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Background <p>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.</p> Methods <p>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.</p> Results <p>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], <i>p</i> = .004; ΔR² = 0.087).</p> Conclusions <p>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.</p>

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Problematic digital use in adolescents with ADHD: impulsivity, obsessive-compulsive symptoms, and perceived cognitive flexibility

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月14日

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  • Dilek Altun Varmış,
  • Hülya Binokay,
  • Serkan Güneş,
  • Cumali Yüksekkaya,
  • Elif Gözde Yüce Antepüzümü,
  • Emine Çiloğulları,
  • Gülsevinç Atay,
  • Pınar Şefik,
  • Nazmiye İnce

摘要

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.