Positive youth development qualities improve mental disorders and addiction: A cross-sectional survey of teenagers in China under the COVID-19 pandemic

Positive youth development qualities improve mental disorders and addiction: A cross-sectional survey of teenagers in China under the COVID-19 pandemic | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Positive youth development qualities improve mental disorders and addiction: A cross-sectional survey of teenagers in China under the COVID-19 pandemic Jiahe Liu, Ni Wu, Shuming Ji, Binxue Hong, Lihua Jiang This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4374395/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Positive youths development (PYD) has been found existing useful impact on the protection of mental health among adolescents in recent years. Anxiety and depression are the main representations of mental disorders in adolescents; meanwhile, internet addiction also is the main addictive behavior. The purpose in this study is to estimate the impact of general PYD quality (GPYDQ) on the anxiety, depression and internet addiction comprehensive; and considered the mental injury come from the COVID-19 pandemic furthermore. Methods 7426 valid questionnaires come from the follow-up of sociological investigation named Chengdu Positive Child Development (CPCD) survey. The corresponding international scales were used to evaluate the performance of PYD, the risk of anxiety, depression, and internet addiction, and the mental damage of COVID-19 pandemic respectively. Results The GPYDQ had a negative association with the score of mental disorders and addictive behavior, which meaning that higher PYD performance in adolescents was associated with a lower risk of mental illness and addiction. The CRIES-13 had the positive connection on the risk of anxiety, depression, and Internet addiction, and had the negative effect on the GPYDQ, which showed that COVID-19 was taking a toll on the mental health of adolescents. Conclusion The positive PYD attributes could effectively improve the mental health, and regulate the dependence on Internet addiction, and the COVID-19 pandemic also could aggravate the expression of depression, anxiety and Internet addiction, and damage their abilities of positive development. Internet addiction Anxiety Depression Positive youth development Structural equation model Figures Figure 1 Introduction The mental health of adolescents has become a focused topic in global public health, a growing number of international studies show that the prevalence of mental disorders such as anxiety, depression and sleep disturbance are rising substantially among youths(Keyes et al., 2019 , David and Kay, 2009 ). This is accompanied by increasing clinical reports of severe symptom of mental illness in youths, as well as increasing reports of self-harm(Zvolensky et al., 2022 , Vogelzangs et al., 2010 ). On the other hand, addiction behaviors perform a critical impact on the mental disorders all the time, especially the internet addiction, and according to the report of BMJ in 2018(Gunnell et al., 2018 ), post-millennial kids are growing up surrounded by social media, which results in less face to face communication and rising risk of over-dependency. In the last decade, our lifestyle is being deeply changed by mobile phone and internet, relevant studies also found that this change set up a closely correlation in youths with sleep complains, social isolation, game addiction and so on(Kaya and Dalgic, 2021 ). The COVID-19 pandemic has already caused a terrible disaster for global public health, studies during the pandemic found that the status of mental health among adolescents are further worse than previous studies(Santomauro et al., 2021 ). This phenomenon has been influenced by a series of elements come from school, family and even society, including but no limited to the adversity of family economy, deterioration of parental relations and destruction of learning environment(Ford et al., 2021, Newlove-Delgado et al., 2021 ). This requires us to make more efforts to protect the mental health of adolescents, including more comprehensive and scientific evaluation tools, more effective psychological intervention measures, and better educational environment. Positive youths development (PYD) is a positive psychological approach which focuses on the growth, cultivation and nurture of developmental assets, abilities and potentials in adolescents(Zhao et al., 2022 ). It focuses on each teenager’s unique talents, strengths, interests and potential, which aims to understand teenagers and engage them in productive activities rather than correct or cure for negative tendencies. It has been highlighted as potentially supporting better health and social outcomes throughout the life course. Compared with PYD research in developed countries, PYD research in developing countries like China is still less. At present, PYD scale in China has been verified, and 15 PYD attributes have been identified, which can be summarized into 4 higher-order dimensions, respectively are cognitive behavioral competence (CBC), prosocial attributes (PA), general PYD qualities (GPYDQ), and positive identity(PI). Among them, GPYDQ is a comprehensive feedback on teenager’s ability of positive development, which can reflect their attitude and ability of positive growth currently(Zhou et al., 2020 ). Our research focus on the effects of GPYDQ on depression, anxiety and Internet addiction in adolescents, and try to assess the potential health value of promoting GPYDQ. Meanwhile, we also establish the correlation between depression, anxiety and Internet addiction, which could provide an evidence to verify the interaction between mental disorders and addictive behaviors. In addition, to evaluate the overall impact of COVID-19 pandemic events on the mental health in youths, the Children’s Revised Impact of Event Scale (CRIES-13) is used to assess the extent of trauma after the COVID-19 pandemic in adolescents, and assess the impact of these injuries on mental disorders, addictive behaviors, and positive developmental capacity. Exploring and understanding these issues could help us better recognize the beneficial effects of PYD, and providing valuable evaluation tools and potential interventions to promote the mental health of adolescents in the context of the COVID-19 pandemic. Materials and Methods Participants The data were collected from the first follow-up of sociological investigation named Chengdu Positive Child Development (CPCD) survey during 16 June 2020 and 8 July 2020. This survey collected data from students in two middle schools and three high schools by cluster sampling. A total of 7985 questionnaires were send out by face-to-face interview with a actual valid rate of 93.00%, and the actual number of valid questionnaires was 7426 at grades 1–9. All participants were signed consent form under informed the research purpose and privacy measures. Measures Covariates The students information of gender, age and body mass index (BMI) were included in the study, which obtained by linking to their physical examination database. Gender was coded as 0 (male) and 1 (female), and BMI was calculated based on height and weight. General positive youth development qualities The general positive youth development qualities (GPYDQ) is one of the four higher-order dimensions of the Chinese Positive Youth Development Scale (CPYDS)(Sun and Shek, 2010 ). The GPYDQ is an overall evaluation of the quality of adolescent positive development and has the strongest correlation with the CPYDS (r = 0.97)(Zhou et al., 2020 ). The GPYDQ is composed by eight factors, which includes “Healthy Bonding”, “Resilience”, “Interpersonal Competence”, “Recognition for Positive Behavior”, “Emotional control and expression”, “Discrimination”, “Sense of self efficacy”, and “Spiritual Qualities” sub-scales(Shek and Ma, 2009 ). The GPYDQ contains a total of 49 items with rated on 6-point ranging from 1 (very disagree) to 6 (very agree), which meanings that the higher scores represent a better quality of positive development. All factors in GPYDQ showed good consistencies, and the mean value of Cronbach’s alpha was 0.82, shown in the S1 of Supplement file . Internet addiction The internet addiction of adolescents was measured by using the Chinese version of Young's Internet Addiction Test (IAT) combined with 3 items developed by Daniel T.L.Shek (Respectively are question 12,16,23 in the scale, shown in supplement 2)(Kim et al., 2013 ). The scale is composed of total 23 items and each item rated on 5-point ranging from 1 (rarely) to 5 (always), and higher scores indicate wider internet addictive behaviors. Since this questionnaire is an improved version of IAT, and different regions didn’t adopt the same constructions to express its psychological properties(Moon et al., 2018 ), we used three dimensions to deconstruct the IAT referred by Lai’s study, and independently conducted an internal consistency test and confirmatory factor analysis (CFA) to judge whether the revision IAT is suitable for our survey(Lai et al., 2013 ). The modified version of IAT in our study included 18 items at last, and correspondingly, the total score of the modified IAT scale is used to indicate no addiction (0–27), mild addiction (28–45), moderate addiction (46–72) and severe addiction (73 and more); which also had a high reliability and Cronbach’s alpha was 0.93, shown in the S2 of Supplement file . Anxiety The severity of anxiety was estimated by using the Chinese version of Child Anxiety Related Emotional Disorders Scale (SCARED)(Isolan et al., 2011 ). The scale contains 41 items in total and participants rated each item on 3-point ranging from 0 (never) to 2 (often), higher scores presented a deeper level of anxiety and total scores over 25 indicated apparently symptoms of anxiety disorders. The SCARED consist of 5 dimensions with panic/somatic, general anxiety, separation anxiety, social phobia, and school phobia respectively(BIRMAHER. et al., 1997). The SCARED expressed a good internal consistency in our studies, and Cronbach’s alpha was 0.95, shown in the S3 of Supplement file (Su et al., 2008 ). Depression The symptom of depression was assessed by using the Chinese version of the Center for Epidemiologic Studies Depression Scale (CES-D)(Li et al., 2010 ). The depression scale consists of 20 items with rated on 4-point ranging from 0 (not at all) to 3 (a lot), higher scores indicated a deeper severity of depressive symptoms and total scores over 15 indicated significant levels of depressive symptoms. The dimensions of CES-D scale divided into four aspects with depressed affect (Items: 3,6,9,10,14,17,18), positive affect (Items: 4,8,12,16), somatic and retarded activity (Items: 1,2,5,7,11,13), interpersonal (Items: 15,19) respectively(Radloff, 2016 ). The scale showed a good internal consistency, and Cronbach’s alpha was 0.89, shown in the S4 of Supplement file (Jiang et al., 2019 ). Revised impact of event with COVID-19 In February 2020, China experienced nearly a month of national silence period, which means all residents had been asked to stay at home to cut off the spread of the virus. The COVID-19 pandemic had a huge impact on adolescents’ psychology, so we used the Children’s Revised Impact of Event Scale (CRIES-13) to evaluate the adolescents’ stress response after the silence of COVID-19(Davico et al., 2021 ). The CRIES-13 contains 13 items in total with recorded to 4 grades (not at all, rarely, sometimes, often), and scored as 0,1,3,5 points respectively. A Higher score