Journal of Affective Disorders 350 (2024) 721–727

Contents lists available at ScienceDirect

Journal of Affective Disorders

journal homepage: www.elsevier.com/locate/jad

Research paper

Childhood maltreatment and Internet addiction among Chinese

adolescents: A moderated mediation model
JingJing Gu 1, YuanYuan Guo 1, Jin-Liang Wang *
Center for Mental Health Education, Faculty of Psychology, Southwest University, China

A R T I C L E I N F O A B S T R A C T

Keywords: Although childhood maltreatment has been suggested to play an important role in developing Internet addiction
Childhood maltreatment among adolescents, little is known about the mediating and moderating mechanisms underlying this association.
Maladaptive cognitive emotion regulation The present study investigated (a) the mediating role of maladaptive cognitive emotion regulation strategy
strategy
(MCERS) in the association between childhood maltreatment and Internet addiction, and (b) the moderating role
Internet addiction
of peer support in the relationship between childhood maltreatment and Internet addiction. A sample of 4163
Peer support
Chinese adolescents (50.3 % females, M age = 14.25, SD = 1.53) were recruited. The moderated mediation model
showed that MCERS mediated the relationship between childhood maltreatment and Internet addiction.
Furthermore, the mediating process was moderated by peer support. Interestingly, peer support can protect
adolescents from being affected by higher levels of MCERS while it displays limited protective effect when ad­
olescents suffered from higher levels of childhood maltreatment. These findings indicate that reducing the
MCERS and enhancing peer support can contribute to the alleviation of negative influences of childhood
maltreatment on Internet addiction.

1. Introduction
Internet addiction and other terms such as Internet use disorder,
pathological or problematic Internet use are used to describe the phe­
nomenon that individuals excessively and uncontrollably use the
Internet and cause damage to one’s physical and mental health, as well
as the social function (Davis, 2001; Spada, 2014; Young and Abreu,
2011). To be specific, the uncontrollable use of the Internet has been
found to be associated with a wide range of negative consequences,
including psychosocial problems (Geng et al., 2021a, b; Sayeed et al.,
2020; Stanković et al., 2021), low academic achievement (Zhang et al.,
2018), suicidal ideation (Peng et al., 2021), and sleep disturbances
(Alimoradi et al., 2019). Given the negative outcomes it may bring in, it
is urgent and necessary to understand the antecedents of Internet
addiction and the underlying mechanisms.
Previous studies have explored the risk factors for Internet addiction,
including low socioeconomic status (Festl et al., 2013), personality
variables (Marciano et al., 2022), family environments (Wu et al., 2016),
peer influence (Li et al., 2019) and childhood maltreatment (Guo et al.,
2023). What remains to clarify is the detailed contributing mechanisms.
In the current study, we aimed to investigate how and why childhood
maltreatment affected Internet addiction and to offer insights on
providing guidance for tailored interventions or prevention.
1.1. Childhood maltreatment and Internet addiction
Childhood maltreatment, which includes physical abuse/neglect,
emotional abuse/neglect and sexual abuse, has been found to be asso­
ciated with various addictive behaviors (Geng et al., 2022; Hagborg
et al., 2020; Mishra et al., 2022) such as Internet addiction (Guo et al.,
2023). The link between childhood maltreatment and Internet addiction
can be explained by Life History Strategy Theory (Figueredo et al.,
2006). According to the Life History Strategy Theory, individuals must
make basic trade-offs between survival efforts and reproduction efforts
based on environmental cues (Figueredo et al., 2006). If the early
childhood environment is safe and predictable, individuals will choose
slow life history strategy characterized by concentrating energy and
resources into survival tasks and paying attention to physical mainte­
nance, knowledge and skills acquirement, and raising offspring. How­
ever, if the early childhood environment is harsh and unpredictable,

* Corresponding author at: Center for Mental Health Education, Faculty of Psychology, Southwest University, 400715, China.
E-mail address: wangjinliang09@gmail.com (J.-L. Wang).
1
JingJing Gu and YuanYuan Guo contributed equally to this paper.

https://doi.org/10.1016/j.jad.2024.01.175
Received 17 July 2023; Received in revised form 15 January 2024; Accepted 18 January 2024
Available online 23 January 2024
0165-0327/© 2024 Elsevier B.V. All rights reserved.

