Abstract
This study aimed to explore the mediating effects of internet gaming disorder, social network use, and generalized pathological internet use (GPIU) on the association between loneliness and depression. A total of 2211 junior high school students completed questionnaires regarding loneliness, internet gaming disorder, social network use, GPIU, and depression (aged 10–16 years). The results of a structural equation model revealed that (a) the path coefficient of loneliness to depression was significantly positive, (b) loneliness could not predict depression through GPIU directly, but (c) loneliness could predict depression through internet gaming disorder to GPIU, (d) loneliness could predict depression through social network use to GPIU, and (e) loneliness could not predict depression through internet gaming disorder to social network use to GPIU. These results provided significant implications for the prevention and reduction of depression in Chinese junior high school students.
Introduction
Junior high school students are faced with such problems as high academic pressure and monotonous life, which may easily lead to loneliness, depression, and other mental health problems (; Zhang, 2000; Xu, 2012). In recent years, many studies have proved that depression is a mental illness with high prevalence, high chronic recurrence rate, high disease burden, and high suicide mortality (), and there was a high correlation between loneliness and depression (Ren et al., 2020). Studies have demonstrated that adolescents with generalized pathological internet use (GPIU) usually suffer from loneliness (Sukenick, 2012) and depression (Zou et al., 2007). A number of studies have focused on the research of internet gaming disorder and social networking disorder (; Wartberg et al., 2020). This study aims at studying the mediating effects of internet gaming disorder, social network use, and GPIU on the association between loneliness and depression.
Depression
World Health Organization research worldwide shows that depression is affecting physical and mental health in the 21st century (). From a psychological point of view, depression is the consequence of an ineffective response to life stress, and emotional disorders are the core characteristic, including worthlessness, helplessness and despair, and decreased levels of physical activity (). Depression affects emotions as well as thinking, motivation, attention, imagination, behavior, social relationships, and physical conditions, resulting in people feeling lonely and unwell (; ). Junior high school students are in a critical period of physical and mental development and social maturity (Zhang, 2017). The contradiction between ideal and reality often leads to negative emotions, mainly manifested by depression and anxiety, which hinders the healthy development of junior high school students’ mental and physical development (). Studies have shown that adolescents’ depressive symptoms increase significantly in frequency and generality (; Yang et al., 2010; ). Many factors affect depression, including both external risk factors and individual susceptibility (Tao, 2006).
Loneliness and Depression
Clinical and related statistics have demonstrated that loneliness is a common issue of modern people (; ). Adolescence is a particularly vulnerable stage for experiencing feelings of loneliness, which is a significant factor for adolescent health and quality of life (; ). pointed that loneliness occurred when a person’s social network made him/her less satisfied than he/she expected. Some authors have reported that when social quality declines, the original network of relationships (loss or loss of loved ones, relocation) or lack of social skills (personality factors) could lead to strong loneliness (Vazquez and Garcia, 1997; Teunisse et al., 1999; Tijhuis et al., 1999; ; Van et al., 2017). Hence, loneliness is a subjective feeling of unpleasant suffering caused by social defects (), and long-term or severe loneliness may trigger certain emotional disorders and reduce mental health ().
Studies found that there was a high correlation between loneliness and depression (; ; Ren et al., 2020). On the one hand, among the negative effects of depression, loneliness is the most common (). When individuals have negative emotions such as anxiety, pessimism, and disappointment, they tend to experience more feelings of loneliness, loss of help, and desire to be understood. However, on the other hand, loneliness is very detrimental to mental health; a high level of the feeling of loneliness is thought to stimulate depressive symptoms (Wei et al., 2005; ). found that the interactive effect of loneliness at 5 and 9 years old predicted depressive symptoms at age 13. published a recent 5-year longitudinal study that found that loneliness predicted an increase in depressive symptoms at yearly intervals, while depressive symptoms did not predict an increase in loneliness at the same time. A longitudinal study also found a gender-dependent impact of loneliness on depressive symptoms. For females, loneliness could significantly predict the increased depressive symptoms, while for males, loneliness could not (). Therefore, our study will focus on the relationship between loneliness and depression. Based on the above literature discussion, we proposed the following Hypothesis 1: Loneliness could positively predict depression.
