International Journal of Child Care and Education Policy

International Journal of Child Care and Education Policy
Psychological distress and problematic electronic devices use among adolescents: The
roles of perceived social support
--Manuscript Draft--
Manuscript Number: ICEP-D-22-00067
Full Title: Psychological distress and problematic electronic devices use among adolescents:
The roles of perceived social support
Article Type: Research
Funding Information:
Abstract: Introduction
The continuously advanced technologies of electronic devices (e-devices) have

become an important information and entertainment resource for adolescents.
However, excessive e-devices use has many adverse effects. The study aims to
describe the impact of excessive e-devices, psychological distress, and perceived
social support in a sample of Jordanian adolescents.
Design
The study is a cross-sectional descriptive correlational study of 485 randomly selected

Jordanian adolescents. Descriptive and inferential statistics were used in this study to
compare the effects of excessive e-devices, psychological distress, and the role of
perceived social support. Regression models tested associations between
adolescents’ level of psychological distress, e-devices use, and the role of perceived
social support in these relationships after adjusting for covariates.
Results
Almost all subjects who use e-devices reported using e-devices for five hours/day.
About 20.2%, 37.9%, and 17% of the subjects had mild to extremely severe
depression, anxiety, and moderate stress levels, respectively. In regression analysis,
the total psychological distress contributed considerably to predicting excessive e-
devices. The role of perceived social support has constantly lowered psychological
problems, especially from family.
Corresponding Author: Maysoun H Atoum, Ph.D

The Hashemite University
Amman, Amman JORDAN
Corresponding Author E-Mail: maysoun_atoum@hu.edu.jo
Corresponding Author Secondary

Information:
Corresponding Author's Institution: The Hashemite University
Corresponding Author's Secondary

Institution:
First Author: Maysoun H Atoum, Ph.D
First Author Secondary Information:
Order of Authors: Maysoun H Atoum, Ph.D
Hadeel Atoum
Order of Authors Secondary Information:
Author Comments:
Suggested Reviewers:
Additional Information:
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Dr. Editor in chief
 Ethics approval and consent to participate
The Hashemite University ethics committee that approved the study and the committee's
reference number have been taken (reference# 5/2/2018/2019)
We wish to submit our manuscript titled "Psychological distress and problematic

electronic devices use among adolescents: The roles of perceived social support."
 Consent for publication
We declare that this manuscript is original, has not been published before, and is not
currently being considered for publication elsewhere. We hope to publish to the
“International Journal of Child Care and Education Policy Editorial Office”
 Consent for publication
As a corresponding author, I confirm that the manuscript has been read and approved for
submission by all the named authors. We hope you find our manuscript suitable for
publication
 Competing interests
We know of no conflicts of interest associated with this publication,

We have no conflict of interest to be disclosed.
Maysoun Atoum's (MA) ORCID Number is 0000-0002-4923-7629

