Exploring the mediating role of social media and gaming in the relationship between adolescents’ feelings of loneliness, ostracism and internalizing and externalizing symptoms

Exploring the mediating role of social media and gaming in the relationship between adolescents’ feelings of loneliness, ostracism and internalizing and externalizing symptoms | 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 Exploring the mediating role of social media and gaming in the relationship between adolescents’ feelings of loneliness, ostracism and internalizing and externalizing symptoms Steven Bruneel, Jeremia Sjöblom, Martin Lgerström, Katarina Alanko This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7944252/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 Social disconnection – particularly loneliness and ostracism – has a significant impact on mental health issues such as internalizing symptoms (e.g., depression, anxiety) and externalizing symptoms (e.g., aggression, conduct problems). Yet, the mechanisms underlying these effects are multifaceted and likely include multiple mediating processes that may either amplify or mitigate the emergence of internalizing and externalizing symptoms. This cross-sectional study examines whether digital behaviors – social media use and gaming – mediate the relationship between school-based loneliness, school-based ostracism, and externalizing and internalizing symptoms in Finnish adolescents. Data were collected from 1,742 secondary school students (mean age 14.9 years; 47.6% male). Results reveal that both social media use and gaming were only weakly correlated with school-based loneliness, school-based ostracism, and mental health outcomes. Mediation analyses demonstrated that neither social media nor gaming robustly mediated the link between social disconnection and externalizing and internalizing symptoms. Limited indirect effects emerged: social media use weakly mediated the ostracism – internalizing symptoms link among girls, and gaming partially mediated the loneliness – internalizing symptoms link among boys. The findings suggest that digital behaviors are not primary explanations for the impact of school-based loneliness and ostracism on adolescent mental health. Future research should utilize longitudinal approaches and other measures of digital engagement to further clarify these relationships and identify alternative mediating processes. Educational Psychology Psychology loneliness ostracism gaming social media internalizing symptoms externalizing symptoms Figures Figure 1 Figure 2 1. Introduction Feelings of loneliness and ostracism peak during adolescence due to heightened expectations, emotional intensity, and the centrality of peer evaluation (Heinrich & Gullone, 2006 ; Lyyra et al., 2022 ; Qualter et al., 2015 ; Schinka et al., 2013 ). A growing body of research highlights the psychological impact of social disconnection – particularly loneliness and ostracism – on mental health issues such as internalizing symptoms (e.g., depression, anxiety) (Heinrich & Gullone, 2006 ; Qualter et al., 2010 ) and externalizing symptoms (e.g., aggression, conduct problems) (Kiuru et al., 2024 ; Schinka et al., 2013 ). However, the pathways through which these effects manifest are complex and likely involve several mediators that can either increase or decrease the development of internalizing and externalizing symptoms. Adolescents today navigate their social lives both offline and online, and the role of digital platforms in shaping psychological well-being is increasingly relevant (Teppers et al., 2014 ). Social media, for example, offers adolescents a platform to maintain contact with peers and seek social validation, with maintaining existing friendships cited as the primary motivation for use (Hall, 2025 ; Karsay et al., 2023 ). Likewise, video gaming – especially since the COVID-19 pandemic – has become deeply embedded in adolescent leisure time, offering distraction, competition, and social interaction (Park et al., 2024 ). Despite their popularity, the psychological consequences of time spent on social media and (online) gaming remain contested. While some studies suggest these activities may serve as a response to social distress, others report limited or inconsistent associations with mental health outcomes. For example, a systematic review by Tang et al. ( 2021 ) found only small associations between screen time and depressive symptoms, and found no consistent longitudinal links with other internalizing symptoms such as anxiety. Also, there was limited evidence of any reverse association between depressive symptoms and subsequent screen time. Given these mixed findings, it remains challenging to establish the relationships among loneliness, ostracism, digital behaviors, and internalizing and externalizing symptoms. Therefore, this study aims to explore whether time spent on social media and gaming function as mediating variables in the associations between loneliness, ostracism, and internalizing and externalizing symptoms among adolescents. This study builds upon and expands the work of Author et al. ( 2025 ), using the same dataset collected in May 2021, during the aftermath of the COVID-19 pandemic. That period was marked by elevated levels of social isolation among adolescents, and earlier systematic reviews have confirmed that adolescents during the pandemic reported higher levels of loneliness, which in turn predicted increases in depression and anxiety (Farrell et al., 2023 ; Houghton et al., 2022 ). School closures further intensified this isolation, as students’ daily social contact was largely limited to online interaction with peers. By revisiting this dataset, the current study aims to clarify the potential mediating role of digital behaviors in the link between adolescents' experiences of social disconnection and their mental health trajectories. 1.1 Ostracism and loneliness Ostracism refers to individuals being ignored or excluded by others (Williams, 2009 ); ostracized individuals describe themselves as being ‘invisible’ to others (Williams, 2001 ). Applied to the school setting, ostracism is both approached as not getting any attention as a result of an indirect way of excluding others (e.g., indirect aggression) as well as more direct forms of rejection (e.g., peer victimization and social rejection). Since adolescence comes with heightened expectations, emotional intensity, and the centrality of peer evaluation (Lyyra et al., 2022 ), ostracism is a significant threat for a healthy, stable, and gradual development of the individual (Çiftci et al., 2023 ). Closely related to ostracism, is the well-known concept of loneliness. Loneliness is a subjective feeling that arises when individuals experience an inadequacy in their social needs (Miguel et al., 2024). This feeling not only manifests itself in the quantity of social relationships, but also, and particularly, in the quality of social connections (Hawkley & Cacioppo, 2010 ). The subjective feeling of loneliness is more experienced during adolescence since adolescents try to manage closer peer relationships simultaneously with changing parent relationships (Qualter et al., 2015 ; Teppers et al., 2014 ). For adolescents, the school environment is where they spend most of their time. Consequently, social dynamics in the school context specifically contribute to feelings of school-based loneliness and school-based ostracism (Jefferson et al., 2023 ). Unsurprisingly, several studies have already shown a strong association between loneliness and ostracism. Çiftci et al. ( 2023 ), for example, found in their study with 14- to 18-year-old adolescents that their level of loneliness increases when the level of ostracism increases. Although there is a conceptual overlap as both concepts entail social exclusion, this study approaches both concepts as separate constructs due to their unique theoretical underpinnings and operational definitions (Williams, 2009 ). That is, ostracism refers to the social context or the behaviors enacted by others. In contrast, loneliness denotes an individual’s subjective emotional experience. There is strong evidence that feelings of loneliness and social exclusion are associated with internalizing symptoms (Heinrich & Gullone, 2006 ; Kiuru et al., 2024 ; Schinka et al., 2013 ). The psychological consequences of ostracism include not only higher levels of depression (Cacioppo & Hawkley, 2003; Niu et al., 2018 ), but also higher rates of helplessness and feelings of unworthiness (Rudert et al., 2021 ). Ostracized individuals also experience negative emotions such as sadness and humiliation to a stronger degree than non-ostracized individuals (Wesselmann et al., 2016 ). The negative consequences of ostracism affect all children, but some adolescents might belong to vulnerable groups at increased risk for being ostracized. Jiang et al. ( 2023 ), for example, demonstrated that ostracized migrant children aged 8 to 17 experienced higher levels of depression and poorer mental health. Individuals who suffer loneliness report similar mental health issues (Kiuru et al., 2024 ). Loneliness is repeatedly linked with increased depression levels (Heinrich & Gullone, 2006 ; Richardson et al., 2017 ) and anxiety (Hawkley & Capiocco, 2010; Heinrich & Gullone, 2006 ). However, some different consequences related to ostracism and loneliness may occur. In a prior article, we found that ostracism was associated with higher levels of internalizing symptoms than loneliness (Author et al., 2025 ). However, both extensive ostracism and prolonged feelings of loneliness are associated with more severe mental health issues such as self-harm (Williams, 2001 ) and increased suicidal thoughts (Barbieri & Mercado, 2022 ; Schrum et al., 2023 ). Next to internalizing symptoms, ostracism and feelings of loneliness are also linked with externalizing symptoms. Social control theory posits that an individual’s attachment to society is critical to prevent delinquent behavior (Hirschi, 1969 ). Nevertheless, ostracism erodes these social bonds, thereby increasing vulnerability to externalizing symptoms (Jiang et al., 2023 ). Ample research has indeed shown a close association between (extensive) ostracism and adolescent aggression (Chen et al., 2025 ; Jiang et al., 2023 ; Tamplin-Wilson et al., 2019 ). Lonely and ostracized individuals are also more likely to experience police contact (Kiuru et al., 2024 ) and engage in antisocial behavior (Williams, 2009 ). Loneliness is linked to substance use (Stickley et al., 2014 ), but particularly to aggression (Heinrich & Gullone, 2006 ). Schinka et al. ( 2013 ) demonstrated, by measuring levels of loneliness of more than 800 children at the age of 9, 11, and 15, that experiences of loneliness impact future behavioral problems and aggression. To sum up, these previous studies not only show similar effects of loneliness and ostracism, but also provide evidence of how internalizing and externalizing symptoms are related (Bilgin et al., 2024 ). 1.2 Screen time: Gaming and social media As adolescents’ daily experiences become increasingly shaped by digital interactions (Teppers et al., 2014 ), understanding how loneliness and ostracism relate to screen use has become an important research focus. While screen engagement and loneliness/ostracism often co-occur, longitudinal studies have found limited evidence supporting a causal relationship between screen use – particularly social media – and changes in loneliness over time among adolescents (Lawrence et al., 2022 ; Tang et al., 2021 ). Descarpentry et al. ( 2023 ) further complicate this picture by reporting weak and inconsistent associations between screen time and both internalizing (e.g., depression, anxiety) and externalizing (e.g., aggression, conduct problems) behaviours in children and young adolescents. Notably, their findings suggest that persistent high screen use is weakly linked to peer problems and conduct issues in older children, but not consistently associated with broader internalizing symptoms. Moreover, the directionality of these relationships remains unclear (Zahedi et al., 2021 ), which leads Hall ( 2025 ) to conclude that screen use, and social media in particular, is not an important cause of changes in loneliness over time for adolescents. 1.2.1 Social media, loneliness/ostracism and internalizing and externalizing symptoms Empirical literature on the association between social media use and mental well-being report mixed results (Fassi et al., 2024 ; Jin & Kim, 2025 ; Svensson et al., 2022 ). While some studies suggest that social media usage has positive effects on well-being (e.g., Odgers & Jensen, 2020 ; Valkenburg et al., 2022a ), the majority indicate negative effects (Verduyn et al., 2017 ), particularly on girls (Svensson et al., 2022 ; Twenge & Martin, 2020 ). Numerous studies associate social media use with increased anxiety (Rutter et al., 2021 ; Sarmiento et al., 2020 ; Vannucci et al., 2017 ), higher levels of depression (Primack et al., 2017; Rutter et al., 2021 ), and lower self-esteem (Kalpidou et al., 2011 ). However, most of these studies report only small effect sizes (O’Day & Heimberg, 2021 ) and some studies find no significant association at all (Coyne et al., 2020 ). Applied to the relationship between social media use and loneliness, Song et al. ( 2014 ) claimed that establishing the causal direction of this relationship remains challenging, leading to the suggestion that the link between social media use and loneliness is bidirectional (Ergün & Alkan, 2020 ; Teppers et al., 2014 ). Similarly, Hall ( 2025 ) also concluded in his narrative review that “social media use appears to play a limited role in predicting change in trait loneliness over time. Most studies show no effects over time” (p. 9). Critics argue that the lack of consistent findings may be due to methodological inconsistencies, particularly in how social media use is measured (O’Day & Heimberg, 2021 ; Svensson et al., 2022 ). Taken together, these findings highlight the ongoing uncertainty and complexity surrounding the link between social media use and mental well-being, simultaneously underscoring the need to explicitly examine its relationship with internalizing symptoms in the present study. 1.2.2 Gaming, loneliness/ostracism and internalizing and externalizing symptoms In addition to social media, gaming has become an integral part of adolescents’ lives, particularly since the COVID-19 pandemic (Park et al., 2024 ). Along with its increasing demand, the amount of research investigating the link between gaming and ostracism, loneliness, and internalizing and externalizing symptoms is also expanding. Video games are frequently examined in experimental settings that explore recovery from social exclusion. These studies mainly focus on pro- and anti-social behaviours, suggesting that video games may help ostracized individuals foster pro-social behaviours and reduce aggression (Liu et al., 2015 ; Tamplin-Wilson et al., 2019 ). In this way, video games – much like social media – can function as digital environments that facilitate social connection and emotional regulation among socially isolated adolescents. However, the relationship between video gaming and loneliness, similar to that of social media, is characterized by mixed findings (Pallavicini et al., 2022 ). Some studies report positive effects: for example, during the COVID-19 lockdowns, video games helped reduce feelings of loneliness among college students in the U.K. and U.S. (Barr & Copeland-Stewart, 2021 ). Other research suggests that online multiplayer games can alleviate loneliness, provided that gameplay remains voluntary and balanced with offline activities (Halbrook et al., 2019 ; Yang et al., 2023 ). These benefits reflect the social affordances of games, which allow adolescents to interact and form meaningful connections. Conversely, playing online games as a coping strategy can also turn out to be harmful for vulnerable individuals, enhancing levels of anxiety, depression, and loneliness (Pallavicini et al., 2022 ) and behavioral problems (Mehroof & Griffiths, 2010 ). Nguyen et al. ( 2021 ), for example, found that excessive engagement with online multiplayer games during the pandemic was associated with greater feelings of loneliness among middle-aged adults. These conflicting findings align with Williams’ ( 2018 ) hypothesis that video games have a dualistic effect on psychosocial factors. That is, playing online video games can both expand and restrict meaningful social contacts (Williams, 2018 ). Beyond loneliness, video gaming has also been examined in relation to broader indicators of mental well-being. A growing body of research suggests that moderate gameplay helps to reduce levels of anxiety, stress, and depression, and may even support cognitive functioning (Shams et al., 2015 ) and emotional benefits (Cejudo et al., 2019 ). The biggest disadvantage is found in problematic gaming, resulting in negative effects on mental health such as higher levels of stress, anxiety, depression, and low self-esteem (Lau et al., 2018 ). Additionally, problematic gaming is related not only to internalizing symptoms but also to externalizing symptoms such as aggression, attention-deficit hyperactivity disorder (ADHD), and conduct problems (Lau et al., 2018 ). This further aligns with previous discussions on the dual impact of digital media use, suggesting that both social media and gaming can act as both risk and protective factors for adolescent mental health – depending on the intensity and context of use. Several studies indicate that males are at greater risk of developing problematic video gaming compared to females (Gentile et al., 2012 ; Lau et al., 2018 ). In sum, prior research highlights the complex and context-dependent nature of gaming’s effects on adolescents’ well-being, emphasizing the importance of examining whether the amount of time spent on gaming is linked to externalizing symptoms such as aggression and conduct problems. 