health and Addiction, 20, 68-82. https://doi.org/10.1007/s11469-020-00340-x

Al-Halabí, S., & Fonseca-Pedrero, E. (2021). Suicidal behavior prevention: The time to act is now. Clínica y Salud, 32(2), 89-92. https://doi.org/10.5093/clysa2021a17

Al-Halabí, S., & García Haro, J. M. (2021). Tratamientos psicológicos para la conducta suicida. En E. Fonseca-Pedrero (Coord.), Manual de tratamientos psicológicos. Adultos[Manual of psychological treatments. Adults] (pp. 639-675). Pirámide.

Al-Halabí, S., Sáiz, P. A., Burón, P., Garrido, M., Benabarre, A., Jiménez, E., Cervilla, J., Navarrete, M.S., Díaz-Mesa, E.M., García-Álvarez, L., Muñiz, J., Posner, K., Oquendo, M.A., García-Portilla, M.P. & Bobes, J. (2016). Validación de la versión en español de la Columbia-Suicide Severity Rating Scale (Escala Columbia para Evaluar el Riesgo de Suicidio) [Validation of the Spanish version of the Columbia-Suicide Severity Rating Scale]. Revista de Psiquiatría y Salud Mental, 9(3), 134-142. https://doi.org/10.1016/j.rpsm.2016.02.002

Apaza, C. M., Sanz, R. S. S., & Arévalo, J. E. S. (2020). Factores psicosociales durante el confinamiento por el Covid-19–Perú [Psychosocial factors during confinement by Covid-19-Peru]. Revista Venezolana De Gerencia, 25(90), 402-410. https://www.redalyc.org/articulo.oa?id=29063559022

Aznar-Díaz, I., Kopecký, K., Romero, J. M., Cáceres, M. P., & Trujillo- Torres, J. M. (2020). Patologías asociadas al uso problemático de Internet. Una revisión sistemática y metaanálisis en WOS y Scopus [Pathologies associated with the problematic use of the internet. A

systematic review and meta-analysis in WOS and Scopus]. Investigación Bibliotecológica, 34(82), 229-253. https://doi.org/10.22201/iibi.24488321xe.2020.82.58118

Balhara, Y. P. S., Doric, A., Stevanovic, D., Knez, R., Singh, S., Chowdhury, M. R. R., Kafali, H. Y., Sharma, P., Vally, Z., Vu, T.V., Arya, S., Mahendru, A., Ransing, R., Erzin, G., & Hong, H.C. (2019). Correlates of problematic internet use among college and university students in eight countries: An international cross-sectional study. Asian Journal of Psychiatry, 45, 113-120. https://doi.org/10.1016/j.ajp.2019.09.004

Banerjee, D. (2020). The COVID-19 outbreak: Crucial role the psychiatrists can play. Asian Journal of Psychiatry, 50, Article 102014. https://doi.org/10.1016/j.ajp.2020.102014

Barrera-Herrera, A., Neira-Cofré, M., Raipán-Gómez, P., Riquelme- Lobos, P., & Escobar-Alaniz, B. (2019). Apoyo social percibido y factores sociodemográficos en relación con los síntomas de ansiedad, depresión y estrés en universitarios chilenos [Perceived social

support and sociodemographic factors in relation to symptoms of anxiety, depression and stress in Chilean university students]. Revista de Psicopatología y Psicología Clínica, 24(2), 105-115. https://doi.org/10.5944/rppc.23676

Blasi, D., Giardina, A., Giordano, C., Coco, G., Tosto, C., Billieux, J., & Schimmenti, A. (2019). Problematic video game use as an emotional coping strategy: Evidence from a sample of MMORPG gamers. Journal of Behavioral Addictions, 8(1), 25-34. https://doi.org/10.1556/2006.8.2019.02