indicate a deeper severity of stress response symptoms and a total score over 30 was set as a cut-off point to diagnosed as post traumatic stress disorder (PTSD)(Zhang et al., 2021 ). There are three dimensions could been divided for CRIES-13 which are intrusion (Items: 1,4,8,9), avoidance (Items: 2,6,7,10), and high arousal (Items: 3,5,11,12,13) respectively. The CRIES-13 showed a good internal consistency in our study, and Cronbach’s alpha was 0.89, shown in the S5 of Supplement file . Data analysis There were three sections in our data analysis, the first section was processing the descriptive and correlative analysis for all scales and covariates. Next section was conducting the internal consistency test and CFA for the GPYDQ, modified version of IAT(Siste et al., 2021 ), anxiety, depression and CRIES-13. Finally, in order to assess the impact of GPYDQ on the risk of internet addiction, anxiety and depression after COVID-19 pandemic, we performed the SEM and used maximum likelihood estimation with robust standard errors via 1000 bootstrapped replications(Chen et al., 2021). In our SEM analysis, considering that internet addiction, anxiety and depression could interact with each other, we established the interactive relationship for these three scales. In addition, considering that the GPYDQ might be influenced by their different age, gender and BMI, these covariates were included in the model to adjust their effects on the GPYDQ. The CRIES-13 after COVID-19 pandemic as an independent factor in the SEM analysis which built connections with all the other factors. In the evaluation of SEM, some model fit indices were recommended to further assess the goodness fit of the model, including standardized root mean square residual (SRMR), root mean square error of approximation (RMSEA), comparative fit index (CFI), normalized fit index (NFI), Tucker-Lewis index (TLI), incremental fit index (IFI), goodness of fit index (GFI), Bayesian information criteria (BIC), Akaike information criterion (AIC)(Wu et al., 2009). According to the recommendation of the acceptable model index, SRMR and RMSEA ideally be smaller than 0.10, and CFI, NFI, TLI, IFI and GFI ideally be greater than 0.8(Iliceto et al., 2011 ). All analysis were using R version 4.2.1 with packages tidyverse, lavaan and semplot, and the significance level was set as a two tailed alpha < 0.05. Results Descriptive analysis Among a total of 7,426 adolescents, the number of male was 3,867 (52.07%) and female was 3,559 (47.93%) respectively, and the mean age was 13.64 ± 2.08 range from 9 to 17 years. The age distribution of male and female adolescents was basically balanced, but had obviously difference in BMI. There were remarkable gaps in four dimensions (Recognition of positive behavior, Discrimination, Sense of self efficacy and Spiritual qualities) of GPYDQ between male and female, and the scores of each dimension in GPYDQ among male was lower than that in females except spiritual qualities, shown in Table 1 . Table 1 The description of Demographic Characteristics and the General Positive Youth Development Qualities Scale among Adolescents Variables Min Max Median IQR Mean ± SD t value P value Age -1.251 .211 Male 9 17 14 3 13.607 ± 2.090 Female 9 17 14 3 13.668 ± 2.071 BMI 3.027 .002 Male 14.001 33.812 17.481 4.085 18.275 ± 3.212 Female 14.004 33.684 17.404 3.900 18.056 ± 3.012 General Positive Youth Development Qualities (GPYDQ) Healthy Bonding -1.860 .063 Male 6 36 33 7 31.120 ± 5.667 Female 6 36 33 7 31.353 ± 5.141 Resilience -0.133 .894 Male 6 36 33 7 31.507 ± 5.391 Female 6 36 33 7 31.523 ± 5.184 Interpersonal competence -1.103 .270 Male 7 42 35 9 33.967 ± 6.739 Female 7 42 35 8 34.134 ± 6.275 Recognition of positive behavior -2.730 .006 Male 4 24 21 6 20.063 ± 4.091 Female 4 24 21 6 20.313 ± 3.789 Emotional control and expression -0.362 .718 Male 6 36 30 10 28.309 ± 6.789 Female 6 36 30 10 28.365 ± 6.610 Discrimination -4.443 .001 Male 6 36 30 8 29.372 ± 5.782 Female 6 36 31 7 29.931 ± 5.072 Sense of self efficacy -2.887 .004 Male 8 42 27 9 27.908 ± 6.376 Female 8 42 27 10 28.341 ± 6.510 Spiritual qualities 5.326 .001 Male 7 49 43 11 40.252 ± 9.039 Female 7 49 43 13 39.083 ± 9.817 Note: IQR, Inter Quartile Range; SD, standard deviation. According to the corresponding criteria of the self-assessed scale, the prevalence of Internet addiction were 51.16% of mild addiction, 16.12% of moderate addiction, 1.27% of severe addiction respectively; the prevalence of anxiety was 21.14%; the prevalence of depression was 34.03% and the prevalence of PTSD was 12.56%. Male scored higher on Internet addiction than women, but lower on anxiety and depression, shown in Table 2 . Table 2 The description of Internet Addiction, Anxiety and Depression among Adolescents Variables Min Max Median IQR Mean ± SD t value P value Internet Addiction Test Withdrawal and social problem 8.467 .001 Male 9 45 14 10 16.275 ± 7.095 Female 9 45 13 8.5 14.942 ± 6.463 Time management and performance 6.817 .001 Male 6 30 10 8 11.510 ± 5.271 Female 6 30 9 7 10.700 ± 4.969 Reality and Substitute 4.502 .001 Male 3 15 4 4 5.107 ± 2.693 Female 3 15 4 3 4.834 ± 2.535 The Center for Epidemiological Studies Depression Scale Depressed affect -4.622 .001 Male 6 24 7 4 8.710 ± 3.876 Female 6 24 7 5 9.146 ± 4.218 Positive affect 5.150 .001 Male 4 16 11 6 10.732 ± 3.856 Female 4 16 10 6 10.280 ± 3.692 Somatic complaints -4.872 .001 Male 10 40 13 7 14.651 ± 5.784 Female 10 40 13 8 15.341 ± 6.365 Screen for Child Anxiety Related Disorders Somatic / panic -6.428 .001 Male 0 26 2 5 3.545 ± 4.786 Female 0 26 2 6 4.310 ± 5.419 Generalized anxiety -11.305 .001 Male 0 18 1 4 2.854 ± 3.783 Female 0 18 2 7 3.927 ± 4.341 Separation anxiety -8.945 .001 Male 0 16 2 4 2.690 ± 3.083 Female 0 16 2 4 3.361 ± 3.357 Social phobia -13.467 .001 Male 0 14 2 6 3.376 ± 3.509 Female 0 14 4 6 4.526 ± 3.824 School phobia -5.167 .001 Male 0 8 0 1 1.002 ± 1.542 Female 0 8 1 2 1.192 ± 1.608 Note: IQR, Inter Quartile Range; SD, standard deviation. Correlation analysis We found a strong correlation between all dimensions within the scale, except the positive affect dimension of the depression scale. In addition, only GPYDQ had negative correlations with Internet addiction, anxiety and depression and PTSD, while all other scales had positive correlations, shown in Table 3 . Table 3 Correlation analysis for all variables Num Withdrawal and social problem Time management and performance Reality and substitute Depressed affect Positive affect Somatic complaints Somatic or panic Generalized anxiety Separation anxiety Social phobia School phobia GPYDQ CRIES-13 1 1*** 2 0.821*** 1*** 3 0.809*** 0.741*** 1*** 4 0.364*** 0.296*** 0.351*** 1*** 5 0.091*** 0.084*** 0.124*** 0.101*** 1*** 6 0.433*** 0.381*** 0.424*** 0.780*** 0.107*** 1*** 7 0.352*** 0.306*** 0.343*** 0.573*** 0.108*** 0.623*** 1*** 8 0.396*** 0.360*** 0.381*** 0.597*** 0.105*** 0.651*** 0.825*** 1*** 9 0.248*** 0.226*** 0.234*** 0.445*** 0.012 0.472*** 0.723*** 0.715*** 1*** 10 0.264*** 0.249*** 0.242*** 0.353*** -0.067*** 0.397*** 0.574*** 0.648*** 0.569*** 1*** 11 0.41*** 0.375*** 0.404*** 0.445*** 0.102*** 0.528*** 0.645*** 0.639*** 0.546*** 0.440*** 1*** 12 -0.433*** -0.397*** -0.425*** -0.468*** -0.336*** -0.509*** -0.417*** -0.466*** -0.310*** -0.298*** -0.420*** 1*** 13 0.194*** 0.185*** 0.181*** 0.296*** 0.037** 0.323*** 0.400*** 0.388*** 0.376*** 0.296*** 0.282*** -0.183*** 1*** Note: * P < 0.05, ** P < 0.01, *** P < 0.001. Weak correlation 0.7. SEM analysis In the path structure of SEM, we found that GPYDQ could obviously reduce the score on scales of mental disorders and addictive behavior ( β internet =-0.658, 95%CI: -0.715–0.607; β anxiety =-0.422, 95%CI: -0.461–0.388; β depression =-0.378, 95%CI: -0.409–0.349), which indicated that GPYDQ has a positive effect on mental health for adolescents. Through the impact of COVID-19 pandemic, the CRIES-13 appeared the significant influence on the scale scores of all the others, and we found that CRIES-13 had the largest effect on the anxiety of youths with standard coefficient is 0.382, and had the smallest effect on the internet addiction of youths (std.coef = 0.140). The CRIES-13 also set up a negative relationship with GPYDQ (std.coef = -0.155), which meanings that the events of COVID-19 pandemic reduce the competence of GPYDQ among youths. In addition, with the growing age and rising BMI, we found that GPYDQ score was decreased (std.coef age = -0.152, std.coef BMI = -0.026), among them, age exhibited a large negative impact on GPYDQ which even equal to the influence of COVID-19. The results shown in Table 4 and Fig. 1 . Table 4 The structural equation model analysis of the effect of GPYDQ on Depression, Anxiety and Internet addiction after COVID-19 pandemic Variables Beta Std.error Z value Std.beta P value Beta 95%CI Lower Upper Measurement model GPYDQ → DC -0.378 0.016 -24.375 -0.466 .001 -0.409 -0.349 COVID-19 → DC 1.014 0.066 15.481 0.279 .001 0.900 1.152 GPYDQ → CA -0.422 0.019 -22.287 -0.386 .001 -0.461 -0.388 COVID-19 → CA 1.878 0.097 19.402 0.382 .001 1.685 2.074 GPYDQ → IA -0.658 0.027 -24.204 -0.428 .001 -0.715 -0.607 COVID-19 → IA 0.964 0.101 9.564 0.140 .001 0.769 1.181 COVID-19 → GPYDQ -0.694 0.064 -10.817 -0.155 .001 -0.822 -0.568 Age → GPYDQ -0.308 0.026 -11.740 -0.152 .001 -0.359 -0.255 Gender → GPYDQ 0.134 0.098 1.373 0.016 .170 -0.042 0.339 BMI → GPYDQ -0.035 0.018 -1.948 -0.026 .051 -0.070 -0.004 Structural model Direct effect GPYDQ + COVID-19 → DC 0.636 0.069 9.208 -0.188 .001 0.508 0.781 GPYDQ + COVID-19 → CA 1.456 0.102 14.331 -0.003 .001 1.262 1.659 GPYDQ + COVID-19 → IA 0.306 0.110 2.778 -0.288 .005 0.087 0.535 COVID-19 → GPYDQ -0.694 0.064 -10.806 -0.155 .001 -0.822 -0.568 Total Direct Effect 1.703 0.230 7.415 -0.634 .001 1.245 2.152 Indirect effect COVID-19→ GPYDQ → DC 0.263 0.028 9.526 0.072 .001 0.213 0.319 COVID-19→ GPYDQ → CA 0.293 0.030 9.648 0.060 .001 0.239 0.354 COVID-19→ GPYDQ → IA 0.457 0.047 9.668 0.066 .001 0.368 0.556 Total Indirect Effect 1.012 0.103 9.843 0.198 .001 0.827 1.216 Total effect COVID-19 + GPYDQ→DC + CA + IA 2.716 0.225 12.086 -0.436 .001 2.247 3.152 Note: Confidence interval (CI); Depression Scale for Children (DC); Children Anxiety (CA); Internet addiction (IA); General Positive Youth Development Qualities (GPYDQ). The assessment of SEM expressed an acceptable fitting performance result, and the goodness of fit indexes were: RMSEA = 0.068 (95%CI: 0.068–0.069), SRMR = 0.080, CFI = 0.866, NFI = 0.862, TLI = 0.854, IFI = 0.866, GFI = 0.834. Discussion In this study, we found that the positive development ability of adolescents has an obvious regulating and improving role on mental disorders and addictive behaviors. Higher GPYDQ score is closely related to better performance of depression, anxiety and Internet addiction. At the same time, however, the impact of the COVID-19 pandemic has indeed hit the adolescent’s ability of positive development and aggravate the degree of mental disorders and addictive behaviors. These results indicate that, in the context of the global COVID-19 pandemic, repairing adolescents’ positive development ability plays an important role in protecting their mental health and positive growth. In the previous studies, PYD also showed a negative correlation with anxiety and depression, a 3-year follow-up study in China showed that low PYD scores in baseline significantly increased the risk of depression or aggravated the symptoms of depression(Chi et al., 2020a ), Another study in middle school students also linked worse PYD to more severe depressive symptoms(Chi et al., 2020b ). In addition, PYD was also found that has a negative relationship with Internet violence and gaming disorder, and Xiang et al. suggested that actively improving PYD is an effective way to avoid the occurrence of Internet adverse events(Xiang et al., 2022 ). Our study is consistent with the previous studies, moreover, we also found that the standardized effects of GPYDQ on mental health problems such as depression, anxiety and Internet addiction are similar, indicating that the improvement of PYD for adolescents can generally benefit their mental health. At present, some foreign institutions have carried out a series of PYD promotion programs, including some camping, wilderness exploration, sports, music and painting guidance(Waid and Uhrich, 2019 ). From the results of intervention, the PYD enhancement program did effectively improve the scores of PYD attributes. Moreover, compared with the control group, students receiving intervention also showed lower crime rate and better academic performance(Ma et al., 2019 ). We suggest that corresponding intervention studies are needed to explore the effect of improving PYD attributes on depression, anxiety and addictive behaviors for adolescents in the future. However, it is also worth noting that COVID-19 has caused significant damage to the mental health status of adolescents, especially the risk of anxiety, which is most associated with the impact of COVID-19; and a lot of studies during pandemic period have also documented a huge toll the pandemic taken on people’s mental health(Collaborators, 2021 ). Meanwhile, COVID-19 has also damaged the positive developmental ability of adolescents and contributed to their pessimism(Shek et al., 2022 ), and their confidence and expectations for the future have suffered a severe blow(Samios et al., 2022 ). These require us to take effective measures to protect and improve the mental health of adolescents as soon as possible. Although this study makes contributions to related literature and practice, several limitations in the current study have to be considered. First, this study is a cross-sectional survey and therefore could not use a cross-lagged approach to explore changes in adolescent mental health before and after COVID-19. Second, this study is mainly based on five schools in southwest China, and the representation of the sample population is limited. It is expected that more students from different regions and cultural backgrounds added for a more extensive investigation in the future. Third, the questionnaire collection in the survey is based on students’ self-report, which may have a certain cognitive bias, future verification using teacher or parent reported questionnaires is encouraged. Conclusion This study comprehensively analyzed the correlation between PYD attributes, depressive and anxiety symptoms, and Internet addictive behaviors of adolescents. The results showed that positive PYD attributes could effectively improve the anxiety and depression, control and regulate the dependence on Internet addiction, and the damage of the COVID-19 pandemic on adolescent mental health should not be ignored, which could aggravate the expression of depression, anxiety and Internet addiction of adolescents, and damage their abilities of positive development. Therefore, we need to take effective actions to protect and improve the healthy growth of adolescents. Declarations Ethics approval and consent to participate This study was approved by the Research Ethics Committee of the Sichuan University ( No.2020YFC2006300, 19H0642). The participants provided their written informed consent to participate in this study. Consent for publication All authors have participated in the study and approved the submission. Availability of data and materials The datasets presented in this article are not readily available because data access is authorized by the school. Requests to access the datasets should be directed to the corresponding authors. Competing interests The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. Funding This study was funded by Study of Diet and Nutrition Assessment and Intervention Technology (No.2020YFC2006300) from Active Health and Aging Technologic Solutions Major Project of National Key R&D Program, and Hong Kong Polytechnic University (19H0642). Authors' contributions Jiahe Liu: Writing-original draft, Methodology, Validation. Ni Wu: Conceptualization, Methodology, Formal analysis, Writing-original draft, Visualization. Shuming Ji: Data collection, Conceptualization, Formal analysis. Binxue Hong: Investigation, Data regulation, Formal analysis. 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Psychometric Properties of the Internet Addiction Test: A Systematic Review and Meta-Analysis. Cyberpsychol Behav Soc Netw. 2018;21:473–84. NEWLOVE-DELGADO T, SADLER MCMANUSS, THANDI K, VIZARD S, CARTWRIGHT T, C., FORD T. Child mental health in England before and during the COVID-19 lockdown. Lancet Psychiatry. 2021;8:353–4. RADLOFF LS. The CES-D Scale: A Self-Report Depression Scale for Research in the General Population. Appl Psychol Meas. 2016;1:385–401. SAMIOS C, PRASKOVA A, RADLINSKA B. The relationship between COVID-19 pandemic-related stress and meaning in life: testing the moderating effects of self-compassion and savoring. Anxiety Stress Coping. 2022;35:9–24. SANTOMAURO DF, MANTILLA HERRERA AM, ZHENG SHADIDJ, PIGOTT PASHBAUGHC, ABBAFATI DM, ADOLPH C, C., AMLAG JO. Global prevalence and burden of depressive and anxiety disorders in 204 countries and territories in 2020 due to the COVID-19 pandemic. Lancet. 2021;398:1700–12. SHEK DTL, DOU D, ZHU X, WONG T, TAN L. Need Satisfaction and Depressive Symptoms Among University Students in Hong Kong During the COVID-19 Pandemic: Moderating Effects of Positive Youth Development Attributes. Front Psychiatry. 2022;13:931404. SHEK DTL, MA CMS. Dimensionality of the Chinese Positive Youth Development Scale: Confirmatory Factor Analyses. Soc Indic Res. 2009;98:41–59. SISTE K, SUWARTONO C, BARDOSONO NASRUNMW, DAMAYANTI SSEKARTINIRPANDELAKIJSARASVITARMURTANIBJ, R., WIGUNA T. Validation study of the Indonesian internet addiction test among adolescents. PLoS ONE. 2021;16:e0245833. SU L, SU WANGKFANF, Y., GAO X. Reliability and validity of the screen for child anxiety related emotional disorders (SCARED) in Chinese children. J Anxiety Disord. 2008;22:612–21. SUN RC, SHEK DT. Life Satisfaction, Positive Youth Development, and Problem Behaviour Among Chinese Adolescents in Hong Kong. Soc Indic Res. 2010;95:455–74. VOGELZANGS N, BEEKMAN SELDENRIJKA, VAN AT, HOUT HP, DE JONGE P, PENNINX BW. Cardiovascular disease in persons with depressive and anxiety disorders. J Affect Disord. 2010;125:241–8. WAID J, UHRICH M. 2019. A Scoping Review of the Theory and Practice of Positive Youth Development. Br J Social Work, 1–20. WU W, WEST, S. G., TAYLOR AB. Evaluating model fit for growth curve models: Integration of fit indices from SEM and MLM frameworks. Psychol Methods. 2009;14:183–201. XIANG GX, ZHANG YH, GAN X, LI QINKNZHOUYN, M., JIN X. Cyberbullying and internet gaming disorder in Chinese youth: The role of positive youth development attributes. Front Public Health. 2022;10:1017123. ZHANG H, XU H, HUANG L, WANG Y, DENG F, WANG X, TANG X, FU WANGW, TAO X, Y., YIN L. Increased occurrence of PTSD symptoms in adolescents with major depressive disorder soon after the start of the COVID-19 outbreak in China: a cross-sectional survey. BMC Psychiatry. 2021;21:395. ZHAO L, SHEK DTL, ZOU K, LEI Y, JIA P. Cohort Profile: Chengdu Positive Child Development (CPCD) survey. Int J Epidemiol. 2022;51:e95–107. ZHOU Z, SHEK DTL, ZHU X, DOU D. 2020. Positive Youth Development and Adolescent Depression: A Longitudinal Study Based on Mainland Chinese High School Students. Int J Environ Res Public Health, 17. ZVOLENSKY MJ, GAREY KAUFFMANBY, L., VIANA, A. G., MATOSKA CT. Interoceptive anxiety-related processes: Importance for understanding COVID-19 and future pandemic mental health and addictive behaviors and their comorbidity. Behav Res Ther. 2022;156:104141. Additional Declarations No competing interests reported. Supplementary Files Supplement.docx Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4374395","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":301270602,"identity":"6059fd66-39c4-43da-aaa9-ba3c8716688d","order_by":0,"name":"Jiahe Liu","email":"","orcid":"","institution":"University of Melbourne","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Jiahe","middleName":"","lastName":"Liu","suffix":""},{"id":301270604,"identity":"beeb2ee8-f026-4fa5-8b6b-a67a877a9f10","order_by":1,"name":"Ni Wu","email":"","orcid":"","institution":"West China School of Public Health, Sichuan University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Ni","middleName":"","lastName":"Wu","suffix":""},{"id":301270605,"identity":"9554cee4-457d-4b57-afc3-76d8b9d19a29","order_by":2,"name":"Shuming Ji","email":"","orcid":"","institution":"Sichuan University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Shuming","middleName":"","lastName":"Ji","suffix":""},{"id":301270606,"identity":"2995b4fd-ea70-447b-8cdd-319937ab449a","order_by":3,"name":"Binxue Hong","email":"","orcid":"","institution":"West China School of Public Health, Sichuan University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Binxue","middleName":"","lastName":"Hong","suffix":""},{"id":301270607,"identity":"09713359-eb89-4e7f-9363-03d435867df3","order_by":4,"name":"Lihua Jiang","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA0ElEQVRIiWNgGAWjYBACPgnGBweAtByEy0aEFjYJhgSQFmPStIDoxAbitUg3JB74uaM2fX77GQOGD2WHGfhnNxDQInMg4WDvmeO5G87kGDDOOHeYQeLOAUIOS0g4wNt2LHeDBI8BM2/bYQYDiQTCWg7+bTuWLj8DqOUvcVpSEg7zttUkMNwAamEkTkvagcOybQcMN5xJKzjYcy6dR+IGAS38EsnNH9+21cnLtx/e+OBHmbUc/wwCWqDgMJg8AMQ8RKkHgjpiFY6CUTAKRsFIBABm70OBJIOajAAAAABJRU5ErkJggg==","orcid":"","institution":"Sichuan University","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"Lihua","middleName":"","lastName":"Jiang","suffix":""}],"badges":[],"createdAt":"2024-05-06 06:10:32","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4374395/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4374395/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":56809073,"identity":"0f3a4dff-4215-4f12-a62c-6e4050b9cb84","added_by":"auto","created_at":"2024-05-20 18:46:44","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":119777,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eThe structure diagram for the effect of GPYDQ on Depression, Anxiety and Internet addiction after COVID-19 pandemic\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u003cstrong\u003eNote: * P \u0026lt; .01.\u003c/strong\u003e\u003c/em\u003e\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-4374395/v1/0637d0c3b6c55e9056663e3a.png"},{"id":72693895,"identity":"0d5d7d28-c014-4608-b12c-1a1d11dac16b","added_by":"auto","created_at":"2024-12-31 10:09:05","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1244899,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4374395/v1/f8423514-d7df-4df3-bf4d-7d64288f3265.pdf"},{"id":56809074,"identity":"97cb1a6a-8ff4-4572-8ab0-b8ca546d49ab","added_by":"auto","created_at":"2024-05-20 18:46:44","extension":"docx","order_by":4,"title":"","display":"","copyAsset":false,"role":"supplement","size":929986,"visible":true,"origin":"","legend":"","description":"","filename":"Supplement.docx","url":"https://assets-eu.researchsquare.com/files/rs-4374395/v1/49d9be8df426ad9741a83f5f.