1.3 Social media and gaming as mediating factors Consequently, social media and gaming may serve as significant mediating factors in the association between loneliness, ostracism, and internalizing and externalizing symptoms. For internalizing symptoms – such as depression and anxiety – adolescents who feel lonely or ostracized may turn to social media platforms to seek social validation, connect with peers, or distract themselves from distressing emotions (Hall, 2025 ). While some evidence suggests that social media can offer opportunities for connection and support (Karsay et al., 2023 ), particularly for those lacking offline relationships, there is also consistent, albeit small, evidence that higher engagement is associated with increased risk for depression, anxiety, and reduced self-esteem (Verduyn et al., 2017 ). These risks may be deepened for adolescents who passively consume content or encounter negative social experiences online, such as cyberbullying or social comparison, thus intensifying the internalizing effects of pre-existing loneliness or ostracism. In terms of externalizing symptoms – such as aggression, conduct problems, or antisocial behavior – both social media and gaming can provide avenues for acting out or expressing frustration resulting from social isolation. For example, problematic or excessive gaming has been linked with greater aggression and behavioral issues, particularly among boys (Lau et al., 2018 ). The online environment may also facilitate exposure to aggressive content, or, in multiplayer settings, encourage hostile interactions. Notably, both social media and gaming can serve as coping mechanisms, but when used excessively or in maladaptive ways, may reinforce a cycle of disengagement from offline relationships and increase the likelihood of problematic behaviors. Taken together, social media and gaming do not function uniformly as risk or protective factors. Instead, the context, motivations, and intensity of use may determine whether these digital behaviors amplify or buffer the mental health risks associated with loneliness and ostracism. Therefore, examining these digital activities as mediating variables is essential for understanding how adolescents’ experiences of social disconnection translate into distinct patterns of internalizing or externalizing symptoms. 2. Aims of the present study This study aims to examine the mediating role of social media use and video gaming in the relationship between school-based ostracism, school-based loneliness, and both internalizing and externalizing symptoms. While existing literature has established various associations among these constructs, limited research has explored the mechanisms through which digital media may influence these relationships. Given that social media and gaming are not only pervasive in adolescents’ lives, but also linked to both ostracism and loneliness as well as to mental health outcomes such as anxiety, depression and behavioral problems such as aggression, this study investigates whether time spent on these digital activities act as mediating factors. To sum up, this study aims to: Examine the associations among feelings of school-based loneliness and school-based ostracism, internalizing and externalizing symptoms, and gaming and social media. Explore the mediating role of gaming and social media in the relationship between feelings of school-based loneliness and school-based ostracism and internalizing and externalizing symptoms. Based on these aims, the hypotheses of this study are: H1a: school-based loneliness is associated with internalizing and externalizing symptoms. H1b: school-based ostracism is associated with internalizing and externalizing symptoms. H2a: school-based loneliness is associated with time spent on social media and gaming. H2b: school-based ostracism is associated with time spent on social media and gaming. H3a: time spent on social media is associated with internalizing symptoms. H3b: time spent on gaming is associated with externalizing symptoms. H4a: the association between school-based loneliness, ostracism, and internalizing symptoms is mediated by the time spent on social media. H4b: the association between school-based loneliness, ostracism and externalizing symptoms is mediated by the time spent on gaming. 3. Methodology 3.1 Participants, sampling, and process This study drew upon data collected within the framework of the School Absence in Finland project (as outlined by Niemi et al., 2022 ). Participant recruitment was conducted in two distinct phases. In the initial phase, school principals and teachers were approached and provided with detailed information regarding the study, accompanied by an invitation to participate in an online seminar focusing on the issue of school absence. Information about the study and the seminar invitation was distributed via e-mail and further disseminated through teacher associations and relevant educational Facebook groups. The seminar, organized in January 2021, comprised presentations on the phenomenon of school absence, as well as a briefing on the planned data collection procedures. Following this, 15 upper primary schools from southern and western regions of Finland agreed to join the study. These participating schools subsequently forwarded information regarding the study to parents through e-mail and requested parental consent for the involvement of their children. Consistent with the ethical standards delineated by the Finnish National Board on Research Integrity (TENK), parental consent was mandatory for participants younger than 15 years. Furthermore, all adolescent participants provided their own written informed consent before completing the survey. In total, data were collected from 2,137 youths with 395 youths excluded due, for example, to lack of consent, implausible reported age, and missing responses in the study variables. After this, the sample comprised 1,742 adolescents. The average age was 14.93 years ( SD = 0.86). Participant gender was male (47.6%) and female (52.4%). The respondents reported on their parent’s highest educational level: 50% university or higher education, 28% upper secondary school or vocational studies, 3% on comprehensive school or equivalent and 0.1% none of the above, the rest unknown having no answer (19%). Three quarters (76%) lived with both parents, 13% interchangeably with two parents, 10% with one parent, 0.6% in residential childcare and 2% with other arrangements or missing. Percentages may not sum to 100 due to rounding. Data were gathered during standard school hours in May 2021. During survey administration, either a research assistant or a teacher was present to offer clarification and technical support as required. To ensure the participation of students with chronic school absence, school personnel contacted absent students directly – this included conducting home visits when necessary – and provided assistance in completing the questionnaire when needed. Through this procedure, 42 responses were collected. 3.2 Measures 3.2.1 Social media and gaming Social media and gaming were assessed by asking the participants to rate how much time, on average, they spend on a weekday on gaming or social media on a 4-point scale (from 0 minutes to more than 5 hours). This item was especially designed for this study. The focus on weekday behaviors was determined by the study focus on school absence – occurring on weekdays. 3.2.2 Symptoms of loneliness and ostracism Loneliness and ostracism were measured utilizing the Inventory of School Attendance Problems (ISAP; Knollmann et al., 2019 ), a questionnaire developed to screen for both emerging and established school attendance problems (SAPs). To specifically assess students’ experiences of loneliness and ostracism, participants were requested to rate their agreement with two statements on a 4-point Likert scale (ranging from 1 = never to 4 = most of the time): “Before or at school I feel excluded by my classmates” (indicating ostracism) and “Before or at school I feel unhappy because I only have a few friends at school” (reflecting loneliness). The ISAP has demonstrated consistent reliability in various contexts, including the current sample (Author et al., 2025 ), as well as in previous investigations with distinct populations (Knollmann et al., 2019 ; Strömbeck et al., 2025 ). 3.2.3 Internalizing and externalizing symptoms Internalizing and externalizing symptoms were evaluated using the Strengths and Difficulties Questionnaire (SDQ; Goodman, 1997 ), a 25-item instrument comprising five subscales: Emotional Symptoms, Conduct Problems, Hyperactivity-Inattention, Peer Problems, and Prosocial Behavior, each containing five items. Responses are provided on a 3-point Likert scale ranging from 0 (not true) to 2 (certainly true), resulting in subscale scores between 0 and 10. For the purposes of this study, the Emotional Symptoms and the Peer Problems subscales were utilized as an indicator of internalizing symptoms; the Conduct Problems and Hyperactivity-Inattention subscales were utilized as indicators of externalizing symptoms. The internal consistency of all these subscales were acceptable ( α = .74). 3.3 Data analysis All data preparation and analyses were performed in R version 4.2.0. The following R packages were used for data cleaning and plotting: tidyverse (Wickham et al., 2019 ), path models lavaan (Rosseel, 2012 ), and correlations Hmisc (Harrell, 2015 ). Data analysis comprised Pearson product-moment correlations and mediation models. Patterns in missing data were inspected using the mice (van Buuren & Groothuis-Oudshoorn, 2011 ) and VIM (Kowarik & Templ, 2016 ) packages in R. Considering that the primary reasons for missing data were due to drop-out and missing responses on gender ( n = 84), no data were imputed. 4. Results 4.1. Descriptive results Table 1 presents descriptive data for all main variables, disaggregated by gender. Girls ( n = 913) reported significantly higher levels of perceived ostracism than boys ( n = 829). Similarly, girls reported higher loneliness scores than boys, though the effect size was small ( d = 0.14). Gender differences were particularly pronounced in leisure activities. Boys reported significantly more gaming activity than girls, with a large effect size ( d = 0.90). Conversely, girls reported more frequent use of social media compared to boys. Girls also reported significantly higher levels of internalizing symptoms than boys, and elevated externalizing symptoms. Table 1 Descriptive Data Boys Girls M SD M SD Range t (df) p d Ostracism 1.29 0.62 1.51 0.78 1–4 5.99 (1471.9) < .001 0.31 Loneliness 1.23 0.62 1.32 0.69 1–4 2.56 (1461.7) .011 0.14 Gaming 2.41 0.92 1.60 0.87 1–4 16.85 (1367.8) < .001 0.90 Social media 2.19 0.87 2.78 0.86 1–4 13.79 (1656.7) < .001 0.68 Internalizing symptoms 6.44 3.11 8.39 3.06 0–20 12.44 (1514.9) < .001 0.63 Externalizing symptoms 6.50 3.05 7.29 2.47 0–20 5.52 (1386.9) < .001 0.28 4.2 Correlations between loneliness, ostracism, social media, gaming, and internalizing and externalizing symptoms Among boys, ostracism and loneliness were strongly correlated, whereas this association was moderate for girls. Loneliness and ostracism correlated moderately with internalizing symptoms for both genders, with no significant gender differences observed, as presented in Table 2. Table 2 Bivariate Correlations between Study Variables, Separate for Boys and Girls 1. 2. 3. 4. 5. 6. 1. Ostracism - 0.59*** 0.13*** 0.18*** 0.33*** 0.20*** 2. Loneliness 0.68*** - 0.13*** 0.16*** 0.23*** 0.14*** 3. Social media 0.01 0.04 - 0.02 0.13*** 0.14*** 4. Gaming 0.08* -0.01 0.10** - 0.01 0.02 5. Internalizing symptoms 0.35*** 0.29*** 0.05 0.10* - 0.47*** 6. Externalizing symptoms 0.28*** 0.20*** 0.06 0.00 0.61*** - Note. Correlations for boys below the diagonal, correlations for girls above the diagonal. All correlations are significant at p < .05. Asterisks indicate significant correlations: * = p < .05, ** = p < .01, *** = p < .001, bold correlations are significantly different for boys and girls. Externalizing symptoms correlated moderately with both ostracism and loneliness, particularly among boys. Interestingly, correlations between social media use and internalizing symptoms were generally low, although a small but significant positive correlation was found in girls but not in boys, suggesting a subtle gender-specific association. 4.3 The mediating role of social media and gaming for the association of loneliness and ostracism with internalizing and externalizing symptoms 4.3.1 The mediating role of social media Separate, saturated, just-identified path models were fit for both girls and boys to estimate if symptoms of loneliness and ostracism on both internalizing and externalizing symptoms were mediated by social media. All reported regression coefficients are standardized. The two path models can be found in Fig. 1. Across both genders, ostracism remained a strong predictor of internalizing and externalizing symptoms. However, social media did not significantly mediate any of the hypothesized paths among neither boys nor girls. Among girls, social media use was weakly associated with internalizing and externalizing symptoms. Despite these significant direct paths, the overall indirect effects of ostracism and loneliness through social media on mental health outcomes were not statistically significant. The explanatory power of the models was generally modest. R² values for internalizing symptoms ranged from 0.11 to 0.16, while externalizing symptoms were less well explained (R² = 0.05 to 0.09). Social media accounted for minimal variance, particularly among boys (R² = 0.00–0.04), indicating that this variable may play a limited mediating role. Note Standardized estimates of the path model. *** p < .001, ** p < 0.01, * p < .05. Table 3 Path Model Parameter Estimates Social Media Path Boys Girls B SE Beta p B SE Beta p Diff Direct effects Ostracism → Internalizing 1.47 0.26 0.29 < .001 1.14 0.16 0.29 < .001 ns. Ostracism → Externalizing 1.09 0.26 0.22 < .001 0.53 0.14 0.17 < .001 ns. Loneliness → Internalizing 0.51 0.26 0.10 .050 0.20 0.18 0.05 .269 ns. Loneliness → Externalizing 0.34 0.26 0.07 .192 0.09 0.16 0.03 .547 ns. Ostracism → Social media -0.02 0.08 -0.02 .777 0.10 0.05 0.09 .048 ns. Loneliness → Social media 0.08 0.08 0.06 .282 0.09 0.06 0.08 .087 ns. Social media → Internalizing 0.11 0.14 0.03 .413 0.30 0.12 0.08 .014 ns. Social media → Externalizing 0.24 0.14 0.07 .081 0.33 0.10 0.11 .001 ns. Indirect effects Ostracism → Social media→ Internalizing -0.00 0.01 -0.00 .789 0.03 0.02 0.01 .123 Ostracism → Social media→ Externalizing -0.01 0.02 -0.00 .780 0.03 0.02 0.01 .092 Loneliness → Social media→ Internalizing 0.01 0.01 0.00 .515 0.03 0.02 0.01 .160 Ostracism → Social media→ Loneliness 0.02 0.02 0.00 .360 0.03 0.02 0.01 .131 R2 Internalizing 0.14 0.12 Externalizing 0.08 0.05 Social Media 0.00 0.02 Note. N Boys = 620, N Girls = 767. Diff = Significant difference in beta values between boys and girls based on confidence intervals. ns = non-significant. 4.3.2 The mediating role of gaming Additionally, the same path models were fit to estimate if symptoms of loneliness and ostracism on both internalizing and externalizing symptoms were mediated by gaming, again separately for girls and boys. The two path models can be found in Fig. 2. Among girls, ostracism had significant direct effects on both internalizing and externalizing symptoms, whereas loneliness did not significantly predict either outcome. Furthermore, gaming was not a significant mediator for girls, as none of the indirect paths were significant. Notably, the path from gaming to internalizing symptoms was non-significant and negative, simultaneously emphasizing gender differences in gaming behaviors and its relation to psychological elements. For boys, ostracism also had a significant direct effect on both internalizing and externalizing symptoms. Gaming partially mediated the relationship between ostracism and internalizing symptoms, though the indirect effect did not reach statistical significance. Loneliness predicted internalizing symptoms directly but was negatively associated with gaming, suggesting different coping mechanisms may be at play. Figure 2 Path Model on Gaming Note Standardized estimates of the path model. *** p < .001, ** p < 0.01, * p < .05. Table 4 Path Model Parameter Estimates Gaming Path Boys Girls B SE Beta p B SE Beta p Diff Direct effect Ostracism → Internalizing 1.41 0.25 0.28 < .001 1.17 0.20 0.30 < .001 ns. Ostracism → Externalizing 1.17 0.26 0.24 < .001 0.65 0.170 0.20 < .001 ns. Loneliness → Internalizing 0.76 0.25 0.15 .003 0.28 0.23 0.06 .236 ns. Loneliness → Externalizing 0.37 0.26 0.08 .150 0.11 0.20 0.03 .589 ns. Ostracism → Gaming 0.23 0.08 0.16 .004 0.14 0.06 0.13 .013 ns. Loneliness → Gaming -0.18 0.08 -0.12 .025 0.10 0.07 0.08 .152 ns. Gaming → Internalizing 0.28 0.13 0.08 .030 -0.06 0.15 -0.02 .685 ns. Gaming → Externalizing -0.06 0.13 -0.02 .617 0.02 0.13 0.01 .856 ns. Indirect effects Ostracism → Gaming→ Internalizing 0.06 0.04 0.01 .082 -0.01 0.02 -0.00 .689 ns. Ostracism → Gaming→ Externalizing -0.02 0.03 -0.00 .622 0.00 0.02 0.00 .856 ns. Loneliness → Gaming→ Internalizing -0.05 0.03 -0.01 .119 -0.01 0.02 -0.00 .696 ns. Ostracism → Gaming→ Loneliness 0.01 0.02 0.00 .626 0.00 0.01 0.00 .857 ns. R2 Internalizing 0.16 0.11 Externalizing 0.09 0.05 Gaming 0.01 0.04 Note. N Boys = 606, N Girls = 545, Diff = Difference in beta values between boys and girls based on confidence intervals. ns = non-significant. 