Downloaded for Anonymous User (n/a) at University of Alberta from ClinicalKey.com by Elsevier on February 20,
2024. For personal use only. No other uses without permission. Copyright ©2024. Elsevier Inc. All rights reserved.
J. Gu et al.
individuals will choose fast life history strategy characterized by
concentrating energy and resources into the reproduction task and
seeking immediate pleasure or temporal satisfaction (Geng et al., 2021a,
b), and the Internet is a perfect access to get such immediate gratifica­
tion and relief. It is generally accepted that individuals with childhood
maltreatment experiences usually live in harsh and unpredictable en­
vironments, which involves the change or inconsistency in interaction
with caregivers and other people (Berman et al., 2022; Gee, 2021). Thus,
we infer that maltreated individuals are inclined to seek for immediate
or temporal satisfaction via excessively using the Internet, which might
increase the risk for developing Internet addiction. Moreover, it would
be much meaningful to explore how and why childhood maltreatment
would be linked to adolescents’ Internet addiction. Therefore, in the
current study, we wanted to investigate the mediating role of MCERS
and the moderating role of peer support between childhood maltreat­
ment and Internet addiction.
1.2. The mediating role of MCERS
Maladaptive cognitive emotion regulation refers to individuals’
negative cognitive responses to emotional experiences associated with
negative or stressful life events (Garnefski et al., 2001), including self-
blame, other-blame, rumination and catastrophizing (Garnefski and
Kraaij, 2009).
Most previous studies have revealed the links between MCERS and
psychopathological outcomes (Ludwig et al., 2019). At present, more
attention has been paid to its associations with online behavioral
problems. For example, Huh et al. (2017) and Pontes et al. (2018) found
that frequent use of MCERS may exacerbate the negative effects of
negative life events and put individuals at risk of experiencing more
negative emotions. To release negative emotions, they may turn to the
Internet, and the excessive use of Internet will increase the vulnerability
of Internet addiction (Kardefelt-Winther, 2014). And specific MCERS
such as rumination can also drive individuals to excessively check their
smartphones or computers and it is directly related to Internet addiction
(Liu et al., 2017).
In addition, childhood maltreatment may be a potential risk factor
for adolescents’ MCERS. First, maltreated individuals are more likely to
form the insecure attachment, and further, are at an increased risk for
developing MCERS (Huh et al., 2017). Second, the interactions between
environments and individuals would hinder or promote individuals’
development (Kahana et al., 2003). And childhood maltreatment,
characterized by uncontrollability and unpredictability, could increase
the risk for adopting maladaptive life strategy, including MCERS (Wu
et al., 2022). Third, adolescents will imitate their parents’ emotion
regulation skills. Maltreating parents are more likely to be difficult in
emotion regulation, increasing the likelihood of using MCERS for their
children (Wang, 2022). Fourth, the brain is of high plasticity during
adolescence, adverse experiences such as childhood maltreatment can
cause irreversible negative effects on brain structure, including the
damage of HPA axis and emotion regulation functional area, meaning
the poor emotion regulation ability (Pirnia et al., 2020). Thus, childhood
maltreatment may be one of the antecedents of MCERS among
adolescents.
Finally, based on the Interaction of Person-Affect-Cognition-
Execution (I-PACE) model, the early traumatic experience (e.g., child­
hood maltreatment) and abnormal coping style (e.g., MCERS) are the
necessary and sufficient condition for the formation of Internet addic­
tion (Brand et al., 2016). To sum, maltreated adolescents are prone to
form MCERS (Weissman et al., 2019), which may produce greater in­
fluence on adolescents’ mental health (Webb et al., 2012), including
Internet addiction (Guo et al., 2023). Empirical studies also demonstrate
that maladaptive emotion regulation strategy may play a mediating role
between childhood adversity and developmental outcomes (Geng et al.,
2022; Haselgruber et al., 2020). Thus, we propose that MCERS may play
a mediating role in the relationship between childhood maltreatment
722
Downloaded for Anonymous User (n/a) at University of Alberta from ClinicalKey.com by Elsevier on February 20,
2024. For personal use only. No other uses without permission. Copyright ©2024. Elsevier Inc. All rights reserved.
Journal of Affective Disorders 350 (2024) 721–727
and Internet addiction (Hypothesis 1).
1.3. The moderating role of peer support
Although childhood maltreatment may increase the risk of devel­
oping Internet addiction through MCERS, it is not the case that all ad­
olescents suffering from childhood maltreatment will form MCERS and
become addicted to Internet. In other words, some adolescents can
achieve healthy development despite their maltreated experiences.
However, until now seldom study has taken the effort to answer such
questions.
Peer support, refers to the emotional support and practical support
that are provided by peers, which may help individuals effectively deal
with the challenging situations (Cohen, 1985). Peer support may buffer
the negative effects of MCERS and childhood maltreatment on Internet
addiction. For instance, some studies have demonstrated that peer
support can attenuate the negative influence of maladaptive emotion
regulation on Internet addiction (Li et al., 2020; Zhou et al., 2017). In
addition, a great number of studies have documented the buffering role
of peer support in the association between childhood maltreatment and
its related negative outcomes, including PTSD (Evans et al., 2013), lower
levels of developmental achievement (Pepin and Banyard, 2006), psy­
chopathology (Gewirtz-Meydan, 2020) and internalizing problems
(Sperry and Widom, 2013). Thus, in this study, we proposed that peer
support could moderate the relationship between MCERS and Internet
addiction as well as the relationship between childhood maltreatment
and Internet addiction (Hypothesis 2).
Yet, peer support, as a buffering factor in the relationship between
risk factors and negative outcomes, may have two different buffering
patterns: the stress-buffering model and the reverse stress-buffering
model (Rueger et al., 2016). According to the stress-buffering model,
the protective effect of peer support on the Internet addiction will be
stronger for adolescents who experience higher levels of MCERS and
childhood maltreatment. Conversely, the reverse stress-buffering model
emphasizes the protective effect will be stronger for adolescents who
experience lower levels of MCERS and childhood maltreatment.
Although both stress-buffering and reverse stress-buffering model of
peer support are likely to happen, which model will be finally supported
has not been checked directly on the association between childhood
maltreatment and Internet addiction as well as on the link between
MCERS and Internet addiction.
1.4. Aims and hypotheses
The current study aimed to offer a more comprehensive under­
standing of the mechanisms through which childhood maltreatment
influences adolescents’ Internet addiction. The first aim was to examine
the mediating role of MCERS between childhood maltreatment and
Internet addiction (Hypothesis 1). The second aim was to check the
moderating role of peer support in the mediation model (Hypothesis 2).
We constituted a moderated mediation model to examine our aims. The
conceptual model can be found in Fig. 1.
Fig. 1. The theoretical model. Note. MCERS = Maladaptive cognitive emotion
regulation strategy.
J. Gu et al. Journal of Affective Disorders 350 (2024) 721–727