Maysoun Hussein Ali Atoum, Ph.D., RN.
Teacher
Department of Community and Mental Health Nursing
Faculty of Nursing, Hashemite University,
Zarqa, Jordan,
Email:maysoun_atoum@hu.edu.jo; mays_atoum@hotmail.com
LinkedIn profile link: https://www.linkedin.com/in/maysoun-atoum-
65619514/?originalSubdomain=jo
Mobile +962798297065
Hadeel Atoum (HA) ORCID Number is 0000-0001-6486-8608
Hadeel Atoum, MD.
Independent Researcher
Email: AtoumH@gmail.com
Author contributions: HA: collected the data, MA wrote the introduction, methods, and
other sections; revised and proofread the final version of the paper; MA: analyzed the data
and reported the results and abstract sections; HA: wrote the discussion; MA: wrote the
implications, and the conclusion. All authors have agreed with the results and conclusion.
Funding
There has been no funding support for this work that could have influenced its outcome.
• Competing interests
The authors declare that they have no known competing financial interests or personal
relationships that could have appeared to influence the work reported in this paper.
• Acknowledgements
I want to express my gratitude and appreciation for adolescent students whose guidance,
support, and encouragement have been invaluable throughout this study. I also wish to thank
the team of the teacher and parents, who have been a great source of support.
• Availability of data and material
Data sharing involves the citation and availability of data supporting the research findings.
Thank you for the consideration of this manuscript. and look forward to hearing from you.
Blinded Manuscript Click here to view linked References
1 1
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4 Psychological distress and problematic electronic devices use among adolescents:
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7 The roles of perceived social support
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9 Abstract
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12 Introduction: The continuously advanced technologies of electronic devices (e-devices) have
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14 become an important information and entertainment resource for adolescents. However,
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17 excessive e-devices use has many adverse effects. The study aims to describe the impact of
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19 excessive e-devices, psychological distress, and perceived social support in a sample of
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21 Jordanian adolescents. Design: The study is a cross-sectional descriptive correlational study of
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24 485 randomly selected Jordanian adolescents. Descriptive and inferential statistics were used in
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26 this study to compare the effects of excessive e-devices, psychological distress, and the role of
27
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29 perceived social support. Regression models tested associations between adolescents’ level of
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31 psychological distress, e-devices use, and the role of perceived social support in these
32
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34 relationships after adjusting for covariates. Results: Almost all subjects who use e-devices
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36 reported using e-devices for five hours/day. About 20.2%, 37.9%, and 17% of the subjects had
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mild to extremely severe depression, anxiety, and moderate stress levels, respectively. In
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41 regression analysis, the total psychological distress contributed considerably to predicting
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43 excessive e-devices. The role of perceived social support has constantly lowered psychological
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46 problems, especially from family.Further analysis of the family and the friends subscales showed
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48 that females reported more friends but less family support than male
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51 adolescents. Conclusion: adolescents exposed to excessive e-devices may be especially
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53 vulnerable to developing psychological distress such as depression and stress. The role of
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perceived social support offsets the adverse effects of e-devices use among the risk group;
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58 implications for prevention efforts are discussed.
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4 Keywords: Electronic devices, Adolescents, Psychological distress, Perceived Social
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7 Support
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9 Introduction
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12 In recent decades, the continuously advanced technologies of electronic devices (e-
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14 devices) have become an important information and entertainment resource for adolescents
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17 (Babic et al., 2017). However, excessive e-devices use has adverse effects, including psychological
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19 problems and social interaction, which increasingly deserved attention for researchers and
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practitioners (Staff, 2016; The World Health Organization, [WHO], 2020). The control of e-devices
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24 over humans will further change the shape of life (Isaac, 2019), and it is expected that e-devices
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26 use will continue to grow among individuals (Poushter, 2016). Despite the many benefits digital
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29 devices bring in improving cognitive skills (Gumustas et al., 2019; Hisam et al., 2018; Nuyens et al.,
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31 2018). However, it is hard to avoid its negative effect; it can be viewed as a double-edged sword.
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34 E-devices are a multidimensional pattern consisting of cognitive and behavioral
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36 symptoms that result in negative social, academic, and professional consequences (Caplan, 2002;
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39 Caplan, 2005; Davis, 2001; Diener et al., 1999; Morahan-Martin & Schumacher, 2003). Researchers use
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41 different terms to describe the phenomenon that causes dysfunction in the individual's
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44 psychological distress and social relationships due to repeated and continuous use of e-devices.
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46 These terms are as follows: problematic online game use or gaming (Demetrovics et al., 2012),
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online gaming addiction (Gulliver et al., 2010), and internet gaming addiction (Kuss, Daria Joanna &
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51 Griffiths, 2012). The internet gaming disorder was included in section III of the Diagnostic and
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53
54
Statistical Manual of Mental Disorders, fifth edition (Block, 2008). The American Psychiatric
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56 Association has also identified the same phenomenon as Internet gaming disorder (American
57
58 Psychiatric Association, 2013). A Gaming disorder was officially adopted as a diagnosis closely
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1 3
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4 related to excessive e-device use new diagnosis in the World Health Organization (WHO) in the
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7 the11th Revision of the International Classification of Diseases (WHO, 2018). Behavioral
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9 addictions seriously negatively affect physical, psychological, social, and financial well-being
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12 (World Health Organization, 2015). Excessive e-device use is possibly a type of behavioral
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14 addiction that presents as a repetitive pattern of behavioral action, similar to the compulsive-
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17 impulsive spectrum disorder (Robbins & Clark, 2015). Given the risk of excessive e-device use,
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19 experts have suggested controlling e-devices for adolescents for two hours per day (Janssen et al.,
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22 2017). Even the American Academy of Pediatrics guidelines recommends limiting e-derives use
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24 to no more than one hour or less per day (American Academy of Pediatrics, (AAP), 2016).
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Researchers have found significant support for the relationship between psychosocial
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29 health and e-devices use. Therefore, spending a long time using e-devices can affect adolescents'
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31 psychological well-being, such as depression, anxiety, and stress (Atoum et al., 2021; Lin et al.,
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34 2016; Wong et al., 2020). Increase behavioral disorders such as gaming gambling, disorders, sex
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36 addictions (Kurniasanti et al., 2019), conduct disorder (George et al., 2018), hostile response and
