BMC psychology · 2026
Problematic digital use in adolescents with ADHD: impulsivity, obsessive-compulsive symptoms, and perceived cognitive flexibility.
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Altun Varmış Dilek, Binokay Hülya, Güneş Serkan, Yüksekkaya Cumali, Yüce Antepüzümü Elif Gözde, Çiloğulları Emine, Atay Gülsevinç, Şefik Pınar, İnce Nazmiye
Аннотация
BACKGROUND: Adolescents with attention-deficit/hyperactivity disorder (ADHD) are at risk for problematic digital use (PDU), which is better characterised by loss of control and functional impairment than by screen time alone. The present study investigated problematic internet, social media, and gaming use among adolescents with ADHD, focusing on impulsivity, obsessive-compulsive (OC) symptoms, and perceived cognitive flexibility.
METHODS: This cross-sectional case-control study included 132 adolescents aged 12-18 years (69 treatment-naive adolescents with ADHD and 63 healthy controls) recruited from a tertiary child and adolescent psychiatry outpatient clinic. Participants completed self-report measures of problematic digital use, impulsivity, obsessive-compulsive symptoms, and perceived cognitive flexibility. ADHD diagnoses were confirmed using the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL). Adjusted binary logistic regression models included participant age and biological sex. The primary within-ADHD regression and moderation models included the Conners ADHD Index.
RESULTS: Problematic internet use and probable problematic social media use were more frequent in the ADHD group and were associated with higher odds of ADHD group membership after adjustment for age and biological sex. Within the ADHD group, impulsivity and obsessive-compulsive symptom severity were independently associated with problematic internet-use severity. For gaming symptoms, impulsivity remained a significant independent correlate, whereas the OCI-R main effect was not statistically significant. A preliminary OCI-R × CFS interaction was observed for gaming symptoms after adjustment for parent-rated ADHD symptom severity (B = 0.024, SE = 0.008, 95% CI [0.007, 0.040], p = .004; ΔR² = 0.087).
CONCLUSIONS: Adolescents with ADHD showed higher frequencies of problematic internet use and probable problematic social media use than healthy controls. Impulsivity was a consistent dimensional correlate of problematic digital use. The interaction involving perceived cognitive flexibility should be considered preliminary and hypothesis-generating and requires replication in larger independent samples.
METHODS: This cross-sectional case-control study included 132 adolescents aged 12-18 years (69 treatment-naive adolescents with ADHD and 63 healthy controls) recruited from a tertiary child and adolescent psychiatry outpatient clinic. Participants completed self-report measures of problematic digital use, impulsivity, obsessive-compulsive symptoms, and perceived cognitive flexibility. ADHD diagnoses were confirmed using the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL). Adjusted binary logistic regression models included participant age and biological sex. The primary within-ADHD regression and moderation models included the Conners ADHD Index.
RESULTS: Problematic internet use and probable problematic social media use were more frequent in the ADHD group and were associated with higher odds of ADHD group membership after adjustment for age and biological sex. Within the ADHD group, impulsivity and obsessive-compulsive symptom severity were independently associated with problematic internet-use severity. For gaming symptoms, impulsivity remained a significant independent correlate, whereas the OCI-R main effect was not statistically significant. A preliminary OCI-R × CFS interaction was observed for gaming symptoms after adjustment for parent-rated ADHD symptom severity (B = 0.024, SE = 0.008, 95% CI [0.007, 0.040], p = .004; ΔR² = 0.087).
CONCLUSIONS: Adolescents with ADHD showed higher frequencies of problematic internet use and probable problematic social media use than healthy controls. Impulsivity was a consistent dimensional correlate of problematic digital use. The interaction involving perceived cognitive flexibility should be considered preliminary and hypothesis-generating and requires replication in larger independent samples.