Exploring mediational roles for self-stigma in associations between types of problematic use of internet and psychological distress in youth with ADHD

Kuan Ying Lee, Chao Ying Chen, Ji Kang Chen, Chih Ching Liu, Kun Chia Chang, Xavier C.C. Fung, Jung Sheng Chen, Yu Chia Kao*, Marc N. Potenza, Amir H. Pakpour, Chung Ying Lin*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

15 Scopus citations


Background: Several studies have linked the problematic use of the Internet (PUI) to psychological distress. Youth with attention deficit hyperactivity disorder (ADHD) are considered a particular disadvantaged population with a high risk of developing PUI, psychological distress, and self-stigma. Nonetheless, the interrelationships of PUI, self-stigma, and psychological distress in adolescents with ADHD are not well understood. Aims: This study investigated whether self-stigma mediates relationships between different forms of PUI, such as problematic gaming (PG), problematic social media use (PSMU), problematic smartphone use (PSPU), and psychological distress (i.e., depression, anxiety, and stress), in children with ADHD. Methods and procedures: We recruited 100 youth with ADHD (mean age=10.80 [SD=3.07] years; 84 boys) from psychiatric outpatient clinics in Taiwan. All participants were assessed for PUI (via Internet Gaming Disorder-Short Form for PG, Bergan Social Medica Addiction Scale for PSMU, and Smartphone Application-Based Addiction Scale for PSPU), self-stigma (via Self-Stigma Short-Scale), and psychological distress (via Depression, Anxiety, Stress Scale). Outcomes and results: The results of path and bootstrapping analyses indicated that self-stigma mediated the associations between PSMU and PSPU, but not PG, and depression, anxiety, and stress. Conclusions and implications: This study expands the extant literature by revealing that self-stigma mediates the association between specific forms of PUI and psychological distress in adolescents with ADHD. Interventions aimed at reducing self-stigma and PUI, particularly PSMU and PSPU, may help decrease psychological distress among adolescents with ADHD.

Original languageEnglish
Article number104410
Pages (from-to)104410
JournalResearch in Developmental Disabilities
StatePublished - 02 2023

Bibliographical note

Copyright © 2023 Elsevier Ltd. All rights reserved.


  • ADHD
  • Addictive behavior
  • Impulsive behavior
  • Internet addiction disorder
  • Online
  • Psychological distress
  • Self-stigma
  • Social Media
  • Humans
  • Psychological Distress
  • Male
  • Behavior, Addictive/psychology
  • Anxiety Disorders
  • Adolescent
  • Attention Deficit Disorder with Hyperactivity/psychology
  • Anxiety/psychology
  • Internet
  • Child


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