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Positive youth development qualities improve mental disorders and addiction: A cross-sectional survey of teenagers in China under the COVID-19 pandemic","fulltext":[{"header":"Introduction","content":"\u003cp\u003eThe mental health of adolescents has become a focused topic in global public health, a growing number of international studies show that the prevalence of mental disorders such as anxiety, depression and sleep disturbance are rising substantially among youths(Keyes et al., \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e2019\u003c/span\u003e, David and Kay, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2009\u003c/span\u003e). This is accompanied by increasing clinical reports of severe symptom of mental illness in youths, as well as increasing reports of self-harm(Zvolensky et al., \u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e2022\u003c/span\u003e, Vogelzangs et al., \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e2010\u003c/span\u003e). On the other hand, addiction behaviors perform a critical impact on the mental disorders all the time, especially the internet addiction, and according to the report of BMJ in 2018(Gunnell et al., \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2018\u003c/span\u003e), post-millennial kids are growing up surrounded by social media, which results in less face to face communication and rising risk of over-dependency. In the last decade, our lifestyle is being deeply changed by mobile phone and internet, relevant studies also found that this change set up a closely correlation in youths with sleep complains, social isolation, game addiction and so on(Kaya and Dalgic, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e2021\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe COVID-19 pandemic has already caused a terrible disaster for global public health, studies during the pandemic found that the status of mental health among adolescents are further worse than previous studies(Santomauro et al., \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). This phenomenon has been influenced by a series of elements come from school, family and even society, including but no limited to the adversity of family economy, deterioration of parental relations and destruction of learning environment(Ford et al., 2021, Newlove-Delgado et al., \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). This requires us to make more efforts to protect the mental health of adolescents, including more comprehensive and scientific evaluation tools, more effective psychological intervention measures, and better educational environment.\u003c/p\u003e \u003cp\u003ePositive youths development (PYD) is a positive psychological approach which focuses on the growth, cultivation and nurture of developmental assets, abilities and potentials in adolescents(Zhao et al., \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). It focuses on each teenager\u0026rsquo;s unique talents, strengths, interests and potential, which aims to understand teenagers and engage them in productive activities rather than correct or cure for negative tendencies. It has been highlighted as potentially supporting better health and social outcomes throughout the life course. Compared with PYD research in developed countries, PYD research in developing countries like China is still less. At present, PYD scale in China has been verified, and 15 PYD attributes have been identified, which can be summarized into 4 higher-order dimensions, respectively are cognitive behavioral competence (CBC), prosocial attributes (PA), general PYD qualities (GPYDQ), and positive identity(PI). Among them, GPYDQ is a comprehensive feedback on teenager\u0026rsquo;s ability of positive development, which can reflect their attitude and ability of positive growth currently(Zhou et al., \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e2020\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eOur research focus on the effects of GPYDQ on depression, anxiety and Internet addiction in adolescents, and try to assess the potential health value of promoting GPYDQ. Meanwhile, we also establish the correlation between depression, anxiety and Internet addiction, which could provide an evidence to verify the interaction between mental disorders and addictive behaviors. In addition, to evaluate the overall impact of COVID-19 pandemic events on the mental health in youths, the Children\u0026rsquo;s Revised Impact of Event Scale (CRIES-13) is used to assess the extent of trauma after the COVID-19 pandemic in adolescents, and assess the impact of these injuries on mental disorders, addictive behaviors, and positive developmental capacity. Exploring and understanding these issues could help us better recognize the beneficial effects of PYD, and providing valuable evaluation tools and potential interventions to promote the mental health of adolescents in the context of the COVID-19 pandemic.\u003c/p\u003e"},{"header":"Materials and Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eParticipants\u003c/h2\u003e \u003cp\u003eThe data were collected from the first follow-up of sociological investigation named Chengdu Positive Child Development (CPCD) survey during 16 June 2020 and 8 July 2020. This survey collected data from students in two middle schools and three high schools by cluster sampling. A total of 7985 questionnaires were send out by face-to-face interview with a actual valid rate of 93.00%, and the actual number of valid questionnaires was 7426 at grades 1\u0026ndash;9. All participants were signed consent form under informed the research purpose and privacy measures.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eMeasures\u003c/h2\u003e \u003cdiv id=\"Sec5\" class=\"Section3\"\u003e \u003ch2\u003eCovariates\u003c/h2\u003e \u003cp\u003eThe students information of gender, age and body mass index (BMI) were included in the study, which obtained by linking to their physical examination database. Gender was coded as 0 (male) and 1 (female), and BMI was calculated based on height and weight.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section3\"\u003e \u003ch2\u003eGeneral positive youth development qualities\u003c/h2\u003e \u003cp\u003eThe general positive youth development qualities (GPYDQ) is one of the four higher-order dimensions of the Chinese Positive Youth Development Scale (CPYDS)(Sun and Shek, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e2010\u003c/span\u003e). The GPYDQ is an overall evaluation of the quality of adolescent positive development and has the strongest correlation with the CPYDS (r\u0026thinsp;=\u0026thinsp;0.97)(Zhou et al., \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). The GPYDQ is composed by eight factors, which includes \u0026ldquo;Healthy Bonding\u0026rdquo;, \u0026ldquo;Resilience\u0026rdquo;, \u0026ldquo;Interpersonal Competence\u0026rdquo;, \u0026ldquo;Recognition for Positive Behavior\u0026rdquo;, \u0026ldquo;Emotional control and expression\u0026rdquo;, \u0026ldquo;Discrimination\u0026rdquo;, \u0026ldquo;Sense of self efficacy\u0026rdquo;, and \u0026ldquo;Spiritual Qualities\u0026rdquo; sub-scales(Shek and Ma, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e2009\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe GPYDQ contains a total of 49 items with rated on 6-point ranging from 1 (very disagree) to 6 (very agree), which meanings that the higher scores represent a better quality of positive development. All factors in GPYDQ showed good consistencies, and the mean value of Cronbach\u0026rsquo;s alpha was 0.82, shown in the \u003cb\u003eS1\u003c/b\u003e of \u003cb\u003eSupplement file\u003c/b\u003e.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section3\"\u003e \u003ch2\u003eInternet addiction\u003c/h2\u003e \u003cp\u003eThe internet addiction of adolescents was measured by using the Chinese version of Young's Internet Addiction Test (IAT) combined with 3 items developed by Daniel T.L.Shek (Respectively are question 12,16,23 in the scale, shown in supplement 2)(Kim et al., \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e2013\u003c/span\u003e). The scale is composed of total 23 items and each item rated on 5-point ranging from 1 (rarely) to 5 (always), and higher scores indicate wider internet addictive behaviors.\u003c/p\u003e \u003cp\u003eSince this questionnaire is an improved version of IAT, and different regions didn\u0026rsquo;t adopt the same constructions to express its psychological properties(Moon et al., \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e2018\u003c/span\u003e), we used three dimensions to deconstruct the IAT referred by Lai\u0026rsquo;s study, and independently conducted an internal consistency test and confirmatory factor analysis (CFA) to judge whether the revision IAT is suitable for our survey(Lai et al., \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e2013\u003c/span\u003e). The modified version of IAT in our study included 18 items at last, and correspondingly, the total score of the modified IAT scale is used to indicate no addiction (0\u0026ndash;27), mild addiction (28\u0026ndash;45), moderate addiction (46\u0026ndash;72) and severe addiction (73 and more); which also had a high reliability and Cronbach\u0026rsquo;s alpha was 0.93, shown in the \u003cb\u003eS2\u003c/b\u003e of \u003cb\u003eSupplement file\u003c/b\u003e.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section3\"\u003e \u003ch2\u003eAnxiety\u003c/h2\u003e \u003cp\u003eThe severity of anxiety was estimated by using the Chinese version of Child Anxiety Related Emotional Disorders Scale (SCARED)(Isolan et al., \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e2011\u003c/span\u003e). The scale contains 41 items in total and participants rated each item on 3-point ranging from 0 (never) to 2 (often), higher scores presented a deeper level of anxiety and total scores over 25 indicated apparently symptoms of anxiety disorders. The SCARED consist of 5 dimensions with panic/somatic, general anxiety, separation anxiety, social phobia, and school phobia respectively(BIRMAHER. et al., 1997). The SCARED expressed a good internal consistency in our studies, and Cronbach\u0026rsquo;s alpha was 0.95, shown in the \u003cb\u003eS3\u003c/b\u003e of \u003cb\u003eSupplement file\u003c/b\u003e(Su et al., \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e2008\u003c/span\u003e).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec9\" class=\"Section3\"\u003e \u003ch2\u003eDepression\u003c/h2\u003e \u003cp\u003eThe symptom of depression was assessed by using the Chinese version of the Center for Epidemiologic Studies Depression Scale (CES-D)(Li et al., \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2010\u003c/span\u003e). The depression scale consists of 20 items with rated on 4-point ranging from 0 (not at all) to 3 (a lot), higher scores indicated a deeper severity of depressive symptoms and total scores over 15 indicated significant levels of depressive symptoms. The dimensions of CES-D scale divided into four aspects with depressed affect (Items: 3,6,9,10,14,17,18), positive affect (Items: 4,8,12,16), somatic and retarded activity (Items: 1,2,5,7,11,13), interpersonal (Items: 15,19) respectively(Radloff, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e2016\u003c/span\u003e). The scale showed a good internal consistency, and Cronbach\u0026rsquo;s alpha was 0.89, shown in the \u003cb\u003eS4\u003c/b\u003e of \u003cb\u003eSupplement file\u003c/b\u003e(Jiang et al., \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e2019\u003c/span\u003e).