CYBERPSYCHOLOGY, BEHAVIOR, AND SOCIAL NETWORKING

Volume 18, Number 9, 2015

ª Mary Ann Liebert, Inc.
DOI: 10.1089/cyber.2015.0121

Internet Addiction and Psychosocial Maladjustment:

Avoidant Coping and Coping Inflexibility
as Psychological Mechanisms

Cecilia Cheng, PhD,1 Peizhen Sun, PhD,2 and Kwok-Kei Mak, PhD1

Abstract

This 6 month prospective study systematically tested some multivariate models that advanced the understanding of
the psychological mechanisms underlying Internet addiction and psychosocial maladjustment. On the basis of
previous theories, avoidant coping and coping inflexibility were proposed as underlying mechanisms. Participants
were 271 Chinese undergraduates (75% women, Mage = 20.49) who took part in both phases of this study. Structural
equation modeling was performed to obtain the best fit models for both the cross-sectional and the prospective data.
The cross-sectional model testing revealed statistically significant mediating effects for both avoidant coping
(b = 0.149 [95% CI 0.071–0.226], p = 0.002) and coping flexibility (b = 0.048 [95% CI 0.013–0.081], p = 0.032). The
prospective model testing further showed that avoidant coping mediated the relationship between Internet addiction
and Time 2 psychosocial maladjustment (b = 0.141 [95% CI 0.065–0.216], p = 0.005), as well as that between coping
flexibility and Time 2 psychosocial maladjustment (b = - 0.096 [95% CI -0.161 to -0.031], p = 0.015). This study
was the first to establish theory-driven models, which unveiled an inflexible, avoidant coping style as psychological
mechanisms that explained the link between Internet addiction and psychosocial maladjustment.

Introduction Apart from emotional problems, individuals with Internet ad-

diction also frequently encounter interpersonal problems.7 The
P roblematic Internet use is common, especially
among young people in Asia.1 Internet addiction has
raised concerns among practitioners, parents, teachers, and the
rich-get-richer hypothesis states that online communication
may benefit extroverts who are endowed with abundant offline
social resources.8 Such psychological benefits, however, are
mass media worldwide because it poses threats to the psy-
absent for introverts because Internet use results in the allo-
chosocial adjustment of a notable portion of users.2,3 Studies
cation of inadequate time for social interactions,9 thus shrink-
have focused on scrutinizing the adjustment problems faced by
ing their already scarce social resources. As individuals with
users with Internet addiction,4,5 but scant attempts have been
Internet addiction were found to report lower levels of extra-
made to explore systematically the underlying mechanisms
version,10 their excessive Internet use may reduce opportuni-
that accounted for their psychosocial maladjustment. Also,
ties to polish their inadequate social skills in the real-life social
most of these studies were cross-sectional in nature, and the
milieu, thus increasing their susceptibility to social mal-
longitudinal effects of psychological risk factors of Internet
adjustment. The following hypothesis was tested:
addiction remained largely unexplored. To fill these knowl-
edge gaps, the present study aimed to formulate and test several
H1: Internet addiction is positively related to psychosocial
theory-driven models that specify psychological mechanisms maladjustment.
for explicating the link between Internet addiction and
psychosocial maladjustment. A two-phase prospective study
Mediating role of avoidant coping
was conducted in order to perform both cross-sectional and
prospective model testing. Studies have revealed that individuals with Internet ad-
diction report higher levels of stress than their counterparts
without this addictive problem.11,12 According to the trans-
Internet addiction and psychosocial maladjustment
actional theory of coping,13 some individuals who consider
A meta-analysis has indicated that Internet addiction is re- the event a challenge tend to confront and tackle the problem
lated to emotional disorders including depression and anxiety.6 directly (i.e., approach coping), whereas those who consider

1
Department of Psychology, University of Hong Kong, Hong Kong.
2
Department of Psychology, Jiangsu Normal University, Xuzhou, China.

