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  • Author or Editor: Joseph T.F. Lau x
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Background and aims

Masculine role discrepancy (i.e., men perceiving themselves not living up to the ideal manhood and being less masculine than the typical “man”) and related discrepancy stress were associated with some risk behaviors. No study has looked at their relationships with addictive use of social networking sites (SNSs), an emerging potential public health concern. The study constructed a moderated mediation model to test whether masculine role discrepancy would be positively associated with discrepancy stress, which would, in turn, be positively associated with addictive use of SNS, and whether self-esteem would buffer (moderate) the association between masculine role discrepancy and discrepancy stress.

Methods

A random population-based cross-sectional telephone survey interviewed 2,000 Hong Kong male adults in the general population.

Results

Currently unmarried and non-cohabiting, younger, and better educated participants reported higher addictive use of SNS scores than others. Adjusted for these variables, masculine role discrepancy and discrepancy stress were positively associated, and self-esteem was negatively associated with addictive use of SNS scores. Path analysis indicated that masculine role discrepancy was associated with addictive use of SNS through discrepancy stress (mediation); self-esteem buffered (moderated) the association between masculine role discrepancy and discrepancy stress; self-esteem was not significantly associated with addictive use of SNS in this model with good fit.

Discussion

The findings support the general strain theory’s postulation that strain is associated with stress, which is in turn associated with addictive use of SNS sites. Implications, potential interventions, and future studies are discussed in this study.

Open access

Abstract

Background and aims

Few studies have tested the underlying mechanisms in the association between workaholism and depression. This study aims to investigate the potential mediation effects of work-life balance stress and chronic fatigue and depression among Chinese male workers in Hong Kong.

Methods

A population-based study among male workers in Hong Kong (n =  1,352) was conducted. The self-reported scales of assessing workaholism, work-life balance stress, chronic fatigue and depressive symptoms were included in the questionnaire. Path analysis was conducted to test the proposed mediation model.

Results

Workaholism was directly and indirectly associated with depression through work-life balance stress and chronic fatigue, respectively. The association between work-life balance stress and chronic fatigue was statistically significant in the correlation analysis but not in the path analysis. As high as 30.5% of the participants were classified as having probable chronic fatigue, while 8.4% of the participants were classified as having probable depression.

Discussion

Workaholism is a stressor that may induce negative consequences on well-being and health among male workers in Hong Kong. Interventions to help workers with time and stress management and fatigue reduction may be beneficial for their mental health. Theoretical and practical implications are discussed.

Open access
Authors: Anise M. S. Wu, Juliet Honglei Chen, Kwok-Kit Tong, Shu Yu and Joseph T. F. Lau

Background and aims

Internet gaming disorder (IGD) has been mainly studied among adolescents, and no research to date has examined its prevalence in general Chinese adult populations. This study estimated the prevalence of probable IGD in community-dwelling adults in Macao, China. Associations between IGD and psychological distress (i.e., depression and anxiety) as well as IGD and character strength (i.e., psychological resilience and purpose in life) were also tested.

Methods

A random, representative sample of 1,000 Chinese residents (44% males; mean age = 40.0) was surveyed using a telephone poll design from October to November 2016.

Results

The estimated prevalence of probable IGD was 2.0% of the overall sample and 4.3% among the recent gamers (n = 473), with no statistically significant sex and age effects observed (p > .05). The two most prevalent IGD symptoms were mood modification and continued engagement, despite negative consequences. Probable IGD respondents were more vulnerable to psychological distress (25.0% and 45.0% for moderate or above levels of depression and anxiety, respectively) than their non-IGD counterparts. They also reported a lower level of psychological resilience than non-IGD respondents. No significant buffering effect of the two character strength variables on the distress–IGD relationship was found.

Discussion and conclusions

These results provide empirical evidence that IGD is a mental health threat not only to adolescents but also to adults. IGD was significantly associated with psychological distress, which should be addressed in conjunction with IGD symptoms in interventions. Inclusion of gamers of both sexes and different age groups in future prevention programs is also recommended.

Open access
Authors: Joseph T. F. Lau, Danielle L. Walden, Anise M. S. Wu, Kit-man Cheng, Mason C. M. Lau and Phoenix K. H. Mo

Background and aims

The aim of the study is to investigate (a) whether probable depression status assessed at baseline prospectively predicted new incidence of Internet addiction (IA) at the 12-month follow-up and (b) whether IA status assessed at baseline prospectively predicted new incidence of probable depression at follow-up.

Methods

We conducted a 12-month cohort study (n = 8,286) among Hong Kong secondary students, and derived two subsamples. The first subsample (n = 6,954) included students who were non-IA at baseline, using the Chen Internet Addiction Scale (≤63), and another included non-depressed cases at baseline (n = 3,589), using the Center for Epidemiological Studies Depression Scale (<16).