5. Discussion The present findings show that school-based loneliness and school-based ostracism are associated with internalizing and externalizing symptoms (hypothesis 1a and 1b). However, school-based ostracism relates more strongly to internalizing and externalizing symptoms than school-based loneliness. Ostracism was a robust predictor of both internalizing and externalizing symptoms across both genders, whereas loneliness contributed uniquely to internalizing symptoms only among boys. The correlation between loneliness and ostracism is moderate, but slightly higher for boys than for girls. These findings reveal consistent gender differences across the key variables in this study, warranting discussion. Girls reported higher levels of perceived ostracism, loneliness, internalizing and externalizing symptoms, and social media use, while boys reported greater engagement in gaming. These findings align with a body of literature suggesting that adolescent girls experience higher levels of loneliness and ostracism (Kiuru et al., 2024 ; Ribeiro et al., 2022 ), externalizing symptoms (Liu et al., 2021 ), internalizing symptoms (Bate et al., 2021 ; Liu et al., 2022 ), and social media use (Andreassen et al., 2017 ; Rutter et al., 2021 ). Some studies, however, suggest that boys are experiencing higher levels of loneliness (Rutter et al., 2021 ), externalizing behaviour (Bate et al., 2021 ; Levante et al., 2023 ) and internalizing behaviour (Wang et al., 2021 ). Therefore, it is important to incorporate gender in future studies in order to determine a clear overview amidst the currently mixed findings on this topic. Mediation analyses further highlighted gender-specific patterns: among boys, gaming partially – but not significantly – mediated the link between ostracism and internalizing symptoms, whereas no such mediation effects were observed for girls. Hypothesis 3a is partially supported as time spent on social media emerged as a weak but significant predictor of mental health symptoms in girls, yet did not significantly mediate any relationships, underscoring its limited explanatory role. The strength of associations between loneliness and ostracism with internalizing and externalizing symptoms was generally moderate, and the path models accounted for modest proportions of variance, particularly in externalizing outcomes. These results point to distinct gendered pathways in adolescents' emotional and behavioral adjustment, with differential roles for digital media use in these processes. Hypotheses 2a and 2b predicted that school-based loneliness and ostracism would be associated with time spent on social media and gaming. However, and contrary to our expectations, both social media use and gaming were only weakly correlated with ostracism, loneliness, and internalizing and externalizing symptoms. This is somewhat surprising, as a significant body of literature has highlighted links between social media use and various mental health outcomes, although often with small effect sizes (O’Day & Heimberg, 2021 ; Svensson et al., 2022 ; Verduyn et al., 2017 ). Furthermore, the mediation analyses show that social media emerged as a weak but significant predictor of internalizing symptoms, but only among girls. This gender-specific result aligns with earlier findings showing that girls may be more vulnerable to the negative effects of social comparison and self-esteem fluctuations related to social media (Svensson et al., 2022 ; Twenge & Martin, 2020 ). At the same time, our findings contrast with studies reporting no association between social media and internalizing symptoms (Coyne et al., 2020 ) or with research claiming that social media usage leads to positive outcomes on well-being (e.g., Odgers & Jensen, 2020 ; Valkenburg et al., 2022a ). Future studies can further explore this relationship, for example by studying how diverse social media activities (like or dislike photos and videos, chatting) are related to mental health problems (Svensson et al., 2022 ). It is also noteworthy that, unlike loneliness, ostracism is rarely conceptualized in recent literature as a condition that can be improved by social media use. On the contrary, social media may itself be a platform for exclusion. Forms of online social exclusion, also referred to as cyber-ostracism, have been shown to carry psychological consequences similar to offline ostracism (Chen et al., 2025 ). This highlights the dual role of digital platforms, which can act both as tools for connection and as instruments of exclusion. Mediation analyses show similar results for gaming: gaming significantly mediates the association between loneliness and internalizing symptoms, but only for boys (Gentile et al., 2012 ; Lau et al., 2018 ). Taken together, these results point to the limited mediating effect of both social media and gaming. This suggests that while these digital activities are relevant, they are not primary pathways through which loneliness and ostracism influence mental health. These results lead to rejecting hypotheses 4a and 4b, proposing that time spent on social media and gaming would mediate the relationship between school-based loneliness, ostracism, and internalizing and externalizing symptoms. Concerning the context of these findings, and as already mentioned, data collection took place in the aftermath of the COVID-19 pandemic (May 2021), a period that likely influenced participants’ experiences of loneliness and ostracism as well as their patterns of social media and gaming use. These unique contextual factors may have shaped the relationships observed in the study, reflecting the social dynamics and digital engagement characteristic of the post-pandemic period. Barbieri and Mercado ( 2022 ), for instance, already claimed that adolescents’ levels of loneliness were higher during the pandemic. Moreover, it should be noted that these findings are based on group-level analyses, meaning the associations reported represent average trends across the sample. As such, individual variation may be obscured; that is, while some adolescents may experience strong links between, for example, school-based loneliness and time spent on social media, for others these association may be absent or even opposite. Therefore, caution is warranted when interpreting group-level patterns as applying equally to all individuals. 5.1 Strengths and limitations Reflecting on the initial research gap, this study is, to the best of our knowledge, the first to investigate potential mediating factors in the well-established association between ostracism, loneliness, and internalizing and externalizing symptoms. While gaming and social media did not emerge as highly significant mediators for either gender, the results – derived from a large sample size and gender-stratified analyses – make a valuable contribution to this field of research. Given that ostracism, loneliness, and internalizing and externalizing symptoms are highly prevalent during adolescence, and all are associated with potentially severe long-term consequences (Royuela-Colomer et al., 2024 ), it is essential to further examine alternative mediating mechanisms that may help explain these relationships. This study also comes with some limitations. First, the reliance on self-report measures to assess all included variables, but especially participants' use of social media and video games introduces potential biases. Self-reported data depends on participants’ subjective perceptions and memory, which may result in inaccurate or inconsistent responses. Furthermore, critics argue that content-based measures are more likely in media effects research than time-based measures (Valkenburg et al., 2022b ). Related to this, the absence of clear definitions for concepts like ‘social media’ and ‘gaming’ within the questionnaire can lead to varied interpretations among participants. For example, some may have interpreted playing a single-player game app on their mobile phone as gaming while others may not. This can affect the accuracy of the data (Valkenburg et al., 2022b ). The second limitation is also linked to the data collection, as these data are part of a larger research project focused on school-related experiences of loneliness and ostracism (see Author et al., 2025 ). Consequently, the questionnaire items primarily targeted participants’ feelings within the school setting. This may not fully capture participants’ feelings of loneliness and ostracism outside school which can potentially limit the ecological validity. Third, due to the lack of a clear definition of social media and reliance on self-report, this study did not differentiate between social media activities. This is a notable limitation given that prior research has shown that specific activities, such as chatting, may have different associations with internalizing symptoms, particularly among girls (Svensson et al., 2022 ). Similarly, Sarmiento et al. ( 2020 ) highlighted that the effect of gender depends on the particular aspect of social media use. Therefore, we suggest that more nuanced measurement is required to understand these relationships. Fourth, the cross-sectional design of this study restricts the ability to draw any causal conclusions. While associations between social media use and mental well-being—especially among girls—are observed, it remains unclear whether social media usage contributes to mental health difficulties, or whether adolescents experiencing such difficulties are more likely to engage with social media. This ambiguity is consistent with existing literature that emphasizes the complex, bidirectional relationship between social media and adolescent mental health (Svensson et al., 2022 ; Twenge & Martin, 2020 ). 5.2 Conclusion Although numerous studies have examined the associations between loneliness, ostracism, and internalizing and externalizing symptoms, to the best of our knowledge, no prior research has investigated the mediating role of gaming and social media within this context. The present findings indicate that school-based ostracism relates more strongly to internalizing and externalizing symptoms than school-based loneliness. Among girls, the relationship between ostracism and internalizing symptoms was weakly mediated by social media use, whereas among boys, gaming significantly mediated the association between loneliness and internalizing symptoms. However, neither gaming nor social media emerged as key mediators in the broader relationship between ostracism, loneliness, and internalizing and externalizing symptoms across genders. These results highlight the need for future research to further investigate these complex associations using longitudinal designs, which allow for causal inferences. In addition, studies should distinguish between different types of social media and gaming activities, and explore alternative mediating constructs that may help clarify how loneliness and ostracism contribute to adolescent mental health challenges. Given the potential long-term consequences of these issues, a more nuanced understanding is essential for informing prevention and intervention strategies. Declarations Acknowledgments & Declarations The present study is part of the EDUCA Flagship funded by the Research Council of Finland (#358924, #358947). 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Clinical Psychology Review , 86 , 102021. https://doi.org/10.1016/j.cpr.2021.102021 Teppers, E., Luyckx, K., Klimstra, T. A., & Goossens, L. (2014). Loneliness and Facebook motives in adolescence: A longitudinal inquiry into directionality of effect. Journal of Adolescence , 37 (5), 691-699. https://doi.org/10.1016/j.adolescence.2013.11.003 Twenge, J. M., & Martin, G. N. (2020). Gender differences in associations between digital media use and psychological well-being: Evidence from three large datasets. Journal of Adolescence, 79, 91-102. https://doi.org/10.1016/j.adolescence.2019.12.018 Valkenburg, P. M., Meier, A., & Beyens, I. (2022a). Social media use and its impact on adolescent mental health: An umbrella review of the evidence. Current Opinion in Psychology, 44, 58-68. https://doi.org/10.1016/j.copsyc.2021.08.017 Valkenburg, P. M., van Driel, I. I., & Beyens, I. (2022b). The associations of active and passive social media use with well-being: A critical scoping review. New Media & Society, 24 (2), 530-549. https://doi.org/10.1177/14614448211065425 van Buuren, S., & Groothuis-Oudshoorn, K. (2011). Mice: Multivariate imputation by chained equations in R. Journal of Statistical Software, 45 (3), 1-67. https://doi.org/10.18637/jss.v045.i03 Vannucci, A., Flannery, K. M., & Ohannessian, C. M. (2017). Social media use and anxiety in emerging adults. Journal of Affective Disorders , 207 , 163-166. https://doi.org/10.1016/jad.2016.08.040 Verduyn, P., Ybarra, O., Résibois, M., Jonides, J., & Kross, E. (2017). Do social network sites enhance or undermine subjective well‐being? A critical review. Social Issues and Policy Review , 11 (1), 274-302. https://doi.org/10.1111/sipr.12033 Wang, J., Wang, Y., Lin, H., Chen, X., Wang, H., & Liang, H., Guo, X., & Fu, C. (2021). Mental health problems among school-aged children after school reopening: A cross-sectional study during the COVID-19 post-pandemic in east China. Frontiers in Psychology, 12, e773134. https://doi.org/10.3389/fpsyg.2021.773134 Wesselmann, E. D., Grzybowski, M. R., Steakley-Freeman, D. M., DeSouza, E. R., Nezlek, J. B., & Williams, K. D. (2016). Social exclusion in everyday life. In P. Riva & J. Eck (Eds.), Social exclusion: Psychological approaches to understanding and reducing its impact (pp. 3–23). Springer International Publishing. Wickham, H., Averick, M., Bryan, J., Chang, W., D’Agostino McGowan, L., François, R., … & Yutani, H. (2019). Welcome to the Tidyverse. Journal of Open Source Software, 4 (43), 1686. https://doi.org/10.21105/joss.01686 Williams, D. (2018). For better or worse: Game structure and mechanisms driving social interactions and isolation. In C. J. Ferguson (Ed.), Video game influences on aggression, cognition, and attention (pp. 173-183). Springer. https://doi.org/10.1007/978-3-319-95495-0_14 Williams, K. D. (2001). Ostracism: The power of silence . Guilford. Williams, K. D. (2009). Ostracism: A temporal need-threat model. In M. P. Zanna (Ed.), Advances in experimental social psychology (pp. 275-314). Elsevier. Yang, J., Wang, R., Cook, A., & Fuller, R. (2023). Gaming during the COVID-19 pandemic: Examining its effect on loneliness & motivation, playing and gratification differences between competitive and recreational gamers. Telematics and Informatics Reports , 11 , 100093. https://doi.org/10.1016/j.teler.2023.100093 Zahedi, S., Jaffer, R., & Iyer, A. (2021). A systematic review of screen-time literature to inform educational policy and practice during COVID-19. International Journal of Educational Research Open, 2, 100094. https://doi.org/10.1016/j.ijedro.2021.100094 Additional Declarations The authors declare no competing interests. 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Sjöblom","email":"","orcid":"https://orcid.org/0009-0008-1017-6794","institution":"Åbo Akademi University","correspondingAuthor":false,"prefix":"","firstName":"Jeremia","middleName":"","lastName":"Sjöblom","suffix":""},{"id":534715920,"identity":"12215598-6c0f-4633-be65-ee2e6bc08c2f","order_by":2,"name":"Martin Lgerström","email":"","orcid":"https://orcid.org/0000-0002-3143-8270","institution":"Åbo AKademi University","correspondingAuthor":false,"prefix":"","firstName":"Martin","middleName":"","lastName":"Lgerström","suffix":""},{"id":534715921,"identity":"7f13dcbe-9124-43e0-a68d-32992f546428","order_by":3,"name":"Katarina 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05:16:40","extension":"html","order_by":8,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":226881,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-7944252/v1/d0a9e65a02d08b5b1dd94a3c.html"},{"id":94939252,"identity":"7908eb51-1cab-46dc-be3d-7958cfd0391a","added_by":"auto","created_at":"2025-11-02 05:16:39","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":248057,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003ePath Model on Social Media\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eNote.\u003c/em\u003e Standardized estimates of the path model. *** \u003cem\u003ep\u003c/em\u003e \u0026lt; .001, ** p \u0026lt; 0.01, * p \u0026lt; .05.