539
540
the same event an uncontrollable threat tend to refrain from
facing it (i.e., avoidant coping). It was predicted that indi-
viduals with Internet addiction are characterized by an avoi-
dant coping style. This notion stems from studies revealing
that these individuals tend to be more dissatisfied with their
real life,2 and that they may have a greater tendency to escape
from the self, which unveils one’s wish to avoid pondering the
painful past and to engage in distracting tasks.14 Unlike the
real world, everything in the virtual world seems alterable and
controllable,15 and individuals with Internet addiction may
rely more on online activities to get away from their real-life
stress.16 Taken together, it was predicted that these individuals
tend to use avoidant coping more than those without Internet
addiction. The following hypothesis was therefore tested:
H2: Internet addiction is positively related to avoidant coping.
Transactional theory states that adaptive coping strategies
should be distinguished from maladaptive ones. Approach
coping strategies (e.g., active coping, planning) are generally
deemed adaptive in tackling the problems directly, thus fos-
tering psychosocial adjustment.17 In contrast, avoidant coping
strategies (e.g., denial, self-blame) are generally considered
maladaptive because the problems remain intact rather than
disappearing, thus eliciting psychosocial maladjustment in the
long run.18 In light of previous findings that revealed the me-
diating effects of coping between addictive behaviors (e.g.,
alcohol use) and social anxiety among university students,19 it
was predicted that greater use of avoidant coping may account
for the link between Internet addiction and psychosocial mal-
adjustment. The following hypotheses were tested:
H3: Avoidant coping is positively linked with psychosocial
maladjustment.
H4: Avoidant coping mediates the link between Internet
addiction and psychosocial maladjustment.
Mediating role of coping inflexibility
Transactional theory also states that coping represents an
ongoing evolving process. Flexible deployment of coping
strategies is thus essential for adjustment to the ever-changing
environment. Coping flexibility (vs. inflexibility) refers to the
capability of modifying one’s strategies to meet specific situa-
tional demands.20 It was predicted that individuals may display
coping inflexibility, as indicated by consistent deployment of
avoidant coping across situations. This prediction stems from
recent neurobiological evidence, which reveals that individuals
with Internet addiction have impaired decision making abili-
ties.21 Such an impairment interferes with their processing of
feedback-related information and judgment of the appropriate-
ness of their responses, both of which are cognitive mechanisms
essential for flexible coping to take place.22 It is thus reasonable
to infer an inverse link between Internet addiction and coping
flexibility, and excessive Internet use may imply a manifestation
of inflexible deployment of avoidant coping regardless of situ-
ational characteristics. The following hypotheses were tested:
H5: Internet addiction is inversely associated with coping
flexibility.
H6: Coping flexibility is inversely associated with avoidant
coping.
CHENG ET AL.
Individuals with Internet addiction may keep engaging in
online activities despite encountering devastating conse-
quences of their online behaviors.21 Such inflexibility is
maladaptive due to an incapability of detecting the contin-
gency between their behaviors and event outcomes.23 Ac-
cording to the theory of learned helplessness,24 such a
perception of lacking control over the situation hinders at-
tempts to adapt to the changing environment, and ultimately
induces a state of learned helplessness and depression. In the
coping literature, results provide support for the beneficial
role of coping flexibility by indicating that individuals who
display greater flexibility generally experience higher levels
of psychosocial well-being, whereas those who are less
flexible generally encounter more psychosocial prob-
lems.25,26 In this light, it was predicted that coping inflexi-
bility may account for the relationship between Internet
addiction and psychosocial maladjustment. The following
hypotheses were tested:
H7: Coping flexibility is inversely linked with psychosocial
maladjustment.
H8: Coping flexibility mediates the link between Internet
addiction and psychosocial maladjustment.
In summary, a set of hypotheses was derived from previous
theories and findings. Several multivariate models were con-
structed to test these hypotheses, specifically the proposed
mediating roles of avoidant coping and coping flexibility be-
tween Internet addiction and psychosocial maladjustment.
Structural equation modeling was performed to obtain the best
fit models for both the cross-sectional and prospective data.
Method
Research design
This study contained two phases conducted 6 months apart.
Adopting a prospective design, all the psychosocial variables
were assessed in the initial phase, but only the criterion vari-
ables were assessed in the follow-up phase.
Participants
A total of 294 Chinese undergraduates voluntarily took
part in both phases. After discarding the data with missing or
incorrect identity codes, the final sample comprised 271
Chinese participants (59 men, 204 women, 8 did not specify),
with an average age of 20.49 years (SD = 1.22 years). Parti-
cipants who completed both phases and those who dropped
out did not differ in any Time 1 measures.
Procedures
This study obtained prior ethical approval from the uni-
versity’s Institutional Review Board. Participants had to sign
a consent form before filling out a set of questionnaires (see
below). In the follow-up session, those who indicated interest
received the questionnaires. All the participants were
thanked and debriefed at the end of the study.
Measures
Internet addiction was assessed by two popular instru-
ments: the Internet Addiction Test and the Online Cognition
INTERNET ADDICTION AND PSYCHOSOCIAL MALADJUSTMENT 541

