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The Relationship Between Impulsivity, Anxiety and Internet Addiction in Adolescents with Autism Spectrum Disorder: A Moderated Mediation Model.

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Title: The Relationship Between Impulsivity, Anxiety and Internet Addiction in Adolescents with Autism Spectrum Disorder: A Moderated Mediation Model.
Authors: Sevincok D; Department of Child and Adolescent Psychiatry, Istinye University, Istanbul, Turkey. dsevincok@hotmail.com., Gurbuz Ozgur B; Department of Child and Adolescent Psychiatry, Izmir Democracy University, Izmir, Turkey., Gercek HG; Department of Child and Adolescent Psychiatry, Afyonkarahisar Health Sciences University, Afyon, Turkey., Tatli S; Department of Child and Adolescent Psychiatry, Aydin Adnan Menderes University, Aydin, Turkey., Aksu H; Department of Child and Adolescent Psychiatry, Tinaztepe University, Izmir, Turkey.
Source: The Psychiatric quarterly [Psychiatr Q] 2026 Jun; Vol. 97 (2), pp. 365-384. Date of Electronic Publication: 2025 Nov 01.
Publication Type: Journal Article
Language: English
Journal Info: Publisher: Kluwer Academic/Plenum Publishers Country of Publication: United States NLM ID: 0376465 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1573-6709 (Electronic) Linking ISSN: 00332720 NLM ISO Abbreviation: Psychiatr Q Subsets: MEDLINE
Imprint Name(s): Publication: 1999- : New York, NY : Kluwer Academic/Plenum Publishers
Original Publication: Utica, N. Y.
MeSH Terms: Internet Addiction Disorder*/epidemiology , Internet Addiction Disorder*/physiopathology , Impulsive Behavior*/physiology , Autism Spectrum Disorder*/epidemiology , Autism Spectrum Disorder*/physiopathology , Anxiety, Separation*/epidemiology , Anxiety, Separation*/physiopathology , Anxiety*/epidemiology, Generalized Anxiety Disorder/epidemiology ; Humans ; Female ; Adolescent ; Male ; Child ; Mediation Analysis ; Comorbidity ; Internet
Abstract: We aimed to examine the relationship between impulsivity and Internet Addiction (IA) evaluating autism symptoms, inattention, hyperactivity, loneliness, anxiety, and depression in adolescents with Autism Spectrum Disorders (ASD). We also investigated whether symptoms of autism, anxiety or depression moderate and/or mediate the relationship between impulsivity and study variables in predicting the severity of IA. Participants (n = 46 adolescents with ASD, ages 12-18) were assessed through Autism Spectrum Screening Questionnaire (ASSQ), Revised Child Anxiety and Depression Scales, Turgay DSM-IV-Based Disruptive Behavioral Disorders Screening and Rating Scale, The Barratt Impulsiveness Scale-Brief, Young Internet Addiction Scale, and UCLA Loneliness Scale. For all the mediation models, total effect of impulsivity on IA was statistically significant (b = 0.329, p < 0.05). The mediator effects of Separation Anxiety Disorder (SpAD) (b = 0.495, CI = 0.039-1.256), and Generalized Anxiety Disorder (GAD) (b = 0.786, CI = 0.113-1.811) were statistically significant on the path between impulsivity and IA. The direct effect of impulsivity on SpAD was moderated by ASSQ (b = 0.041, p < 0.05). SpAD and GAD mediates the relationship between impulsivity and IA. The higher the autism level, the more likely the individual with ASD is to become an internet addict, strengthening higher relationship between impulsivity, SpAD, and GAD.
(© 2025. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Competing Interests: Declarations. Ethics Approval: The study protocol was approved by the Ethics Committee of Aydin Adnan Menderes University (Ref. Num: 2023/03). The study protocol was in accordance with the Declaration of Helsinki. Patient Consent: Written informed consent was obtained both from adolescents and their parents. Clinical Trial Registration: Reg. No: 2023/038 Conflict of interest: No potential financial or non-financial conflict of interest were declared by the authors.
