ORIGINAL RESEARCH article
Front. Psychiatry
Sec. Adolescent and Young Adult Psychiatry
Volume 16 - 2025 | doi: 10.3389/fpsyt.2025.1558276
This article is part of the Research TopicYouth Mental Health, Particularly in Asian PopulationsView all 94 articles
Symptom-Level Interactions between Anxiety and Internet Addiction in Chinese Adolescents: A Large-Scale Network and Residence Difference Analysis
Provisionally accepted
Yi Xie1
Cheng Xiaofei1Cong Wang1,2Jia Cai1,2Yu Wang1Yun-Fei Mu1,2
Zhongyue Deng1,2Ai-Ping Deng1,3Hong-Jun Song1,3
Xuehua Huang1,2Lan Zhang1,2
Zhang Jun1,2
Yi Huang1,2
Li Yin1,2Wen-Wu Shen4
Mingli Li1,2*
Mao-Sheng Ran1,2*- 1Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
- 2Institute of Psychiatry, West China Hospital, Sichuan University, chengdu, China
- 3School of Nursing, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
- 4West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
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Background: Anxiety and Internet addiction (IA) are prevalent and exhibit a strong correlation among adolescents. This study aimed to (a) identify key symptoms and relationships of the anxiety-IA combined network in Chinese adolescents and (b) examine the differences in anxiety-IA symptoms between rural and urban adolescents. Methods: The study was a cross-sectional survey conducted in 122 secondary schools in Sichuan Province, China, using the Generalized Anxiety Disorder Scale and the Internet Addiction Test. General network analysis and bridge network analysis were used to identify the most influential symptoms and key connectors by adopting expected influence and bridge expected influence values. Network comparison tests were conducted to explore the global strength and network structure differences between rural and urban adolescents. Results: The study included 60,268 adolescents (mean age 15.90 ± 1.65 years; 54.44% females), stratified by residence: rural (n = 49,819) and urban (n = 10,449). In the general network, "Fantasize about being on the web" (IAT15), "Neglect household chores" (IAT2), and "Reluctant to be offline" (IAT16) were the most influential symptoms. Bridge network analysis revealed that "Use the web to escape from emotion" (IAT10), "Feeling afraid" (GAD7), and "Defensive or secretive about being on the web" (IAT9) served as key connectors that bridge the comorbid network of anxiety and IA. The network structure test detected residence-related differences, and the most influential and bridging symptoms diverged by residence. "Craving for next Internet use" (IAT11) and "Irritability" (GAD6) characterized rural adolescents, Conclusions: This study offers new insights into the symptom-level interactions between anxiety and IA in adolescents. These findings also highlight the necessity of precisely addressing the comorbidity of anxiety and IA between rural and urban adolescents.
Keywords: Anxiety, Internet addiction disorder, Comorbidity, Network analysis, Adolescent, China
Received: 10 Jan 2025; Accepted: 20 Aug 2025.
Copyright: © 2025 Xie, Xiaofei, Wang, Cai, Wang, Mu, Deng, Deng, Song, Huang, Zhang, Jun, Huang, Yin, Shen, Li and Ran. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Mingli Li, Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
Mao-Sheng Ran, Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
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