Scale.27,28 The latter examined four types of cognition re- Table 1. Descriptive Statistics
garding Internet addiction: emotional discomfort, diminished for Time 1 and Time 2 Variables
impulse control, distraction, and social comfort (reverse
scored). Variable M SD a
Avoidant coping style was assessed by four subscales of Young’s Internet Addiction Scale 35.59 10.02 0.87
the Brief COPE: denial, substance use, behavioral disen-
Online Cognition Scale (Internet addiction)
gagement, and self-blame.29 The Coping Flexibility Scale Emotional discomfort 19.29 5.66 0.71
was employed to measure two coping flexibility processes: Distraction 22.19 7.78 0.84
evaluation and adaptation.30 Diminished impulse control 35.46 7.87 0.70
To assess psychosocial maladjustment, three common Social comfort (reverse scored) 42.95 11.49 0.86
criterion measures were included: Emotional and Social Brief COPE (avoidant coping)
Loneliness Scale, negative affect subscale of the Positive Denial 3.83 1.43 0.60
Affect and Negative Affect Schedule, and Interaction An- Substance use 2.93 1.53 0.86
xiousness Scale.31–33 Behavioral disengagement 4.36 1.36 0.67
All the measures were in Chinese, the native language of Self-blame 5.70 1.33 0.64
the participants. These measures were validated in Chinese Coping Flexibility Scale
samples and were found to display good psychometric Evaluation coping process 14.55 1.98 0.73
properties.34,35 Adaptive coping process 15.70 2.69 0.85
Psychosocial maladjustment indicators
Results Loneliness—Time 1 43.70 7.55 0.88
Negative affect—Time 1 22.80 7.04 0.90
A priori statistical analysis plan Social anxiety—Time 1 40.50 7.81 0.81
To test the proposed models, structural equation modeling Loneliness—Time 2 41.10 7.84 0.83
(SEM) was performed using SPSS Statistics for Windows Negative affect—Time 2 22.64 6.57 0.87
v19.0 (IBM Corp., Armonk, NY) and MPlus 6.0. We eval- Social anxiety—Time 2 42.90 7.40 0.73
uated the level of overall data fit of each tested model using
the following fit indices36: comparative fit index (CFI), root
(see Fig. 1c). Results showed that this additional path was
mean square error of approximation (RMSEA), standardized
statistically significant (b = - 0.24, p = 0.002), and this model
root mean square residual (SRMR), and Tucker–Lewis index
also showed a good data fit (see the upper panel of Table 2).
(TLI).
When Model 3 with Model 2 were compared, the additional
The candidate models were then compared using the
path substantially contributed to the explanatory power of
Akaike information criterion (AIC) and Bayesian informa-
Model 3 (Dv2 [1] = 10.93, p < 0.01; AIC difference = 8.93,
tion criterion (BIC). According to the general rule of thumb,
BIC difference = 4.71). Model 3 was the preferred cross-
the preferred model would be the one with the lowest AIC
sectional model due to its smallest AIC and BIC values.
and BIC values.37 A more robust test of the mediating effects
The statistically significant mediating effects of avoidant
of the preferred model was carried out using the bootstrap
coping and coping flexibility identified in Model 3 were then
estimation procedures, which involved repeated sampling of
tested using the bootstrap estimation procedures. As shown
the dataset and estimating the indirect effect in each re-
in the upper panel of Table 3, Internet addiction was sig-
sampled dataset.38 The indirect effect was significant at the
nificantly related to Time 1 psychosocial maladjustment.
0.05 level if the 95% confidence intervals (CI) for the av-
Moreover, both avoidant coping and coping flexibility were
erage estimates excluded zero.39
significant mediators, with statistically significant effects
comprising (a) the mediating role of avoidant coping be-
Cross-sectional model testing tween Internet addiction and Time 1 psychosocial mal-
adjustment; (b) the mediating role of coping flexibility
Before performing cross-sectional model testing, the study
between Internet addiction and Time 1 psychosocial mal-
first examined whether there were sex differences. The pre-
adjustment; and (c) the mediating role of avoidant coping
liminary analyses revealed no overall sex differences, and
between coping flexibility and Time 1 psychosocial mal-
thus all the analyses were performed based on the pooled
adjustment.
sample. Table 1 presents the descriptive statistics of the
study variables.
Prospective model testing
Figure 1 depicts the standardized parameters of all the
cross-sectional models, and Table 2 presents the fit indices of A prospective model (Model 4) was constructed based on
each of these models. The upper panel of Table 2 shows that the preferred model (Model 3) obtained from the cross-
Models 1 and 2 both had a good fit of the baseline data. sectional analyses. As shown in Figure 2a, the results indicated
However, the models significantly differed from each other that the path from Internet addiction to Time 2 psychosocial
(Dv2[1] = 22.90, p < 0.01; AIC difference = 20.90, BIC dif- maladjustment, as well as that from coping flexibility to Time 2
ference = 16.67), indicating that the additional path from psychosocial maladjustment, were not statistically significant.
Internet addiction to Time 1 psychosocial maladjustment had Then another model (Model 5) was built by omitting these
a considerable contribution to the explanatory power of two nonsignificant paths (see Fig. 2b). Although the two
Model 2 (see Fig. 1b). models similarly showed a good data fit (see the lower panel of
The study further examined Model 3 that contained an Table 2), Model 5 had a slight improvement over Model 4 (AIC
additional path from coping flexibility to avoidant coping difference = - 0.62, BIC difference = - 9.36), as indicated by
542 CHENG ET AL.