Results

In the first subsample, 11.5% of the non-IA cases developed IA during follow-up, and probable depression status at baseline significantly predicted new incidence of IA [severe depression: adjusted odds ratio (ORa) = 2.50, 95% CI = 2.07, 3.01; moderate: ORa = 1.82, 95% CI = 1.45, 2.28; mild: ORa = 1.65, 95% CI = 1.32, 2.05; reference: non-depressed], after adjusting for sociodemographic factors. In the second subsample, 38.9% of those non-depressed participants developed probable depression during follow-up. Adjusted analysis showed that baseline IA status also significantly predicted new incidence of probable depression (ORa = 1.57, 95% CI = 1.18, 2.09).

Discussion and conclusions

The high incidence of probable depression is a concern that warrants interventions, as depression has lasting harmful effects in adolescents. Baseline probable depression predicted IA at follow-up and vice versa, among those who were free from IA/probable depression at baseline. Healthcare workers, teachers, and parents need to be made aware of this bidirectional finding. Interventions, both IA and depression prevention, should thus take both problems into consideration.

Open access

Background and aims

Internet gaming disorder (IGD) imposes a potential public health threat worldwide. Gaming motives are potentially salient factors of IGD, but research on Chinese gaming motives is scarce. This study empirically evaluated the psychometric properties of the Chinese version of the Motives for Online Gaming Questionnaire (C-MOGQ), the first inventory that measures seven different gaming motives applicable to all type of online games. We also investigated the associations between various gaming motives and IGD symptoms among Chinese gamers.

Methods

Three hundred and eighty-three Chinese adult online gamers (Mean age = 23.7 years) voluntarily completed our online, anonymous survey in December 2015.

Results

The confirmatory factor analysis results supported a bi-factor model with a general factor subsuming all C-MOGQ items (General Motivation) and seven uncorrelated domain-specific factors (Escape, Coping, Fantasy, Skill Development, Recreation, Competition, and Social). High internal consistencies of the overall scale and subscales were observed. The criterion-related validity of this Chinese version was also supported by the positive correlations of C-MOGQ scale scores with psychological need satisfaction and time spent gaming. Furthermore, we found that high General Motivation (coupled with high Escape motive and low Skill Development motive) was associated with more IGD symptoms reported by our Chinese participants.

Discussion and conclusions

Our findings demonstrated the utility of C-MOGQ in measuring gaming motives of Chinese online gamers, and we recommend the consideration of both its total score and subscale scores in future studies.

Open access
Authors: Ji-Bin Li, Joseph T. F. Lau, Phoenix K. H. Mo, Xue-Fen Su, Jie Tang, Zu-Guo Qin and Danielle L. Gross

Background and aims

This study aims to examine the mediating effects of insomnia on the associations between problematic Internet use, including Internet addiction (IA) and online social networking addiction (OSNA), and depression among adolescents.

Methods

A total of 1,015 secondary school students from Guangzhou in China participated in a cross-sectional survey. Levels of depression, insomnia, IA, and OSNA were assessed using the Center for Epidemiological Studies-Depression Scale, Pittsburgh Sleep Quality Index, Young’s Diagnostic Questionnaire, and Online Social Networking Addiction Scale, respectively. Logistic regression models were fit to test the associations between IA, OSNA, insomnia, and depression. The mediation effects of insomnia were tested using Baron and Kenny’s strategy.

Results

The prevalence of depression at moderate level or above (CES-D ≥ 21), insomnia, IA, and OSNA were 23.5%, 37.2%, 8.1%, and 25.5%, respectively. IA and OSNA were significantly associated with depression (IA: AOR = 2.79, 95% CI: 1.71, 4.55; OSNA: AOR = 3.27, 95% CI: 2.33, 4.59) and insomnia (IA: AOR = 2.83, 95% CI: 1.72, 4.65; OSNA: AOR = 2.19, 95% CI: 1.61, 2.96), after adjusting for significant background factors. Furthermore, insomnia partially mediated 60.6% of the effect of IA on depression (Sobel Z = 3.562, p < .002) and 44.8% of the effect of OSNA on depression (Sobel Z = 3.919, p < .001), respectively.

Discussion

The high prevalence of IA and OSNA may be associated with increased risk of developing depression among adolescents, both through direct and indirect effects (via insomnia). Findings from this study indicated that it may be effective to develop and implement interventions that jointly consider the problematic Internet use, insomnia, and depression.