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec10\" class=\"Section3\"\u003e \u003ch2\u003eRevised impact of event with COVID-19\u003c/h2\u003e \u003cp\u003eIn February 2020, China experienced nearly a month of national silence period, which means all residents had been asked to stay at home to cut off the spread of the virus. The COVID-19 pandemic had a huge impact on adolescents\u0026rsquo; psychology, so we used the Children\u0026rsquo;s Revised Impact of Event Scale (CRIES-13) to evaluate the adolescents\u0026rsquo; stress response after the silence of COVID-19(Davico et al., \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2021\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe CRIES-13 contains 13 items in total with recorded to 4 grades (not at all, rarely, sometimes, often), and scored as 0,1,3,5 points respectively. A Higher score indicate a deeper severity of stress response symptoms and a total score over 30 was set as a cut-off point to diagnosed as post traumatic stress disorder (PTSD)(Zhang et al., \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). There are three dimensions could been divided for CRIES-13 which are intrusion (Items: 1,4,8,9), avoidance (Items: 2,6,7,10), and high arousal (Items: 3,5,11,12,13) respectively. The CRIES-13 showed a good internal consistency in our study, and Cronbach\u0026rsquo;s alpha was 0.89, shown in the \u003cb\u003eS5\u003c/b\u003e of \u003cb\u003eSupplement file\u003c/b\u003e.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eData analysis\u003c/h2\u003e \u003cp\u003eThere were three sections in our data analysis, the first section was processing the descriptive and correlative analysis for all scales and covariates. Next section was conducting the internal consistency test and CFA for the GPYDQ, modified version of IAT(Siste et al., \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e2021\u003c/span\u003e), anxiety, depression and CRIES-13. Finally, in order to assess the impact of GPYDQ on the risk of internet addiction, anxiety and depression after COVID-19 pandemic, we performed the SEM and used maximum likelihood estimation with robust standard errors via 1000 bootstrapped replications(Chen et al., 2021).\u003c/p\u003e \u003cp\u003eIn our SEM analysis, considering that internet addiction, anxiety and depression could interact with each other, we established the interactive relationship for these three scales. In addition, considering that the GPYDQ might be influenced by their different age, gender and BMI, these covariates were included in the model to adjust their effects on the GPYDQ. The CRIES-13 after COVID-19 pandemic as an independent factor in the SEM analysis which built connections with all the other factors.\u003c/p\u003e \u003cp\u003eIn the evaluation of SEM, some model fit indices were recommended to further assess the goodness fit of the model, including standardized root mean square residual (SRMR), root mean square error of approximation (RMSEA), comparative fit index (CFI), normalized fit index (NFI), Tucker-Lewis index (TLI), incremental fit index (IFI), goodness of fit index (GFI), Bayesian information criteria (BIC), Akaike information criterion (AIC)(Wu et al., 2009). According to the recommendation of the acceptable model index, SRMR and RMSEA ideally be smaller than 0.10, and CFI, NFI, TLI, IFI and GFI ideally be greater than 0.8(Iliceto et al., \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e2011\u003c/span\u003e). All analysis were using R version 4.2.1 with packages tidyverse, lavaan and semplot, and the significance level was set as a two tailed alpha\u0026thinsp;\u0026lt;\u0026thinsp;0.05.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eDescriptive analysis\u003c/h2\u003e \u003cp\u003eAmong a total of 7,426 adolescents, the number of male was 3,867 (52.07%) and female was 3,559 (47.93%) respectively, and the mean age was 13.64\u0026thinsp;\u0026plusmn;\u0026thinsp;2.08 range from 9 to 17 years. The age distribution of male and female adolescents was basically balanced, but had obviously difference in BMI. There were remarkable gaps in four dimensions (Recognition of positive behavior, Discrimination, Sense of self efficacy and Spiritual qualities) of GPYDQ between male and female, and the scores of each dimension in GPYDQ among male was lower than that in females except spiritual qualities, shown in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eThe description of Demographic Characteristics and the General Positive Youth Development Qualities Scale among Adolescents\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"8\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMin\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMax\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMedian\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eIQR\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eMean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003et value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-1.251\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e.211\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e13.607\u0026thinsp;\u0026plusmn;\u0026thinsp;2.090\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e13.668\u0026thinsp;\u0026plusmn;\u0026thinsp;2.071\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003eBMI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e3.027\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e.002\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e14.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e33.812\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e17.481\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4.085\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e18.275\u0026thinsp;\u0026plusmn;\u0026thinsp;3.212\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e14.004\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e33.684\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e17.404\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.900\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e18.056\u0026thinsp;\u0026plusmn;\u0026thinsp;3.012\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eGeneral Positive Youth Development Qualities (GPYDQ)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003eHealthy Bonding\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-1.860\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e.063\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e31.120\u0026thinsp;\u0026plusmn;\u0026thinsp;5.667\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e31.353\u0026thinsp;\u0026plusmn;\u0026thinsp;5.141\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003eResilience\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.133\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e.894\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e31.507\u0026thinsp;\u0026plusmn;\u0026thinsp;5.391\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e31.523\u0026thinsp;\u0026plusmn;\u0026thinsp;5.184\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003eInterpersonal competence\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-1.103\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e.270\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e33.967\u0026thinsp;\u0026plusmn;\u0026thinsp;6.739\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e34.134\u0026thinsp;\u0026plusmn;\u0026thinsp;6.275\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003eRecognition of positive behavior\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-2.730\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e.006\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e20.063\u0026thinsp;\u0026plusmn;\u0026thinsp;4.091\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e20.313\u0026thinsp;\u0026plusmn;\u0026thinsp;3.789\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003eEmotional control and expression\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.362\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e.718\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e28.309\u0026thinsp;\u0026plusmn;\u0026thinsp;6.789\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e28.365\u0026thinsp;\u0026plusmn;\u0026thinsp;6.610\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003eDiscrimination\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-4.443\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e29.372\u0026thinsp;\u0026plusmn;\u0026thinsp;5.782\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e29.931\u0026thinsp;\u0026plusmn;\u0026thinsp;5.072\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003eSense of self efficacy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-2.887\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e.004\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e27.908\u0026thinsp;\u0026plusmn;\u0026thinsp;6.376\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e28.341\u0026thinsp;\u0026plusmn;\u0026thinsp;6.510\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003eSpiritual qualities\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e5.326\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e43\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e40.252\u0026thinsp;\u0026plusmn;\u0026thinsp;9.039\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e43\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e39.083\u0026thinsp;\u0026plusmn;\u0026thinsp;9.817\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"8\"\u003e\u003cb\u003eNote: IQR, Inter Quartile Range; SD, standard deviation.\u003c/b\u003e\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eAccording to the corresponding criteria of the self-assessed scale, the prevalence of Internet addiction were 51.16% of mild addiction, 16.12% of moderate addiction, 1.27% of severe addiction respectively; the prevalence of anxiety was 21.14%; the prevalence of depression was 34.03% and the prevalence of PTSD was 12.56%. Male scored higher on Internet addiction than women, but lower on anxiety and depression, shown in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eThe description of Internet Addiction, Anxiety and Depression among Adolescents\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"8\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMin\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMax\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMedian\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eIQR\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eMean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003et value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003eInternet Addiction Test\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003eWithdrawal and social problem\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e8.467\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e16.275\u0026thinsp;\u0026plusmn;\u0026thinsp;7.095\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e8.