\u003c/p\u003e","description":"","filename":"floatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-7944252/v1/3f1fdc0789f7f6b4a04e7440.png"},{"id":94939253,"identity":"9fe7efaf-af34-424f-86f8-eec76499daac","added_by":"auto","created_at":"2025-11-02 05:16:39","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":243483,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003ePath Model on Gaming\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eNote.\u003c/em\u003e Standardized estimates of the path model. *** \u003cem\u003ep\u003c/em\u003e \u0026lt; .001, ** p \u0026lt; 0.01, * p \u0026lt; .05.\u003c/p\u003e","description":"","filename":"floatimage2.png","url":"https://assets-eu.researchsquare.com/files/rs-7944252/v1/5235a654de1d05a26965e5e5.png"},{"id":94990533,"identity":"a37e074b-697b-4a24-a255-bbb11d59c56c","added_by":"auto","created_at":"2025-11-03 07:17:46","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1757353,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7944252/v1/4cb6bff2-caf1-46bd-a64f-fd16771632ac.pdf"}],"financialInterests":"The authors declare no competing interests.","formattedTitle":"\u003cp\u003e\u003cstrong\u003eExploring the mediating role of social media and gaming in the relationship between adolescents’ feelings of loneliness, ostracism and internalizing and externalizing symptoms\u003c/strong\u003e\u003c/p\u003e","fulltext":[{"header":"1. Introduction","content":"\u003cp\u003eFeelings of loneliness and ostracism peak during adolescence due to heightened expectations, emotional intensity, and the centrality of peer evaluation (Heinrich \u0026amp; Gullone, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e2006\u003c/span\u003e; Lyyra et al., \u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e2022\u003c/span\u003e; Qualter et al., \u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e2015\u003c/span\u003e; Schinka et al., \u003cspan citationid=\"CR57\" class=\"CitationRef\"\u003e2013\u003c/span\u003e). A growing body of research highlights the psychological impact of social disconnection \u0026ndash; particularly loneliness and ostracism \u0026ndash; on mental health issues such as internalizing symptoms (e.g., depression, anxiety) (Heinrich \u0026amp; Gullone, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e2006\u003c/span\u003e; Qualter et al., \u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e2010\u003c/span\u003e) and externalizing symptoms (e.g., aggression, conduct problems) (Kiuru et al., \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e2024\u003c/span\u003e; Schinka et al., \u003cspan citationid=\"CR57\" class=\"CitationRef\"\u003e2013\u003c/span\u003e). However, the pathways through which these effects manifest are complex and likely involve several mediators that can either increase or decrease the development of internalizing and externalizing symptoms.\u003c/p\u003e\u003cp\u003eAdolescents today navigate their social lives both offline and online, and the role of digital platforms in shaping psychological well-being is increasingly relevant (Teppers et al., \u003cspan citationid=\"CR66\" class=\"CitationRef\"\u003e2014\u003c/span\u003e). Social media, for example, offers adolescents a platform to maintain contact with peers and seek social validation, with maintaining existing friendships cited as the primary motivation for use (Hall, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e2025\u003c/span\u003e; Karsay et al., \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). Likewise, video gaming \u0026ndash; especially since the COVID-19 pandemic \u0026ndash; has become deeply embedded in adolescent leisure time, offering distraction, competition, and social interaction (Park et al., \u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). Despite their popularity, the psychological consequences of time spent on social media and (online) gaming remain contested. While some studies suggest these activities may serve as a response to social distress, others report limited or inconsistent associations with mental health outcomes. For example, a systematic review by Tang et al. (\u003cspan citationid=\"CR65\" class=\"CitationRef\"\u003e2021\u003c/span\u003e) found only small associations between screen time and depressive symptoms, and found no consistent longitudinal links with other internalizing symptoms such as anxiety. Also, there was limited evidence of any reverse association between depressive symptoms and subsequent screen time.\u003c/p\u003e\u003cp\u003eGiven these mixed findings, it remains challenging to establish the relationships among loneliness, ostracism, digital behaviors, and internalizing and externalizing symptoms. Therefore, this study aims to explore whether time spent on social media and gaming function as mediating variables in the associations between loneliness, ostracism, and internalizing and externalizing symptoms among adolescents.\u003c/p\u003e\u003cp\u003eThis study builds upon and expands the work of Author et al. (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2025\u003c/span\u003e), using the same dataset collected in May 2021, during the aftermath of the COVID-19 pandemic. That period was marked by elevated levels of social isolation among adolescents, and earlier systematic reviews have confirmed that adolescents during the pandemic reported higher levels of loneliness, which in turn predicted increases in depression and anxiety (Farrell et al., \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e2023\u003c/span\u003e; Houghton et al., \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). School closures further intensified this isolation, as students\u0026rsquo; daily social contact was largely limited to online interaction with peers. By revisiting this dataset, the current study aims to clarify the potential mediating role of digital behaviors in the link between adolescents' experiences of social disconnection and their mental health trajectories.\u003c/p\u003e\u003cdiv id=\"Sec2\" class=\"Section2\"\u003e\u003ch2\u003e1.1 Ostracism and loneliness\u003c/h2\u003e\u003cp\u003eOstracism refers to individuals being ignored or excluded by others (Williams, \u003cspan citationid=\"CR78\" class=\"CitationRef\"\u003e2009\u003c/span\u003e); ostracized individuals describe themselves as being \u0026lsquo;invisible\u0026rsquo; to others (Williams, \u003cspan citationid=\"CR77\" class=\"CitationRef\"\u003e2001\u003c/span\u003e). Applied to the school setting, ostracism is both approached as not getting any attention as a result of an indirect way of excluding others (e.g., indirect aggression) as well as more direct forms of rejection (e.g., peer victimization and social rejection). Since adolescence comes with heightened expectations, emotional intensity, and the centrality of peer evaluation (Lyyra et al., \u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e2022\u003c/span\u003e), ostracism is a significant threat for a healthy, stable, and gradual development of the individual (\u0026Ccedil;iftci et al., \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2023\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eClosely related to ostracism, is the well-known concept of loneliness. Loneliness is a subjective feeling that arises when individuals experience an inadequacy in their social needs (Miguel et al., 2024). This feeling not only manifests itself in the quantity of social relationships, but also, and particularly, in the quality of social connections (Hawkley \u0026amp; Cacioppo, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e2010\u003c/span\u003e). The subjective feeling of loneliness is more experienced during adolescence since adolescents try to manage closer peer relationships simultaneously with changing parent relationships (Qualter et al., \u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e2015\u003c/span\u003e; Teppers et al., \u003cspan citationid=\"CR66\" class=\"CitationRef\"\u003e2014\u003c/span\u003e). For adolescents, the school environment is where they spend most of their time. Consequently, social dynamics in the school context specifically contribute to feelings of school-based loneliness and school-based ostracism (Jefferson et al., \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e2023\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eUnsurprisingly, several studies have already shown a strong association between loneliness and ostracism. \u0026Ccedil;iftci et al. (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2023\u003c/span\u003e), for example, found in their study with 14- to 18-year-old adolescents that their level of loneliness increases when the level of ostracism increases. Although there is a conceptual overlap as both concepts entail social exclusion, this study approaches both concepts as separate constructs due to their unique theoretical underpinnings and operational definitions (Williams, \u003cspan citationid=\"CR78\" class=\"CitationRef\"\u003e2009\u003c/span\u003e). That is, ostracism refers to the social context or the behaviors enacted by others. In contrast, loneliness denotes an individual\u0026rsquo;s subjective emotional experience.\u003c/p\u003e\u003cp\u003eThere is strong evidence that feelings of loneliness and social exclusion are associated with internalizing symptoms (Heinrich \u0026amp; Gullone, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e2006\u003c/span\u003e; Kiuru et al., \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e2024\u003c/span\u003e; Schinka et al., \u003cspan citationid=\"CR57\" class=\"CitationRef\"\u003e2013\u003c/span\u003e). The psychological consequences of ostracism include not only higher levels of depression (Cacioppo \u0026amp; Hawkley, 2003; Niu et al., \u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e2018\u003c/span\u003e), but also higher rates of helplessness and feelings of unworthiness (Rudert et al., \u003cspan citationid=\"CR54\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). Ostracized individuals also experience negative emotions such as sadness and humiliation to a stronger degree than non-ostracized individuals (Wesselmann et al., \u003cspan citationid=\"CR74\" class=\"CitationRef\"\u003e2016\u003c/span\u003e). The negative consequences of ostracism affect all children, but some adolescents might belong to vulnerable groups at increased risk for being ostracized. Jiang et al. (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e2023\u003c/span\u003e), for example, demonstrated that ostracized migrant children aged 8 to 17 experienced higher levels of depression and poorer mental health. Individuals who suffer loneliness report similar mental health issues (Kiuru et al., \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). Loneliness is repeatedly linked with increased depression levels (Heinrich \u0026amp; Gullone, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e2006\u003c/span\u003e; Richardson et al., \u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e2017\u003c/span\u003e) and anxiety (Hawkley \u0026amp; Capiocco, 2010; Heinrich \u0026amp; Gullone, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e2006\u003c/span\u003e). However, some different consequences related to ostracism and loneliness may occur. In a prior article, we found that ostracism was associated with higher levels of internalizing symptoms than loneliness (Author et al., \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2025\u003c/span\u003e). However, both extensive ostracism and prolonged feelings of loneliness are associated with more severe mental health issues such as self-harm (Williams, \u003cspan citationid=\"CR77\" class=\"CitationRef\"\u003e2001\u003c/span\u003e) and increased suicidal thoughts (Barbieri \u0026amp; Mercado, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2022\u003c/span\u003e; Schrum et al., \u003cspan citationid=\"CR58\" class=\"CitationRef\"\u003e2023\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eNext to internalizing symptoms, ostracism and feelings of loneliness are also linked with externalizing symptoms. Social control theory posits that an individual\u0026rsquo;s attachment to society is critical to prevent delinquent behavior (Hirschi, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e1969\u003c/span\u003e). Nevertheless, ostracism erodes these social bonds, thereby increasing vulnerability to externalizing symptoms (Jiang et al., \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). Ample research has indeed shown a close association between (extensive) ostracism and adolescent aggression (Chen et al., \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2025\u003c/span\u003e; Jiang et al., \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e2023\u003c/span\u003e; Tamplin-Wilson et al., \u003cspan citationid=\"CR64\" class=\"CitationRef\"\u003e2019\u003c/span\u003e). Lonely and ostracized individuals are also more likely to experience police contact (Kiuru et al., \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e2024\u003c/span\u003e) and engage in antisocial behavior (Williams, \u003cspan citationid=\"CR78\" class=\"CitationRef\"\u003e2009\u003c/span\u003e). Loneliness is linked to substance use (Stickley et al., \u003cspan citationid=\"CR61\" class=\"CitationRef\"\u003e2014\u003c/span\u003e), but particularly to aggression (Heinrich \u0026amp; Gullone, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e2006\u003c/span\u003e). Schinka et al. (\u003cspan citationid=\"CR57\" class=\"CitationRef\"\u003e2013\u003c/span\u003e) demonstrated, by measuring levels of loneliness of more than 800 children at the age of 9, 11, and 15, that experiences of loneliness impact future behavioral problems and aggression. To sum up, these previous studies not only show similar effects of loneliness and ostracism, but also provide evidence of how internalizing and externalizing symptoms are related (Bilgin et al., \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2024\u003c/span\u003e).\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003e1.2 Screen time: Gaming and social media\u003c/h2\u003e\u003cp\u003eAs adolescents\u0026rsquo; daily experiences become increasingly shaped by digital interactions (Teppers et al., \u003cspan citationid=\"CR66\" class=\"CitationRef\"\u003e2014\u003c/span\u003e), understanding how loneliness and ostracism relate to screen use has become an important research focus. While screen engagement and loneliness/ostracism often co-occur, longitudinal studies have found limited evidence supporting a causal relationship between screen use \u0026ndash; particularly social media \u0026ndash; and changes in loneliness over time among adolescents (Lawrence et al., \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e2022\u003c/span\u003e; Tang et al., \u003cspan citationid=\"CR65\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). Descarpentry et al. (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e2023\u003c/span\u003e) further complicate this picture by reporting weak and inconsistent associations between screen time and both internalizing (e.g., depression, anxiety) and externalizing (e.g., aggression, conduct problems) behaviours in children and young adolescents. Notably, their findings suggest that persistent high screen use is weakly linked to peer problems and conduct issues in older children, but not consistently associated with broader internalizing symptoms. Moreover, the directionality of these relationships remains unclear (Zahedi et al., \u003cspan citationid=\"CR80\" class=\"CitationRef\"\u003e2021\u003c/span\u003e), which leads Hall (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e2025\u003c/span\u003e) to conclude that screen use, and social media in particular, is not an important cause of changes in loneliness over time for adolescents.