Bousoño,M., Al-Halabí, S., Burón, P., Garrido, M., Díaz-Mesa, E.V., Galván, G., García-Álvarez, L., Carli, V., Hoven, C., Sarchiapone, M., Wasserman, D., Bousoño, M., García-Portilla, M.P., Iglesias, C., Sáiz, P.A. & Bobes, J. (2017). Uso y abuso de sustancias psicotrópicas e internet,

psicopatología e ideación suicida en adolescentes [Substance use or abuse, internet use, psychopathology and suicidal ideation in adolescents]. Adicciones, 29(2), 97-104. https://www.redalyc.org/articulo.oa?id=289150531004

Cheng, Y., Tseng, P., Lin, P., Chen, T., Stubbs, B., Carvalho, A. F., Wu, C., Chen, Y., & Wu, M. (2018). Internet addiction and its relationship with suicidal behaviors: a meta-analysis of multinational observational studies. The Journal of Clinical Psychiatry, 79(4), Article 9291. https://doi.org/10.4088/JCP.17r11761

Deleuze, J., Maurage, P., Schimmenti, A., Nuyens, F., Melzer, A., & Billieux, J. (2019). Escaping reality through videogames is linked to an implicit preference for virtual over real-life stimuli. Journal of Affective Disorders, 245, 1024-1031. https://doi.org/10.1016/j.jad.2018.11.078

Diez-Quevedo, C., Rangil, T., Sanchez-Planell, L., Kroenke, K., & Spitzer, R. L. (2001). Validation and utility of the patient health questionnaire in diagnosing mental disorders in 1003 general hospital Spanish inpatients. Psychosomatic Medicine, 63(4), 679-686. https://doi.org/10.1097/00006842-200107000-00021

Fonseca-Pedrero, E., Pérez-Álvarez, M., Al-Halabí, S., Inchausti, F., Muñiz, J., López-Navarro, E., Pérez, A., Lucas, B., Debbané, M., Bobes-Bascarán, M., Gimeno-Peón, A., Prado-Abril, J., Fernández- Álvarez, J., Rodríguez-Testal, J., González, D., Díez-Gómez, A., García, J.M., García-Cerdán, L., Osma, J., […] Quilez, A. (2021). Tratamientos psicológicos empíricamente apoyados para adultos: una revisión selectiva [Evidence-based psychological treatments for adults: a selective review]. Psicothema, 33(2), 188-197. https://doi.org/ 10.7334/psicothema2020.426

Frangos, C. C., Fragkos, K. C., & Kiohos, A. (2010). Internet addiction among Greek university students: Demographic associations with the phenomenon, using the Greek version of young’s internet addiction test. International Journal of Economic Sciences and Applied Research,

(1), 49-74. https://econpapers.repec.org/article/teijournl/v_3a3_3ay_3a2010_3ai_3a1_3ap_3a49-74.htm

García-Peñalvo, F. J., Corell, A., Abella-García, V., & Grande, M. (2020). Online assessment in higher education in the time of COVID-19. Education in the Knowledge Society, 21, 1-26. https://doi.org/10.14201/eks.23013

Gavurova, B., Ivankova, V., & Rigelsky, M. (2020). Relationships between perceived stress, depression and alcohol use disorders in university students during the COVID-19 pandemic: a socio-economic dimension. International Journal of Environmental Research and Public Health, 17(23), Article 8853. https://doi.org/10.3390/ijerph17238853

González, N., & Estévez, A. (2017). El apoyo social percibido moderador entre el uso problemático de internet y la sintomatología depresiva en jóvenes adultos [Moderating perceived social support between problematic internet use and depressive symptomatology in young adults]. Salud y Drogas, 17(1), 53-62. https://www.redalyc.org/pdf/839/83949782006.pdf

Granados, J. A., Gómez, O., Islas, M. I., Maldonado, G., Martínez, H. F., & Pineda, A. M. (2020). Depression, anxiety and suicidal behavior in medical training at a University in Mexico. Investigación en Educación Médica, 9(35), 65-74. https://doi.org/10.22201/facmed.20075057e.2020.35.20224

