DOI: 10.5061/dryad.1g1jwsv4z
title: Recurrent pain symptoms in adolescents with generalized and specific problematic Internet use: Associations analysis, confounding and mediating effects of comorbid psychosocial problems

description: Problematic Internet use (PIU) in adolescents is a global public health
 issue especially exacerbated by the restrictions caused by the COVID-19
 epidemic. The authors assume a negative impact of PIU not only in relation
 to adolescents’ mental health and social behaviour but also relative to
 somatic components of their health, particularly concerning the occurrence
 of pain symptoms – recurrent headache (RH), recurrent abdominal pain
 (RAP), and recurrent back pain (RBP). The present study aims to identify
 the associations between different types of PIU (generalized PIU – PIUgen,
 problematic computer game use – PUgame, and problematic social media use –
 PUsocial), and pain symptoms (RH, RAP and RBP), and to determine the role
 of psychosocial factors in the emergence of these associations. Methods:
 The research represents a one-stage observational study of 4,411
 adolescents (53.6% girls; Mage = 14.53±1.52) in an unbiased school sample,
 held in three large cities of Central Siberia. The frequency and intensity
 of pain symptoms over the past three months were ascertained by completing
 a number of questionnaires. The following questionnaires were used to
 identify PIU and its types: the Chen Internet Addiction Scale (CIAS for
 PIUgen), the Game Addiction Scale for Adolescents (GASA for PUgame), and
 The Social Media Disorder Scale (SMDS for PUsocial). The psychological
 problems were assessed using The Strengths and Difficulties Questionnaire
 (SDQ). Logistic and linear regression, as well as mediation analysis, were
 used. Results: Considering both the frequency and intensity of pain, along
 with the presence of psychosocial problems as a confounder, a direct
 association of RH with PUsocial only was revealed (OR = 1.68, CI =
 1.33–2.11). Using the same criteria, RAP in this sample was associated
 with PIUgen and PUsocial (OR = 1.99, CI = 1.51–2.62 and 2.10, CI =
 1.62–2.72, respectively). RBP, according to the obtained data, was also
 associated with PIUgen and PUsocial both in terms of pain frequency (OR =
 1.99, CI = 1.53–2.57 and OR = 2.20, CI = 1.44–3.38, respectively) and
 intensity. PUgame was weakly associated only with RAP and showed no
 significant association with RH and RBP. The mediation analysis indicated
 that the revealed positive associations were largely mediated by
 psychosocial problems comorbid for PIUgen and PUsocial (but not PUgame).
 Conclusions: The frequently reported association of recurrent pain
 symptoms with PIU in adolescents is largely mediated by comorbid
 psychosocial problems. The direct effect of excessive Internet use on
 somatic pain symptoms in adolescents is mild-to-moderate and depends on
 the content predominantly consumed.
description: <strong>Participants</strong> The
 study is a one-stage observational survey of an unbiased school sample in
 three large cities in Central Siberia. The research object is represented
 by 12-18-year-old adolescents (n = 4,411) – students of 10 comprehensive
 schools in Krasnoyarsk, Russia (n = 2,843), 4 comprehensive schools in
 Abakan, Russia (n = 1,357) and 2 comprehensive schools in Kyzyl, Russia (n
 = 211).
 <strong>Measurement</strong> After
 obtaining informed consent from the parents and confirming the
 voluntariness of participation with the students, the researchers assured
 the latter of the confidentiality of the study. The students were asked to
 complete paper versions of self-report questionnaires within 45 minutes in
 a classroom setting. The survey was conducted in the spring of 2019. The
 study was approved by the Ethics Committee of the Federal Research Centre
 “Krasnoyarsk Science Center of the Siberian Branch of the Russian Academy
 of Sciences”. <em><strong>Recurrent pain
 symptoms measurement</strong></em>
 Adolescents were asked a number of questions regarding the
 presence, frequency and intensity of pain symptoms in the past three
 months. The criteria for inclusion in RH, RAP and RBP groups for all types
 of pain were as follows: pain episodes 3 or more times per month within
 the past three months regardless of pain intensity OR 1–2 times per month
 with pain intensity ≥4 points according to the Wong-Baker FACES pain
 rating scale. <em><strong>Problematic
 Internet use measurement</strong></em> The
 Chen Internet Addiction Scale (CIAS) was used to reveal the presence of
 Internet addictive behaviour [1]. The Russian version of the CIAS was
 adapted by Malygin et al. and can be freely downloaded from http://www.medpsy.ru/library/library135.pdf (accessed on 12 May 2024). The CIAS covers five symptomatic criteria of addictive behaviour, among which are compulsive symptoms, abstinence symptoms, signs of anergy, the presence of psychological or somatic problems, and time management difficulties. The questionnaire consists of 26 statements, each rated on a 4-point scale: “does not match at all” (1 point), “weakly matches” (2 points), “partially matches” (3 points), and “completely matches” (4 points). A total CIAS score of ≥65 was considered indicative of generalized problematic Internet use (PIUgen). The structure of content consumption in adolescents with gaming addiction was analysed using the Russian version of the Game Addiction Scale for Adolescents [2] and the Social Media Disorder Scale [3]. The Game Addiction Scale includes 7 questions that address behavioural disorders in adolescents caused by excessive Internet gaming. Each question offers the following answer options: “never,” “rarely,” “sometimes,” “often,” and “very often.” According to the