Mediating Roles of GPIU
Pathological internet use (PIU) refers to a phenomenon of obvious social and psychological damage caused by excessive use of the internet, which means people are unable to control their internet usage (; Starcevic et al., 2018). Based on the literature, proposed a cognitive behavioral model of PIU, which highlighted the important role of maladaptive cognition in the development of PIU. The cognitive–behavioral model provided a theoretical explanation for the origin and pathogenesis of GPIU and specific pathological internet use (SPIU) in identifying the etiology of PIU. proposed two types of PIU (Figure 1): SPIU and GPIU. SPIU is a reliance on the special features of the internet, such as internet gaming disorder and social networks use; GPIU refers to the global set of online behaviors, which contains general, multifaceted internet overuse that perhaps includes no clear destination killing time online (). believed that psychopathology was the distal necessary cause of GPIU/SPIU symptoms. The underlying psychopathology itself did not cause the symptoms of GPIU/SPIU, but it was a necessary factor in its etiology. The key factor in the occurrence of GPIU/SPIU was maladaptive cognition, which was its proximal and sufficient reason.
FIGURE 1
Generalized pathological internet use, characterized by excessive or compulsive internet use and a preoccupation with and loss of control over this use, results in negative personal, professional consequences (
Internet addiction was positively associated with loneliness and depression (
Mediating Role of Internet Gaming Disorder and Social Network Use Between Loneliness and GPIU
To improve prevention and intervention of GPIU, its inner working process must be explored, such as an investigation of the intermediary mechanism, which helps to explain how loneliness affects GPIU. The internet gaming disorder and problematic use of social networks belong to SPIU. Young and Kimberly (1998, 2007) conducted a series of studies on the behavioral characteristics of internet addicts. The results suggest that internet addicts tend to prefer online chat and online interactive games. Therefore, Young and Rogers (1998) posited that the internet was not addictive, but special network applications contributed to the occurrence of internet addiction.
First, we proposed social network use as a mediator between loneliness and GPIU.
Another mediator variable is internet gaming disorder. Internet games are a new form of entertainment combining traditional games with the internet, which have strong interactivity and virtuality, and will lead to many behavioral problems among teenagers (
What is more, at present, more and more people use internet games to socialize online, but there are few relevant studies. Therefore, this study will also explore the chain mediating effect of internet gaming disorder to social network use in loneliness to GPIU. So, we further put forward Hypothesis 5: Loneliness could predict depression through internet gaming disorder to social network use to GPIU.
Materials and Methods
This study conformed to the code of ethics of the World Medical Association (Declaration of Helsinki) for experiments involving humans and was approved by the Ethics Committee of Shandong Normal University. Additionally, our research obtained written informed consent from the parents of the participants.
Participants
The participants were from a junior high school in Eastern China, which is an ordinary school and whose students are representative. Students in the first through third grades were included. After eliminating incomplete and repetitive questionnaires, a total of 2211 valid questionnaires were received. Overall, 1087 (49.2%) participants were male and 1124 (50.8%) were female. Their mean age was 13.04 years (aged 10–16 years, M = 13.04, SD = 1.226).
Procedures
We obtained informed consent from the school administrators and students before data collection. The paper questionnaire in Chinese was used in this study. To maintain the quality of the investigation, the junior high school students were gathered in a large assembly room to complete their questionnaires with the help of two researchers. The other grades finished the questionnaires with the help of two researchers during one full class period of 45 min.
Measures
UCLA Loneliness Scale
The UCLA Loneliness Scale comprises 20 items, for example, “I am unhappy doing so many things alone.” The items were rated on a four-point scale for frequency (1 = often to 4 = never). The final score was calculated by the total score of all the items, and higher scores indicated greater levels of loneliness. We also conducted CFA, with χ2/df = 3.846, RMSEA = 0.023, and CFI = 0.993. Cronbach’s alpha for the UCLA Loneliness Scale was 0.855.