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39 aggression thoughts (Fengqiang et al., 2016), and intrapersonal difficulties such as loneliness and
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41 social isolation (Esen et al., 2013; Herrero, Torres et al., 2019; Naseri et al., 2015; Ostovar et al., 2016),
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44 cause harm cognitive functioning and academic achievement (Oswald et al., 2020). Furthermore,
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46 risk behaviors such as initiating substance abuse(Riehm et al., 2021), and on top of suicidal
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49 behaviors (Liu, X. C. et al., 2019).
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51 E-device usage has become an aggressive consumer phenomenon, significantly changing
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the nature of regular face-to-face interactions. E-devices are not simply a technology but
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56 represent a context that differs in important ways from traditional and other digital methods of
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interacting and and communicating (McFarland & Ployhart, 2015). Such virtual reality will
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1 4
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4 substitute the adolescent's real life. Although those adolescents are still socially connected, they
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7 are more isolated. Moreover, adolescence is considered a period characterized by a high
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9 frequency of psychological health problems in an individual's life and is more likely than other
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12 age periods(Arnett, 1999).
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14 In terms of prevention, there is growing evidence to suggest that social support plays a
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17 crucial buffering role in adolescents' social adaptation essential for maintaining psychological
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19 health (Bilgin & Tas, 2018; Tandon et al., 2013; Uçur & Dönmez, 2021; Yasin & Dzulkifli, 2010; Ystgaard
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et al., 1999). Perceived social support protects against compulsion to e-devices use (J Kuss et al.,
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24 2014; Kuss & Griffiths, 2012; Mazzoni et al., 2016; Naseri et al., 2015; Tan et al., 2016; Wang, P. et al.,
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26 2018), decreases the feeling of loneliness (Tan et al., 2016), prevents addiction to substance use
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29 (Mo et al., 2018), and develops better social development and academic achievement(Wentzel et
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31 al., 2016; Xiao-Yu, 2014); moreover, lower rates of suicide (Cho & Haslam, 2010; Rojas et al., 2017).
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34 Theories and research on subjects' well-being provide the idea of a broad concept,
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36 including psychological well-being. The social compensation theory claims that adolescents with
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39 previous psychological problems tend to spend extended periods on e-devices to cope with their
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41 problems; the use of e-devices can improve their social skills and distract them from negative
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thoughts and symptoms (Firth et al., 2017; Kim, J. et al., 2015; Valkenburg & Peter, 2007; Wenbin &
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46 Zhiyan, 2006). According to Davis's cognitive-behavioral model, a lack of social support can lead
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48 to excessive dependence on the e-devices in a quest for equivalent assistance in the virtual world,
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51 which maybe be associated with the compulsion to e-devices use (Davis, 2001).
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53 The findings from a systematic review by (Stiglic & Viner, 2019) support policy action to
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56 limit the duration of e-devices because of evidence of harmful effects. Health care providers
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58 receive attention to establishing long-standing follow-up mental health services for developing
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4 early intervention and prevention strategies among Jordanian adolescent students. In this article,
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7 the researchers will investigate how psychological distress is related to e-devices and how
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9 perceived social support is across gender since perceived social support would be more relevant
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12 to facilitating psychological regulation and reducing e-devices use. Therefore, the aim is to
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14 describe the relationship between psychological distress, e-devices, and perceived social support
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17 to examine the differential relationship between types of perceived social support (family,
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19 friends, or significant others), e-devices, and psychological symptoms among Jordanian
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21 adolescents. Moreover, to determine whether high levels of psychological distress and excessive
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24 e-devices predict lower levels of perceived social support among adolescents with high e-devices
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26 use.
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29 Design: This study is a cross-sectional descriptive correlational study. The population of
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31 this study was adolescents aged 15-17 years old. A multiple‐ stage cluster sampling technique
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34 was used to select the research sample among the randomly chosen educational districts in
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36 Amman. After that, two schools (one for males and another for females) were randomly selected
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from a list of all government schools. Afterward, random selection was employed to choose three
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41 classes from each school's 9th-, 10th-and 11th-grade levels. The final sample consists of 235
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43 male and 250 female students drawn out of 1,210 males and 1,380 female students in two
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46 schools. A conventional sample size value was calculated for an alpha of .05, a power of .80, and
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48 a relatively small effect size of 0.2 using the G*Power 3.1.2. The criteria for inclusion in this
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51 study were being a school student, using the e-devices at least 2 hr/week, and agreeing to
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53 participate in the study. A sample of at least 343 participants would be needed, while 550
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students were invited to compensate for expected incomplete questionnaires, and 485 students
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58 agreed and completed the study. Thus, the response (88%) rate was excellent.
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4 Procedure
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7 The permission to conduct this study at Jordanian schools was obtained from the
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9 university's ethics committee of the Institutional Review Board (IRB) (reference ########). The
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12 Ministry of Education-Jordan was approved for this study. Participants were given
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14 questionnaires and instructed to return questionnaires. Data were collected during regular school
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17 hours in the academic year of 2018/2019. Following ethical rules, informed consent letters were
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19 sent to the adolescents' parents in the directed classes, informing them about the nature of the
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21 current research. Informed consent was achieved from all adolescents as well. All participants
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24 were assured that they had the right to participate, refuse, and withdraw at any time without any
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26 effect, and their confidentiality would be preserved. A researcher was at hand to clarify matters if
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29 adolescents had requested. A completely anonymous survey was conducted. Mearsures
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31 A valid and reliable self-administered measure was used for data collection, containing
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34 three sections: sociodemographic factors, psychological distress (depression, anxiety, and stress),
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36 and perceived social support received (family members, friends, or others ). The section of