Gupta, A., Khan, A. M., Rajoura, O. P., & Srivastava, S. (2018). Internet addiction and its mental health correlates among undergraduate college students of a university in north India. Journal of Family Medicine and Primary Care, 7(4), 721-727. https://doi.org/10.4103/jfmpc.jfmpc_266_17

Hassan, T., Alam, M., Wahab, A., & Hawlader, M. (2020). Prevalence and associated factors of internet addiction among young adults in Bangladesh. Journal of the Egyptian Public Health Association, 95, Article 3. https://doi.org/10.1186/s42506-019-0032-7

Huang, Y., & Zhao, N. (2020). Chinese mental health burden during the COVID-19 pandemic. Asian Journal of Psychiatry, 51, Article 102052. https://doi.org/10.1016/j.ajp.2020.102052

Instituto Nacional de Estadística (2019). Encuesta sobre Equipamiento y Uso de Tecnologías de Información y Comunicación en los Hogares [Survey on Equipment and Use of Information and Communication Technologies in Households]. https://www.ine.es/ss/Satellite?L=es _ES &c=IN E Publicacion_P&cid=1254735117586&idp=1254735117586&p=1254735110606&pagename=ProductosYServicios%2FPYSLayout&tittema=Ciencia%20y%20tecnolog%C3%ADa

Islam, M.A., & Hossin, M. Z. (2016). Prevalence and risk factors of problematic internet use and the associated psychological distress among graduate students of Bangladesh. Asian Journal of Gambling Issues and Public Health, 6(1), 1-14. https://doi.org/10.1186/s40405-016-0020-1

Islam, M. S., Ferdous, M. Z., & Potenza, M. N. (2020). Panic and generalized anxiety during the COVID-19 pandemic among Bangladeshi people: An online pilot survey early in the outbreak. Journal of Affective Disorders, 276, 30-37. https://doi.org/10.1016/j.jad.2020.06.049

Islam, M. S., Sujan, M.S.H, Tasnim, R., Sikder, M.T., Potenza, M.N. & Van Os, J. (2020). Psychological responses during the COVID-19 outbreak among university students in Bangladesh. PloS One, 15(12), Article e0245083. https://doi.org/10.1371/journal.pone.0245083

Johnson, J. G., Harris, E. S., Spitzer, R. L., & Williams, J. B. (2002). The patient health questionnaire for adolescents: validation of an instrument for the assessment of mental disorders among adolescent primary care patients. Journal of Adolescent Health, 30(3), 196-204. https://doi.org/10.1016/S1054-139X(01)00333-0

Kim, K., Ryu, E., Chon, M., Yeun, E., Choi, S., Seo, J., & Nam, B. (2006). Internet addiction in Korean adolescents and its relation to depression and suicidal ideation: a questionnaire survey.

International Journal of Nursing Studies, 43(2), 185-192. https://doi.org/10.1016/j.ijnurstu.2005.02.005

King, C.A., Kramer, A., Preuss, L., Kerr, D.C.R., Weisse, L., & Venkataraman, S. (2006). Youth-Nominated Support Team for suicidal adolescents (Version 1): A randomized controlled trial. Journal of Consulting and Clinical Psychology, 74(1), 199-206. https://doi.org/10.1037/0022-006X.74.1.199

Knipe, D., Hawton, K., Siynor, M., & Niederkrotenthaler, T. (2021). Researchers must contribute to responsible reporting of suicide. BMJ, 372, Article n351. https://doi.org/10.1136/bmj.n351

Kitazawa, M., Yoshimura, M., Hitokoto, H., Sato-Fujimoto, Y., Murata, M., Negishi, K., Mimura, M., Tsubota, K., & Kishimoto, T. (2019). Survey of the effects of internet usage on the happiness of Japanese university students. Health and Quality of Life Outcomes, 17(1), 1-8. https://doi.org/10.1186/s12955-019-1227-5

Kroenke, K., Spitzer, R. L., & Williams, J. B. (2001). The PHQ-9: validity of a brief depression severity measure. Journal of General Internal Medicine, 16(9), 606–613. https://doi.org/10.1046/j.1525-1497.2001.016009606.x