Center for Epidemiologic Studies Depression Scale (CES-D)
The CES-D Scale was used to measure the students’ depression, which was adapted to the Chinese language and culture and comprised 20 items, for example, “I felt that I could not shake off the blues even with help from my family or friends.” The students rated each item on a four-point scale from 1 = rarely or none of the time (less than 1 day) to 4 = most or all of the time (5–7 days). To calculate the final CES-D score, the scores of all the items were added. A very high score meant severe depression. We also conducted CFA, with χ2/df = 3.510, RMSEA = 0.022, CFI = 0.994, and Cronbach’s alpha was 0.894.
Generalized Pathological Internet Use Scale (GPIUS)
To measure the students’ generalized pathological use of the internet, Patricia Gomez’s GPIUS was adapted (
Ten-Item Internet Gaming Disorder Test
The Ten-Item Internet Gaming Disorder Test (IGDT-10) comprised 10 items and assesses levels of IGD (
Social Network Use Intensity Scale
The original scale used the social strength website questionnaire compiled by Ellison, Steinfield, and Lampe to assess the intensity of youth social networking use (
Statistical Analysis
Liu pointed that the coefficient test results of normal distribution should be combined with the sample size. In large samples (n ≥ 200), the influence of non-normal would be reduced; that is, the assumption of normal distribution in large samples could be slightly violated (
FIGURE 2

The Q–Q graph of each variable.
Moreover, parceling strategy was adopted to improve the quality of the model fit and the indicators (Tian et al., 2017). Firstly, we executed a factor analysis. Then, we sorted the items of each observed variable from highest to lowest according to factor loading size (Rogers and Schmitt, 2004). We sequentially assigned the highest and lowest remaining items to each package in turn and alternated the package until all items were completed.
The fits of the model were assessed using the chi-square (χ2) test, the RMSEA, the CFI, and the TLI. Considering the χ2 test is easily affected by the size of samples, model fit indices were used as the major standard to assess the model fit (
We used the structural equation model to investigate the relationship of these variables through Mplus 7.0. The bootstrapping method was conducted to test the mediation effects. According to the mediation effect test procedure, the direct effect of loneliness on depression was first tested, and then the significance of the path coefficient and the fitting of the model after the addition of the mediator variables social network use, internet gaming disorder, and GPIU were tested. From 1000 resamples of the data, this method produced 95% bias-corrected confidence intervals of these effects. When the confidence interval did not contain zero, it meant that there was a significant effect at p < 0.05.
We conducted the common variance analysis to measure whether common method biases existed in this study. The χ2 test of Bartlett’s test of sphericity was significant. Then, we extracted 12 eigenvalues greater than 1 after a principal component analysis. The first factor to explain the variance was 19.305%. The results were less than the critical standard of 40% (
Results
Descriptive Statistics and Correlation Analysis
Table 1 shows the descriptive statistics and Pearson correlation of social network use, loneliness, internet gaming disorder, depression, and GPIU. The results indicated that loneliness had a weak negative correlation with social network use, and there was a significant positive correlation between other variables.
TABLE 1
| Variable | M | SD | 1 | 2 | 3 | 4 | 5 |
| Loneliness | 41.42 | 9.16 | 1 | ||||
| Social network use | 49.83 | 14.23 | −0.046* | 1 | |||
| internet gaming disorder | 24.76 | 12.99 | 0.199** | 0.344** | 1 | ||
| GPIU | 31.02 | 12.73 | 0.221** | 0.305** | 0.616** | 1 | |
| Depression | 17.34 | 10.14 | 0.626** | 0.103** | 0.318** | 0.341** | 1 |
Descriptive statistics and correlation matrix of all variables.
N = 2211. * p < 0.05, ** p < 0.01.
Testing for Multiple Mediating Roles of Social Network Use, Internet Gaming Disorder, and GPIU
First, the finding demonstrated that the path coefficient of loneliness to depression was significantly positive (Figure 3). The fits of this model were χ2/df = 5.78, RMSEA = 0.051, NFI = 0.978, CFI = 0.975, and TLI = 0.968, which indicated that the model was appropriate and acceptable.
FIGURE 3

Total effect model. Path values are the path coefficients. ∗∗p < 0.01. The latent variables loneliness and depression were divided into four packages through the packaging strategy.
