Association Between Adverse Childhood Experiences and Digital Addiction in Mainland Chinese Children and Adolescents: A Three-Level Meta-Analytic Review.

Mainland China's large youth internet-user population, rapid digitalization, and substantial sociocultural and regional heterogeneity provide a unique context for examining how adverse childhood experiences (ACEs) relate to digital addiction among children and adolescents. Despite growing empirical interest, existing findings remain fragmented and highly variable. Therefore, the current three-level meta-analysis aimed to generate reliable estimates of the associations between ACEs and five forms of digital addiction, and to examine whether these associations differed by study-, sample-, or measurement-level characteristics. A systematic literature search across four English-language and three Chinese-language databases identified 65 articles (152 effect sizes; N = 218,210). Results showed that ACEs were significantly and positively associated with internet addiction (r = .190), gaming addiction (r = .225), mobile phone addiction (r = .284), social media addiction (r = .225), and short-form video addiction (r = .297). Moderator analyses further showed that the association between ACEs and internet addiction was stronger in studies with a higher proportion of left-behind children, and in western regions (mean r = .319) than in central regions (mean r = .158) of mainland China. Overall, these findings suggest that ACEs constitute a risk factor for multiple forms of digital addiction among Chinese youth, and highlight the need for targeted prevention and intervention efforts for vulnerable populations mainly living in less-developed regional contexts.