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sociodemographic included data such as age, gender, height, weight, the number of family
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41 members, educational level of parents, and monthly income. Additional questions were asked on
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43 variables about using e-devices (smartphones, video game consoles, laptops, or tablets
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46 (responses were either yes or no, yes, no) and the average duration of hours of screen time used
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48 per day.
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51 This study used the Depression Anxiety Stress Scale-21 (DASS-21) to assess
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53 psychological distress. From the 21 items measured, each takes seven things to measure one
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56 dimension of depression, anxiety, and stress (Lovibond & Lovibond, 1995). The total score of each
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58 dimension is computed by adding the scores of the seven items and then multiplying them by
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1 7
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4 two, with the subscales scoring the range between (0 - 42). The higher scores indicated severe
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7 psychological distress. The total score for the whole scale ranged from (0 -126) calculated by
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9 summing the scores of the three dimensions. Subjects were categorized based on their scores on
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12 psychological distress (depression, anxiety, and stress) into normal, mild, moderate, and severe
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14 to extremely severe based on the cut-off scores, normal (0-14 points), mild, 15-18, moderate19-
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17 25, and severe to extremely severe >25 for stress subscale, normal (0–7 points), mild (8–9),
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19 moderate (10–14), severe to extremely severe >14 for anxiety subscale, and normal (0–9 points),
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21 mild (10–13), moderate (14–20), severe to extremely severe >20 for the depression subscale,
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24 respectively. The validity and reliability of the DASS-21 questionnaire in measuring the
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26 dimensions of depression, anxiety, and stress have been provided in several studies on the
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29 adolescent population (Ali & Milstein, 2012; Moussa et al., 2017; Osman et al., 2014). In the
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31 current study, Cronbach's reliability alpha was 0.71, 0.63, 0.67, and 0.83 for the stress, anxiety,
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34 and depression subscales and the total scale scores, respectively.
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36 The Multidimensional Scale of Perceived Social Support (MSPSS) is a self-report
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consisting of a 12-item scale employing a 7- point Likert type format with three sub-scales
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41 designed to explore variations of social support received from friends (items 6,7,9,12), family
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43 (items 3,4,8,11) and significant other (1,2,5,10). Each statement is scored across a 7-point Likert-
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46 type scale which ranges from (1 "very strongly disagree" to 7 "very strongly agree"). The scores
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48 of 22 were calculated by summing each of the 12 items to gain an overall total score. The scores
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51 range from 12-84. Each sub-scale can be scored separately, e.g., 'friends,' by summing the scores
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53 and dividing by 4 (Zimet et al., 1988). Higher scores on the scale reveal better social support
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56 perception. The MSPSS has proven to have good psychometrically properties and good internal
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58 reliability; the author's report coefficient alphas for the subscales ranging from .85 to .91 and
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1 8
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4 test-retest correlations ranging from .75 to .85 (Dahlem et al., 1991; Zimet et al., 1988). In the
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7 current study, Cronbach's reliability alpha was 0.84, 0.82, 0.83, and 0.87 for the friends, family,
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9 and significant other subscales and the total scale scores, respectively.
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12 Data Analysis
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14 Descriptive statistics such as frequency (percentage) and mean (±standard deviation) are
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17 proper for the measurement level to summarize the subjects' demographic and clinical
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19 characteristics. Subjects were classified based on their cut-off scores of > 20 for the depression
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subscale, >14 for the anxiety subscale, and >25 for the stress subscale, respective scores on
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24 psychological distress (depression, anxiety, and stress) into normal, mild, moderate, and severe
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26 to extremely severe. The data analysis was conducted using the SPSS version 25 to analyze that
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29 data with 0.05 as the significance level. To examine the relations between using excessive e-
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31 devices with psychological distress and perceived social support, subjects were divided into two
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34 groups on the mean hours of using e-devices per day (low or high). The Independent Sample t-
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36 tests were used to compare psychological distress and social support scores between low and
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high e-device users and compare males and females regarding their e-devices use, perceived
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41 social support, and psychological distress. Also, a bivariate correlation analysis was performed to
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43 show the correlation between subjects' characteristics and the main study variables.
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46 Additionally, standard multiple linear regression analyses were conducted to examine
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48 these relationships. The first regression model was read to indicate whether psychological
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51 distress predicates the role of perceived social support while controlling other variables. The
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53 second regression model was concerned with showing whether perceived social support
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56 predicates psychological distress while controlling other variables. The third regression model
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1 9
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4 was examined to indicate whether hours of e-devices can predicate psychological distress and
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7 perceived social support while controlling other variables.
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9 The Subjects' Characteristics and Scores on Main Study Variables
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12 The adolescents' mean age was 16 years, ranging from 15-18 years (Table 1). The total
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14 sample (N=485) was school students. Slightly more than half of the subjects were female. The
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17 average number of family members was 4.76 members. About half of the subjects reported
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19 family income of $401-$800 per month, and mothers had a high school level of education. One-
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21 third of the subjects' fathers had a high school level of education. The comparative results of
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24 adolescent students with different demographic characteristics are displayed in Table 1.
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26 Please insert Table 1 here
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29 Almost all subjects use e-devices reported using e-devices for a mean of 5 hours/day
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31 (Table 2). Subjects reported using these devices for an average of 5.26 hours per day. On
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34 psychological distress, the adolescents' total scores (total DASS-21) had an average of about
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36 42.49±20.3, mainly indicating mild distress (Table 2). However, on the psychological subscales,
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the subjects had mean scores that revealed mild depression, moderate anxiety, and stress. As
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41 shown in Table 2, about 20.2%, 37.9%, and 17% of the subjects had severe to extremely severe