2. Method Social Support (MSPSS) was used to assess peer support (Zimet et al.,
1988). This subscale had 4 items. Sample items are like “I have friends
2.1. Participants with whom I can share my joys and sorrows”. Participants were asked to
rate on a 7-point scale (1 = totally agree, 7 = completely agree). The
The participants were recruited from three schools by cluster sam­ total score is summed and the higher score represented higher levels of
pling. In total, 4163 (50.3 % females, M age = 14.25, SD = 1.53) par­ peer support. In this study, the Cronbach’s α for this scale was 0.90.
ticipants participated in this study. Among them, 42.6 % lived in city,
25.8 % were the only child in the family, and the largest proportion of 2.2.4. Internet addiction
parents’ education level is primary school to high school (90.1 % for Internet addiction was measured by the Internet Addiction Test
mother and 89.9 % for father). All the details can be found in Table 1. (Young, 1998). This scale includes 8 items. Items are like “Stay online
longer than originally intended”, “Feel restless, moody, depressed, or
irritable when attempting to cut down or stop Internet use”. Participants
2.2. Measures were asked to rate on a 5-point scale (1 = totally disagree; 5 = totally
agree). The total score is summed and the higher scores represented
2.2.1. Childhood maltreatment higher levels of Internet addiction. In this study, the Cronbach’s α for
Childhood maltreatment was measured by the Childhood Trauma this scale was 0.90.
Questionnaire-Short Form (Bernstein et al., 2003). This scale has five
dimensions, including physical abuse (5 items), physical neglect (5
items), emotional abuse (5 items), emotional neglect (5 items), and 2.3. Procedure
sexual abuse (5 items). Sample items are like “Beaten hard enough to see
a doctor”, “Family said hurtful things”. Participants were asked to The study was approved by the first author’s University Ethics
respond on a 5-point scale (1 = never true; 5 = very often true). The total Committee and implemented in accordance with the approved guide­
score is summed and the higher scores represented higher levels of lines and regulations before data collection. We obtained informed
childhood maltreatment. This scale has been widely used among Chi­ consent from parents, teachers and all participating students before data
nese sample and showed good reliability and validity (Wang et al., collection. Then the graduate students in our research team went to the
2020). In this study, the Cronbach’s α for this scale was 0.90. schools and gathered data. All the participants finished the online
questionnaires in computer rooms. Every room has one or two teachers
2.2.2. Maladaptive cognitive emotion regulation strategy or graduate students who will give instructions and help students
MCERS was measured by the maladaptive cognitive emotion regu­ complete the questionnaires. The survey takes approximately 20–25 min
lation strategy subscale (16 items) of Emotion Regulation Strategy to complete.
Questionnaire (Garnefski et al., 2001). MCERS included four di­
mensions: self-blame, other-blame, rumination and catastrophizing. 2.4. Data analysis
Items are like “I often think about how I feel about what I have expe­
rienced”, “I often think that what I have experienced is much worse than All data were analyzed by SPSS 21.0 and Mplus 8.3. First of all, we
what others have experienced”. Each item is rated on a 5-point scale (1 conducted the descriptive statistics and Pearson’s r correlations to
= almost never, 5 = almost always). The total score is summed and the examine the associations among childhood maltreatment, MCERS, peer
higher scores represented more frequent use of maladaptive emotion support and Internet addiction. Then, we constituted a mediation model
regulation strategy. The Emotion Regulation Strategy Questionnaire has to examine whether MCERS mediated the relationship between child­
been used in the Chinese sample and shows good reliability and validity hood maltreatment and Internet addiction via Mplus 8.3. After con­
(Guo et al., 2023). In the present study, Cronbach’s α for the MCERS firming the mediation model, we constituted a moderated mediation
subscale was 0.93. model and explored whether peer support moderated the mediation
model. Specifically, we tested whether peer support moderated the
2.2.3. Peer support second path (MCERS-Internet addiction) and the direct path (childhood
The peer support subscale of Multi-dimensional Scale of Perceived maltreatment-Internet addiction) of the mediation model. We used
maximum likelihood estimation and the bias-corrected bootstrap 95 %
Table 1 confidence interval based on 5000 bootstrapping. If the 95 % bootstrap
Demographics of the participants. did not contain zero in confidence interval, the effect was significant.
Variable N %
3. Results
Gender
Male 2067 49.7
Female 2096 50.3 3.1. Descriptive analyses
Birthplace
City 1773 42.6
Table 2 provides means, standard deviations and correlations of all
Countryside 2390 57.4
Only child
study variables. The average score for each aggregated variable were M
Yes 1074 25.8 = 31.945 (SD = 9.838) for childhood maltreatment, M = 38.780 (SD =
No 3089 74.2 11.707) for MCERS, M = 20.358 (SD = 5.741) for peer support, M =
Paternal education level
Never go to school 28 0.7
Primary school to high school 3742 89.9 Table 2
Vocational school 196 4.7 Correlations, means and standardized deviation of all the study variables.
Undergraduate 180 4.3 1 2 3 4 M SD
Graduate or higher 17 0.4
Maternal education level 1.Childhood 1 31.95 9.84
Never go to school 134 3.2 maltreatment
Primary school to high school 3749 90.1 2.MCERS 0.40** 1 38.78 11.71
Vocational school 151 3.6 3.Peer support − 0.26** − 0.10** 1 20.36 5.74
Undergraduate 115 2.8 4.Internet addiction 0.33** 0.46** − 0.15** 1 17.39 7.55
Graduate or higher 14 0.3
Note. **p<0.01. MCERS = Maladaptive emotion regulation strategy.

723

Downloaded for Anonymous User (n/a) at University of Alberta from ClinicalKey.com by Elsevier on February 20,
2024. For personal use only. No other uses without permission. Copyright ©2024. Elsevier Inc. All rights reserved.
J. Gu et al. Journal of Affective Disorders 350 (2024) 721–727

17.386 (SD = 7.550) for Internet addiction. According to the correlation

analysis, childhood maltreatment was positively associated with MCERS
and Internet addiction but negatively associated with peer support.
MCERS was positively associated with Internet addiction but negatively
associated with peer support. Internet addiction was negatively associ­
ated with peer support.

3.2. Testing for mediation effect

In the mediation model, all the demographic variables mentioned in

Table 1 except for birth place (which is not associated with Internet
addiction) are regarded as control variables. The model fit of the
mediation model is good (χ 2 = 141.569, CFI = 0.941, TLI = 0.923,
RMSEA = 0.056, SRMR = 0.040). The results showed that childhood
maltreatment was significantly positively associated with MCERS (β =
0.403, p<0.001), which in turn was significantly positively associated
with Internet addiction (β = 0.383, p<0.001). The direct effect was
significant (β = 0.179, p<0.001) and the indirect effect was also sig­
nificant (β = 0.154, p<0.001), which indicated that the mediation model
was valid, and MCERS partially mediated the relationship between
childhood maltreatment and Internet addiction. The mediation model
can be found in Fig. 2.
3.3. Testing for the moderation effect of peer support
Fig. 3. Peer support moderates the relationship between childhood maltreat­
ment and Internet addiction as well as the relationship between maladaptive
cognitive emotion regulation strategy and Internet addiction. Note. CTQ =
Childhood maltreatment; MCERS = Maladaptive emotion regulation strategy;
PS=Peer support; IA = Internet addiction; MCERS×PS = The interaction be­
tween MCERS and peer support; CTQ × PS = The interaction between child­
hood maltreatment and peer support. The standardized coefficients and
confidence interval are presented in the path line. The numbers in the bracket
represent the 95 % confidence interval. The results of mediation model showed
that paternal education and only child were not associated with Internet
addiction, so gender and maternal education were regarded as control variables
in the moderated mediation model.