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Contributed Indexing: Keywords: Anxiety; Autism spectrum disorders; Impulsivity; Internet addiction
Entry Date(s): Date Created: 20251101 Date Completed: 20260702 Latest Revision: 20260702
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DOI: 10.1007/s11126-025-10224-9
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  Data: &lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Internet+Addiction+Disorder%22&quot;&gt;Internet Addiction Disorder*&lt;/searchLink&gt;/&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Internet+Addiction+Disorder+epidemiology%22&quot;&gt;epidemiology&lt;/searchLink&gt; &lt;br /&gt;&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Internet+Addiction+Disorder%22&quot;&gt;Internet Addiction Disorder*&lt;/searchLink&gt;/&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Internet+Addiction+Disorder+physiopathology%22&quot;&gt;physiopathology&lt;/searchLink&gt; &lt;br /&gt;&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Impulsive+Behavior%22&quot;&gt;Impulsive Behavior*&lt;/searchLink&gt;/&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Impulsive+Behavior+physiology%22&quot;&gt;physiology&lt;/searchLink&gt; &lt;br /&gt;&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Autism+Spectrum+Disorder%22&quot;&gt;Autism Spectrum Disorder*&lt;/searchLink&gt;/&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Autism+Spectrum+Disorder+epidemiology%22&quot;&gt;epidemiology&lt;/searchLink&gt; &lt;br /&gt;&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Autism+Spectrum+Disorder%22&quot;&gt;Autism Spectrum Disorder*&lt;/searchLink&gt;/&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Autism+Spectrum+Disorder+physiopathology%22&quot;&gt;physiopathology&lt;/searchLink&gt; &lt;br /&gt;&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Anxiety%2C+Separation%22&quot;&gt;Anxiety, Separation*&lt;/searchLink&gt;/&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Anxiety%2C+Separation+epidemiology%22&quot;&gt;epidemiology&lt;/searchLink&gt; &lt;br /&gt;&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Anxiety%2C+Separation%22&quot;&gt;Anxiety, Separation*&lt;/searchLink&gt;/&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Anxiety%2C+Separation+physiopathology%22&quot;&gt;physiopathology&lt;/searchLink&gt; &lt;br /&gt;&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Anxiety%22&quot;&gt;Anxiety*&lt;/searchLink&gt;/&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Anxiety+epidemiology%22&quot;&gt;epidemiology&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Generalized+Anxiety+Disorder%22&quot;&gt;Generalized Anxiety Disorder&lt;/searchLink&gt;/&lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Generalized+Anxiety+Disorder+epidemiology%22&quot;&gt;epidemiology&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Humans%22&quot;&gt;Humans&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Female%22&quot;&gt;Female&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Adolescent%22&quot;&gt;Adolescent&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Male%22&quot;&gt;Male&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Child%22&quot;&gt;Child&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Mediation+Analysis%22&quot;&gt;Mediation Analysis&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Comorbidity%22&quot;&gt;Comorbidity&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Internet%22&quot;&gt;Internet&lt;/searchLink&gt;
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: We aimed to examine the relationship between impulsivity and Internet Addiction (IA) evaluating autism symptoms, inattention, hyperactivity, loneliness, anxiety, and depression in adolescents with Autism Spectrum Disorders (ASD). We also investigated whether symptoms of autism, anxiety or depression moderate and/or mediate the relationship between impulsivity and study variables in predicting the severity of IA. Participants (n = 46 adolescents with ASD, ages 12-18) were assessed through Autism Spectrum Screening Questionnaire (ASSQ), Revised Child Anxiety and Depression Scales, Turgay DSM-IV-Based Disruptive Behavioral Disorders Screening and Rating Scale, The Barratt Impulsiveness Scale-Brief, Young Internet Addiction Scale, and UCLA Loneliness Scale. For all the mediation models, total effect of impulsivity on IA was statistically significant (b = 0.329, p &amp;lt; 0.05). The mediator effects of Separation Anxiety Disorder (SpAD) (b = 0.495, CI = 0.039-1.256), and Generalized Anxiety Disorder (GAD) (b = 0.786, CI = 0.113-1.811) were statistically significant on the path between impulsivity and IA. The direct effect of impulsivity on SpAD was moderated by ASSQ (b = 0.041, p &amp;lt; 0.05). SpAD and GAD mediates the relationship between impulsivity and IA. The higher the autism level, the more likely the individual with ASD is to become an internet addict, strengthening higher relationship between impulsivity, SpAD, and GAD.&lt;br /&gt; (&#169; 2025. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
– Name: Abstract
  Label: Competing Interests
  Group: Ab
  Data: Declarations. Ethics Approval: The study protocol was approved by the Ethics Committee of Aydin Adnan Menderes University (Ref. Num: 2023/03). The study protocol was in accordance with the Declaration of Helsinki. Patient Consent: Written informed consent was obtained both from adolescents and their parents. Clinical Trial Registration: Reg. No: 2023/038 Conflict of interest: No potential financial or non-financial conflict of interest were declared by the authors.
– Name: Ref
  Label: References
  Group: RefInfo
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  Data: &lt;i&gt;Keywords: &lt;/i&gt;Anxiety; Autism spectrum disorders; Impulsivity; Internet addiction
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  Data: &lt;i&gt;Date Created: &lt;/i&gt;20251101 &lt;i&gt;Date Completed: &lt;/i&gt;20260702 &lt;i&gt;Latest Revision: &lt;/i&gt;20260702
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        Value: 10.1007/s11126-025-10224-9
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      – Code: eng
        Text: English
    PhysicalDescription:
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        StartPage: 365
    Subjects:
      – SubjectFull: Generalized Anxiety Disorder epidemiology
        Type: general
      – SubjectFull: Humans
        Type: general
      – SubjectFull: Female
        Type: general
      – SubjectFull: Adolescent
        Type: general
      – SubjectFull: Male
        Type: general
      – SubjectFull: Child
        Type: general
      – SubjectFull: Mediation Analysis
        Type: general
      – SubjectFull: Comorbidity
        Type: general
      – SubjectFull: Internet
        Type: general
      – SubjectFull: Internet Addiction Disorder epidemiology
        Type: general
      – SubjectFull: Internet Addiction Disorder physiopathology
        Type: general
      – SubjectFull: Impulsive Behavior physiology
        Type: general
      – SubjectFull: Autism Spectrum Disorder epidemiology
        Type: general
      – SubjectFull: Autism Spectrum Disorder physiopathology
        Type: general
      – SubjectFull: Anxiety, Separation epidemiology
        Type: general
      – SubjectFull: Anxiety, Separation physiopathology
        Type: general
      – SubjectFull: Anxiety epidemiology
        Type: general
    Titles:
      – TitleFull: The Relationship Between Impulsivity, Anxiety and Internet Addiction in Adolescents with Autism Spectrum Disorder: A Moderated Mediation Model.
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            – D: 01
              M: 06
              Text: 2026 Jun
              Type: published
              Y: 2026
          Identifiers:
            – Type: issn-electronic
              Value: 1573-6709
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            – TitleFull: The Psychiatric quarterly
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