Open access
Authors: Ji-Bin Li, Phoenix K. H. Mo, Joseph T. F. Lau, Xue-Fen Su, Xi Zhang, Anise M. S. Wu, Jin-Cheng Mai and Yu-Xia Chen

Background and aims

The aim of this study is to estimate the longitudinal associations between online social networking addiction (OSNA) and depression, whether OSNA predicts development of depression, and reversely, whether depression predicts development of OSNA.

Methods

A total of 5,365 students from nine secondary schools in Guangzhou, Southern China were surveyed at baseline in March 2014, and followed up 9 months later. Level of OSNA and depression were measured using the validated OSNA scale and CES-D, respectively. Multilevel logistic regression models were applied to estimate the longitudinal associations between OSNA and depression.

Results

Adolescents who were depressed but free of OSNA at baseline had 1.48 times more likely to develop OSNA at follow-up compared with those non-depressed at baseline [adjusted OR (AOR): 1.48, 95% confidence interval (CI): 1.14–1.93]. In addition, compared with those who were not depressed during the follow-up period, adolescents who were persistently depressed or emerging depressed during the follow-up period had increased risk of developing OSNA at follow-up (AOR: 3.45, 95% CI: 2.51–4.75 for persistent depression; AOR: 4.47, 95% CI: 3.33–5.99 for emerging depression). Reversely, among those without depression at baseline, adolescents who were classified as persistent OSNA or emerging OSNA had higher risk of developing depression compared with those who were no OSNA (AOR: 1.65, 95% CI: 1.01–2.69 for persistent OSNA; AOR: 4.29; 95% CI: 3.17–5.81 for emerging OSNA).

Conclusion

The findings indicate a bidirectional association between OSNA and depression, meaning that addictive online social networking use is accompanied by increased level of depressive symptoms.

Open access

Abstract

Background and aims

Internet gaming disorder (IGD) has been recognized as a mental illness. Cognitive and emotional illness representations affect coping and health outcomes. Very little is known about such perceptions related to IGD, in both general and diseased populations. This study examined the psychometric properties of the Revised Illness Perception Questionnaire (IPQ-R) for IGD in a general population that included mostly non-cases while a small proportion of the sample was IGD cases.

Methods

An anonymous cross-sectional telephone survey was conducted in a random sample of 1,501 Chinese community-dwelling adults (41.3% male; mean age = 40.42, SD = 16.85) in Macao, China.

Results

The confirmatory factor analysis identified a modified 6-factor model (i.e., timeline cyclical, consequences, personal control, treatment control, illness coherence, and emotional representations) of 26 items that showed satisfactory model fit and internal consistency. Criterion-related validity was supported by the constructs' significant correlations with stigma (positive correlations: timeline cyclical, consequence, emotional representations; negative correlations: illness coherence). Ever-gamers, compared to never-gamers, reported higher mean scores in the subscales of personal control and illness coherence, and lower mean scores in time cyclical, consequence, and emotional representations. Among the sampled gamers, probable IGD cases were more likely than non-IGD cases to perceive IGD as cyclical and involved more negative emotions.

Conclusions

This study shows that the revised 26-item version of IPQ-R is a valid instrument for assessing illness representation regarding IGD in a general population of Chinese adults. It can be used in future research that examines factors of incidence and prevention related to IGD.

Open access
Authors: Ji-Bin Li, Anise M.S. Wu, Li-Fen Feng, Yang Deng, Jing-Hua Li, Yu-Xia Chen, Jin-Chen Mai, Phoenix K.H. Mo and Joseph T.F. Lau

Abstract

Background and aims

Problematic online social networking use is prevalent among adolescents, but consensus about the instruments and their optimal cut-off points is lacking. This study derived an optimal cut-off point for the validated Online Social Networking Addiction (OSNA) scale to identify probable OSNA cases among Chinese adolescents.

Methods

A survey recruited 4,951 adolescent online social networking users. Latent profile analysis (LPA) and receiver operating characteristic curve (ROC) analyses were applied to the validated 8-item OSNA scale to determine its optimal cut-off point.

Results

The 3-class model was selected by multiple criteria, and validated in a randomly split-half subsample. Accordingly, participants were categorized into the low risk (36.4%), average risk (50.4%), and high risk (13.2%) groups. The highest risk group was regarded as “cases” and the rest as “non-cases”, serving as the reference standard in ROC analysis, which identified an optimal cut-off point of 23 (sensitivity: 97.2%, specificity: 95.2%). The cut-off point was used to classify participants into positive (probable case: 17:0%) and negative groups according to their OSNA scores. The positive group (probable cases) reported significantly longer duration and higher intensity of online social networking use, and higher prevalence of Internet addiction than the negative group.

Conclusions

The classification strategy and results are potentially useful for future research that measure problematic online social networking use and its impact on health among adolescents. The approach can facilitate research that requires cut-off points of screening tools but gold standards are unavailable.

Open access