Laconi, S., Rodgers, R. F., & Chabrol, H. (2014). The measurement of Internet addiction: A critical review of existing scales and their psychometric properties. Computers in Human Behavior, 41, 190-202. https://doi.org/10.1016/j.chb.2014.09.026

Lam, L. T., & Peng, Z. (2010). Effect of pathological use of the internet on adolescent mental health: a prospective study. Archives of Pediatrics & Adolescent Medicine, 164(10), 901-906. https://doi.org/10.1001/archpediatrics.2010.159

Ley de protección de datos personales y garantía de derechos digitales, del 5 de diciembre[Spanish Organic Law 3/2018 on personal data protection and digital rights guarantee]. Boletín Oficial del estado, 294, del 6 de diciembre de 2018. https://www.boe.es/eli/es/lo/2018/12/05/3

Lin, L. Y., Sidani, J. E., Shensa, A., Radovic, A., Miller, E., Colditz, J. B., Hoffman, B. L., Giles, L. M., & Primack, B. A. (2016). Association between social media use and depression among US young adults. Depression and Anxiety, 33(4), 323-331. https://doi.org/10.1002/da.22466

Ma, Z., Zhao, J., Li, Y., Chen, D., Wang, T., Zhang, Z., Chen, Z., Yu, Q., Jiang, J., & Fan, F. (2020). Mental health problems and correlates among 746 217 college students during the coronavirus disease 2019 outbreak in China. Epidemiology and Psychiatric Sciences, 29, Article e181. https://doi.org/10.1017/S2045796020000931

Machimbarrena, J. M., González-Cabrera, J., Ortega-Barón, J., Beranuy- Fargues, M., Álvarez-Bardón, A., & Tejero, B. (2019). Profiles of problematic internet use and its impact on adolescents’ health-related quality of life. International Journal of Environmental Research and Public Health, 16(20), Article 3877. https://doi.org/10.3390/ijerph16203877

Mamun, M. A., & Griffiths, M. D. (2019). The assessment of internet addiction in Bangladesh: Why are prevalence rates so different? Asian Journal of Psychiatry, 40, 46-47. https://doi.org/10.1016/j.ajp.2019.01.017

Morrison, C. M., & Gore, H. (2010). The relationship between excessive Internet use and depression: a questionnaire-based study of 1,319 young people and adults. Psychopathology, 43(2), 121-126. https://doi.org/10.1159/000277001

Odaci, H., & Çikrici, Ö. (2017). An exploration of the associations among internet use, depression, anxiety and stress among youths. Mediterranean Journal of Clinical Psychology, 5(3), 1-13. https://doi.org/10.6092/2282-1619/2017.5.1635

Oka, T., Hamamura, T., Miyake, Y., Kobayashi, N., Honjo, M., Kawato, M., Kubo, T., & Chiba, T. (2021). Prevalence and risk factors of internet gaming disorder and problematic internet use before and during the COVID-19 pandemic: A large online survey of Japanese adults. Journal

of Psychiatric Research, 142, 218-225. https://doi.org/10.1016/j.jpsychires.2021.07.054

Pettorruso, M., Valle, S., Cavic, E., Martinotti, G., Di Giannantonio, M., & Grant, J. E. (2020). Problematic Internet use (PIU), personality profiles and emotion dysregulation in a cohort of young adults: trajectories from risky behaviors to addiction. Psychiatry Research, 289, Article 113036. https://doi.org/10.1016/j.psychres.2020.113036

Polo del Río, M., Lázaro, S. M., del Barco, B. L., & Castaño, E. F. (2017). Abuso del móvil en estudiantes universitarios y perfiles de victimización y agresión [Mobile phone abuse in university students and profiles of victimization and aggression]. Adicciones, 29(4), 245-255. https://www.redalyc.org/articulo.oa?id=289153037004

Qiu, J., Shen, B., Zhao, M., Wang, Z., Xie, B., & Xu, Y. (2020). A nationwide survey of psychological distress among Chinese people in the COVID-19 epidemic: implications and policy recommendations. General Psychiatry, 33, Article e100213. https://doi.org/10.1136/gpsych-2020-100213