Based on the mediation model, we included a moderate variable-peer

support to examine whether it could moderate the relationship between
MCERS and Internet addiction as well as the relationship between
childhood maltreatment and Internet addiction. The model fit of the
moderated mediation model is good (χ 2 = 69.457, CFI = 0.970, TLI =
0.957, RMSEA = 0.040, SRMR = 0.023). As Fig. 3. illustrated, the
interaction between MCERS and peer support was negatively and
significantly correlated to Internet addiction (β = − 0.039, p<0.001),
and the interaction between childhood maltreatment and peer support
was positively and significantly correlated to Internet addiction (β =
0.088, p<0.001).
In order to clearly describe the interaction effect, we plotted MCERS
on Internet addiction separately at low and high levels of peer support (1
SD above the mean and 1 SD below the mean, see Fig. 4). The results
showed that individuals with lower peer support reported higher levels
of Internet addiction than those with higher levels of peer support with
the increasing MCERS. Individuals benefited more from peer support
when they were at higher levels of MCERS. Then, we plotted childhood
maltreatment on Internet addiction separately at low and high levels of
peer support (1 SD above the mean and 1 SD below the mean, see Fig. 5).
The results showed that individuals low in peer support reported higher
levels of Internet addiction than those high in peer support with the
increasing childhood maltreatment. Individuals benefit more from peer
support when experiencing a lower level of childhood maltreatment. Fig. 4. The interaction of MCERS and PS on Internet addiction. Note. MCERS =
Maladaptive emotion regulation strategy; PS=Peer support.

4. Discussion

Given the potential threat of Internet addiction for adolescents (Kuss

Fig. 2. Maladaptive cognitive emotion regulation strategy plays a mediating
role between childhood maltreatment and Internet addiction. Note. CTQ =
Childhood maltreatment; MCERS = Maladaptive cognitive emotion regulation
strategy; IA = Internet addiction. The standardized coefficients and confidence
interval are presented in the path line. The numbers in the bracket represent the
95 % confidence interval.
et al., 2013), it is necessary to investigate how and why adolescents
develop Internet addiction, especially for those disadvantaged adoles­
cents. In the current study, we used a large sample (N = 4163) and
explored the underlying mechanisms between childhood maltreatment
and Internet addiction. This study is among the first to investigate the
mediating role of MCERS and the moderating role of peer support be­
tween childhood maltreatment and Internet addiction spontaneously.
The results showed that MCERS played as a “bridge” between childhood
maltreatment and Internet addiction, and peer support moderated the
mediation model. Interestingly, we found that peer support supported

