Screening for Adolescent Problematic Internet Use: Validation of the Problematic and Risky Internet Use Screening Scale (PRIUSS)

doi:10.1016/j.acap.2015.07.001

Academic Pediatrics

Volume 15, Issue 6, November–December 2015, Pages 658-665

Presented in part at the Society for Adolescent Health and Medicine annual meeting, March 2013, Atlanta, Ga, and the Pediatric Academic Societies annual meeting, May 2013, Washington, DC.

https://doi.org/10.1016/j.acap.2015.07.001 Get rights and content

Abstract

Objective

Problematic Internet use (PIU) is an emerging health concern that lacks screening measures validated for use with adolescents and young adults. This study aimed to validate the Problematic and Risky Internet Use Screening Scale (PRIUSS) for use with older adolescents and to increase its clinical utility by determining scoring guidelines and assessing the relationship between PIU and other mental health conditions.

Methods

This cross-sectional survey study took place at a large, public Midwestern university among 330 older adolescents aged 18 to 25 years. Confirmatory factor analysis and Spearman's correlations were used to assess the PRIUSS' structural and construct validity, respectively. A risk-based scoring cutoff was estimated using a Bayesian latent class modeling approach to computing a receiver operating characteristic curve.

Results

The confirmatory factor analysis indices for the 3-factor model indicated an acceptable fit (goodness-of-fit index 0.89, root mean square error of approximation 0.07). A cutoff of 25 (sensitivity 0.80, 95% confidence interval [CI] 0.47–0.99; specificity 0.79, 95% CI 0.73–0.84) is proposed for identifying those at risk for PIU. Participants at risk for PIU were at significantly greater odds of also reporting symptoms of attention-deficit/hyperactivity disorder (odds ratio [OR] 2.36 95% CI 1.21–4.62, P = .009), depression (OR 3.25, 95% CI 1.65–6.42, P = .008), and social anxiety (OR 3.77, 95% CI 2.06–6.89, P < .000).

Conclusions

The PRIUSS demonstrated validity as a PIU screening instrument for adolescents and young adults. Screening for PIU may also help to identify those at high reciprocal risk for other mental health conditions.

Section snippets

Subjects and Setting

This cross-sectional survey study was conducted between January 2012 and June of 2013. Approval of the study was granted by the institutional review board at the University of Wisconsin. Participants were older adolescents aged 18 to 25 years recruited from undergraduate students enrolled in a nutritional sciences course at a public university located in the Midwest, a course that has both a high enrollment number and fulfills general education requirements for a variety of programs and majors.

Procedure

Participants

A total of 330 participants completed the survey (50% response rate). Participants reported on average 5.0 (SD 3.0) total daily hours of Internet use, and 5.8% (n = 19) reported >6 hours of daily recreational use and were categorized as a high user. PRIUSS scores ranged from 0 to 49; the median score was 17. Nonwhite participants scored higher on the PRIUSS overall (mean 22.5, SD 11.5 versus mean 17.6, SD 9.9, P = .004). There were no significant differences by sex (P = .700), year in school (P

Discussion

In the current study, evidence supported the structural and construct validity of the PRIUSS in an AYA college student sample. Participants' responses across the PRIUSS items suggest that some degree of PIU may be normative among older AYAs, particularly when it comes to balancing online time with other priorities. Clinicians talking with patients about their Internet use may find it helpful to focus on those who either report significant life consequences in connection to symptoms or to

Conclusions

Given the growing influence of the Internet in the lives of AYAs, advancing the development of screening and intervention tools for PIU is of critical importance. The present study validates the PRIUSS as a clinical screening measure for PIU in older adolescents and highlights the reciprocal relationship between PIU and other common AYA mental health conditions. Future research that includes longitudinal assessments and at-risk populations will help to refine methods for implementing the PRIUSS