Ramón-Arbués, E., Gea-Caballero, V., Granada-López, J. M., Juárez-Vela, R., Pellicer-García, B., & Antón-Solanas, I. (2020). The prevalence of depression, anxiety and stress and their associated factors in college students. International Journal of Environmental Research and Public Health, 17(19), Article 7001. https://doi.org/10.3390/ijerph17197001

Restrepo, J. E., Sánchez, O. A., Vallejo, G. C., Quirama, T. C., Sánchez, Y. O., & Cardona, P. D. (2018). Depresión y su relación con el consumo de sustancias psicoactivas, el estrés académico y la ideación suicida en estudiantes universitarios colombianos [Depression and its relationship with the consumption of psychoactive substances, academic stress and suicidal ideation in colombian university students]. Health and Addictions, 18(2), 227-239. https://dialnet.unirioja.es/servlet/articulo?codigo=6546342

Rial, A. R., Gómez, P., Isorna, M., Gallego, M. A., & Mallou, J. V. (2015). EUPI-a: Escala de Uso Problemático de Internet en adolescentes. Desarrollo y validación psicométrica [PIUS-a: Problematic Internet Use Scale in adolescents. Development and psychometric validation].

Adicciones, 27(1), 47-63. https://doi.org/10.20882/adicciones.193

Rodrigues, B., Marques, M., Pereira, A. T., & Macedo, A. (2020). Internet use patterns and the relation between generalized problematic internet use and psychological distress in Portuguese university students. Revista de Psicopatologia y Psicologia Clinica, 25(1), 31-39. https://doi.org/10.5944/rppc.25324

Sánchez-Álvarez, N., Extremera, N., Rey, L., Chang, E.C. & Chang, O. D. (2020). Frequency of Suicidal Ideation Inventory: Psychometric Properties of the Spanish Version. Psicothema, 32(2), 253–260. https://doi.org/10.7334/psicothema2019.344

Salari, N., Hosseinian-Far, A., Jalali, R., Vaisi-Raygani, A., Rasoulpoor, S., Mohammadi, M., Rasoulpoor, S., & Khaledi-Paveh, B. (2020). Prevalence of stress, anxiety, depression among the general population during the COVID-19 pandemic: a systematic review and meta-analysis. Globalization and Health, 16, 1-11. https://doi.org/10.1186/s12992-020-00589-w

Schimmenti, A., Billieux, J., & Starcevic, V. (2020). The four horsemen of fear: An integrated model of understanding fear experiences during the COVID-19 pandemic. Clinical Neuropsychiatry, 17(2), 41-45. https://doi.org/10.36131/CN20200202

Servidio, R., Bartolo, M. G., Palermiti, A. L., & Costabile, A. (2021). Fear of COVID-19, depression, anxiety, and their association with Internet addiction disorder in a sample of Italian students. Journal of Affective Disorders Reports, 4, Article 100097. https://doi.org/10.1016/j.jadr.2021.100097

Shadzi, M. R., Salehi, A., & Vardanjani, H. M. (2020). Problematic internet use, mental health, and sleep quality among medical students: A path-analytic model. Indian Journal of Psychological Medicine, 42(2), 128-135. https://doi.org/10.4103/IJPSYM.IJPSYM_238_19

Shigemura, J., Ursano, R. J., Morganstein, J. C., Kurosawa, M., & Benedek, D. M. (2020). Public responses to the novel 2019 coronavirus (2019‐nCoV) in Japan: Mental health consequences and target populations. Psychiatry and Clinical Neurosciences, 74(4), 277-283. https://doi.org/10.1111/pcn.12988

Spitzer, R. L., Kroenke, K., Williams, J. B., & Patient Health Questionnaire Primary Care Study Group, & Patient Health Questionnaire Primary

Care Study Group (1999). Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study. JAMA, 282(18), 1737-1744. https://doi.org/10.1001/jama.282.18.1737