FIG. 1. Results from cross-

sectional model testing. (a)
Model 1; (b) Model 2; (c)
Model 3. IA1, Young’s In-
ternet Addiction Test; IA2,
Emotional Discomfort sub-
scale of Online Cognition
Scale; IA3, Diminished Im-
pulse Control subscale of
Online Cognition Scale; IA4,
Distraction subscale of On-
line Cognition Scale; IA5,
Social Comfort subscale of
Online Cognition Scale (re-
verse scored); CF1, Evalua-
tion Coping Process subscale
of Coping Flexibility Scale;
CF2, Adaptive Coping Pro-
cess subscale of Coping
Flexibility Scale; AC1, De-
nial subscale of Brief COPE;
AC2, Substance Use subscale
of Brief COPE; AC3, Beha-
vioral Disengagement sub-
scale of Brief COPE; AC4,
Self-Blame subscale of Brief
COPE; PM-T1, psychosocial
maladjustment assessed at
Time 1; PM1, Emotional and
Social Loneliness Scale;
PM2, Negative Affect sub-
scale of Positive Affect and
Negative Affect Schedule;
PM3, Interaction Anxious-
ness Scale.

smaller AIC and BIC values. Model 5 was the preferred pro-
spective model because it was more parsimonious with all the
nonsignificant paths removed.
The lower panel of Table 3 displays the indirect effects and
their respective 95% CI for Model 5. Results from the boot-
strap estimation procedures revealed that the mediating effect
of avoidant coping between Internet addiction and Time 2
psychosocial maladjustment was statistically significant. In
addition, the indirect effect of avoidant coping between
coping flexibility and Time 2 psychosocial maladjustment
was also statistically significant.
Discussion
The present study is the first to explain the intricate rela-
tionships between Internet addiction and psychosocial mal-
adjustment using both cross-sectional and prospective model
testing. New findings indicate that individuals with Internet
INTERNET ADDICTION AND PSYCHOSOCIAL MALADJUSTMENT 543

Table 2. Fit Indices of Candidate Models

Model v2 df CFI TLI RMSEA SRMR AIC BIC
Cross-sectional model testing
1 267.56 73 0.91 0.93 0.073 0.062 36,344.59 36,538.92
2 244.66 72 0.92 0.94 0.069 0.055 36,323.69 36,522.25
3 233.73 71 0.92 0.94 0.067 0.048 36,314.76 36,517.54
Prospective model testing
4 226.89 71 0.94 0.92 0.061 0.054 33,453.19 33,663.11
5 230.25 73 0.94 0.92 0.061 0.058 33,452.57 33,653.75
df, degrees of freedom; CFI, comparative fit index; TLI, Tucker–Lewis index; RMSEA, root mean square error of approximation; SRMR,
standardized root mean square residual; AIC, Akaike information criterion; BIC, Bayesian information criterion.