\u003c/p\u003e\u003cdiv id=\"Sec4\" class=\"Section3\"\u003e\u003ch2\u003e1.2.1 Social media, loneliness/ostracism and internalizing and externalizing symptoms\u003c/h2\u003e\u003cp\u003eEmpirical literature on the association between social media use and mental well-being report mixed results (Fassi et al., \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e2024\u003c/span\u003e; Jin \u0026amp; Kim, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e2025\u003c/span\u003e; Svensson et al., \u003cspan citationid=\"CR63\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). While some studies suggest that social media usage has positive effects on well-being (e.g., Odgers \u0026amp; Jensen, \u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e2020\u003c/span\u003e; Valkenburg et al., \u003cspan citationid=\"CR68\" class=\"CitationRef\"\u003e2022a\u003c/span\u003e), the majority indicate negative effects (Verduyn et al., \u003cspan citationid=\"CR72\" class=\"CitationRef\"\u003e2017\u003c/span\u003e), particularly on girls (Svensson et al., \u003cspan citationid=\"CR63\" class=\"CitationRef\"\u003e2022\u003c/span\u003e; Twenge \u0026amp; Martin, \u003cspan citationid=\"CR67\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). Numerous studies associate social media use with increased anxiety (Rutter et al., \u003cspan citationid=\"CR55\" class=\"CitationRef\"\u003e2021\u003c/span\u003e; Sarmiento et al., \u003cspan citationid=\"CR56\" class=\"CitationRef\"\u003e2020\u003c/span\u003e; Vannucci et al., \u003cspan citationid=\"CR71\" class=\"CitationRef\"\u003e2017\u003c/span\u003e), higher levels of depression (Primack et al., 2017; Rutter et al., \u003cspan citationid=\"CR55\" class=\"CitationRef\"\u003e2021\u003c/span\u003e), and lower self-esteem (Kalpidou et al., \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e2011\u003c/span\u003e). However, most of these studies report only small effect sizes (O\u0026rsquo;Day \u0026amp; Heimberg, \u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e2021\u003c/span\u003e) and some studies find no significant association at all (Coyne et al., \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). Applied to the relationship between social media use and loneliness, Song et al. (\u003cspan citationid=\"CR60\" class=\"CitationRef\"\u003e2014\u003c/span\u003e) claimed that establishing the causal direction of this relationship remains challenging, leading to the suggestion that the link between social media use and loneliness is bidirectional (Erg\u0026uuml;n \u0026amp; Alkan, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e2020\u003c/span\u003e; Teppers et al., \u003cspan citationid=\"CR66\" class=\"CitationRef\"\u003e2014\u003c/span\u003e). Similarly, Hall (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e2025\u003c/span\u003e) also concluded in his narrative review that \u0026ldquo;social media use appears to play a limited role in predicting change in trait loneliness over time. Most studies show no effects over time\u0026rdquo; (p. 9). Critics argue that the lack of consistent findings may be due to methodological inconsistencies, particularly in how social media use is measured (O\u0026rsquo;Day \u0026amp; Heimberg, \u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e2021\u003c/span\u003e; Svensson et al., \u003cspan citationid=\"CR63\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). Taken together, these findings highlight the ongoing uncertainty and complexity surrounding the link between social media use and mental well-being, simultaneously underscoring the need to explicitly examine its relationship with internalizing symptoms in the present study.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec5\" class=\"Section3\"\u003e\u003ch2\u003e1.2.2 Gaming, loneliness/ostracism and internalizing and externalizing symptoms\u003c/h2\u003e\u003cp\u003eIn addition to social media, gaming has become an integral part of adolescents\u0026rsquo; lives, particularly since the COVID-19 pandemic (Park et al., \u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). Along with its increasing demand, the amount of research investigating the link between gaming and ostracism, loneliness, and internalizing and externalizing symptoms is also expanding.\u003c/p\u003e\u003cp\u003eVideo games are frequently examined in experimental settings that explore recovery from social exclusion. These studies mainly focus on pro- and anti-social behaviours, suggesting that video games may help ostracized individuals foster pro-social behaviours and reduce aggression (Liu et al., \u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e2015\u003c/span\u003e; Tamplin-Wilson et al., \u003cspan citationid=\"CR64\" class=\"CitationRef\"\u003e2019\u003c/span\u003e). In this way, video games \u0026ndash; much like social media \u0026ndash; can function as digital environments that facilitate social connection and emotional regulation among socially isolated adolescents.\u003c/p\u003e\u003cp\u003eHowever, the relationship between video gaming and loneliness, similar to that of social media, is characterized by mixed findings (Pallavicini et al., \u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). Some studies report positive effects: for example, during the COVID-19 lockdowns, video games helped reduce feelings of loneliness among college students in the U.K. and U.S. (Barr \u0026amp; Copeland-Stewart, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). Other research suggests that online multiplayer games can alleviate loneliness, provided that gameplay remains voluntary and balanced with offline activities (Halbrook et al., \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2019\u003c/span\u003e; Yang et al., \u003cspan citationid=\"CR79\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). These benefits reflect the social affordances of games, which allow adolescents to interact and form meaningful connections.\u003c/p\u003e\u003cp\u003eConversely, playing online games as a coping strategy can also turn out to be harmful for vulnerable individuals, enhancing levels of anxiety, depression, and loneliness (Pallavicini et al., \u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e2022\u003c/span\u003e) and behavioral problems (Mehroof \u0026amp; Griffiths, \u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e2010\u003c/span\u003e). Nguyen et al. (\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e2021\u003c/span\u003e), for example, found that excessive engagement with online multiplayer games during the pandemic was associated with greater feelings of loneliness among middle-aged adults. These conflicting findings align with Williams\u0026rsquo; (\u003cspan citationid=\"CR76\" class=\"CitationRef\"\u003e2018\u003c/span\u003e) hypothesis that video games have a dualistic effect on psychosocial factors. That is, playing online video games can both expand and restrict meaningful social contacts (Williams, \u003cspan citationid=\"CR76\" class=\"CitationRef\"\u003e2018\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eBeyond loneliness, video gaming has also been examined in relation to broader indicators of mental well-being. A growing body of research suggests that moderate gameplay helps to reduce levels of anxiety, stress, and depression, and may even support cognitive functioning (Shams et al., \u003cspan citationid=\"CR59\" class=\"CitationRef\"\u003e2015\u003c/span\u003e) and emotional benefits (Cejudo et al., \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2019\u003c/span\u003e). The biggest disadvantage is found in problematic gaming, resulting in negative effects on mental health such as higher levels of stress, anxiety, depression, and low self-esteem (Lau et al., \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e2018\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eAdditionally, problematic gaming is related not only to internalizing symptoms but also to externalizing symptoms such as aggression, attention-deficit hyperactivity disorder (ADHD), and conduct problems (Lau et al., \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e2018\u003c/span\u003e). This further aligns with previous discussions on the dual impact of digital media use, suggesting that both social media and gaming can act as both risk and protective factors for adolescent mental health \u0026ndash; depending on the intensity and context of use. Several studies indicate that males are at greater risk of developing problematic video gaming compared to females (Gentile et al., \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e2012\u003c/span\u003e; Lau et al., \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e2018\u003c/span\u003e). In sum, prior research highlights the complex and context-dependent nature of gaming\u0026rsquo;s effects on adolescents\u0026rsquo; well-being, emphasizing the importance of examining whether the amount of time spent on gaming is linked to externalizing symptoms such as aggression and conduct problems.\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv id=\"Sec6\" class=\"Section2\"\u003e\u003ch2\u003e1.3 Social media and gaming as mediating factors\u003c/h2\u003e\u003cp\u003eConsequently, social media and gaming may serve as significant mediating factors in the association between loneliness, ostracism, and internalizing and externalizing symptoms. For internalizing symptoms \u0026ndash; such as depression and anxiety \u0026ndash; adolescents who feel lonely or ostracized may turn to social media platforms to seek social validation, connect with peers, or distract themselves from distressing emotions (Hall, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e2025\u003c/span\u003e). While some evidence suggests that social media can offer opportunities for connection and support (Karsay et al., \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e2023\u003c/span\u003e), particularly for those lacking offline relationships, there is also consistent, albeit small, evidence that higher engagement is associated with increased risk for depression, anxiety, and reduced self-esteem (Verduyn et al., \u003cspan citationid=\"CR72\" class=\"CitationRef\"\u003e2017\u003c/span\u003e). These risks may be deepened for adolescents who passively consume content or encounter negative social experiences online, such as cyberbullying or social comparison, thus intensifying the internalizing effects of pre-existing loneliness or ostracism.\u003c/p\u003e\u003cp\u003eIn terms of externalizing symptoms \u0026ndash; such as aggression, conduct problems, or antisocial behavior \u0026ndash; both social media and gaming can provide avenues for acting out or expressing frustration resulting from social isolation. For example, problematic or excessive gaming has been linked with greater aggression and behavioral issues, particularly among boys (Lau et al., \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e2018\u003c/span\u003e). The online environment may also facilitate exposure to aggressive content, or, in multiplayer settings, encourage hostile interactions. Notably, both social media and gaming can serve as coping mechanisms, but when used excessively or in maladaptive ways, may reinforce a cycle of disengagement from offline relationships and increase the likelihood of problematic behaviors.\u003c/p\u003e\u003cp\u003eTaken together, social media and gaming do not function uniformly as risk or protective factors. Instead, the context, motivations, and intensity of use may determine whether these digital behaviors amplify or buffer the mental health risks associated with loneliness and ostracism. Therefore, examining these digital activities as mediating variables is essential for understanding how adolescents\u0026rsquo; experiences of social disconnection translate into distinct patterns of internalizing or externalizing symptoms.\u003c/p\u003e\u003c/div\u003e"},{"header":"2. Aims of the present study","content":"\u003cp\u003eThis study aims to examine the mediating role of social media use and video gaming in the relationship between school-based ostracism, school-based loneliness, and both internalizing and externalizing symptoms. While existing literature has established various associations among these constructs, limited research has explored the mechanisms through which digital media may influence these relationships. Given that social media and gaming are not only pervasive in adolescents\u0026rsquo; lives, but also linked to both ostracism and loneliness as well as to mental health outcomes such as anxiety, depression and behavioral problems such as aggression, this study investigates whether time spent on these digital activities act as mediating factors. To sum up, this study aims to:\u003c/p\u003e\u003cp\u003e\u003col\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003eExamine the associations among feelings of school-based loneliness and school-based ostracism, internalizing and externalizing symptoms, and gaming and social media.\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003eExplore the mediating role of gaming and social media in the relationship between feelings of school-based loneliness and school-based ostracism and internalizing and externalizing symptoms.\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003c/ol\u003e\u003c/p\u003e\u003cp\u003eBased on these aims, the hypotheses of this study are:\u003c/p\u003e\u003cp\u003eH1a: school-based loneliness is associated with internalizing and externalizing symptoms.\u003c/p\u003e\u003cp\u003eH1b: school-based ostracism is associated with internalizing and externalizing symptoms.\u003c/p\u003e\u003cp\u003eH2a: school-based loneliness is associated with time spent on social media and gaming.\u003c/p\u003e\u003cp\u003eH2b: school-based ostracism is associated with time spent on social media and gaming.\u003c/p\u003e\u003cp\u003eH3a: time spent on social media is associated with internalizing symptoms.\u003c/p\u003e\u003cp\u003eH3b: time spent on gaming is associated with externalizing symptoms.\u003c/p\u003e\u003cp\u003eH4a: the association between school-based loneliness, ostracism, and internalizing symptoms is mediated by the time spent on social media.\u003c/p\u003e\u003cp\u003eH4b: the association between school-based loneliness, ostracism and externalizing symptoms is mediated by the time spent on gaming.\u003c/p\u003e"},{"header":"3. Methodology","content":"\u003cdiv id=\"Sec9\" class=\"Section2\"\u003e\u003ch2\u003e3.1 Participants, sampling, and process\u003c/h2\u003e\u003cp\u003eThis study drew upon data collected within the framework of the School Absence in Finland project (as outlined by Niemi et al., \u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). Participant recruitment was conducted in two distinct phases. In the initial phase, school principals and teachers were approached and provided with detailed information regarding the study, accompanied by an invitation to participate in an online seminar focusing on the issue of school absence. Information about the study and the seminar invitation was distributed via e-mail and further disseminated through teacher associations and relevant educational Facebook groups. The seminar, organized in January 2021, comprised presentations on the phenomenon of school absence, as well as a briefing on the planned data collection procedures. Following this, 15 upper primary schools from southern and western regions of Finland agreed to join the study. These participating schools subsequently forwarded information regarding the study to parents through e-mail and requested parental consent for the involvement of their children. Consistent with the ethical standards delineated by the Finnish National Board on Research Integrity (TENK), parental consent was mandatory for participants younger than 15 years. Furthermore, all adolescent participants provided their own written informed consent before completing the survey.\u003c/p\u003e\u003cp\u003eIn total, data were collected from 2,137 youths with 395 youths excluded due, for example, to lack of consent, implausible reported age, and missing responses in the study variables. After this, the sample comprised 1,742 adolescents. The average age was 14.93 years (\u003cem\u003eSD\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.86). Participant gender was male (47.6%) and female (52.4%). The respondents reported on their parent\u0026rsquo;s highest educational level: 50% university or higher education, 28% upper secondary school or vocational studies, 3% on comprehensive school or equivalent and 0.1% none of the above, the rest unknown having no answer (19%). Three quarters (76%) lived with both parents, 13% interchangeably with two parents, 10% with one parent, 0.6% in residential childcare and 2% with other arrangements or missing. Percentages may not sum to 100 due to rounding.\u003c/p\u003e\u003cp\u003eData were gathered during standard school hours in May 2021. During survey administration, either a research assistant or a teacher was present to offer clarification and technical support as required. To ensure the participation of students with chronic school absence, school personnel contacted absent students directly \u0026ndash; this included conducting home visits when necessary \u0026ndash; and provided assistance in completing the questionnaire when needed. Through this procedure, 42 responses were collected.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec10\" class=\"Section2\"\u003e\u003ch2\u003e3.2 Measures\u003c/h2\u003e\u003cdiv id=\"Sec11\" class=\"Section3\"\u003e\u003ch2\u003e3.2.1 Social media and gaming\u003c/h2\u003e\u003cp\u003eSocial media and gaming were assessed by asking the participants to rate how much time, on average, they spend on a weekday on gaming or social media on a 4-point scale (from 0 minutes to more than 5 hours). This item was especially designed for this study. The focus on weekday behaviors was determined by the study focus on school absence \u0026ndash; occurring on weekdays.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec12\" class=\"Section3\"\u003e\u003ch2\u003e3.2.2 Symptoms of loneliness and ostracism\u003c/h2\u003e\u003cp\u003eLoneliness and ostracism were measured utilizing the Inventory of School Attendance Problems (ISAP; Knollmann et al., \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e2019\u003c/span\u003e), a questionnaire developed to screen for both emerging and established school attendance problems (SAPs). To specifically assess students\u0026rsquo; experiences of loneliness and ostracism, participants were requested to rate their agreement with two statements on a 4-point Likert scale (ranging from 1\u0026thinsp;=\u0026thinsp;never to 4\u0026thinsp;=\u0026thinsp;most of the time): \u0026ldquo;Before or at school I feel excluded by my classmates\u0026rdquo; (indicating ostracism) and \u0026ldquo;Before or at school I feel unhappy because I only have a few friends at school\u0026rdquo; (reflecting loneliness). The ISAP has demonstrated consistent reliability in various contexts, including the current sample (Author et al., \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2025\u003c/span\u003e), as well as in previous investigations with distinct populations (Knollmann et al., \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e2019\u003c/span\u003e; Str\u0026ouml;mbeck et al., \u003cspan citationid=\"CR62\" class=\"CitationRef\"\u003e2025\u003c/span\u003e).