The association between psychological distress and internet addiction: A systematic review and three-level meta-analysis.

Internet addiction has emerged as a global public health concern, with psychological distress recognized as a key contributing factor. Numerous studies have investigated the association between psychological distress and Internet addiction; however, their findings have remained inconsistent, and the moderating factors influencing this relationship have not been comprehensively examined. To address these gaps, the present study conducted a three-level meta-analysis to systematically assess the association between psychological distress and Internet addiction, as well as to explore potential moderators. In total, 135 studies involving 263,780 participants and 632 effect sizes were identified by a systematic literature search. The results revealed a significant positive correlation between psychological distress and Internet addiction. Furthermore, several variables significantly moderated this relationship, including study design, publication year, COVID-19 pandemic context, gender, age group, educational stage, country, living arrangement, measurement of Internet addiction, dimensions of Internet addiction, and types of Internet addiction. These findings provide more comprehensive insights to understand the complex link between psychological distress and Internet addiction and offer theoretical guidance for the development of targeted prevention and intervention strategies.