addiction are characterized by a maladaptive coping style among individuals with Internet addiction can be explained by
that comprises both avoidant coping and coping inflexibility. their deployment of avoidant coping regardless of the char-
First, the positive link between Internet addiction and avoi- acteristics of stressful events. Such an inflexible, avoidant
dant coping indicates that Chinese young adults with Internet coping style bears some resemblance to learned helplessness,
addiction may have a greater propensity to handle stress a psychological condition in which individuals perceive
using avoidant coping. More important, avoidant coping is a having no control over their environment due to prolonged
psychological mechanism that explains the link between repeated exposure to aversive events.41 Hence, the present
Internet addiction and psychosocial maladjustment. These results provide evidence that the classic theory of learned
findings imply that individuals with Internet addiction are helplessness,24 formulated a few decades ago, may also be
more likely to find ways to escape from real-life difficulties applicable to explicate the contemporary problem of Internet
rather than to handle stress actively. addiction.
The new findings also indicate that inflexible coping style is Results from the prospective model testing document that
another mediator that accounts for the link between Internet only avoidant coping, but not coping inflexibility, can explain
addiction and psychosocial maladjustment. From a biological the link between Internet addiction and subsequent psycho-
perspective, the greater tendency to cope inflexibly with en- social maladjustment. Results further show that avoidant
vironmental changes may be related to the greater brain ac- coping also accounts for the link between coping inflexibility
tivation in bilateral precuneus among individuals with and subsequent psychosocial maladjustment. These findings
Internet addiction.40 Taken together, the inverse link between suggest that coping inflexibility per se cannot account for the
avoidant coping and coping flexibility indicates that individ- maladaptive aspect of Internet addiction, and coping inflexi-
uals with Internet addiction are characterized by an inflexible, bility predicts subsequent psychosocial maladjustment due to
avoidant coping style. The psychosocial maladjustment the deployment of avoidant coping. Such results are consistent
with theories of coping flexibility,20 which distinguishes two
types of coping inflexibility: (a) active inflexible coping, which
Table 3. Standardized Effects and 95% refers to the indiscriminant use of approach coping regardless
Confidence Intervals for Models 3 and 5 of situational demands, and (b) passive inflexible coping,
95% CI which refers to the indiscriminant use of avoidant coping re-
gardless of situational demands. Previous studies have indi-
Estimated Lower Upper cated that active and passive inflexible coping are related to
Path effect bound bound dissimilar psychosocial outcomes, with more desirable out-
comes associated with an active inflexible coping style and
Model 3 (Cross-sectional model testing) more undesirable ones associated with a passive inflexible
Direct effect
IA/PM-T1 0.291*** 0.176 0.397 coping style.42,43 In line with these findings, the prospective
findings of the current study specify that individuals with In-
Indirect effect ternet addiction are characterized by a passive (avoidant) in-
IA/AC/PM-T1 0.149** 0.071 0.226
IA/CF/PM-T1 0.048* 0.013 0.081 flexible coping style but not an active inflexible one.
IA/CF/AC 0.038 0.002 0.073 The present findings may have practical implications for
CF/AC/PM-T1 - 0.104** - 0.165 - 0.044 mental health professionals working with clients with Internet
IA/CF/AC/PM-T1 0.017 0.001 0.033 addiction. Specifically, these new findings demonstrate that
Model 5 (Prospective model testing) strengthening flexible coping—through reducing avoidant
Indirect effect coping and enhancing approach coping—may foster psycho-
IA/AC/PM-T2 0.141** 0.065 0.216 social adjustment among this group of clients. Before deliv-
IA/CF/AC 0.037* 0.008 0.011 ering training sessions to achieve these overarching goals,
CF/AC/PM-T2 - 0.096* - 0.161 - 0.031 practitioners should enhance the clients’ awareness of their
IA/CF/AC/PM-T2 .001 -.015 -.029 inflexible, avoidant coping style and its maladaptiveness in
preventing them from facing real-life stressful events. Given
*p < 0.05; **p < 0.01.
CI, confidence intervals; IA, Internet addiction; PM-T1, psychosocial that all coping strategies have their unique goals and charac-
maladjustment assessed at Time 1; AC, avoidant coping; CF, coping teristics,44,45 the clients should then learn to distinguish the
flexibility; PM-T2, psychosocial maladjustment assessed at Time 2. specific characteristics of an array of stressful events and to
544 CHENG ET AL.

