Internet addiction and psychological problems among youth in the Eastern Mediterranean Region: A gender-stratified network analysis.

BACKGROUND: Internet addiction represents a growing public health concern, particularly among youth in the Eastern Mediterranean Region (EMR), where Internet use is high. This study examined gender-stratified domain-level and item-level networks linking Internet addiction with psychological problems among youth in the EMR. METHODS: A cross-sectional study was conducted among 6204 participants aged 15-24 years from 15 EMR countries from June 1 to December 20, 2024. Internet addiction was assessed using the Compulsive Internet Use Scale, covering five domains: conflict, loss of control, preoccupation, coping and mood modification, and withdrawal symptoms. Psychological problems were assessed using the Strengths and Difficulties Questionnaire, including emotional, conduct, peer, and hyperactivity problems. Gender-stratified ordinal Markov random field models and centrality indices were estimated at the domain and item levels to identify the most influential domains and symptoms, as well as the strongest cross-domain and cross-symptom associations between Internet addiction and psychological problems. RESULTS: In both genders, the domain-level analysis identified conflict as the most central domain, meanwhile the item-level analysis identified being nervous in new situations as the most influential symptom. Internet-related withdrawal formed the strongest cross-domain associations with psychological problems in the domain-level analysis. Preference for online engagement over spending time with others and solitary behavior was the strongest cross-symptom association in the item-level analysis in both males and females. CONCLUSIONS: The identified central domain and symptom, along with the strongest cross-domain and cross-symptom associations, may represent promising targets for interventions to reduce Internet addiction and its psychological comorbidity among youth.