724

Downloaded for Anonymous User (n/a) at University of Alberta from ClinicalKey.com by Elsevier on February 20,
2024. For personal use only. No other uses without permission. Copyright ©2024. Elsevier Inc. All rights reserved.
J. Gu et al.
Fig. 5. The interaction of CTQ and PS on Internet addiction. Note. CTQ =
Childhood maltreatment; PS=Peer support.
both the stress-buffering model and the reverse stress-buffering model
(Rueger et al., 2016). Specifically, peer support can protect adolescents
from being heavily affected by higher levels of MCERS (stress-buffering
model) while it displays limited protective effect when adolescents
suffered from higher levels of childhood maltreatment (reverse stress-
buffering model). These findings can help policymakers and psycho­
logical professionals make more effective and tailored interventions and
prevention to reduce adolescents’ Internet addiction and decrease the
negative effects of childhood maltreatment.
4.1. The direct effect between childhood maltreatment and internet
addiction
Adolescents who experienced childhood maltreatment are prone to
engage in Internet addiction. This finding is consistent with previous
studies showing that childhood maltreatment is predictive of Internet
addiction (Arslan, 2017; Hsieh et al., 2016). Additionally, this result
supports the Life History Strategy Theory (Figueredo et al., 2006).
Maltreated individuals are inclined to turn to Internet for immediate
satisfaction or relief, which might increase the risk for unappropriated
use of Internet (Dalbudak et al., 2014). Further, the immediate gratifi­
cation getting from Internet use would prompt to form the maladaptive
cognition about the Internet, such as “the online world is much better
than reality”, and reinforce the motivation and behavior of Internet
addiction, especially when adolescents were maltreated (Davis, 2001;
Brand et al., 2016).
4.2. The mediating effect of MCERS
This study extends the prior literature by showing that MCERS me­
diates the relationship between childhood maltreatment and Internet
addiction, which supports Hypothesis 1. Our findings are consistent with
the I-PACE model (Brand et al., 2019), which suggests that risk factors
such as childhood maltreatment may contribute to Internet addiction via
mediators such as MCERS. Previous studies also indicated that mal­
treated individuals are at increased risk for developing maladaptive
emotion regulation strategy, which may predispose individuals to
excessively use the Internet (Aldao et al., 2010; Mo et al., 2018).
We can better understand this mediation model from two
725
Downloaded for Anonymous User (n/a) at University of Alberta from ClinicalKey.com by Elsevier on February 20,
2024. For personal use only. No other uses without permission. Copyright ©2024. Elsevier Inc. All rights reserved.
Journal of Affective Disorders 350 (2024) 721–727
perspectives. First, the results showed that adolescents who experienced
higher level of childhood maltreatment are very likely to develop
MCERS. This result can be explained by the attachment theory (Bowlby,
1988). According to attachment theory (Bowlby, 1988), the positive
interactions between parents or caregivers and children can not only
help children form safe attachment but also provide children with op­
portunities to learn effective emotion regulation skills. Yet, adolescents
who were maltreated cannot develop positive interactions with their
parents. Even worse, they may learn maladaptive emotion regulation
skills from their parents (Morris et al., 2017). Second, this study shows
that MCERS can be considered as a risk factor for Internet addiction,
which supports the conclusions of studies exploring the links of mal­
adaptive emotion regulation strategy and addictive behaviors (Blan­
chard et al., 2019). Individuals with childhood maltreatment
experiences lack the opportunity to learn or acquire adaptive emotion
regulation skills and they are more likely to encounter stressors that are
far beyond their coping ability, such that maltreated adolescents are at
increased risk of suffering from a “double-hit”. The “double-hit” increase
the risk of developing Internet addiction. The mediating mechanism
implies that interventions aiming for preventing the formation of
MCERS can help reduce the risk of Internet addiction.
4.3. The moderating effect of peer support
Our results indicate that peer support moderates the link between
MCERS and Internet addiction (which supports Hypothesis 2) and it
exerts greater protective effect at higher levels of MCERS (Fig. 4), which
can be explained by the stress-buffering model (Rueger et al., 2016). The
potential explanation may be that peer support can help adolescents feel
emotionally supported (Allnock, 2015), and alleviate the negative
emotions that can’t be regulated by their habitual MCERS. As a result,
adolescents are less likely to be addicted to finding relief on the Internet
even when they are at higher levels of MCERS.
Additionally, peer support moderates the association between
childhood maltreatment and Internet addiction (which supports Hy­
pothesis 2) and it exerts greater protective effect when individuals are at
lower levels of childhood maltreatment (Fig. 5), which can be explained
by the reverse stress-buffering model (Rueger et al., 2016). When in­
dividuals are at lower levels of childhood maltreatment, peer support
can protect them from being heavily affected by it. Similar primary role
of friend support is also revealed regarding the prediction of childhood
maltreatment on psychological distress (Goemans et al., 2023). How­
ever, higher levels of childhood maltreatment could harm individual’s
sensitivity to peer relationships and they are less likely to feel and
receive support from their friends (Tung et al., 2018), thus the limited
positive effects of peer support will be covered by the detrimental effects
of higher levels of childhood maltreatment. This finding implies that
severe childhood maltreatment may produce detrimental and irrevers­
ible negative influence on adolescents. Previous studies also supported
our inferences by indicating that severe childhood maltreatment may
alter the brain structure, which may cause life-long influence on in­
dividuals’ emotion regulation ability (Burrus, 2013). Thus, prevention
for severe childhood maltreatment is very important for reducing ado­
lescents’ Internet addiction.
5. Strengths and limitations
This study extends the extant literature in several theoretical and
practical ways. Theoretically, the findings of the present study provided