FIG. 2. Results from pro-

spective model testing. (a)
Model 4; (b) Model 5.
PM-T2, psychosocial mal-
adjustment assessed at Time
2; PM1, Emotional and
Social Loneliness Scale
assessed at Time 2; PM2,
Negative Affect subscale of
Positive Affect and Negative
Affect Schedule assessed at
Time 2; PM3, Interaction
Anxiousness Scale assessed
at Time 2. All scales and
subscales were assessed at
Time 1 unless specified.
Dash arrows indicate statis-
tically nonsignificant paths.

deploy situation-appropriate coping strategies to meet the
specific demands of diverse stressful situations.46
There are, however, some limitations of this study. This study
only recruited young adults because individuals from this age
cohort are the most vulnerable to Internet addiction,47 and many
of the participants were residing in urban cities. Previous find-
ings have revealed differences in the susceptibility to Internet
addiction between rural and urban youngsters,48 and further
studies should evaluate the generalization of the present findings
to samples with distinct demographic characteristics such as
adults from rural areas and hard-to-reach hidden youth.49 Also,
other addictive behaviors that are usually clustered with Internet
addiction, such as smoking and compulsive overeating, were not
studied here. These addictive behaviors together with Internet
addiction may have conjoint effects on psychosocial mal-
adjustment. Last but not least, this study examined psychosocial
maladjustment as a criterion, but it is equally possible that it is an
antecedent that leads to Internet addiction. Future studies should
test the feasibility of this alternative model.
Despite such limitations, this study contributes to the liter-
ature by being the first to examine some psychological
mechanisms, which explain the role of avoidant coping style
and coping flexibility in accounting for the relationship be-
tween Internet addiction and psychosocial maladjustment.
Unlike the scattered results in the coping literature, the present
study examined both coping style and process in a more
comprehensive manner. More important, it is also the first
attempt to adopt both a cross-sectional and a prospective de-
sign that systematically test several candidate multivariate
models, thus providing a useful theoretical framework that
may lay a foundation for designing intervention programs to
treat Internet addiction. The different patterns of findings
yielded by the cross-sectional and prospective model testing
provide further support for the value of adopting more than one
time point in Internet addiction research.
Acknowledgments
Preparation of this manuscript was supported by the Hong
Kong Research Grants Council’s General Research Fund
(17400714) and Seed Funding Program for Basic Research
(201411159152) to Cecilia Cheng; and the National Social
Science Foundation of China Research Grant (15CSH052)
and Priority Academic Program Development of Jiangsu
Higher Education Institutions to Peizhen Sun.
Author Disclosure Statement
No competing financial interests exist.
References
1. Mak K, Lai C, Watanabe H, et al. Epidemiology of Internet
behaviors and addiction among adolescents in six Asian
countries. Cyberpsychology, Behavior, & Social Network-
ing 2014; 17:720–728.
INTERNET ADDICTION AND PSYCHOSOCIAL MALADJUSTMENT
2. Cheng C, Li AY. Internet addiction prevalence and quality
of (real) life: a meta-analytic review of 31 nations across
seven world regions. Cyberpsychology, Behavior, & Social
Networking 2014; 17:755–760.
3. Al-Gamal E, Alzayyat A, Ahmad MM. Prevalence of In-
ternet addiction and its association with psychological dis-
tress and coping strategies among university students in
Jordan. Perspectives in Psychiatric Care 2015; doi: 10.1111/
ppc.12102.
4. Burnay J, Billieux J, Blairy S, Larøi F. Which psycholog-
ical factors influence Internet addiction? Evidence through
an integrative model. Computers in Human Behavior 2015;
43:28–34.