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43 depression, anxiety, and stress levels, respectively. Half of the subjects reported that they
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46 perceived social support. The subjects had low/moderate/high total social support and support
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48 from family, friends, and significant other.
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53 Differences between low and high e-devices users on main study variables
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Independent Samples t-tests were used to compare low and high e-devices users in terms
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58 of total psychological distress scores (total DASS-21) with subscales scores (depression, anxiety,
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1 10
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4 and stress) and the total perceived social support subscale of support from family, friends, and
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7 significant other. As shown in Table 3, the result showed that the total psychological distress
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9 scores and all its subscales scores were significant between the two kinds of users, with those
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12 high e-devices users having poorer scores than low e-devices users (Table 3). At the same time,
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14 the total perceived social support and the family subscales scores were positively significant
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17 between the two kinds of users, with those in high e-devices users having lower scores than low
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19 e-devices.
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24 Differences between male and female adolescents in the main study variables
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26 It used the independent samples t-tests to compare male and female adolescents in terms
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29 of total psychological distress scores (total DASS-21) with subscales scores (depression, anxiety,
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31 and stress) and the total perceived social support subscale of support from family, friends, and
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34 significant other. Specifically, females had higher (worse) scores on the anxiety and stress
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36 subscales and the total scores on psychological distress (total DASS-21). Further analysis of the
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family and the friends subscales showed that females reported more friends but less family
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41 support than male adolescents.
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46 Relationships Between E-devices Use and Selected Demographic Variables
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48 Table 5 shows the correlation between subjects' characteristics and the main study
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51 variables. However, the magnitude of some correlations was small. The result indicates that the
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53 duration of e-devices uses significantly correlated with the total T-DASS 21 and the T-MSPSS
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score. There was a positive correlation. The students with higher psychological distress used
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58 excessive e-devices. There is a significant correlations were observed between total
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1 11
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4 psychological distress T-DASS 21 and e-devices (r = 0.160, p < .01) . Furthermore, a negative
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7 correlation between the total perceived social support (r=-.25., p < 0.01) and total psychological
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9 distress. In the study, students with lower social support were more likely to use e-devices,
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12 suggesting that increased social support is associated with decreased psychological distress.
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15
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17 Mediation role of psychological distress on the relationship between the hours of e-
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19 devices use and the role of perceived social support
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21 The first regression model was examined to indicate whether psychological distress
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24 predicates the role of perceived social support. While controlling other variables such as age,
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26 gender, number of family members, income, max body index (BMI), and hours of e-devices use,
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29 the predictor is the total perceived social support (T-MSPSS). The model was highly significant,
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31 with the ANOVA table of the regression yielding a p < 0.000 level, well below the threshold of
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34 0.05 for significance. The finding shows that three items emerged as substantial predictors
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36 related to gender (ref to female), duration of e-devices use, and family support (Table 6) were
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significant predictors. The duration of using e-devices was a significant predictor, and family
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41 support was the only support adolescents could get to decrease their psychological problems,
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43 especially females. The variables in the model explained only about 21% of the variance of the
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46 dependent variable.
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48 Mediation role of perceived social support on the relationship between the hours of e-
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51 devices use and psychological distress
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53 The second regression model was examined to indicate whether perceived social support
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predicate psychological distress. While controlling other variables such as age, gender, number
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58 of family members, income, max body index (BMI), and hours of e-devices use, the predictor is
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1 12
2
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4 the total psychological distress (T-DASS 21). Also, the model shows that the total social support
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7 as a dependent variable was highly significant, p<.000 (Table 6). Four significant items related to
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9 age, gender (ref female), stress, and depression, but the e-devices use time was not a significant
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12 predictor. According to the coefficient analysis of the regression model, the variables in the
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14 model explain about 17.1% of the variance of the dependent variable (Total social support).
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17 Increased perceived social support was associated with decreased depression and stress levels
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19 among adolescent students.
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Mediation role of hours e-devices use the relationship between psychological distress
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24 and perceived social support
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26 The third regression model was examined to indicate whether hours of e-devices can
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29 predicate psychological distress and perceived social support. While controlling other variables
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31 such as age, gender, number of family members, income, body max index (BMI), and hours of e-
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34 devices use, the predictor is the e-devices use. The model shows that the total social support as a
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36 dependent variable was highly significant, p<.001 (Table 6). Only one significant item was
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related to total psychological distress (T-DASS 21). According to the coefficient analysis of the
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41 regression model, the variables in the model explain about 20.2%. Increased e-devices use was
42
43 associated with increased psychological distress among adolescent students.
44
45
47
48 Discussion
49
50
51 The current research investigated e-devices, psychological distress, and the role of
52
53 perceived social support among adolescent students. The findings show that psychological
54
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56
distress is related to excessive e-devices use, and the total psychological distress significantly
57
58 predicted excessive e-devices. At the same time, the role of perceived social support has
59
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1 13
2
3
4 constantly lowered psychological problems, especially from family. Also, the results indicate a
5
6