Acknowledgments

This work was supported by R01DA031580-01. This grant is supported by the Common Fund, which is managed by the OD/Office of Strategic Coordination (OSC). Funding for this project was also provided by the University of Wisconsin Graduate School. These funding sources had no role design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. The authors

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Within student populations, the PRIUSS has consistently demonstrated strong reliability and validity (Jelenchick et al., 2014, 2015; Moreno, Jelenchick, & Breland, 2015). Based on recommendations from Jelenchick et al. (2014; 2015) the overall PRIUSS score (composite of all 17 items) was used. For time 1, PIU scale scores ranged from 0 to 4.59, with average response of 1.82 (SD = 0.64); for time 2, scale scores ranged from 0 to 5 with an average response of 1.92 (SD = 0.67).
With the rise of internet accessibility and usage among adolescents, we need to better understand the ways in which family experiences may be impacting problematic internet usage (PIU) for adolescents. Using data collected at two time points from a sample of adolescents (N = 741) enrolled in private secondary schools in Lagos, Nigeria, we examine the roles of family and parental work experience factors on adolescent PIU and the ways in which this PIU may be associated with negative adolescent and family outcomes. Results suggest that PIU is positively associated with increased adolescent aggression (p = .008) and serves as a mechanism for the indirect positive relationship between parental monitoring of online activity and family satisfaction (p < .05). In addition, there are a variety of individual (quantity of internet usage, p < .001), family (family satisfaction, p < .001, and familialism, p < .001) and parental (parent-child attachment, p < .001, parental monitoring of online activity, p = .007, and low parental work-family conflict, p < .05) factors that are negatively related to PIU behaviors for adolescents.
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Participants then completed The Problematic and Risky Internet Use Screening Scale (PRIUSS), a validated 18-item scale with scores ranging from 0 to 72. A score cutoff of 25 identifies those at risk for PIU [6,7]. At T2, after completing the PRIUSS, participants were told whether their score met criteria as at risk for PIU.
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Of 319 participants, 56% were female, 58% were from the Midwest, and 75% were white. Problematic internet use prevalence estimates varied between 9% and 11% over the 4 years. Problematic internet use risk status from the previous time period was identified as the main predictor for problematic internet use (OR 24.1, 95% CI 12.8-45.4, P < .0001). Receiver operating curve analysis identified the optimal threshold for defining Intermediate risk was a PRIUSS score of 15.
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: The authors declare that they have no conflict of interest.

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Sleep for Preschoolers, BMI and Utilization, Reach Out and Read, Problematic Internet UseScreening for Adolescent Problematic Internet Use: Validation of the Problematic and Risky Internet Use Screening Scale (PRIUSS)

Abstract

Objective

Methods

Results

Conclusions

Section snippets

Subjects and Setting

Procedure

Participants

Discussion

Conclusions

Acknowledgments

Compr Psychiatry

Clin Psychol Rev

J Adolesc Health

Comput Human Behav

Comput Human Behav

Comput Human Behav

Comput Human Behav

Personality Individual Differences

J Clin Epidemiol

Comput Human Behav

Comput Human Behav

Comput Human Behav

Problematic Internet use and health in adolescents: data from a high school survey in Connecticut

J Clin Psychiatry

Problematic Internet usage in US college students: a pilot study

BMC Med

Child maltreatment, alexithymia, and problematic Internet use in young adulthood

Cyberpsychol Behav Soc Netw

Predictive values of psychiatric symptoms for Internet addiction in adolescents: a 2-year prospective study

Arch Pediatr Adolesc Med

Effect of pathological use of the Internet on adolescent mental health

Arch Pediatr Adolesc Med

Problematic Internet use during adolescence and young adulthood

Problematic Internet use among US youth: a systematic review

Arch Pediatr Adolesc Med

Sleep for Preschoolers, BMI and Utilization, Reach Out and Read, Problematic Internet Use
Screening for Adolescent Problematic Internet Use: Validation of the Problematic and Risky Internet Use Screening Scale (PRIUSS)