\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec13\" class=\"Section3\"\u003e\u003ch2\u003e3.2.3 Internalizing and externalizing symptoms\u003c/h2\u003e\u003cp\u003eInternalizing and externalizing symptoms were evaluated using the Strengths and Difficulties Questionnaire (SDQ; Goodman, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e1997\u003c/span\u003e), a 25-item instrument comprising five subscales: Emotional Symptoms, Conduct Problems, Hyperactivity-Inattention, Peer Problems, and Prosocial Behavior, each containing five items. Responses are provided on a 3-point Likert scale ranging from 0 (not true) to 2 (certainly true), resulting in subscale scores between 0 and 10. For the purposes of this study, the Emotional Symptoms and the Peer Problems subscales were utilized as an indicator of internalizing symptoms; the Conduct Problems and Hyperactivity-Inattention subscales were utilized as indicators of externalizing symptoms. The internal consistency of all these subscales were acceptable (\u003cem\u003eα\u003c/em\u003e\u0026thinsp;\u003cb\u003e=\u003c/b\u003e\u0026thinsp;.74).\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv id=\"Sec14\" class=\"Section2\"\u003e\u003ch2\u003e3.3 Data analysis\u003c/h2\u003e\u003cp\u003eAll data preparation and analyses were performed in R version 4.2.0. The following R packages were used for data cleaning and plotting: \u003cem\u003etidyverse\u003c/em\u003e (Wickham et al., \u003cspan citationid=\"CR75\" class=\"CitationRef\"\u003e2019\u003c/span\u003e), path models \u003cem\u003elavaan\u003c/em\u003e (Rosseel, \u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e2012\u003c/span\u003e), and correlations \u003cem\u003eHmisc\u003c/em\u003e (Harrell, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e2015\u003c/span\u003e). Data analysis comprised Pearson product-moment correlations and mediation models. Patterns in missing data were inspected using the mice (van Buuren \u0026amp; Groothuis-Oudshoorn, \u003cspan citationid=\"CR70\" class=\"CitationRef\"\u003e2011\u003c/span\u003e) and VIM (Kowarik \u0026amp; Templ, \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e2016\u003c/span\u003e) packages in R. Considering that the primary reasons for missing data were due to drop-out and missing responses on gender (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;84), no data were imputed.\u003c/p\u003e\u003c/div\u003e"},{"header":"4. Results","content":"\u003cdiv id=\"Sec16\" class=\"Section2\"\u003e\u003ch2\u003e4.1. Descriptive results\u003c/h2\u003e\u003cp\u003eTable\u0026nbsp;1 presents descriptive data for all main variables, disaggregated by gender. Girls (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;913) reported significantly higher levels of perceived ostracism than boys (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;829). Similarly, girls reported higher loneliness scores than boys, though the effect size was small (\u003cem\u003ed\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.14). Gender differences were particularly pronounced in leisure activities. Boys reported significantly more gaming activity than girls, with a large effect size (\u003cem\u003ed\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.90). Conversely, girls reported more frequent use of social media compared to boys. Girls also reported significantly higher levels of internalizing symptoms than boys, and elevated externalizing symptoms.\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\u003e\u003cem\u003eDescriptive Data\u003c/em\u003e\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"9\"\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\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003eBoys\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u003cp\u003eGirls\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cem\u003eM\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cem\u003eSD\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cem\u003eM\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cem\u003eSD\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eRange\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u003cem\u003et (df)\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e\u003cem\u003ed\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOstracism\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1.29\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.62\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1.51\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.78\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1\u0026ndash;4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e5.99 (1471.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.31\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLoneliness\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1.23\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.62\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1.32\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.69\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1\u0026ndash;4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e2.56 (1461.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e.011\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.14\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eGaming\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e2.41\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.92\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1.60\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.87\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1\u0026ndash;4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e16.85 (1367.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.90\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSocial media\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e2.19\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.87\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2.78\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.86\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1\u0026ndash;4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e13.79\u003c/p\u003e\u003cp\u003e(1656.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.68\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eInternalizing symptoms\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e6.44\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3.11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e8.39\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e3.06\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0\u0026ndash;20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e12.44 (1514.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.63\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eExternalizing symptoms\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e6.50\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3.05\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e7.29\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e2.47\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0\u0026ndash;20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e5.52 (1386.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.28\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec17\" class=\"Section2\"\u003e\u003ch2\u003e4.2 Correlations between loneliness, ostracism, social media, gaming, and internalizing and externalizing symptoms\u003c/h2\u003e\u003cp\u003eAmong boys, ostracism and loneliness were strongly correlated, whereas this association was moderate for girls. Loneliness and ostracism correlated moderately with internalizing symptoms for both genders, with no significant gender differences observed, as presented in Table\u0026nbsp;2.\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\u003e\u003cem\u003eBivariate Correlations between Study Variables, Separate for Boys and Girls\u003c/em\u003e\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"7\"\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\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1.\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2.\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003e3.\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003e4.\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003e5.\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003e6.\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e1. Ostracism\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003e0.59***\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003e0.13***\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.18***\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.33***\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.20***\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e2. Loneliness\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003e0.68***\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.13***\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e0.16***\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.23***\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.14***\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e3. Social media\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003e0.01\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.04\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.02\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.13***\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.14***\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e4. Gaming\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.08*\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003e-0.01\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.10**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.01\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.02\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e5. Internalizing symptoms\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.35***\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.29***\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.05\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.10*\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u003cb\u003e0.47***\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e6. Externalizing symptoms\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.28***\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.20***\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.06\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u003cb\u003e0.61***\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"7\"\u003e\u003cem\u003eNote.\u003c/em\u003e Correlations for boys below the diagonal, correlations for girls above the diagonal. All correlations are significant at \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.05. Asterisks indicate significant correlations: * = \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.05, ** = \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.01, *** = \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.001, bold correlations are significantly different for boys and girls.\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eExternalizing symptoms correlated moderately with both ostracism and loneliness, particularly among boys. Interestingly, correlations between social media use and internalizing symptoms were generally low, although a small but significant positive correlation was found in girls but not in boys, suggesting a subtle gender-specific association.\u003c/p\u003e\u003cp\u003e4.3 The mediating role of social media and gaming for the association of loneliness and ostracism with internalizing and externalizing symptoms\u003c/p\u003e\u003cdiv id=\"Sec18\" class=\"Section3\"\u003e\u003ch2\u003e4.3.1 The mediating role of social media\u003c/h2\u003e\u003cp\u003eSeparate, saturated, just-identified path models were fit for both girls and boys to estimate if symptoms of loneliness and ostracism on both internalizing and externalizing symptoms were mediated by social media. All reported regression coefficients are standardized. The two path models can be found in Fig.\u0026nbsp;1.\u003c/p\u003e\u003cp\u003eAcross both genders, ostracism remained a strong predictor of internalizing and externalizing symptoms. However, social media did not significantly mediate any of the hypothesized paths among neither boys nor girls.\u003c/p\u003e\u003cp\u003eAmong girls, social media use was weakly associated with internalizing and externalizing symptoms. Despite these significant direct paths, the overall indirect effects of ostracism and loneliness through social media on mental health outcomes were not statistically significant. The explanatory power of the models was generally modest. R\u0026sup2; values for internalizing symptoms ranged from 0.11 to 0.16, while externalizing symptoms were less well explained (R\u0026sup2; = 0.05 to 0.09). Social media accounted for minimal variance, particularly among boys (R\u0026sup2; = 0.00\u0026ndash;0.04), indicating that this variable may play a limited mediating role.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eNote\u003c/strong\u003e\u003cp\u003eStandardized estimates of the path model. *** \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.001, ** p\u0026thinsp;\u0026lt;\u0026thinsp;0.01, * p\u0026thinsp;\u0026lt;\u0026thinsp;.05.\u003c/p\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\u003e\u003cem\u003ePath Model Parameter Estimates Social Media\u003c/em\u003e\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"11\"\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\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePath\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cem\u003eBoys\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u003cem\u003eGirls\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cem\u003eB\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cem\u003eSE\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cem\u003eBeta\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u003cem\u003eB\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\"\u003e\u003cp\u003e\u003cem\u003eSE\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c9\"\u003e\u003cp\u003e\u003cem\u003eBeta\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c10\"\u003e\u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c11\"\u003e\u003cp\u003e\u003cem\u003eDiff\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDirect effects\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\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\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eOstracism \u0026rarr; Internalizing\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1.47\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.26\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.29\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e1.14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.29\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003ens.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eOstracism \u0026rarr; Externalizing\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1.09\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.26\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.22\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.53\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003ens.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eLoneliness \u0026rarr; Internalizing\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.51\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.26\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.050\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.18\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.05\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e.269\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003ens.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eLoneliness \u0026rarr; Externalizing\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.34\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.26\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.07\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.192\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.09\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.03\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e.547\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003ens.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eOstracism \u0026rarr; Social media\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-0.02\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.08\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-0.02\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.777\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.05\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.09\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e.048\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003ens.