evidence to explain how childhood maltreatment impacted Internet
addiction and to clarify how MCERS and peer support played a role in
the relationship between childhood maltreatment and Internet addic­
tion. It is worthy to note that these findings extend our knowledge on the
association between childhood maltreatment and Internet addiction.
Importantly, the stress-buffering effect of peer support in the association
between MCERS and Internet addiction demonstrates that it is effective
J. Gu et al.
to take measures to reduce Internet addiction through reducing the use
of MCERS. In addition, we find the reverse stress-buffering effect of peer
support in the association between childhood maltreatment and Internet
addiction, which implies that we should be aware of the limited pro­
tective effect of peer support when helping those high in childhood
maltreatment.
Even with the important findings in the current study, several limi­
tations need to be acknowledged. First, causal conclusions regarding the
study variables are not eligible given the cross-sectional design of this
study. Longitudinal studies are necessary to support the findings of the
current study. Second, we used the self-report data, which may limit the
objectivity of the findings. Third, we only investigated the mediating
role of MCERS and the moderating role of peer support. There may be
other mediating variables or moderating variables in the relationship
between childhood maltreatment and Internet addiction. For example, it
is possible that basic psychological needs satisfaction and grit may also
be the underlying mechanisms between childhood maltreatment and
Internet addiction.
6. Implications
This study revealed the mediating role of MCERS and the moderating
role of peer support between childhood maltreatment and Internet
addiction, which offers us new insights for the prevention and in­
terventions of Internet addiction. Based on these findings, interventions
(such as growth mindset intervention) aiming to promoting individuals
to adopt adaptive emotion regulation strategies (Kneeland et al., 2016)
may be a good choice for the reduction of Internet addiction (Parada
et al., 2022). In addition, some group activities that can help individuals
make friends and get support from their peers are also helpful to the
reduction of Internet addiction (Chun, 2018).
7. Conclusions
The present study, with a large population of adolescents, confirms
the mediating role of MCERS in the relationship between childhood
maltreatment and Internet addiction, and further identifies the buffering
role of peer support in the relationship between MCERS and Internet
addiction, childhood maltreatment and Internet addiction. These find­
ings may deepen our understanding of how childhood maltreatment
influences Internet addiction. Additionally, it is important to find that
reducing maladaptive cognitive emotion regulation strategy and
enhancing peer support is helpful for the reduction of the adverse effects
from childhood maltreatment.
Funding
This study is funded by the program “The Research Innovation
Program of Graduate Students in Chongqing (CYB23097)” and “the
China Scholarship Council” and “The Influence of Cumulative Risk
Factors on Mental Health of Left-behind Children in Urban-Rural Areas
of Chongqing and the Related Interventions (2021WT3)”.
CRediT authorship contribution statement
JingJing Gu: Conceptualization, Data curation, Formal analysis,
Investigation, Methodology, Writing – original draft, Writing – review &
editing. YuanYuan Guo: Conceptualization, Data curation, Formal
analysis, Investigation. Jin-Liang Wang: Supervision.
Declaration of competing interest
The authors declare that the research was conducted in the absence
of any commercial or financial relationships that could be construed as a
potential conflict of interest.
726
Downloaded for Anonymous User (n/a) at University of Alberta from ClinicalKey.com by Elsevier on February 20,
2024. For personal use only. No other uses without permission. Copyright ©2024. Elsevier Inc. All rights reserved.
Journal of Affective Disorders 350 (2024) 721–727
Acknowledgments
None.
References
Aldao, A., Nolen-Hoeksema, S., Schweizer, S., 2010. Emotion-regulation strategies across
psychopathology: a meta-analytic review. Clin. Psychol. Rev. 30 (2), 217–237.
https://doi.org/10.1016/j.cpr.2009.11.004.
Alimoradi, Z., Lin, C.Y., Broström, A., Bülow, P.H., Bajalan, Z., Griffiths, M.D.,
Ohayon, M.M., Pakpour, A.H., 2019. Problematic Internet use and sleep problems: a
systematic review and meta-analysis. Sleep Med. Rev. 47, 51–61. https://doi.org/
10.1016/j.smrv.2019.06.004.
Allnock, D., 2015. Child maltreatment: how can friends contribute to safety? Safer
Communities 14 (1), 27.
Arslan, G., 2017. Psychological maltreatment, forgiveness, mindfulness, and internet
addiction among young adults: A study of mediation effect. Comput. Hum. Behavi.
72, 57–66. https://doi.org/10.1016/j.chb.2017.02.037.
Berman, I., McLaughlin, K., Tottenham, N., Godfrey, K., Seeman, T., Loucks, E.,
Sheridan, M., 2022. Measuring early life adversity: a dimensional approach. Dev.
Psychopathol. 34 (2), 499–511. https://doi.org/10.1017/S0954579421001826.
Bernstein, D.P., Stein, J.A., Newcomb, M.D., Walker, E., Pogge, D., Ahluvalia, T.,
Stokes, J., Handelsman, L., Medrano, M., Desmond, D., Zule, W., 2003. Development
and validation of a brief screening version of the Childhood Trauma Questionnaire.
Child Abuse Negl. 27 (2), 169–190. https://doi.org/10.1016/S0145-2134(02)
00541-0.
Blanchard, B.E., Stevens, A., Cann, A.T., Littlefield, A.K., 2019. Regulate yourself:
emotion regulation and protective behavioral strategies in substance use behaviors.
Addict. Behav. 92, 95–101. https://doi.org/10.1016/j.addbeh.2018.12.020.
Bowlby, J., 1988. Attachment, Communication, and the Therapeutic Process. Parent-
Child Attachment and Healthy Human Development, A Secure Base, pp. 137–157.
Brand, M., Young, K.S., Laier, C., Wolfling, K., Potenza, M.N., 2016. Integrating
psychological and neurobiological considerations regarding the development and
maintenance of specific internet-use disorders: an Interaction of Person-Affect-
Cognition-Execution (I-PACE) model. Neurosci. Biobehav. Rev. 71, 252–266.
https://doi.org/10.1016/j.neubiorev.2016.08.033.
Brand, M., Wegmann, E., Stark, R., Müller, A., Wolfling, K., Robbins, T.W., Potenza, M.
N., 2019. The interaction of Person-Affect-Cognition-Execution (I-PACE) model for
addictive behaviors: update, generalization to addictive behaviors beyond internet-
use disorders, and specification of the process character of addictive behaviors.