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e14.942\u0026thinsp;\u0026plusmn;\u0026thinsp;6.463\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003eTime management and performance\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e6.817\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e11.510\u0026thinsp;\u0026plusmn;\u0026thinsp;5.271\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e10.700\u0026thinsp;\u0026plusmn;\u0026thinsp;4.969\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003eReality and Substitute\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e4.502\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e5.107\u0026thinsp;\u0026plusmn;\u0026thinsp;2.693\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e4.834\u0026thinsp;\u0026plusmn;\u0026thinsp;2.535\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eThe Center for Epidemiological Studies Depression Scale\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003eDepressed affect\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-4.622\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e8.710\u0026thinsp;\u0026plusmn;\u0026thinsp;3.876\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e9.146\u0026thinsp;\u0026plusmn;\u0026thinsp;4.218\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003ePositive affect\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e5.150\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e10.732\u0026thinsp;\u0026plusmn;\u0026thinsp;3.856\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e10.280\u0026thinsp;\u0026plusmn;\u0026thinsp;3.692\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003eSomatic complaints\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-4.872\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e14.651\u0026thinsp;\u0026plusmn;\u0026thinsp;5.784\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e15.341\u0026thinsp;\u0026plusmn;\u0026thinsp;6.365\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eScreen for Child Anxiety Related Disorders\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003eSomatic / panic\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-6.428\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3.545\u0026thinsp;\u0026plusmn;\u0026thinsp;4.786\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e4.310\u0026thinsp;\u0026plusmn;\u0026thinsp;5.419\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003eGeneralized anxiety\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-11.305\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.854\u0026thinsp;\u0026plusmn;\u0026thinsp;3.783\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3.927\u0026thinsp;\u0026plusmn;\u0026thinsp;4.341\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003eSeparation anxiety\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-8.945\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.690\u0026thinsp;\u0026plusmn;\u0026thinsp;3.083\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3.361\u0026thinsp;\u0026plusmn;\u0026thinsp;3.357\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003eSocial phobia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-13.467\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3.376\u0026thinsp;\u0026plusmn;\u0026thinsp;3.509\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e4.526\u0026thinsp;\u0026plusmn;\u0026thinsp;3.824\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003eSchool phobia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-5.167\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.002\u0026thinsp;\u0026plusmn;\u0026thinsp;1.542\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.192\u0026thinsp;\u0026plusmn;\u0026thinsp;1.608\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"8\"\u003e\u003cb\u003eNote: IQR, Inter Quartile Range; SD, standard deviation.\u003c/b\u003e\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003eCorrelation analysis\u003c/h2\u003e \u003cp\u003eWe found a strong correlation between all dimensions within the scale, except the positive affect dimension of the depression scale. In addition, only GPYDQ had negative correlations with Internet addiction, anxiety and depression and PTSD, while all other scales had positive correlations, shown in Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eCorrelation analysis for all variables\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"14\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c11\" colnum=\"11\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c12\" colnum=\"12\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c13\" colnum=\"13\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c14\" colnum=\"14\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNum\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWithdrawal and \u003c/p\u003e \u003cp\u003e social problem\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eTime management \u003c/p\u003e \u003cp\u003e and performance\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eReality and \u003c/p\u003e \u003cp\u003e substitute\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eDepressed \u003c/p\u003e \u003cp\u003e affect\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003ePositive \u003c/p\u003e \u003cp\u003e affect\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eSomatic complaints\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eSomatic or \u003c/p\u003e \u003cp\u003e panic\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003eGeneralized\u003c/p\u003e \u003cp\u003eanxiety\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e \u003cp\u003eSeparation\u003c/p\u003e \u003cp\u003eanxiety\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c11\"\u003e \u003cp\u003eSocial\u003c/p\u003e \u003cp\u003ephobia\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c12\"\u003e \u003cp\u003eSchool\u003c/p\u003e \u003cp\u003ephobia\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c13\"\u003e \u003cp\u003eGPYDQ\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c14\"\u003e \u003cp\u003eCRIES-13\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.821***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.809***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.741***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.364***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.296***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.351***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.091***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.084***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.124***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.101***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.433***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.381***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.424***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.780***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.107***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.352***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.306***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.343***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.573***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.108***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.623***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.396***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.360***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.381***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.597***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.105***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.651***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.825***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.248***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.226***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.234***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.445***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.012\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.472***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.723***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.715***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e1***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.264***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.249***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.242***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.353***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-0.067***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.397***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.574***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.648***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.569***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e1***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.41***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.375***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.404***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.445***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.102***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.528***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.645***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.639***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.546***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e0.440***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e1***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-0.433***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-0.397***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-0.425***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0.468***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-0.336***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.509***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e-0.417***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e-0.466***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e-0.310***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e-0.298***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-0.420***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e1***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.194***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.185***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.181***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.296***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.037**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.323***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.400***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.388***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.376***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e0.296***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e0.282***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e-0.183***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e1***\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"14\"\u003e\u003cb\u003eNote: * P\u0026thinsp;\u0026lt;\u0026thinsp;0.05, ** P\u0026thinsp;\u0026lt;\u0026thinsp;0.01, *** P\u0026thinsp;\u0026lt;\u0026thinsp;0.001.\u003c/b\u003e\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"14\"\u003e\u003cb\u003eWeak correlation\u0026thinsp;\u0026lt;\u0026thinsp;0.4, Medium correlation 0.4\u0026ndash;0.7, Strong correlation\u0026thinsp;\u0026gt;\u0026thinsp;0.7.