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eLoneliness \u0026rarr; Social media\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.08\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.08\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.06\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.282\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.09\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.06\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.08\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e.087\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003ens.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSocial media \u0026rarr; Internalizing\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.03\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.413\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.30\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.08\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e.014\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003ens.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSocial media \u0026rarr; Externalizing\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.24\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.07\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.081\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.33\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003ens.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eIndirect effects\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\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\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eOstracism \u0026rarr; Social media\u0026rarr; Internalizing\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-0.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.01\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-0.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.789\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.03\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.02\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.01\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e.123\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eOstracism \u0026rarr; Social media\u0026rarr; Externalizing\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-0.01\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.02\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-0.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.780\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.03\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.02\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.01\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e.092\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eLoneliness \u0026rarr; Social media\u0026rarr; Internalizing\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.01\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.01\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.515\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.03\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.02\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.01\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e.160\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eOstracism \u0026rarr; Social media\u0026rarr; Loneliness\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.02\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.02\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.360\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.03\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.02\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.01\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e.131\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eR2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\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\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eInternalizing\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.14\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\u003cp\u003e0.12\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\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eExternalizing\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.08\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\u003cp\u003e0.05\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\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSocial Media\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.00\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\u003cp\u003e0.02\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\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"11\"\u003e\u003cem\u003eNote. N\u003c/em\u003e\u003csub\u003e\u003cem\u003eBoys\u003c/em\u003e\u003c/sub\u003e = 620, \u003cem\u003eN\u003c/em\u003e\u003csub\u003e\u003cem\u003eGirls\u003c/em\u003e\u003c/sub\u003e = 767. Diff\u0026thinsp;=\u0026thinsp;Significant difference in beta values between boys and girls based on confidence intervals. ns\u0026thinsp;=\u0026thinsp;non-significant.\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec19\" class=\"Section3\"\u003e\u003ch2\u003e4.3.2 The mediating role of gaming\u003c/h2\u003e\u003cp\u003eAdditionally, the same path models were fit to estimate if symptoms of loneliness and ostracism on both internalizing and externalizing symptoms were mediated by gaming, again separately for girls and boys. The two path models can be found in Fig.\u0026nbsp;2.\u003c/p\u003e\u003cp\u003eAmong girls, ostracism had significant direct effects on both internalizing and externalizing symptoms, whereas loneliness did not significantly predict either outcome. Furthermore, gaming was not a significant mediator for girls, as none of the indirect paths were significant. Notably, the path from gaming to internalizing symptoms was non-significant and negative, simultaneously emphasizing gender differences in gaming behaviors and its relation to psychological elements.\u003c/p\u003e\u003cp\u003eFor boys, ostracism also had a significant direct effect on both internalizing and externalizing symptoms. Gaming partially mediated the relationship between ostracism and internalizing symptoms, though the indirect effect did not reach statistical significance. Loneliness predicted internalizing symptoms directly but was negatively associated with gaming, suggesting different coping mechanisms may be at play.\u003c/p\u003e\u003cp\u003e\u003cb\u003eFigure 2\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003cem\u003ePath Model on Gaming\u003c/em\u003e\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eNote\u003c/strong\u003e\u003cp\u003eStandardized estimates of the path model. *** \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.001, ** p\u0026thinsp;\u0026lt;\u0026thinsp;0.01, * p\u0026thinsp;\u0026lt;\u0026thinsp;.05.\u003c/p\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\u003e\u003cem\u003ePath Model Parameter Estimates Gaming\u003c/em\u003e\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"11\"\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\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePath\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cem\u003eBoys\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u003cem\u003eGirls\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cem\u003eB\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cem\u003eSE\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cem\u003eBeta\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u003cem\u003eB\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\"\u003e\u003cp\u003e\u003cem\u003eSE\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c9\"\u003e\u003cp\u003e\u003cem\u003eBeta\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c10\"\u003e\u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c11\"\u003e\u003cp\u003e\u003cem\u003eDiff\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDirect effect\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\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\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eOstracism \u0026rarr; Internalizing\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1.41\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.25\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.28\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e1.17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.30\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003ens.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eOstracism \u0026rarr; Externalizing\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1.17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.26\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.24\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.65\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.170\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003ens.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eLoneliness \u0026rarr; Internalizing\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.25\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.003\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.28\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.23\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.06\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e.236\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003ens.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eLoneliness \u0026rarr; Externalizing\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.37\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.26\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.08\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.150\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.03\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e.589\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003ens.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eOstracism \u0026rarr;\u003c/p\u003e\u003cp\u003eGaming\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.23\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.08\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.004\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.06\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e.013\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003ens.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eLoneliness \u0026rarr;\u003c/p\u003e\u003cp\u003eGaming\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-0.18\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.08\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-0.12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.025\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.07\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.08\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e.152\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003ens.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eGaming \u0026rarr; Internalizing\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.28\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.08\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.030\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e-0.06\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e-0.02\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e.685\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003ens.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eGaming \u0026rarr; Externalizing\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-0.06\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-0.02\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.617\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.02\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.01\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e.856\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003ens.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eIndirect effects\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\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\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eOstracism \u0026rarr; Gaming\u0026rarr; Internalizing\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.06\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.04\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.01\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.082\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e-0.01\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.02\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e-0.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e.689\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003ens.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eOstracism \u0026rarr; Gaming\u0026rarr; Externalizing\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-0.02\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.03\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-0.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.622\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.02\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e.856\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003ens.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eLoneliness \u0026rarr; Gaming\u0026rarr; Internalizing\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-0.05\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.03\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-0.01\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.119\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e-0.01\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.02\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e-0.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e.696\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003ens.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eOstracism \u0026rarr; Gaming\u0026rarr;\u003c/p\u003e\u003cp\u003eLoneliness\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.01\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.02\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.626\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.01\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e.857\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003ens.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eR2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\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\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eInternalizing\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.16\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\u003cp\u003e0.11\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\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eExternalizing\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.09\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\u003cp\u003e0.05\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\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eGaming\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.01\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\u003cp\u003e0.04\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\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"11\"\u003e\u003cem\u003eNote. N\u003c/em\u003e\u003csub\u003e\u003cem\u003eBoys\u003c/em\u003e\u003c/sub\u003e = 606, \u003cem\u003eN\u003c/em\u003e\u003csub\u003e\u003cem\u003eGirls\u003c/em\u003e\u003c/sub\u003e = 545, Diff\u0026thinsp;=\u0026thinsp;Difference in beta values between boys and girls based on confidence intervals. ns\u0026thinsp;=\u0026thinsp;non-significant.\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e"},{"header":"5. Discussion","content":"\u003cp\u003eThe present findings show that school-based loneliness and school-based ostracism are associated with internalizing and externalizing symptoms (hypothesis 1a and 1b). However, school-based ostracism relates more strongly to internalizing and externalizing symptoms than school-based loneliness. Ostracism was a robust predictor of both internalizing and externalizing symptoms across both genders, whereas loneliness contributed uniquely to internalizing symptoms only among boys. The correlation between loneliness and ostracism is moderate, but slightly higher for boys than for girls.