Neurosci. Biobehav. Rev. 104, 1–10. https://doi.org/10.1016/j.
neubiorev.2019.06.032.
Burrus, C., 2013. Developmental trajectories of abuse - an hypothesis for the effects of
early childhood maltreatment on dorsolateral prefrontal cortical development. Med.
Hypotheses 81 (5), 826–829. https://doi.org/10.1016/j.mehy.2013.09.006.
Chun, J., 2018. Conceptualizing effective interventions for smartphone addiction among
Korean female adolescents. Child Youth Serv. Rev. 84, 35–39. https://doi.org/
10.1016/j.childyouth.2017.11.013.
Cohen, S., 1985. Stress, social support and buffering hypothesis. Psychol. Bull. 98.
Dalbudak, E., Evren, C., Aldemir, S., Evren, B., 2014. The severity of Internet addiction
risk and its relationship with the severity of borderline personality features,
childhood traumas, dissociative experiences, depression and anxiety symptoms
among Turkish university students. Psychiatry Res. 219 (3), 577–582. https://doi.
org/10.1016/j.psychres.2014.02.032.
Davis, R.A., 2001. A cognitive-behavioral model of pathological Internet use. Comput.
Hum. Behav. 17, 187–195. https://doi.org/10.1016/S0747-5632(00)00041-8.
Evans, S.E., Steel, A.L., Dilillo, D., 2013. Child maltreatment severity and adult trauma
symptoms: does perceived social support play a buffering role? Child Abuse Negl. 37
(11), 934–943. https://doi.org/10.1016/j.chiabu.2013.03.005.
Festl, R., Scharkow, M., Quandt, T., 2013. Problematic computer game use among
adolescents, younger and older adults. Addiction 108 (3), 592–599. https://doi.org/
10.1111/add.12016.
Figueredo, A.J., Vásquez, G., Brumbach, B.H., Schneider, S., Sefcek, J.A., Tal, I.R., et al.,
2006. Consilience and life history theory: from genes to brain to reproductive
strategy. Dev. Rev. 26 (2), 243–275. https://doi.org/10.1016/j.dr.2006.02.002.
Garnefski, N., Kraaij, V., 2009. Cognitive coping and psychological adjustment in
different types of stressful life events. Individ. Differ. Res. 7 (3), 168–181. https://
doi.org/10.1016/j.adolescence.2008.01.003.
Garnefski, N., Kraaij, V., Spinhoven, P., 2001. Negative life events, cognitive emotion
regulation and emotional problems. Personal. Individ. Differ. 30 (8), 1311–1327.
https://doi.org/10.1016/S0191-8869(00)00113-6.
Gee, D.G., 2021. Early adversity and development: parsing heterogeneity and identifying
pathways of risk and resilience. Am. J. Psychiatry 178 (11), 998–1013. https://doi.
org/10.1176/appi.ajp.2021.21090944.
Geng, Y., Gu, J., Wang, J., Zhang, R., 2021a. Smartphone addiction and depression,
anxiety: the role of bedtime procrastination and self-control. J. Affect. Disord. 293,
415–421. https://doi.org/10.1016/j.jad.2021.06.062.
Geng, Y., Sai, X., Jonason, P.K., Yang, M., Zhu, X., Gu, J., Kong, H., 2021b. Childhood
adversity is associated with adulthood white blood cell count through narcissism.
Personal. Individ. Differ. 174, 110662 https://doi.org/10.1016/j.paid.2021.110662.
Geng, J., Bao, L., Wang, H., Wang, J., Gao, T., Lei, L., 2022. Does childhood maltreatment
increase the subsequent risk of problematic smartphone use among adolescents?
A two-wave longitudinal study. Addictive Behaviors 129 (59), 107250. https://doi.
org/10.1016/j.addbeh.2022.107250.
J. Gu et al.
Gewirtz-Meydan, A., 2020. The relationship between child sexual abuse, self-concept and
psychopathology: the moderating role of social support and perceived parental
quality. Child Youth Serv. Rev. 113, 104938 https://doi.org/10.1016/j.
childyouth.2020.104938.
Goemans, A., Viding, E., McCrory, E., 2023. Child maltreatment, peer victimization, and
mental health: neurocognitive perspectives on the cycle of victimization. Trauma
Violence Abuse 24 (2), 530–548. https://doi.org/10.1177/15248380211036393.
Guo, Y.Y., Gu, J.J., Gaskin, J., Yin, X.Q., Zhang, Y.H., Wang, J.L., 2023. The association
of childhood maltreatment with Internet addiction: the serial mediating effects of
cognitive emotion regulation strategies and depression. Child Abuse Negl. 140,
106134 https://doi.org/10.1016/j.chiabu.2023.106134.
Hagborg, J.M., Thorvaldsson, V., Fahlke, C., 2020. Child maltreatment and substance-
use-related negative consequences: longitudinal trajectories from early to mid
adolescence. Addict. Behav. 106, 106365 https://doi.org/10.1016/j.
addbeh.2020.106365.
Haselgruber, A., Sölva, K., Lueger-Schuster, B., 2020. Perspective matters: differences
between child- and caregiver-reports of emotion regulation mediating the
relationship between cumulative childhood trauma and mental health problems in
foster children. Child Abuse Negl. 107, 104558 https://doi.org/10.1016/j.
chiabu.2020.104558.
Hsieh, Y.P., Shen, A.C.T., Wei, H.S., Feng, J.Y., Huang, S.C.Y., Hwa, H.L., 2016.
Associations between child maltreatment, PTSD, and internet addiction among
Taiwanese students. Comput. Hum. Behav. 56, 209–214. https://doi.org/10.1016/j.
chb.2015.11.048.
Huh, H.J., Kim, K.H., Lee, H.K., Chae, J.H., 2017. The relationship between childhood
trauma and the severity of adulthood depression and anxiety symptoms in a clinical
sample: the mediating role of cognitive emotion regulation strategies. J. Affect.
Disord. 213, 44–50. https://doi.org/10.1016/j.jad.2017.02.009.
Kahana, E., Lovegreen, L., Kahana, B., Kahana, M., 2003. Person, environment, and
person-environment fit as influences on residential satisfaction of elders. Environ.
Behav. 35 (3), 434–453. https://doi.org/10.1177/0013916503035003007.
Kardefelt-Winther, Daniel, 2014. A conceptual and methodological critique of internet
addiction research: towards a model of compensatory internet use. Comput. Hum.
Behav. 31 (31), 351–354. https://doi.org/10.1016/j.chb.2013.10.059.
Kuss, D.J., Van Rooij, A.J., Shorter, G.W., Griffiths, M.D., van de Mheen, D., 2013.
Internet addiction in adolescents: Prevalence and risk factors. Comput. Hum. Behav.
29 (5), 1987–1996.
Kneeland, E.T., Dovidio, J.F., Joormann, J., Clark, M.S., 2016. Emotion malleability
beliefs, emotion regulation, and psychopathology: integrating affective and clinical
science. Clin. Psychol. Rev. 45, 81–88. https://doi.org/10.1016/j.cpr.2016.03.008.
Li, X., Luo, X., Zheng, R., Jin, X., Mei, L., Xie, X., Gu, H., Hou, F., Liu, L., Luo, X.,
Meng, H., Zhang, J., Song, R., 2019. The role of depressive symptoms, anxiety
symptoms, and school functioning in the association between peer victimization and
internet addiction: a moderated mediation model. J. Affect. Disord. 256, 125–131.
https://doi.org/10.1016/j.jad.2019.05.080.
Li, B., Pan, Y., Liu, G., Chen, W., Lu, J., Li, X., 2020. Perceived social support and self-
esteem mediate the relationship between childhood maltreatment and psychosocial