7 gender difference; females had higher (worse) depression and stress subscales scores on the real
8
9 psychological distress and perceived their social support from their friends or significant others.
10
11
12 As the results above showed, our sample's average use of e-devices was five hours a day
13
14 which goes against the WHO recommendation to reduce screen time to two hours or less per
15
16
17 day. This study may guide the development of early intervention and prevention strategies. We
18
19 have witnessed a great use of e-device and dependence among the adolescent population(Chaput
20
21
et al., 2014; Hysing et al., 2015). Since e-devices are in almost all educational institutions in Jordan
22
23
24 (schools, colleges, and universities), the accessibility of the Internet may contribute to increasing
25
26 e-devices use. Furthermore, the duration of e-devices uses could be higher after the association
27
28
29 with the COVID-19 outbreak (Korhonen, 2021).
30
31 The present study revealed that adolescents with higher use of e-devices were more likely
32
33
34 to report more difficulties related to both psychological and social problems (Gros et al., 2020;
35
36 Koban et al., 2021). The significant effect of the increased duration of hours of e-devices use can
37
38
39 provoke psychological distress; the findings are consistent with many previous studies (Atoum et
40
41 al., 2021; Buabbas et al., 2021; Madigan et al., 2019; Neophytou et al., 2019; Stiglic & Viner, 2019;
42
43
Zimmermann, 2021). Also, the duration of e-devices use can predict adolescent psychological
44
45
46 distress, similar to findings reported by many previous studies (Al Salman et al., 2020; Ramón-
47
48 Arbués et al., 2020). Our finding is similar to a national random sample in the United States of
49
50
51 40,337 children and adolescents ( 2-17) years of the study. The finding showed that moderate use
52
53 of e-devices uses time with 4 hours/day associated with lower psychological well-being than
54
55
56 higher than 7 hours/day hours were more than twice as likely ever to have been diagnosed with
57
58 depression and anxiety (Twenge & Campbell, 2018). Moreover, Herrero et al. (2019) revealed that
59
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63
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1 14
2
3
4 the higher the e-devices technology addiction scores, the higher the reported rate of feeling
5
6
7 technological dependency (Herrero, Urueña et al., 2019).
8
9 Psychological well-being is affected by several factors, such as demographic factors (age,
10
11
12 gender, socioeconomic status, society, heredity, culture, and environmental factors) (Putul et al.,
13
14 2018), , evaluation of life experiences, personality, social support, and religiosity (Ryff & Keyes,
15
16
17 1995). Although other findings on the level of psychological distress showed moderate, similar to
18
19 the previous research (Jeong et al., 2016; Samaha & Hawi, 2016), but had higher the scores on
20
21
22 psychological distress than those reported in the literature (Mishra et al., 2018; Ostovar et al., 2016).
23
24 For example, subjects in our study had a higher level than Indians (Mishra et al., 2018) and
25
26
27
Malaysian adolescents (Abdul Latiff et al., 2016).
28
29 Excessive e-devices are characterized by impulsivity (Kalra & Swedo, 2009), alterations in
30
31
32
reward (Rigby & Ryan, 2016), and dopaminergic systems (Jorgenson et al., 2016), which can cause
33
34 increasing white matter and an imbalance in the brain chemistry of gamma-aminobutyric acid
35
36 (GABA) (Gong et al., 2017; Pujol et al., 2016). When we look at MRI brain scans for adolescents
37
38
39 who play for 20 hours or more using e-devices a week, their scans are similar to people addicted
40
41 to drugs or alcohol (Pujol et al., 2016) similar to substance addictions to drugs or alcohol in many
42
43
44 domains (Lee et al., 2013). Within an excessive dependence on e-devices use, the individual mind
45
46 becomes increasingly unable to differentiate between the lived and the alternative realities that
47
48
49 produce direct stimulation, pleasure, and reward.
50
51 E-devices can separate users and provide them with a temporary escape from bad
52
53
54
experiences (Liu, R. et al., 2019). In the possibility of an inverse relationship, adolescents with high
55
56 psychological distress may spend more time on e-devices as a coping mechanism to escape their
57
58
life's fears and worries and escape reality (Avci & Kelleci, 2016; Domingues‐Montanari, 2017; Vidal et
59
60
61
62
63
64
65
1 15
2
3
4 al., 2020). E-devices use can worsen the quality of face-to-face interactions, leading to another
5
6
7 possible negative influence on well-being (Kim et al., 2015; Rotondi et al., 2017). Adolescents are
8
9 related to a higher level of loneliness, which contacts and causes isolation (Andreassen et al., 2016;
10
11
12 Stiglic & Viner, 2019; Twenge & Campbell, 2018), which has unique effects on the brain and
13
14 behavioral development, sequentially are implicated in psychological problems (Orben et al.,
15
16
17 2020). E-devices can be solitary activities and lesser everyday face‐ to‐ face communication.
18
19 Spending excessive time on e-devices to cope with loneliness is an essential predictor of e-
20
21
22 devices use (Wang, T. et al., 2021) and can lead to social isolation, which negatively impacts
23
24 psychological well-being (Orben et al., 2020; Tan et al., 2016; Wang et al., 2018). Thus alleviating
25
26
27 psychological distress such as depression can reduce time and resources for face-to-face
28
29 interaction, which increases the probability of problematic e-devices use(Kim et al., 2015).
30
31
Therefore the development of psychological distress and social isolation among e-devices
32
33
34 users due to the socially stimulating activities of time spent on e-devices (Nikkelen et al., 2014).
35
36 These findings lend some backing to concerns that increased use of e-devices could negatively
37
38
39 impact impulse control and the ability to evaluate delayed rewards appropriately.
40
41 Among the various factors that affect adolescents' psychological distress and excessive
42
43
44 use of e-devices, the role of perceived social support has attracted considerable attention from
45
46 many researchers (Bilgin & Tas, 2018; Chu et al., 2010; Jibeen, 2016; Van Droogenbroeck et al., 2018;
47
48
49 Yasin & Dzulkifli, 2010; Ystgaard et al., 1999). Perceived social support might function as a buffer to
50
51 reducing adolescents' psychological distress (Bilgin & Tas, 2018; Pietromonaco et al., 2013; Siedlecki
52
53
54
et al., 2014; Van Zalk & Van Zalk, 2015; Wang et al., 2018) and protective factors against addictive
55
56 behaviors like e-devices use (Bilgin & Tas, 2018; Mazzoni et al., 2016; Mo et al., 2018; Wu et al.,
57
58
2016). Our results are in line with the results of systematic reviews(Gariepy et al., 2016; Hellfeldt et
59
60
61
62
63
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65
1 16
2
3
4 al., 2020) and a meta-analysis (Rueger et al., 2016), and some empirical studies supported the
5
6
7 protecting role of perceived social support on adolescent psychological distress (Rueger et al.,
8
9 2016; Yu et al., 2016). Social support might lower psychological distress, which is similar to our
10
11
12 findings (Amit & Ibrahim, 2017; Scardera et al., 2020), and facilitate maintaining the relationship
13
14 and social interaction (Wilmer & Chein, 2016). The need for social support causes an increased
15
16
17 desire to remain in virtual e-devices social life—an inverse relationship between e-devices use
18
19 and level of social support (Herrero et al., 2019). So, insufficient social support can cause
20
21
22 adolescents to fulfill their psychological needs from inappropriate sources, leading to the
23
24 development of e-devices addiction (Wang et al., 2018), Which probably delays recovery and may
25
26
27
cross into later stages of a lifetime (Brand & Kirov, 2011).
28
29 Our study proposes three types of social resources (family, friends, and significant
30
31 others). The higher the mean of perceived social support, the fewer psychological problems, such
32
33
34 as depression, anxiety, and stress (Kaniasty & Norris, 2008). The finding indicates that family is the
35
36 only social support for adolescents with high e-devices, which confirms the previous research
37
38
39 findings and suggests that perceptions of support from family relationships have been linked
40
41 with decreases in psychological problems (Cavaleri et al., 2011; Fosco et al., 2012; Fuller-Iglesias et
42
43
44 al., 2015). Family is a critical source of social support for all adolescents student groups (Nelson, 2019;
45
46 Theodore et al., 2017). Psychological distress during adolescence could be related to family
47
48
49 relationships. Which can identify an appropriate balance between e-devices time and other
50
51 activities, set boundaries for accessing content, guide displays of adolescents' information,
52
53
54
support open family communication, and implement consistent rules about e-devices use (Flint-
55
56 Bretler et al., 2013; Reid Chassiakos et al., 2016). However, parents are busier, have no control over
57
58 their families, have higher academic and job prospects, and adolescents are exposed to
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61
62
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1 17
2
3
4 spectacular technological developments that fulfill their needs and support them in escaping their
5
6
7 problems (Kuss, Daria J. et al., 2013). Therefore, this generation is more vulnerable to e-devices
8
9 addiction due to changes in modern civilization.
10
11
12 Similar to our finding, family support played a more significant role than peer support in
13
14 affecting psychological problems; the finding stated that perceived social support from family is
15
16
17 a significant predictor of depression because the family has more socioemotional support (Amit
18
19 & Ibrahim, 2017). The beneficial effects of social support were observed for severe symptoms and
20
21
22