Second, the indirect effects of internet gaming disorder, social network use, and GPIU between loneliness and depression were explored (Figure 4). The path coefficients of loneliness to internet gaming disorder/social network use, internet gaming disorder to social network use, internet gaming disorder/social network use to GPIU, and GPIU to depression were significantly positive. Specifically, the direct path coefficients of loneliness to GPIU were not significant.
FIGURE 4

Multiple mediation model. ∗p < 0.05, ∗∗p < 0.01, ∗∗∗p < 0.001. The latent variables loneliness and depression were divided into four packages through the packaging strategy, and the latent variables social network use, internet gaming disorder, and GPIU were divided into two packages through the packaging strategy.
Third, most of the mediated effects paths were significant (Table 2). Specifically, loneliness could predict depression through social network/internet gaming disorder to GPIU. However, loneliness could not predict depression through GPIU. The direct effect of loneliness on depression was significant, but path loneliness to GPIU was not significant after the addition of two mediator variables. What is more, loneliness could not predict depression through internet gaming disorder to social network use to GPIU.
TABLE 2
| Path | Standardized path coefficient | 95% confidence interval | |
| Lower | Upper | ||
| a. Total effect model | |||
| Loneliness → depression | 0.044** | 0.012 | 0.078 |
| b. Multiple mediation model | |||
| Loneliness → GPIU → depression | 0.001 | –0.020 | 0.023 |
| Loneliness → internet gaming disorder → GPIU → depression | 0.034** | 0.015 | 0.054 |
| Loneliness → social network use → GPIU → depression | 0.009* | 0.002 | 0.017 |
| Loneliness → internet game disorder → social network use → GPIU → depression | 0.005 | –0.003 | 0.011 |
Test of the total effect model and mediation effect model.
N = 2211. *p < 0.05, **p < 0.01.
Discussion
The purpose of this study was to explore the relationship between loneliness and depression and the mediating effects of social network use, internet gaming disorder, and GPIU, in order to further explore the underlying mechanisms by which loneliness affects depression. The total effect model indicated that loneliness could positively predict depression, and Hypothesis 1 was supported. The multiple mediation model showed that loneliness did not affect depression through GPIU, which did not support Hypothesis 2. The model also indicated that the two mediators of internet gaming disorder and social network use parallel mediated the relationship between loneliness and depression through GPIU, which supported Hypotheses 3 and 4. However, the two mediator variables could not have a sequential relationship between loneliness and depression, which did not support Hypothesis 5.
Loneliness and Depression
The result showed that the path coefficients of loneliness to depression were significantly positive, which was consistent with previous studies (Wei et al., 2005; Wang et al., 2008;
Several reasons have been proposed to explain why loneliness is connected with the development of depression. First, lonely individuals always have negative perceptions of things, are susceptible to negative emotions, and often show hostility, and hostility is significantly related to depression (
However, there is a co-existence between depression and loneliness (
The Key Mediating Role of GPIU
Loneliness, internet gaming disorder, and social network use were significantly associated with GPIU, and GPIU was significantly related to depression. The results of this study supported the theory by
This study found that loneliness was not directly related to depression through GPIU, which was not consistent with previous assumptions. Previous studies supported the idea that some people used the internet to cope with negative emotions such as sadness, anxiety, or loneliness (Scherer, 1997;
The possible reason about this study result is that loneliness could actually affect depression through GPIU, but as a result of SPIU (internet gaming disorder and pathological social network use) as a mediation variable in the model, the direct effect of loneliness on GPIU is weakened. According to Davis’ cognitive behavior model of PIU (
Mediating Roles of Social Network Use and Internet Gaming Disorder
In the mediation process of loneliness to internet gaming disorder/social network use to GPIU to depression, the results of this research were consistent with other related research (
Social networks are an emerging network of communication media used primarily to maintain existing relationships (
What is more, the concealment of the network and the irritability of internet games greatly satisfy the self-demand that they cannot achieve in reality. Internet games have also become a passive lazy escape response to problems. According to the reinforcement theory (Villere and Hartman, 1991), the increasing use and reinforcement of technology are the elements of internet gaming disorder. The improvement of game technology will make individuals psychologically satisfied and thereby escape and eliminate the discomfort brought to them by real life sense. Through continuous learning and upgrading skills in the game, teenagers show their extraordinary wisdom through superb technology, win the attention of all players, and enjoy the sense of accomplishment brought by self-realization (