criteria provided by the authors [2], a polythetic format addiction or PUgame was diagnosed if the adolescent responded with “sometimes,” “often,” or “very often” to any 4 out of the 7 questions. The Social Media Disorder Scale comprises 9 questions related to social media addiction. Each question has two answer options: “no” and “yes”. Five or more affirmative responses out of nine suggest the presence of [3]. A recent cross-national analysis of adolescents’ psychometric characteristics conducted in 44 countries demonstrated a high level of validity and reliability for the SMDS questionnaire [4]. <em><strong>Psychosocial problems assessment</strong></em> The Strengths and Difficulties Questionnaire (SDQ) was developed by Goodman et al. [5], as a concise psychopathological screening tool, is recommended for identifying and classifying psychosocial problems in adolescents. The SDQ is extensively utilised in both clinical practice and research due to its brevity, reliability, and capability to assess various aspects of adolescents’ psychosocial states. An undeniable advantage of the SDQ is its broad accessibility; it has been translated into more than 80 languages and is freely available on the developers’ website (https://sdqinfo.org, accessed on 12 May 2024). This accessibility facilitates cross-cultural comparisons. The Russian-language version of the SDQ was rigorously validated by Ruchkin et al. [6] and Slobodskaya et al. [7] in a sample of Siberian schoolchildren (Novosibirsk, Russia). A self-rated version of the SDQ for children aged 12–17 was employed. The SDQ comprises 25 statements designed to evaluate the adolescent’s problematic and socially acceptable behaviours over the previous 6 months. Responses are scored on a 3-point scale: 0 = not true, 1 = somewhat true, and 2 = certainly true. Scores are assigned in either a forward or reverse order for each item, as per the authors’ instructions [5]) and are categorised into five scales: Emotional Symptoms, Hyperactivity/Inattention, Conduct Problems, Peer Problems, and Prosocial Behavior. A Total Difficulties Score can be calculated by summing the scores from the first four scales. References: 1.       Chen, S.-H.; Weng, L.-J.; Su, Y.-J.; Wu, H.-M.; Yang, P.-F. Development of a Chinese Internet Addiction Scale and Its Psychometric Study. <em>Chinese Journal of Psychology </em>2003, <em>45</em>, 279-294. 2.       Lemmens, J.S.; Valkenburg, P.M.; Peter, J. Development and validation of a game addiction scale for adolescents. <em>Media Psychology </em>2009, <em>12</em>, 77-95; DOI:10.1080/15213260802669458. 3.       Van Den Eijnden, R.J.J.M.; Lemmens, J.S.; Valkenburg, P.M. The Social Media Disorder Scale. <em>Computers in Human Behavior </em>2016, <em>61</em>, 478-487; DOI:10.1016/j.chb.2016.03.038. 4.       Boer, M.; van den Eijnden, R.J.; Finkenauer, C.; Boniel‐Nissim, M.; Marino, C.; Inchley, J.; Cosma, A.; Paakkari, L.; Stevens, G.W. Cross‐national validation of the social media disorder scale: findings from adolescents from 44 countries. <em>Addiction </em>2022, <em>117</em>, 784-795. 5.       Goodman, R.; Meltzer, H.; Bailey, V. The strengths and difficulties questionnaire: A pilot study on the validity of the self-report version. <em>European Child & Adolescent Psychiatry </em>1998, <em>7</em>, 125-130; DOI:10.1007/s007870050057. 6.       Ruchkin, V.; Koposov, R.; Schwab-Stone, M. The strength and difficulties questionnaire: Scale validation with Russian adolescents. <em>Journal of Clinical Psychology </em>2007, <em>63</em>, 861-869; DOI:10.1002/jclp.20401. 7.       Slobodskaya, H.R.; Akhmetova, O.A.; Ryabichenko, T.I. Siberian child and adolescent mental health: prevalence estimates and psychosocial factors. <em>Alaska medicine </em>2007, <em>49</em>, 261-266.
description: # Recurrent pain symptoms in adolescents with generalized and specific
 problematic Internet use: Associations analysis, confounding and mediating
 effects of comorbid psychosocial problems
 [https://doi.org/10.5061/dryad.1g1jwsv4z](https://doi.org/10.5061/dryad.1g1jwsv4z) This dataset contains primary data from a survey of 4411 adolescents. The dataset contains demographic data, test data from the following questionnaires:  - The Strengths and Difficulties Questionnaire (SDQ) \- The Chen Internet Addiction Scale (CIAS) \- The Game Addiction Scale for Adolescents (GASA) \- The Social Media Disorder Scale (SMDS) In addition, the dataset contains coded responses from adolescents regarding the frequency and intensity of recurrent pain symptoms: headache, abdominal pain, and back pain. ## Description of the data Code: the unique code of the adolescent Age_group: 1 - &lt;= 14 years; 2 &gt; 14 years Sex: 1 - male; 2 - female Ethnicity: Russians - 1; Tuvans - 2; Khakass - 3; Others - 4 G_1-G_25 and G_Sum: test results by The Strengths and Difficulties Questionnaire (SDQ) CIAS_1-CIAS_26 and CIAS_Sum: test results of The Chen Internet Addiction Scale (CIAS) questionnaire. GASA_1-GASA_7 and GASA_Sum: test results of The Game Addiction Scale for Adolescents (GASA). SMDS_1-SMDS_9 and SMDS_Sum: test results from The Social Media Disorder Scale (SMDS). Recurrent headache frequency: 0 - none; 1 - ≤ 2 episodes per month; 2 - &gt; 2 episodes per month.  Recurrent headache intensity: 0 to 5 according to the Wong-Baker FACES pain rating scale. Recurrent abdominal pain frequency: 0 - none; 1 - ≤ 2 episodes per month; 2 - &gt; 2 episodes per month.  Recurrent abdominal pain intensity: 0 to 5 according to the Wong-Baker FACES pain rating scale. Recurrent back pain frequency: 0 - none; 1 - ≤ 2 episodes per month; 2 - &gt; 2 episodes per month. Recurrent back pain intensity from 0 to 5 according to the Wong-Baker FACES pain rating scale Value 'NA' for all cells - no data available