symptoms ranging across the spectrum of severity. Even in cases where people previously
23
24 experienced psychological health problems, social support was beneficial for psychological
25
26 health later on. Adolescents with higher average levels of perceived social support had lower
27
28
29 chances of experiencing severe anxiety, depression symptoms, suicidal ideation, and attempts
30
31 one year late (Scardera et al., 2020). In contrast, more psychological and behavioral problems are
32
33
34 observed among adolescents who report inadequate social support (Van Droogenbroeck et al.,
35
36 2018). Moreover, when considering the role of social support for psychological distress, it is
37
38
39 essential to be aware that cultural differences can occur concerning how adolescents evaluate
40
41 their social support (Jibeen, 2016). In this regard, a growing body of research proposes that
42
43
44 parenting's influence on the adolescent's psychosocial alteration can also differ as a function of
45
46 the cultural context (Garcia et al., 2019; Pinquart & Gerke, 2019).
47
48
49
Concerning gender, research constantly shows that females had a significantly higher
50
51 prevalence of total psychological distress than their male counterparts (Chen, B. et al., 2017;
52
53 Rosenberg et al., 2018; Van Droogenbroeck et al., 2018). The rates of depression, mood, and anxiety
54
55
56 disorders are greater among females than males during adolescents (Duffy et al., 2019; Merikangas
57
58 et al., 2022). Females are more stress-reactive and fearful than males due to the variance effect of
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61
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63
64
65
1 18
2
3
4 pituitary adenylate cyclase-activating polypeptide, stress, and sex hormones which confers risk
5
6
7 in females but not males (Albert, 2015; King et al., 2017). Also, females were substantially more
8
9 addicted to e-devices than the male age group in the same age group (Tavakolizadeh et al., 2014),
10
11
12 contributing to fear of learning and adaptations to stressors. Additionally, a review by Toffoletto
13
14 et al. (2014) indicated that the menstrual cycle and sex steroid hormones affect the cortical and
15
16
17 subcortical regions implicated in emotional and cognitive processing(Toffoletto et al., 2014).
18
19 Usually, male adolescents engage more frequently in behavior related to excessive online
20
21
22
gaming, gambling, and sex chatting (Chen et al., 2017; Escario & Wilkinson, 2020; Su et al., 2019).
23
24 Although males typically show more geek behavior, some studies have evidenced that such
25
26
behavior is rising among females, too (Salonen et al., 2017). Furthermore, some contrary findings
27
28
29 reported that the prevalence of psychological distress among adolescent males was higher than
30
31 among females using e-devices (de-Sola et al., 2017; Ostovar et al., 2016). In contrast, other
32
33
34 research findings revealed that males and females did not show significant differences in their
35
36 time spent on e-devices nor related to psychological problems (Kim, M. et al., 2019).
37
38
39 Perceived social support is essential in protecting early adolescents against increasing
40
41 psychological anxiety over time (Van Zalk & Van Zalk, 2015). The research shows that females react
42
43
44 more strongly and positively to social support than males. Further analysis of the family and the
45
46 friends' subscales revealed that females report a more significant number of support from their
47
48
49
friends (Bilgin & Tas, 2018; Colarossi, 2001; Rueger et al., 2008). Close friend social support as a
50
51 buffer appeared to be more robust for adolescents female than males (Fredrick et al., 2018), which
52
53 might explain why that conflict and lack of closeness within the mother-daughter relationship, in
54
55
56 particular, relate to increases in female adolescents' weight friends social support. Such
57
58 differences can be explained by the difference in social roles and circumstances. Females appear
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1 19
2
3
4 to be more sensitive to the effect of social support, in which females are socialized as warm,
5
6
7 supportive, sympathetic, sensitive to the feelings of others, and emotionally expressive, while
8
9 men are socialized as independent and self-reliant (Beehr et al., 2003; Reevy & Maslach, 2001). The
10
11
12 finding has been suggested that because females not only receive but also provide more social
13
14 support than males, they may be more negatively affected by psychological distress from e-
15
16
17 devices misuse (Johansen et al., 2021). Findings suggest that female participants might be more
18
19 likely to be affected by psychological distress but the same time, more likely to benefit from
20
21
22
interventions that facilitate social support.
23
24 Adolescents lacking psychological distress and support are at the highest risk of e-devices
25
26 use (Durkee et al., 2012). Furthermore, individuals with excessive e-devices usually ignore real-
27
28
29 world social networking, resulting in frustrated individual friendships and reduced social support
30
31 resources, thus leading to elevated levels of depression and anxiety (Chen, L. et al., 2016). It may
32
33
34 cause maladaptive behavioral difficulties and addiction, which can add to a significant problem
35
36 among adolescents, especially friends (Colarossi, 2001; Rueger et al., 2008).
37
38
39 Research has shown that e-devices addicts are more likely to have psychological health
40
41 problems such as depression, anxiety, and stress, potentially leading to intrapersonal difficulties,
42
43
44
academic failure, and family interruption. They also share that e-devices addiction has the same
45
46 negative consequences stemming from behavioral addictions (such as gambling, for example),
47
48 like poor psychological adjustment, problems at work, or increased conflicts with family and
49
50
51 friends (Oswald et al., 2020).
52
53 So, determining the most appropriate intervention requires further investigations. A
54
55
56 qualitative study will also be required to understand these associations within the Jordanian
57
58 context. The present study contributes to the rising evidence of the relationship between
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1 20
2
3
4 perceived social support and reduced e-devices among adolescents and highlights the need for
5
6
7 interventions to increase social support among adolescents through facilitating adaptive emotion
8
9 regulations. These results highpoint the diverse nature of adolescent e-device use and emphasize
10
11
12 the need to consider gender in future research and policy.
13
14 Limitations and Implications
15
16
17 Although the study has many strengths, such as proper tools and sizeable randomized
18
19 sampling that may help generalize the findings. However, the cross-sectional design limits
20
21 inferring of the cause-effect relationship. All variables were evaluated through a self-report
22
23
24 questionnaire, leading to social desirability bias. Moreover, the study does not identify tools to
25
26 assess e-devices used, but the researcher used the mean of the duration of e-devices to measure
27
28
29 excessive e-devices use. At the same time, it is highly recommended to use objective measures to
30
31 compare findings from subjective and objective measures. Although this study used random
32
33
34 selection, it could not represent all adolescent students. Future research should increase the
35
36 representativeness of the sample. Longitudinal and experimental studies are necessary to allow
37
38
39
attribution of causation. Despite these limitations, our study extends the previous results
40
41 regarding the relationship between e-devices, psychological distress, and perceived social
42
43 support by estimating the mediating effects of social support on the relationship between e-
44
45
46 devices and psychological distress among adolescent students. The findings of this study call for
47
48 global research agenda to national and international cooperation in evaluating and intervening in
49
50
51 addiction to e-devices and the Internet to gather more knowledge about this phenomenon and
52
53 assess the effectiveness of treatment (Tran et al., 2020). In a systematic review meeting, the
54
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56 recommendations combine physical activity and sedentary time to improve psychological
57
58 wellbeing among adolescents (Sampasa-Kanyinga et al., 2020).
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1 21
2
3
4 Given the importance of friend support, especially for females, helping adolescents foster
5
6
7 close and supportive relationships with their friends is crucial (Wentzel, 2017). However, more
8
9 research is needed to identify the effective interventions for these issues among adolescents and
10
11
12 involve clinicians, teachers, parents, and adolescents to foster proper e-device use and promote
13
14 psychological wellbeing and social support. Based on these findings, it could be concluded that
15
16
17 further studies that include other predictors of e-devices use are needed.
18
19 There is growing empirical support for programs at the secondary level using early
20
21
intervention and prevention services, such as psychoeducation training programs and crisis
22
23
24 interventions (problem-solving skills, free time management techniques) (Alves et al., 2020). Self-
25
26 control, self-regulation, executive control, and ego strength show profound benefits across every
27
28
29 aspect of life functioning to decrease e-devices use (Liu et al., 2019) and cognitive behavioral
30
31 therapy (de Souza et al., 2013; Rith-Najarian et al., 2019). These skills are necessary to develop
32
33
34 positive outcomes among students at school.
35
36 After reviewing the literature on the potential risks associated with inappropriate e-
37
38
39 devices use, this paper offers suggestions to consider when devising policies balancing
40
