Abstract

Pathways from internet addiction to suicidal behaviors among junior high school students in Ghana: A mediation analysis of online bullying.

Enoch Azasu, PhD1, Graham Zulu, MSW2 and Ali Lateef, MD3
(1)University at Buffalo, Buffalo, NY, (2)University of Denver, Denver, CO, (3)Washington University in Saint Louis, Saint Louis, MO

APHA 2025 Annual Meeting and Expo

Background: Internet addiction is an emerging mental and behavioral health issue, particularly among individuals experiencing elevated psychosocial stress. While factors such as stress, loneliness, anxiety, and depression have been linked to Internet addiction, the mechanisms underlying these relationships remain understudied. This study examined the mediating roles of friend support, coping skills, and parental support in these associations.

Methods: This cross-sectional study used data from 1,651 participants recruited through a population-based survey. Validated measures assessed levels of stress, loneliness, anxiety, depression, Internet addiction, friend support, coping skills, and parental support. Structural equation modeling (SEM) was conducted in Mplus to test direct and indirect pathways. Missing data were handled using listwise deletion.

Results: Parental support emerged as a strong mediator. All four predictors (stress, loneliness, anxiety, and depression) were significantly negatively associated with parental support (βs = -0.086 to -0.134, p < .001), which in turn was negatively associated with Internet addiction. Coping skills also mediated the relationship between stress and Internet addiction, with stress lowering coping (β = -0.112, p < .001), and coping being positively linked to addiction (β = 0.091, p < .001). Interestingly, loneliness was positively associated with coping skills (β = 0.096, p < .001), suggesting a potential adaptive function. Friend support, although related to loneliness and Internet addiction, did not significantly mediate their relationship. The full model explained 4.7% of the variance in Internet addiction.

Conclusions and Implications: Parental support and coping skills play critical mediating roles in how psychosocial stressors affect Internet addiction risk. Findings highlight the importance of family-based interventions and mental health strategies focused on strengthening coping mechanisms. Public health practitioners and policymakers should prioritize early intervention and support systems that buffer youth and vulnerable populations from digital behavioral health risks.

Basic medical science applied in public health Diversity and culture Epidemiology Public health or related research