\u003c/p\u003e\u003cp\u003eThese findings reveal consistent gender differences across the key variables in this study, warranting discussion. Girls reported higher levels of perceived ostracism, loneliness, internalizing and externalizing symptoms, and social media use, while boys reported greater engagement in gaming. These findings align with a body of literature suggesting that adolescent girls experience higher levels of loneliness and ostracism (Kiuru et al., \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e2024\u003c/span\u003e; Ribeiro et al., \u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e2022\u003c/span\u003e), externalizing symptoms (Liu et al., \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e2021\u003c/span\u003e), internalizing symptoms (Bate et al., \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e2021\u003c/span\u003e; Liu et al., \u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e2022\u003c/span\u003e), and social media use (Andreassen et al., \u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2017\u003c/span\u003e; Rutter et al., \u003cspan citationid=\"CR55\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). Some studies, however, suggest that boys are experiencing higher levels of loneliness (Rutter et al., \u003cspan citationid=\"CR55\" class=\"CitationRef\"\u003e2021\u003c/span\u003e), externalizing behaviour (Bate et al., \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e2021\u003c/span\u003e; Levante et al., \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e2023\u003c/span\u003e) and internalizing behaviour (Wang et al., \u003cspan citationid=\"CR73\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). Therefore, it is important to incorporate gender in future studies in order to determine a clear overview amidst the currently mixed findings on this topic.\u003c/p\u003e\u003cp\u003eMediation analyses further highlighted gender-specific patterns: among boys, gaming partially \u0026ndash; but not significantly \u0026ndash; mediated the link between ostracism and internalizing symptoms, whereas no such mediation effects were observed for girls. Hypothesis 3a is partially supported as time spent on social media emerged as a weak but significant predictor of mental health symptoms in girls, yet did not significantly mediate any relationships, underscoring its limited explanatory role. The strength of associations between loneliness and ostracism with internalizing and externalizing symptoms was generally moderate, and the path models accounted for modest proportions of variance, particularly in externalizing outcomes. These results point to distinct gendered pathways in adolescents' emotional and behavioral adjustment, with differential roles for digital media use in these processes.\u003c/p\u003e\u003cp\u003eHypotheses 2a and 2b predicted that school-based loneliness and ostracism would be associated with time spent on social media and gaming. However, and contrary to our expectations, both social media use and gaming were only weakly correlated with ostracism, loneliness, and internalizing and externalizing symptoms. This is somewhat surprising, as a significant body of literature has highlighted links between social media use and various mental health outcomes, although often with small effect sizes (O\u0026rsquo;Day \u0026amp; Heimberg, \u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e2021\u003c/span\u003e; Svensson et al., \u003cspan citationid=\"CR63\" class=\"CitationRef\"\u003e2022\u003c/span\u003e; Verduyn et al., \u003cspan citationid=\"CR72\" class=\"CitationRef\"\u003e2017\u003c/span\u003e). Furthermore, the mediation analyses show that social media emerged as a weak but significant predictor of internalizing symptoms, but only among girls. This gender-specific result aligns with earlier findings showing that girls may be more vulnerable to the negative effects of social comparison and self-esteem fluctuations related to social media (Svensson et al., \u003cspan citationid=\"CR63\" class=\"CitationRef\"\u003e2022\u003c/span\u003e; Twenge \u0026amp; Martin, \u003cspan citationid=\"CR67\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). At the same time, our findings contrast with studies reporting no association between social media and internalizing symptoms (Coyne et al., \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e2020\u003c/span\u003e) or with research claiming that social media usage leads to positive outcomes on well-being (e.g., Odgers \u0026amp; Jensen, \u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e2020\u003c/span\u003e; Valkenburg et al., \u003cspan citationid=\"CR68\" class=\"CitationRef\"\u003e2022a\u003c/span\u003e). Future studies can further explore this relationship, for example by studying how diverse social media activities (like or dislike photos and videos, chatting) are related to mental health problems (Svensson et al., \u003cspan citationid=\"CR63\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). It is also noteworthy that, unlike loneliness, ostracism is rarely conceptualized in recent literature as a condition that can be improved by social media use. On the contrary, social media may itself be a platform for exclusion. Forms of online social exclusion, also referred to as cyber-ostracism, have been shown to carry psychological consequences similar to offline ostracism (Chen et al., \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2025\u003c/span\u003e). This highlights the dual role of digital platforms, which can act both as tools for connection and as instruments of exclusion. Mediation analyses show similar results for gaming: gaming significantly mediates the association between loneliness and internalizing symptoms, but only for boys (Gentile et al., \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e2012\u003c/span\u003e; Lau et al., \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e2018\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eTaken together, these results point to the limited mediating effect of both social media and gaming. This suggests that while these digital activities are relevant, they are not primary pathways through which loneliness and ostracism influence mental health. These results lead to rejecting hypotheses 4a and 4b, proposing that time spent on social media and gaming would mediate the relationship between school-based loneliness, ostracism, and internalizing and externalizing symptoms.\u003c/p\u003e\u003cp\u003eConcerning the context of these findings, and as already mentioned, data collection took place in the aftermath of the COVID-19 pandemic (May 2021), a period that likely influenced participants\u0026rsquo; experiences of loneliness and ostracism as well as their patterns of social media and gaming use. These unique contextual factors may have shaped the relationships observed in the study, reflecting the social dynamics and digital engagement characteristic of the post-pandemic period. Barbieri and Mercado (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2022\u003c/span\u003e), for instance, already claimed that adolescents\u0026rsquo; levels of loneliness were higher during the pandemic.\u003c/p\u003e\u003cp\u003eMoreover, it should be noted that these findings are based on group-level analyses, meaning the associations reported represent average trends across the sample. As such, individual variation may be obscured; that is, while some adolescents may experience strong links between, for example, school-based loneliness and time spent on social media, for others these association may be absent or even opposite. Therefore, caution is warranted when interpreting group-level patterns as applying equally to all individuals.\u003c/p\u003e\u003cdiv id=\"Sec21\" class=\"Section2\"\u003e\u003ch2\u003e5.1 Strengths and limitations\u003c/h2\u003e\u003cp\u003eReflecting on the initial research gap, this study is, to the best of our knowledge, the first to investigate potential mediating factors in the well-established association between ostracism, loneliness, and internalizing and externalizing symptoms. While gaming and social media did not emerge as highly significant mediators for either gender, the results \u0026ndash; derived from a large sample size and gender-stratified analyses \u0026ndash; make a valuable contribution to this field of research. Given that ostracism, loneliness, and internalizing and externalizing symptoms are highly prevalent during adolescence, and all are associated with potentially severe long-term consequences (Royuela-Colomer et al., \u003cspan citationid=\"CR53\" class=\"CitationRef\"\u003e2024\u003c/span\u003e), it is essential to further examine alternative mediating mechanisms that may help explain these relationships.\u003c/p\u003e\u003cp\u003eThis study also comes with some limitations. First, the reliance on self-report measures to assess all included variables, but especially participants' use of social media and video games introduces potential biases. Self-reported data depends on participants\u0026rsquo; subjective perceptions and memory, which may result in inaccurate or inconsistent responses. Furthermore, critics argue that content-based measures are more likely in media effects research than time-based measures (Valkenburg et al., \u003cspan citationid=\"CR69\" class=\"CitationRef\"\u003e2022b\u003c/span\u003e). Related to this, the absence of clear definitions for concepts like \u0026lsquo;social media\u0026rsquo; and \u0026lsquo;gaming\u0026rsquo; within the questionnaire can lead to varied interpretations among participants. For example, some may have interpreted playing a single-player game app on their mobile phone as gaming while others may not. This can affect the accuracy of the data (Valkenburg et al., \u003cspan citationid=\"CR69\" class=\"CitationRef\"\u003e2022b\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eThe second limitation is also linked to the data collection, as these data are part of a larger research project focused on school-related experiences of loneliness and ostracism (see Author et al., \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2025\u003c/span\u003e). Consequently, the questionnaire items primarily targeted participants\u0026rsquo; feelings within the school setting. This may not fully capture participants\u0026rsquo; feelings of loneliness and ostracism outside school which can potentially limit the ecological validity.\u003c/p\u003e\u003cp\u003eThird, due to the lack of a clear definition of social media and reliance on self-report, this study did not differentiate between social media activities. This is a notable limitation given that prior research has shown that specific activities, such as chatting, may have different associations with internalizing symptoms, particularly among girls (Svensson et al., \u003cspan citationid=\"CR63\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). Similarly, Sarmiento et al. (\u003cspan citationid=\"CR56\" class=\"CitationRef\"\u003e2020\u003c/span\u003e) highlighted that the effect of gender depends on the particular aspect of social media use. Therefore, we suggest that more nuanced measurement is required to understand these relationships.\u003c/p\u003e\u003cp\u003eFourth, the cross-sectional design of this study restricts the ability to draw any causal conclusions. While associations between social media use and mental well-being\u0026mdash;especially among girls\u0026mdash;are observed, it remains unclear whether social media usage contributes to mental health difficulties, or whether adolescents experiencing such difficulties are more likely to engage with social media. This ambiguity is consistent with existing literature that emphasizes the complex, bidirectional relationship between social media and adolescent mental health (Svensson et al., \u003cspan citationid=\"CR63\" class=\"CitationRef\"\u003e2022\u003c/span\u003e; Twenge \u0026amp; Martin, \u003cspan citationid=\"CR67\" class=\"CitationRef\"\u003e2020\u003c/span\u003e).\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec22\" class=\"Section2\"\u003e\u003ch2\u003e5.2 Conclusion\u003c/h2\u003e\u003cp\u003eAlthough numerous studies have examined the associations between loneliness, ostracism, and internalizing and externalizing symptoms, to the best of our knowledge, no prior research has investigated the mediating role of gaming and social media within this context. The present findings indicate that school-based ostracism relates more strongly to internalizing and externalizing symptoms than school-based loneliness. Among girls, the relationship between ostracism and internalizing symptoms was weakly mediated by social media use, whereas among boys, gaming significantly mediated the association between loneliness and internalizing symptoms. However, neither gaming nor social media emerged as key mediators in the broader relationship between ostracism, loneliness, and internalizing and externalizing symptoms across genders. These results highlight the need for future research to further investigate these complex associations using longitudinal designs, which allow for causal inferences. In addition, studies should distinguish between different types of social media and gaming activities, and explore alternative mediating constructs that may help clarify how loneliness and ostracism contribute to adolescent mental health challenges. Given the potential long-term consequences of these issues, a more nuanced understanding is essential for informing prevention and intervention strategies.\u003c/p\u003e\u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003eAcknowledgments \u0026amp; Declarations\u003c/p\u003e\n\u003cp\u003eThe present study is part of the EDUCA Flagship funded by the Research Council of Finland (#358924, #358947).\u003c/p\u003e\n\u003cp\u003eThe study protocol received approval from the Research Ethics Committee of Åbo Akademi University (Reference number: 2020/06/26).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eParent(s)/legal guardian(s) of the children under 18y/o consent to participate in the study was collected.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eAndreassen, C. S., Pallesen, S., \u0026amp; Griffiths, M. D. (2017). 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Zanna (Ed.), \u003cem\u003eAdvances in experimental social psychology \u003c/em\u003e(pp. 275-314). Elsevier.\u003c/li\u003e\n\u003cli\u003eYang, J., Wang, R., Cook, A., \u0026amp; Fuller, R. (2023). Gaming during the COVID-19 pandemic: Examining its effect on loneliness \u0026amp; motivation, playing and gratification differences between competitive and recreational gamers. \u003cem\u003eTelematics and Informatics Reports\u003c/em\u003e, \u003cem\u003e11\u003c/em\u003e, 100093. https://doi.org/10.1016/j.teler.2023.100093 \u003c/li\u003e\n\u003cli\u003eZahedi, S., Jaffer, R., \u0026amp; Iyer, A. (2021). A systematic review of screen-time literature to inform educational policy and practice during COVID-19. \u003cem\u003eInternational Journal of Educational Research Open, 2, \u003c/em\u003e100094. https://doi.org/10.1016/j.ijedro.2021.100094 \u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"University of Turku","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":"loneliness, ostracism, gaming, social media, internalizing symptoms, externalizing symptoms","lastPublishedDoi":"10.21203/rs.3.rs-7944252/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7944252/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eSocial disconnection – particularly loneliness and ostracism – has a significant impact on mental health issues such as internalizing symptoms (e.g., depression, anxiety) and externalizing symptoms (e.g., aggression, conduct problems). Yet, the mechanisms underlying these effects are multifaceted and likely include multiple mediating processes that may either amplify or mitigate the emergence of internalizing and externalizing symptoms. This cross-sectional study examines whether digital behaviors – social media use and gaming – mediate the relationship between school-based loneliness, school-based ostracism, and externalizing and internalizing symptoms in Finnish adolescents. Data were collected from 1,742 secondary school students (mean age 14.9 years; 47.6% male). Results reveal that both social media use and gaming were only weakly correlated with school-based loneliness, school-based ostracism, and mental health outcomes. Mediation analyses demonstrated that neither social media nor gaming robustly mediated the link between social disconnection and externalizing and internalizing symptoms. Limited indirect effects emerged: social media use weakly mediated the ostracism – internalizing symptoms link among girls, and gaming partially mediated the loneliness – internalizing symptoms link among boys. The findings suggest that digital behaviors are not primary explanations for the impact of school-based loneliness and ostracism on adolescent mental health. Future research should utilize longitudinal approaches and other measures of digital engagement to further clarify these relationships and identify alternative mediating processes.\u003c/p\u003e","manuscriptTitle":"Exploring the mediating role of social media and gaming in the relationship between adolescents’ feelings of loneliness, ostracism and internalizing and externalizing symptoms","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-11-02 05:16:35","doi":"10.21203/rs.3.rs-7944252/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":"505f8ea7-c306-4b15-b99b-0f0a5b008aca","owner":[],"postedDate":"November 2nd, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":56853288,"name":"Educational Psychology"},{"id":56853289,"name":"Psychology"}],"tags":[],"updatedAt":"2025-11-02T05:16:35+00:00","versionOfRecord":[],"versionCreatedAt":"2025-11-02 05:16:35","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7944252","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7944252","identity":"rs-7944252","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}