41 adolescents' rights with their safety and wellbeing before ending with a brief conclusion. Overall,
42
43
44
it is crucial to provide strategies at the community and school levels to avoid excessive e-
45
46 devices, which can significantly help mental health professionals appropriate for severe e-
47
48 devices problems. Besides, the effectiveness of a training program builds teachers' capability to
49
50
51 identify and appropriately refer adolescents with mental health problems (Vieira et al., 2014). The
52
53 finding also emphasized the importance of using parental restricting styles intervention (Nikken,
54
55
56 2018) and self-regulation as a protective influence on adolescents' compulsive e-devices uses
57
58 (Chang et al., 2019; Meeus et al., 2019).
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1 22
2
3
4 Conclusion
5
6
7 The study emphasized the potential negative impact of excessive e-device use on psychological
8
9 distress and the value of perceived social support in benefiting psychological wellbeing,
10
11
12 especially from family. There are gender differences in the value of perceived social from
13
14 friends appear to have a more substantial role as a protective factor among females than males.
15
16
17 The findings of our study may raise the points of giving effective collaborative community-based
18
19 programs to protect this age group. The study supports policymakers and a collaborative team of
20
21 parents, educators, and health professionals such as school nurses to prevent the harmful effects
22
23
24 of excessive e-devices. Based on the findings of this study, the following recommendations are
25
26 suggested to avoid the detrimental impacts of hours of e-devices use and psychological distress.
27
28
29 First, parents should limit the hours of e-devices use; second, schools should educate students
30
31 about the effects of e-devices use. Third, crisis interventions and education programs should
32
33
34 target high-risk groups with psychological distress. Finally, conducting other studies on specific
35
36 interventions to improve health with excessive e-devices used among that age group in Jordan
37
38
39
and conducting interventional studies to help adolescents in inappropriate use of excessive e-
40
41 devices.
42
43
44
45
46
47
48
49
50
51
52
53
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56
57
58
59
60
61
62
63
64
65
1 23
2
3
4
5
6
7
8
9
10
11
12
13
14
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17
18
19
20
21
22
23
24
25
26
27
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29
30
31
32
33
34
35
36 Table 1. Demographic characteristics of the sample (N=485)
37 Characteristic Mean ±SD or n
38 (%)†
39 Age, Years 16.1 ±0.77
40 15 years 111 (22.9)
41 16 years 230 (47.4)
42 17 years 132 (27.2)
43 18 years 12 (2.5)
44 Gender,
45 Female 250 (51.5)
46 Male 235 (48.5)
47 BMI
48 Underweight (<19) 23 (4.7)
49 Normal (19-25) 396 (76.1)
50 Overweight (>25-30) 70 (14.4)
51 Obese (>30) 4.76±1.259
52 Smoking status,
53 Non-smokers 437 (90.1)
54 Smokers 48 (9.9)
55
56 Family Income, JD 745.98±214
57 ≤ 814 (below the poverty line) 243 (50.1)
58 >814 242 (49.9)
59
60
61
62
63
64
65
1 24
2
3
4 Number of Family Members,
5 3 Members 4.76±1.26
6 4 Members 79 (16.3)
7 5 Members 154 (31.8)
8 ≥ 6 Members 117 (24.1)
9 135 (27.8)
10 Fathers Level of
11 Education, 66 (13.6)
12 ≤ Primary level 180 (37.1)
13 High school level 99 (20.4)
14 Diploma level 140 (28.8)
15 ≥ University level
16 Mothers Level of
17 Education, 57 (11.7)
18 ≤ Primary level 229 (47.2)
19
High school level 111 (22.9)
20
Diploma level 88 (18.1)
21
≥ University level
22
Mothers Work 146 (30.1)
23
Yes 339 (69.9
24
No
25
Parent’s Marital 35 (7.2)
26
Divorced 450 (92.8)
27
28 Married
29 †SD = standard deviation
30
31
32
33
34
35
36
37
38 Table 2. The sample's data on e-devices use, psychological distress, and perceived social support (N=485)
39 Characteristic Mean ±SD or n (%)†
40 Use e-devices, Yes 478 (98.6)
41 Average hours of e-devices/day 5.26±4.0
42
Average hours of sleep time (including naps)/day 8.63± 2.01
43
44 Psychological distress (T-DASS 21)
45 Total scores 42.49±20.3
46 Stress subscale scores 15.73±8.74
47 Anxiety subscale scores 12.95±7.5
48 Depression subscale scores 13.81±8.2
49
50 Depression categories (D-DASS 21)
51 Normal (0-9) 160 (33)
52 Mild (10-13) 79 (16.3)
53 Moderate (14-20) 148 (30.5)
54 Severe to extremely severe (> 20 98 (20.2)
55 Anxiety categories (A-DASS 21)
56 Normal (0-7) 114 (23.5)
57 Mild (8-9) 38 (7.8)
58 Moderate (10-14) 149 (30.7)
59 Severe to extremely severe (>14) 184 (37.9)
60
61
62
63
64
65
1 25
2
3
4 Stress categories (S-DASS 21)
5 Normal (0-14) 255 (52.6)
6 Mild (15-18) 63 (13)
7 Moderate (19-25) 84 (17.3)
8 Severe to extremely severe (>25) 83 (17.1)
9
10 Perceived Social Support (MSPSS)
11 Total Perceived Social Support (T- MSPSS) 55.41 (11.44)
12 Family-Support (FA- MSPSS) 19.05 (5.34)
13 Friends-Support (Fr- MSPSS) 16.90 (5.27)
14 Other-Support (Oth-MSPSS) 19.46 (4.80)
15
16 DASS 21= Depression Anxiety Stress Scale - 21; †SD = standard deviation
17 MSPSS= Multidimensional Scale of Perceived Social Support Scale
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
13
14
15
16
17 26
18
19
20 Table 3: Comparison between low users and high e-devices users (N=485)
21 Low e-device users (n=339) † High e-devices users t- test P-value
Characteristic
22 (n=146) † (df1, 483) (2-tailed)
23
T-DASS 21 40.72±19.36 47.71±20.15 -3.872 <.000
24
25 D-DASS 21 15.63±8.13 15.63±8.13 -3.311 .001
26 A-DASS 21 12.45±7.44 14.14±7.57 -2.281 .023
27 S-DASS 21 14.76±8.50 18.08±8.94 -3.882 <.000
28
29 T- MSPSS 56.19±10.96 53.59±12.34 .084 .022
30 Fa- MSPSS 19.76±4.31 17.38±5.76 5.021 <.000
31 Fr- MSPSS 16.89±5.20 16.92±5.66 -.055 .956
32 Oth- MSPSS 19.53±4.73 19.29±4.98 .509 .611
33 †Data are presented as mean ±standard deviation
36
37
38
39
40 Table 4: Comparison of psychological distress scores and perceived social support
41 between male and female adolescents (N=485)
42 Male Females t- test (df 1, 483) P-value
Characteristic
43 (n=235)† (n=250)† (2-tailed)
44 T-DASS 21 39.51±18.406 45.34±21.59 -3.187 0.002
45 D-DASS 21 13.46±7.90 14.14±8.51 -.922 0.36
46 A-DASS 21 11.69±6.87 14.14±7.90 -3.651 < 0.000
47 S-DASS 21 14.37±8.07 17.0±9.18 -3.400 0.001
48
49 T- MSPSS 53.70±10.786 57.02±11.812 -3.224 0.001
50 Fa- MSPSS 18.76±4.754 19.33±5.043 -1.280 .201
51 Fr- MSPSS 16.12±5.424 17.62±5.157 -3.123 0.002
52 Oth- MSPSS 18.82±4.903 20.06±4.632 -2.880 0.004
53 †Data are presented as mean ±standard deviation
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65
13
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15
16
17 27
18
19
20
21
22 Table 5: Correlations between Students’ Characteristics, e-devices, psychological distress, and
23 perceived social support (N=485)
24
Characteristic 1 2 3 4 5 6 7 8
25
26 --
1 Age
27
28 2 Gender .176** --
29
30 3 Number of family members 125** .048 --
31
32 4 Income -.143** .012 -.038 -- .
33
5 BMI .090* -.021 .086 057 --
34
35 .099* .074 -.029 .008 .009 --
6 Hours of e-devices use
36
37 7 T-DASS 21 .202** .144** 149** -.041 .107* .160** --
38
39 8 T-MSPSS -.134** .145** -.101* .053 -.020 -.099* -.252** --
40
41 M 16.09 .52 4.76 745.98 21.376 5.2586 42.52 55.41
42
43 SD .770 .500 1.259 214.094 3.9397 4.00431 20.298 11.436
44
45
* p < 0.05; ** p < 0.01
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47
48
49
50
51 Table 7: Standard multiple linear regression with the psychological status and perceived social support
52 as outcome variables (N=485).
53 Predictor Variables B* S. Error β* t p
54
55 Model 1
56 Outcome: Total psychological score
57 Age 2.233 1.140 .085 1.959 .051
58 Gender 5.754 1.718 .142 3.349 .001
59 Duration of using e-devices .415 .212 .082 1.961 .050
60 Number of family members 1.156 .678 .072 1.705 .089
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63
64
65
13
14
15
16
17 28
18
19
20 Income .000 .004 .002 .048 .962
21 BMI .414 .213 .080 1.944 .053
22 Fa-Support -1.466 .188 -.355 -7.779 <.000
23 Fr-Support -.066 .184 -.017 -.361 .718
24 Oth-Support .064 .211 .015 .305 .761
25 Model F(9,475)= 22.574, p<.000, Adj R2 .208
26
Model 2
27
Outcome: Total social support
28
Age -2.094 .685 -.141 -3.058 .002
29
30 Gender 4.151 .987 .182 4.205 <.000
31 Duration of using e-devices -.229 .122 -.080 -1.881 .061
32 Number of family members -.638 .388 -.070 -1.646 .100
33 Income .001 .002 .010 .247 .805
34 BMI .057 .123 .019 .459 .646
35 D-Dass 21 -.502 .074 -.361 -6.764 <.000
36 A-Dass 21 -.046 .080 -.030 -.584 .560
37 S-Dass 21 .148 .072 .113 2.064 .040
38 Model F(9,475)= 19.893, p<.000, Adj R2 .171
39
Model 3
40
41 Outcome: e-devices use
42 Age .335 .247 .064 1.359 .175
43 Gender .455 .376 .057 1.211 .226
44 Number of family members -.138 .146 -.043 -.946 .345
45 Income .000 .001 .024 .520 .603
46 BMI -.007 .046 -.006 -.142 .887
47 Total psychological score .026 .010 .132 2.732 .007
48 Total social support -.026 .017 -.073 -1.538 .125
49 Model F(7,477)= 6.358, p<.002, Adj R2 .202
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51
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53
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Article Type: Research

The continuously advanced technologies of electronic devices (e-devices) have

The study is a cross-sectional descriptive correlational study of 485 randomly selected

Corresponding Author: Maysoun H Atoum, Ph.D

Corresponding Author E-Mail: maysoun_atoum@hu.edu.jo

Corresponding Author Secondary

Corresponding Author's Institution: The Hashemite University

Corresponding Author's Secondary

First Author: Maysoun H Atoum, Ph.D

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Order of Authors: Maysoun H Atoum, Ph.D

Order of Authors Secondary Information:

Dr. Editor in chief

 Ethics approval and consent to participate

We wish to submit our manuscript titled "Psychological distress and problematic

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 Consent for publication

We know of no conflicts of interest associated with this publication,

Maysoun Atoum's (MA) ORCID Number is 0000-0002-4923-7629

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