Problematic internet use and mental health: Moderated mediating effect of social media identity and loneliness (Preprint)

BACKGROUND To better understand the underlying mechanism of the effect of problematic internet use (PIU) on mental health, this study aims to test the mediating effect of loneliness moderated by social media identity. OBJECTIVE This study aims to test the mediating effect of loneliness moderated by social media identity. METHODS A cross-sectional survey was conducted on 21,292 participants using a multi-stage stratified sampling strategy from 31 provinces/regions in mainland China. A moderated mediation model was established to examine the mediating effect of loneliness on the association between PIU and mental health outcomes, moderated by social media identity. RESULTS Loneliness significantly mediated the association between PIU and mental health outcomes, explaining 42.53% and 45.48% of the total effect of PIU on depression and anxiety, respectively. Social media identity significantly moderated the association between PIU and depression (β= 0.002, 95% CI: 0.001 to 0.002), between PIU and anxiety (β= 0.001, 95% CI: 0.000 to 0.002), between loneliness and depression (β= 0.010, 95% CI: 0.007 to 0.013), and between loneliness and anxiety (β= 0.007, 95% CI: 0.004 to 0.010). Higher levels of social media identity were significantly associated with lower levels of loneliness (β=-0.018, 95% CI: -0.020 to -0.016). CONCLUSIONS Addressing loneliness may serve as a valuable approach to mitigate the impact of PIU on mental health outcomes. However, the role of social media identity poses a significant challenge in addressing health issues linked to PIU. CLINICALTRIAL All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (Shaanxi Institute of International Trade and Commerce, JKWH-2022-02) and with the Helsinki Declaration of 1975, as revised in 2000 (5). Informed consent was obtained from all patients for being included in the study.