Implications for Prevention of Depression
The results of this study were of great significance to depression prevention and intervention strategies for Chinese students. First of all, junior high school students under great study pressure and housing pressure were very prone to depression. Therefore, depressed students deserve more attention from teachers and parents. Teachers and school doctors are required to improve their quality, pay attention to the psychological status of students, and treat students with a positive attitude. Parents should also strive to provide good parenting for their children. Through appropriate expectations and a harmonious family environment, parents can provide children a benign stimulus so that they can adopt a positive coping style to apply to various contradictions and prevent the formation of adverse emotions (Zhu et al., 2003;
Limitations and Future Directions
Although this study was conducive to understanding the relationship between loneliness and depression in Chinese students, there were still some limitations. First, this study was a cross-sectional study, and its results could not provide a causal relationship. Therefore, further research could explore the causal relationship between these variables through experiments or longitudinal studies, such as loneliness and depression. Another limitation was that the questionnaire survey used in this study may cause some errors. For example, self-reported questionnaires were influenced by social desirability. Hence, further research may apply more professional surveys (e.g., Survey Monkey or Google Forums) to directly record time spent, eliminating coding data errors and controlling the answers at random. In addition, the convenience sampling may limit the generalizability of the result, so if there is an opportunity, we will expand the sample and increase the randomization level of the sample. What is more, other mediators of the relationship between loneliness and depression (such as meditation), as well as how social network use and internet gaming disorders predict depression, and how the two-way relationship needs to be explored. Last but not least, this study was conducted in the context of Chinese culture, so the cross-cultural applicability of the conclusions must be further verified.
Conclusion
In this study, we discussed the mediating effects of internet gaming disorder, social network use, and GPIU on loneliness and depression, and the conclusions were as follows: (a) loneliness could positively predict depression; (b) loneliness could not predict depression through GPIU directly; (c) loneliness could predict depression through internet gaming disorder to GPIU; (d) loneliness could predict depression through social network use to GPIU; and (e) loneliness could not predict depression through internet gaming disorder to social network use to GPIU.
Statements
Data availability statement
The datasets for this manuscript are not publicly available because the datasets are used only for the team of this article by the permission of the guardians. Requests to access the datasets should be directed to PW, 122394108@qq.com.
Ethics statement
The studies involving human participants were reviewed and approved by the Ethics Committee of Shandong Normal University. The guardians of the participants provided written informed consent to let them participate in this study.
Author contributions
PW was the research designer. JW and YY were in charge of writing. XZ and YT participated in the discussion and offered suggestions. YS was the corresponding author. All authors contributed to the article and approved the submitted version.
Funding
This work was supported by the 2018 Shandong Graduate Education Quality Improvement Plan Project under grant number SDYJD18020, fund for Projects of Shandong Social Science Planning under grant number 18CQXJ06, and fund for Projects of Shandong Natural Science under grant number ZR2020MF158.
Acknowledgments
The authors would like to thank the reviewers whose suggestions and comments greatly helped to improve and clarify this manuscript.
Conflict of interest
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
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Summary
Keywords
loneliness, internet gaming disorder, social network use, depression, multiple mediating effects, generalized pathological internet use
Citation
Wang P, Wang J, Yan Y, Si Y, Zhan X and Tian Y (2021) Relationship Between Loneliness and Depression Among Chinese Junior High School Students: The Serial Mediating Roles of Internet Gaming Disorder, Social Network Use, and Generalized Pathological Internet Use. Front. Psychol. 11:529665. doi: 10.3389/fpsyg.2020.529665
Received
26 January 2020
Accepted
23 December 2020
Published
12 February 2021
Volume
11 - 2020
Edited by
Claudio Longobardi, University of Turin, Italy
Reviewed by
Hengliang Yeh, Taipei Veterans General Hospital, Taiwan; Niko Männikkö, Oulu University of Applied Sciences, Finland
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© 2021 Wang, Wang, Yan, Si, Zhan and Tian.
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*Correspondence: Yingdong Si, 1021865921@qq.com
†These authors share first authorship
This article was submitted to Educational Psychology, a section of the journal Frontiers in Psychology
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