\u003c/b\u003e\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003eSEM analysis\u003c/h2\u003e \u003cp\u003eIn the path structure of SEM, we found that GPYDQ could obviously reduce the score on scales of mental disorders and addictive behavior (\u003cb\u003eβ\u003c/b\u003e\u003csub\u003e\u003cb\u003einternet\u003c/b\u003e\u003c/sub\u003e=-0.658, 95%CI: -0.715\u0026ndash;0.607; \u003cb\u003eβ\u003c/b\u003e\u003csub\u003e\u003cb\u003eanxiety\u003c/b\u003e\u003c/sub\u003e=-0.422, 95%CI: -0.461\u0026ndash;0.388; \u003cb\u003eβ\u003c/b\u003e\u003csub\u003e\u003cb\u003edepression\u003c/b\u003e\u003c/sub\u003e=-0.378, 95%CI: -0.409\u0026ndash;0.349), which indicated that GPYDQ has a positive effect on mental health for adolescents. Through the impact of COVID-19 pandemic, the CRIES-13 appeared the significant influence on the scale scores of all the others, and we found that CRIES-13 had the largest effect on the anxiety of youths with standard coefficient is 0.382, and had the smallest effect on the internet addiction of youths (std.coef\u0026thinsp;=\u0026thinsp;0.140). The CRIES-13 also set up a negative relationship with GPYDQ (std.coef = -0.155), which meanings that the events of COVID-19 pandemic reduce the competence of GPYDQ among youths. In addition, with the growing age and rising BMI, we found that GPYDQ score was decreased (std.coef\u003csub\u003eage\u003c/sub\u003e = -0.152, std.coef\u003csub\u003eBMI\u003c/sub\u003e = -0.026), among them, age exhibited a large negative impact on GPYDQ which even equal to the influence of COVID-19. The results shown in Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e and Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eThe structural equation model analysis of the effect of GPYDQ on Depression, Anxiety and Internet addiction after COVID-19 pandemic\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"8\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eBeta\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eStd.error\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eZ value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eStd.beta\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003eBeta 95%CI\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eLower\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eUpper\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003eMeasurement model\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGPYDQ \u0026rarr; DC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-0.378\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.016\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-24.375\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0.466\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.409\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e-0.349\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCOVID-19 \u0026rarr; DC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.014\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.066\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e15.481\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.279\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.900\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.152\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGPYDQ \u0026rarr; CA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-0.422\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.019\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-22.287\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0.386\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.461\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e-0.388\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCOVID-19 \u0026rarr; CA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.878\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.097\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e19.402\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.382\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.685\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e2.074\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGPYDQ \u0026rarr; IA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-0.658\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.027\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-24.204\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0.428\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.715\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e-0.607\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCOVID-19 \u0026rarr; IA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.964\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.101\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9.564\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.140\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.769\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.181\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCOVID-19 \u0026rarr; GPYDQ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-0.694\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.064\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-10.817\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0.155\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.822\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e-0.568\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge \u0026rarr; GPYDQ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-0.308\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.026\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-11.740\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0.152\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.359\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e-0.255\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGender \u0026rarr; GPYDQ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.134\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.098\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.373\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.016\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.170\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.042\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.339\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBMI \u0026rarr; GPYDQ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-0.035\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.018\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-1.948\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0.026\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.051\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.070\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e-0.004\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eStructural model\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDirect effect\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGPYDQ\u0026thinsp;+\u0026thinsp;COVID-19 \u0026rarr; DC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.636\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.069\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9.208\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0.188\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.508\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.781\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGPYDQ\u0026thinsp;+\u0026thinsp;COVID-19 \u0026rarr; CA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.456\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.102\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e14.331\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0.003\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.262\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.659\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGPYDQ\u0026thinsp;+\u0026thinsp;COVID-19 \u0026rarr; IA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.306\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.110\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.778\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0.288\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.005\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.087\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.535\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCOVID-19 \u0026rarr; GPYDQ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-0.694\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.064\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-10.806\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0.155\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.822\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e-0.568\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal Direct Effect\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.703\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.230\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7.415\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0.634\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.245\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e2.152\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eIndirect effect\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCOVID-19\u0026rarr; GPYDQ \u0026rarr; DC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.263\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.028\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9.526\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.072\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.213\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.319\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCOVID-19\u0026rarr; GPYDQ \u0026rarr; CA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.293\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.030\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9.648\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.060\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.239\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.354\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCOVID-19\u0026rarr; GPYDQ \u0026rarr; IA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.457\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.047\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9.668\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.066\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.368\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.556\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal Indirect Effect\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.012\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.103\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9.843\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.198\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.827\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.216\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTotal effect\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCOVID-19\u0026thinsp;+\u0026thinsp;GPYDQ\u0026rarr;DC\u0026thinsp;+\u0026thinsp;CA\u0026thinsp;+\u0026thinsp;IA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2.716\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.225\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12.086\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0.436\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2.247\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e3.152\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"8\"\u003e\u003cb\u003eNote: Confidence interval (CI); Depression Scale for Children (DC); Children Anxiety (CA);\u003c/b\u003e\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"8\"\u003e\u003cb\u003eInternet addiction (IA); General Positive Youth Development Qualities (GPYDQ).\u003c/b\u003e\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eThe assessment of SEM expressed an acceptable fitting performance result, and the goodness of fit indexes were: RMSEA\u0026thinsp;=\u0026thinsp;0.068 (95%CI: 0.068\u0026ndash;0.069), SRMR\u0026thinsp;=\u0026thinsp;0.080, CFI\u0026thinsp;=\u0026thinsp;0.866, NFI\u0026thinsp;=\u0026thinsp;0.862, TLI\u0026thinsp;=\u0026thinsp;0.854, IFI\u0026thinsp;=\u0026thinsp;0.866, GFI\u0026thinsp;=\u0026thinsp;0.834.