Starcevic, V., & Khazaal, Y. (2017). Relationships between behavioural addictions and psychiatric disorders: What is known and what is yet to

be learned?. Frontiers in Psychiatry, 8, Article 53. https://doi.org/10.3389/fpsyt.2017.00053

Sun, Y., Li, Y., Bao, Y., Meng, S., Sun, Y., Schumann, G., Kosten, T., Strang, J., Lu, L., & Shi, J. (2020). Brief report: increased addictive internet and substance use behavior during the COVID‐19 pandemic in China. The American Journal on Addictions, 29(4), 268-270. https://doi.org/10.1111/ajad.13066

The jamovi project (2022). Jamovi (version 2.3.9) [Computer Software]. Retrieved from https://www.jamovi.org

Tateno, M., Teo, A. R., Shiraishi, M., Tayama, M., Kawanishi, C., & Kato, T. A. (2018). Prevalence rate of Internet addiction among Japanese

college students: Two cross‐sectional studies and reconsideration of cut‐off points of Young’s Internet Addiction Test in Japan. Psychiatry

and Clinical Neurosciences, 72(9), 723-730. https://doi.org/10.1111/pcn.12686

Torales, J., O’Higgins, M., Castaldelli-Maia, J. M., & Ventriglio, A. (2020). The outbreak of COVID-19 coronavirus and its impact on

global mental health. International Journal of Social Psychiatry, 66(4), 317-320. https://doi.org/10.1177/0020764020915212

Uddin, M. S., Al Mamun, A., Iqbal, M. A., Nasrullah, M., Asaduzzaman, M., Sarwar, M. S., & Amran, M. S. (2016). Internet addiction disorder

and its pathogenicity to psychological distress and depression among university students: A cross-sectional pilot study in Bangladesh.

Psychology, 7(8), 1126-1137. https://doi.org/10.4236/psych.2016.78113

Ueno, T., Ito, K., Murai, T., & Fujiwara, H. (2020). Mental Health Problems and Their Association With Internet Use in Medical Residents. Frontiers in Public Health, 8, Article 587390. https://doi.org/10.3389/fpubh.2020.587390

Vigna-Taglianti, F., Brambilla, R., Priotto, B., Angelino, R., Cuomo, G., & Diecidue, R. (2017). Problematic internet use among high school students: Prevalence, associated factors and gender differences. Psychiatry Research, 257, 163-171. https://doi.org/10.1016/j.psychres.2017.07.039

Wang, C., Pan, R., Wan, X., Tan, Y., Xu, L., Ho, C. S., & Ho, R. C. (2020). Immediate psychological responses and associated factors during the initial stage of the 2019 coronavirus disease (COVID-19) epidemic among the general population in China. International Journal of Environmental Research and Public Health, 17(5), Article 1729. https://doi.org/10.3390/ijerph17051729

Wathelet, M., Duhem, S., Vaiva, G., Baubet, T., Habran, E., Veerapa, E., Debien, C., Molenda, S., Horn, M., & Grandgenèvre, P. (2020). Factors associated with mental health disorders among university students in France confined during the COVID-19 pandemic. JAMA Network

Open, 3(10), Article e2025591. https://doi.org/10.1001/jamanetworkopen.2020.25591

World Health Organization. (2020). Mental health and psychosocial considerations during the COVID-19 outbreak-18 March (No. WHO/2019-nCoV/MentalHealth/2020.1). https://www.who.int/docs/default-source/coronaviruse/mental-health- considerations.pdf

Young, K. S. (2004). Internet addiction: A new clinical phenomenon and its consequences. American Behavioral Scientist, 48(4), 402-415. https://doi.org/10.1177/0002764204270278

Zhang, Y., Peters, A., & Chen, G. (2018). Perceived stress mediates the associations between sleep quality and symptoms of anxiety and depression among college nursing students. International Journal of Nursing Education Scholarship, 15(1), Article 20170020. https://doi.org/10.1515/ijnes-2017-0020