5. Floros G, Siomos K, Stogiannidou A, et al. The relationship
between personality, defense styles, Internet addiction dis-
order, and psychopathology in college students. Cyberpsy-
chology, Behavior, & Social Networking 2014; 17:672–676.
6. Ho RC, Zhang MW, Tsang TY, et al. The association be-
tween Internet addiction and psychiatric co-morbidity: a
meta-analysis. BMC Psychiatry 2014; 14:183.
7. Caplan SE. A social skill account of problematic Internet
use. Journal of Communication 2005; 55:721–736.
8. Kraut R, Kiesler S, Boneva B, et al. Internet paradox re-
visited. Journal of Social Issues 2002; 58:49–74.
9. Valkenburg PM, Peter J. Online communication and ado-
lescent well-being: testing the stimulation versus the dis-
placement hypothesis. Journal of Computer-Mediated
Communication 2007; 12:1169–1182.
10. Van der Aa N, Overbeek G, Engels RC, et al. Daily and
compulsive Internet use and well-being in adolescence: a
diathesis-stress model based on Big Five personality traits.
Journal of Youth & Adolescence 2009; 38:765–76.
11. Tang J, Yu Y, Du Y, et al. Prevalence of Internet addiction
and its association with stressful life events and psycho-
logical symptoms among adolescent Internet users. Ad-
dictive Behaviors 2014; 39:744–747.
12. Yan W, Li Y, Sui N. The relationship between recent stressful
life events, personality traits, perceived family functioning
and Internet addiction among college students. Stress &
Health 2014; 30:3–11.
13. Lazarus RS, Folkman S. Transactional theory and research
on emotions and coping. European Journal of Personality
1987; 1:141–169.
14. Kwon J-H, Chung C-S, Lee J. The effects of escape from
self and interpersonal relationship on the pathological use
of Internet games. Community Mental Health Journal 2011;
47:113–121.
15. Boellstorff T. (2008) Coming of age in Second Life: an
anthropologist explores the virtually human. Princeton, NJ:
Princeton University.
16. Snodgrass JG, Lacy MG, Dengah Ii HJF, et al. A vacation
from your mind: problematic online gaming is a stress re-
sponse. Computers in Human Behavior 2014; 38:248–260.
17. Holahan CJ, Moos RH, Schaefer JA. (1996) Coping, stress
resistance, and growth: conceptualizing adaptive function-
ing. In Zeidner M, Endler NS, eds. Handbook of coping:
theory, research, applications. New York: Wiley, pp. 24–43.
18. Vaillant GE. Ego mechanisms of defense and personality
psychopathology. Journal of Abnormal Psychology 1994;
103:44–50.
19. Lewis MA, Hove MC, Whiteside U, et al. Fitting in and feeling
fine: conformity and coping motives as mediators of the re-
lationship between social anxiety and problematic drinking.
Psychology of Addictive Behaviors 2008; 22:58–67.
545
20. Cheng C, Lau HB, Chan MS. Coping flexibility and psycho-
logical adjustment to stressful life changes: a meta-analytic
review. Psychological Bulletin 2014; 140:1582–1607.
21. Dong G, Hu Y, Lin X, et al. What makes Internet addicts
continue playing online even when faced by severe nega-
tive consequences? Possible explanations from an fMRI
study. Biological Psychology 2013; 94:282–289.
22. Cheng C, Cheung MWL. Cognitive processes underlying
coping flexibility: differentiation and integration. Journal of
Personality 2005; 73:859–886.
23. Cheng C. Dialectical thinking and coping flexibility: a
multimethod approach. Journal of Personality 2009;
77:471–494.
24. Seligman ME. (1975) Helplessness: on depression, devel-
opment and death. San Francisco, CA: Freeman.
25. Burton CL, Yan OH, Pat-Horenczyk R, et al. Coping flexi-
bility and complicated grief: a comparison of American and
Chinese samples. Depression & Anxiety 2012; 29:16–22.
26. Gan Y, Shang J, Zhang Y. Coping flexibility and locus of
control as predictors of burnout among Chinese college stu-
dents. Social Behavior & Personality 2007; 35:1087–1098.
27. Young KS. Internet addiction: the emergence of a new clinical
disorder. CyberPsychology & Behavior 1998; 1:237–244.