\u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eIn this study, we found that the positive development ability of adolescents has an obvious regulating and improving role on mental disorders and addictive behaviors. Higher GPYDQ score is closely related to better performance of depression, anxiety and Internet addiction. At the same time, however, the impact of the COVID-19 pandemic has indeed hit the adolescent\u0026rsquo;s ability of positive development and aggravate the degree of mental disorders and addictive behaviors. These results indicate that, in the context of the global COVID-19 pandemic, repairing adolescents\u0026rsquo; positive development ability plays an important role in protecting their mental health and positive growth.\u003c/p\u003e \u003cp\u003eIn the previous studies, PYD also showed a negative correlation with anxiety and depression, a 3-year follow-up study in China showed that low PYD scores in baseline significantly increased the risk of depression or aggravated the symptoms of depression(Chi et al., \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2020a\u003c/span\u003e), Another study in middle school students also linked worse PYD to more severe depressive symptoms(Chi et al., \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e2020b\u003c/span\u003e). In addition, PYD was also found that has a negative relationship with Internet violence and gaming disorder, and Xiang et al. suggested that actively improving PYD is an effective way to avoid the occurrence of Internet adverse events(Xiang et al., \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). Our study is consistent with the previous studies, moreover, we also found that the standardized effects of GPYDQ on mental health problems such as depression, anxiety and Internet addiction are similar, indicating that the improvement of PYD for adolescents can generally benefit their mental health.\u003c/p\u003e \u003cp\u003eAt present, some foreign institutions have carried out a series of PYD promotion programs, including some camping, wilderness exploration, sports, music and painting guidance(Waid and Uhrich, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e2019\u003c/span\u003e). From the results of intervention, the PYD enhancement program did effectively improve the scores of PYD attributes. Moreover, compared with the control group, students receiving intervention also showed lower crime rate and better academic performance(Ma et al., \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e2019\u003c/span\u003e). We suggest that corresponding intervention studies are needed to explore the effect of improving PYD attributes on depression, anxiety and addictive behaviors for adolescents in the future.\u003c/p\u003e \u003cp\u003eHowever, it is also worth noting that COVID-19 has caused significant damage to the mental health status of adolescents, especially the risk of anxiety, which is most associated with the impact of COVID-19; and a lot of studies during pandemic period have also documented a huge toll the pandemic taken on people\u0026rsquo;s mental health(Collaborators, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). Meanwhile, COVID-19 has also damaged the positive developmental ability of adolescents and contributed to their pessimism(Shek et al., \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e2022\u003c/span\u003e), and their confidence and expectations for the future have suffered a severe blow(Samios et al., \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). These require us to take effective measures to protect and improve the mental health of adolescents as soon as possible.\u003c/p\u003e \u003cp\u003eAlthough this study makes contributions to related literature and practice, several limitations in the current study have to be considered. First, this study is a cross-sectional survey and therefore could not use a cross-lagged approach to explore changes in adolescent mental health before and after COVID-19. Second, this study is mainly based on five schools in southwest China, and the representation of the sample population is limited. It is expected that more students from different regions and cultural backgrounds added for a more extensive investigation in the future. Third, the questionnaire collection in the survey is based on students\u0026rsquo; self-report, which may have a certain cognitive bias, future verification using teacher or parent reported questionnaires is encouraged.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis study comprehensively analyzed the correlation between PYD attributes, depressive and anxiety symptoms, and Internet addictive behaviors of adolescents. The results showed that positive PYD attributes could effectively improve the anxiety and depression, control and regulate the dependence on Internet addiction, and the damage of the COVID-19 pandemic on adolescent mental health should not be ignored, which could aggravate the expression of depression, anxiety and Internet addiction of adolescents, and damage their abilities of positive development. Therefore, we need to take effective actions to protect and improve the healthy growth of adolescents.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was approved by the Research Ethics Committee of the Sichuan University ( No.2020YFC2006300, 19H0642). The participants provided their written informed consent to participate in this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll authors have participated in the study and approved the submission.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets presented in this article are not readily available because data access is authorized by the school. Requests to access the datasets should be directed to the corresponding authors.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was funded by Study of Diet and Nutrition Assessment and Intervention Technology (No.2020YFC2006300) from Active Health and Aging Technologic Solutions Major Project of National Key R\u0026amp;D Program, and Hong Kong Polytechnic University (19H0642).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eJiahe Liu: Writing-original draft, Methodology, Validation. Ni Wu: Conceptualization, Methodology, Formal analysis,\u0026nbsp;Writing-original draft,\u0026nbsp;Visualization. Shuming Ji: Data collection, Conceptualization, Formal analysis. Binxue Hong: Investigation, Data regulation, Formal analysis. Lihua Jiang: Conceptualization, Investigation, Resources, Data regulation, Writing - review \u0026amp; editing, Supervision.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe sincerely thank everyone who participated in our research.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eBIRMAHER., B., KHETARPAL., S., BRENT., D., CULLY., M., BALACH., L., KAUFMAN., J. \u0026amp; NEER., S. M. 1997. The Screen for Child Anxiety Related Emotional Disorders (SCARED): Scale Construction and Psychometric Characteristics. 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Evaluating model fit for growth curve models: Integration of fit indices from SEM and MLM frameworks. Psychol Methods. 2009;14:183\u0026ndash;201.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eXIANG GX, ZHANG YH, GAN X, LI QINKNZHOUYN, M., JIN X. Cyberbullying and internet gaming disorder in Chinese youth: The role of positive youth development attributes. Front Public Health. 2022;10:1017123.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZHANG H, XU H, HUANG L, WANG Y, DENG F, WANG X, TANG X, FU WANGW, TAO X, Y., YIN L. Increased occurrence of PTSD symptoms in adolescents with major depressive disorder soon after the start of the COVID-19 outbreak in China: a cross-sectional survey. BMC Psychiatry. 2021;21:395.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZHAO L, SHEK DTL, ZOU K, LEI Y, JIA P. Cohort Profile: Chengdu Positive Child Development (CPCD) survey. Int J Epidemiol. 2022;51:e95\u0026ndash;107.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZHOU Z, SHEK DTL, ZHU X, DOU D. 2020. Positive Youth Development and Adolescent Depression: A Longitudinal Study Based on Mainland Chinese High School Students. Int J Environ Res Public Health, 17.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZVOLENSKY MJ, GAREY KAUFFMANBY, L., VIANA, A. G., MATOSKA CT. Interoceptive anxiety-related processes: Importance for understanding COVID-19 and future pandemic mental health and addictive behaviors and their comorbidity. Behav Res Ther. 2022;156:104141.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Internet addiction, Anxiety, Depression, Positive youth development, Structural equation model","lastPublishedDoi":"10.21203/rs.3.rs-4374395/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4374395/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cb\u003eBackground\u003c/b\u003e\u003c/p\u003e \u003cp\u003ePositive youths development (PYD) has been found existing useful impact on the protection of mental health among adolescents in recent years. Anxiety and depression are the main representations of mental disorders in adolescents; meanwhile, internet addiction also is the main addictive behavior. The purpose in this study is to estimate the impact of general PYD quality (GPYDQ) on the anxiety, depression and internet addiction comprehensive; and considered the mental injury come from the COVID-19 pandemic furthermore.\u003c/p\u003e\u003cp\u003e\u003cb\u003eMethods\u003c/b\u003e\u003c/p\u003e \u003cp\u003e7426 valid questionnaires come from the follow-up of sociological investigation named Chengdu Positive Child Development (CPCD) survey. The corresponding international scales were used to evaluate the performance of PYD, the risk of anxiety, depression, and internet addiction, and the mental damage of COVID-19 pandemic respectively.\u003c/p\u003e\u003cp\u003e\u003cb\u003eResults\u003c/b\u003e\u003c/p\u003e \u003cp\u003eThe GPYDQ had a negative association with the score of mental disorders and addictive behavior, which meaning that higher PYD performance in adolescents was associated with a lower risk of mental illness and addiction. The CRIES-13 had the positive connection on the risk of anxiety, depression, and Internet addiction, and had the negative effect on the GPYDQ, which showed that COVID-19 was taking a toll on the mental health of adolescents.\u003c/p\u003e\u003cp\u003e\u003cb\u003eConclusion\u003c/b\u003e\u003c/p\u003e \u003cp\u003eThe positive PYD attributes could effectively improve the mental health, and regulate the dependence on Internet addiction, and the COVID-19 pandemic also could aggravate the expression of depression, anxiety and Internet addiction, and damage their abilities of positive development.\u003c/p\u003e","manuscriptTitle":"Positive youth development qualities improve mental disorders and addiction: A cross-sectional survey of teenagers in China under the COVID-19 pandemic","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-05-20 18:46:39","doi":"10.21203/rs.3.rs-4374395/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"fd9ce9f3-154e-47e0-85a5-01c02592d3bc","owner":[],"postedDate":"May 20th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-12-31T10:08:43+00:00","versionOfRecord":[],"versionCreatedAt":"2024-05-20 18:46:39","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4374395","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4374395","identity":"rs-4374395","version":["v1"]},"buildId":"7rjqhiLT3MXkJMwkYKINL","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}