28. Davis RA, Flett GL, Besser A. Validation of a new scale for
measuring problematic Internet use: Implications for pre-
employment screening. CyberPsychology & Behavior 2002;
5:331–345.
29. Carver CS. You want to measure coping but your proto-
col’s too long: consider the Brief COPE. International
Journal of Behavioral Medicine 1997; 4:92–100.
30. Kato T. Development of the Coping Flexibility Scale: ev-
idence for the coping flexibility hypothesis. Journal of
Counseling Psychology 2012; 59:262–273.
31. Russell D, Cutrona CE, Rose J, et al. Social and emotional
loneliness: an examination of Weiss’s typology of loneli-
ness. Journal of Personality & Social Psychology 1984;
46:1313–1321.
32. Leary MR. Social anxiousness: the construct and its mea-
surement. Journal of Personality Assessment 1983; 47:66–75.
33. Watson D, Clark LA, Tellegen A. Development and vali-
dation of brief measures of positive and negative affect: the
PANAS scales. Journal of Personality & Social Psychology
1988; 54:1063–1070.
34. Yang CF. (1997) Measures of personality and social psy-
chological attitudes. Vol. 1. Taipei, Taiwan: Yuan-Liou. [in
Chinese].
35. Lai CM, Mak KK, Watanabe H, et al. Psychometric
properties of the Internet addiction test in Chinese adoles-
cents. Journal of Pediatric Psychology 2013; 38:794–807.
36. Byrne BM. (2006) Structural equation modeling with EQS:
basic concepts, applications, and programming. 2nd ed.
Mahwah, NJ: Lawrence Erlbaum.
37. Satorra A, Bentler PM. Ensuring positiveness of the scaled
difference chi-square test statistic. Psychometrika 2010;
75:243–248.
38. MacKinnon DP, Lockwood CM, Williams J. Confidence
limits for the indirect effect: distribution of the product and
resampling methods. Multivariate Behavioral Research
2004; 39:99–128.
39. Shrout PE, Bolger N. Mediation in experimental and non-
experimental studies: new procedures and recommenda-
tions. Psychological Methods 2002; 7:422–445.
40. Dong G, Lin X, Zhou H, et al. Cognitive flexibility in
Internet addicts: FMRI evidence from difficult-to-easy and
546
easy-to-difficult switching situations. Addictive Behaviors
2014; 39:677–683.
41. Peterson C, Maier SF, Seligman MEP. (1993) Learned
helplessness: a theory for the age of personal control. New
York: Oxford University.
42. Cheng C, Chan N, Chio JH, et al. Being active or flexible?
Role of control coping on quality of life among patients with
gastrointestinal cancer. Psycho-Oncology 2012; 21:211–218.
43. Gan Y, Zhang Y, Wang X, et al. The coping flexibility of
neurasthenia and depressive patients. Personality & In-
dividual Differences 2006; 40:859–871.
44. Bonanno GA, Burton CL. Regulatory flexibility: an individual
differences perspective on coping and emotion regulation.
Perspectives on Psychological Science 2013; 8:591–612.
45. Cheng C. Cognitive and motivational processes underlying
coping flexibility: a dual-process model. Journal of Per-
sonality & Social Psychology 2003; 84:425–438.
46. Cheng C, Kogan A, Chio JH. The effectiveness of a new,
coping flexibility intervention as compared with a cognitive–
behavioural intervention in managing work stress. Work &
Stress 2012; 26:272–288.
CHENG ET AL.
47. Dayan J, Bernard A, Olliac B, et al. Adolescent brain de-
velopment, risk-taking and vulnerability to addiction.
Journal of Physiology 2010; 104:279–286.
48. Li Y, Zhang X, Lu F, et al. Internet addiction among ele-
mentary and middle school students in China: a nationally
representative sample study. Cyberpsychology, Behavior,
& Social Networking 2014; 17:111–116.
49. Wong PWC, Li TMH, Chan M, et al. The prevalence and
correlates of severe social withdrawal (hikikomori) in Hong
Kong: a cross-sectional telephone-based survey study. In-
ternational Journal of Social Psychiatry 2015; 61:330–342.
Address correspondence to:
Dr. Cecilia Cheng
Department of Psychology
University of Hong Kong
Pokfulam Road
Hong Kong
E-mail: ceci-cheng@hku.hk
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