flourishing in Chinese undergraduate students. Child Youth Serv. Rev. 117 https://
doi.org/10.1016/j.childyouth.2020.105303.
Liu, Q.Q., Zhou, Z.K., Yang, X.J., Kong, F.C., Niu, G.F., Fan, C.Y., 2017. Mobile phone
addiction and sleep quality among Chinese adolescents: A moderated mediation
model. Comput. Hum. Behav. 72, 108–114. https://doi.org/10.1016/j.
chb.2017.02.042.
Ludwig, Lea, Werner, Dirk, Lincoln, Tania M., 2019. The relevance of cognitive emotion
regulation to psychotic symptoms – a systematic review and meta-analysis. Clin.
Psychol. Rev. 101746 https://doi.org/10.1016/j.cpr.2019.101746.
Marciano, L., Camerini, A.L., Schulz, P.J., 2022. Neuroticism and internet addiction:
what is next? A systematic conceptual review. Personal. Individ. Differ. 185, 111260
https://doi.org/10.1016/j.paid.2021.111260.
Mishra, A.A., Marceau, K., Christ, S.L., Schwab Reese, L.M., Taylor, Z.E., Knopik, V.S.,
2022. Multi-type childhood maltreatment exposure and substance use development
from adolescence to early adulthood: A GxE study. Child Abuse Negl. 126, 105508
https://doi.org/10.1016/j.chiabu.2022.105508.
Mo, P.K.H., Chan, V.W.Y., Chan, S.W., Lau, J.T.F., 2018. The role of social support on
emotion dysregulation and internet addiction among Chinese adolescents: a
structural equation model. Addict. Behav. 82, 86–93. https://doi.org/10.1016/j.
addbeh.2018.01.027.
Morris, A.S., Criss, M.M., Silk, J.S., Houltberg, B.J., 2017. The impact of parenting on
emotion regulation during childhood and adolescence. Child Dev. Perspect. 11,
233–238. https://doi.org/10.1111/cdep.12238.
Parada, S., Legrand, E., Taschini, E., Laqueille, X., Verlhiac, J.F., 2022. Dweck’s mindset
theory applied to addictions: a scoping review. Curr. Addict. Rep. 9 (3), 133–150.
https://doi.org/10.1007/s40429-022-00427-6.
Peng, C., Wang, M., Cheng, J., Tan, Y., Huang, Y., Rong, F., Kang, C., Ding, H., Yu, Y.,
2021. Association between internet addiction and suicidal ideation, suicide plans,
727
Downloaded for Anonymous User (n/a) at University of Alberta from ClinicalKey.com by Elsevier on February 20,
2024. For personal use only. No other uses without permission. Copyright ©2024. Elsevier Inc. All rights reserved.
Journal of Affective Disorders 350 (2024) 721–727
and suicide attempts among Chinese adolescents with and without parental
migration. Comput. Hum. Behav. 125, 106949 https://doi.org/10.1016/j.
chb.2021.106949.
Pepin, E.N., Banyard, V.L., 2006. Social support: a mediator between child maltreatment
and developmental outcomes. J. Youth Adolesc. 35 (4), 617–630. https://doi.org/
10.1007/s10964-006-9063-4.
Pirnia, B., Khosravani, V., Maleki, F., Kalbasi, R., Pirnia, K., Malekanmehr, P.,
Zahiroddin, A., 2020. The role of childhood maltreatment in cortisol in the
hypothalamic–pituitary–adrenal (HPA) axis in methamphetamine-dependent
individuals with and without depression comorbidity and suicide attempts. J. Affect.
Disord. 263, 274–281. https://doi.org/10.1016/j.jad.2019.11.168.
Pontes, H.M., Taylor, M., Stavropoulos, V., 2018. Beyond “facebook addiction”: the role
of cognitive-related factors and psychiatric distress in social networking site
addiction. Cyberpsychol. Behav. Soc. Netw. 21 (4), 240–247. https://doi.org/
10.1089/cyber.2017.0609.
Rueger, S.Y., Malecki, C.K., Pyun, Y., Aycock, C., Coyle, S., 2016. A meta-analytic review
of the association between perceived social support and depression in childhood and
adolescence. Psychol. Bull. 142 (10), 1017–1067. https://doi.org/10.1037/
bul0000058.
Sayeed, A., Hassan, M.N., Rahman, M.H., El Hayek, S., Banna, M.H., Al, Mallick, T.,
Hasan, A. R., Meem, A. E., & Kundu, S., 2020. Facebook addiction associated with
internet activity, depression and behavioral factors among university students of
Bangladesh: A cross-sectional study. Child Youth Serv. Rev. 118, 105424 https://doi.
org/10.1016/j.childyouth.2020.105424.
Spada, M.M., 2014. An overview of problematic internet use. Addict. Behav. 39 (1), 3–6.
https://doi.org/10.1016/j.addbeh.2013.09.007.
Sperry, D.M., Widom, C.S., 2013. Child abuse and neglect, social support, and
psychopathology in adulthood: A prospective investigation. Child Abuse Negl. 37
(6), 415–425. https://doi.org/10.1016/j.chiabu.2013.02.006.
Stanković, M., Nešić, M., Čičević, S., Shi, Z., 2021. Association of smartphone use with
depression, anxiety, stress, sleep quality, and internet addiction. Empirical evidence
from a smartphone application. Personal. Individ. Differ. 168, 110342 https://doi.
org/10.1016/j.paid.2020.110342.
Tung, Irene, Noroña, Amanda N., Lee, Steve S., 2018. Childhood maltreatment affects
adolescent sensitivity to parenting and close friendships in predicting growth in
externalizing behavior. Dev. Psychopathol. 1–17 https://doi.org/10.1017/
s0954579418000585.
Wang, X., 2022. Intergenerational effects of childhood maltreatment: the roles of
parents’ emotion regulation and mentalization. Child Abuse Negl. 128, 104940
https://doi.org/10.1016/j.chiabu.2021.104940.
Wang, X., Zhao, F., Yang, J., Gao, L., Li, B., Lei, L., Wang, P., 2020. Childhood
maltreatment and bullying perpetration among Chinese adolescents: a moderated
mediation model of moral disengagement and trait anger. Child Abuse Negl. 106,
104507 https://doi.org/10.1016/j.chiabu.2020.104507.
Webb, T.L., Miles, E., Sheeran, P., 2012. Dealing with feeling: a meta-analysis of the
effectiveness of strategies derived from the process model of emotion regulation.
Psychol. Bull. 138 (4), 775–808. https://doi.org/10.1037/a0027600.
Weissman, D.G., Bitran, D., Miller, A.B., Schaefer, J.D., Sheridan, M.A., Mclaughlin, K.A.,
2019. Difficulties with emotion regulation as a transdiagnostic mechanism linking
child maltreatment with the emergence of psychopathology. Dev. Psychopathol. 31
(3), 899–915. https://doi.org/10.1017/S0954579419000348.
Wu, C.S.T., Wong, H.T., Yu, K.F., Fok, K.W., Yeung, S.M., Lam, C.H., Liu, K.M., 2016.
Parenting approaches, family functionality, and internet addiction among Hong
Kong adolescents. BMC Pediatr. 16 (1), 1–10. https://doi.org/10.1186/s12887-016-
0666-y.
Wu, Y.Q., Liu, F., Chan, K.Q., Wang, N.X., Zhao, S., Sun, X., Shen, W., Wang, Z.J., 2022.
Childhood psychological maltreatment and internet gaming addiction in Chinese
adolescents: mediation roles of maladaptive emotion regulation strategies and
psychosocial problems. Child Abuse Negl. 129, 105669 https://doi.org/10.1016/j.
chiabu.2022.105669.
Young, K.S., 1998. Internet addiction: the emergence of a new clinical disorder.
CyberPsychol. Behav. 1 (3), 237–244. https://doi.org/10.1089/cpb.1998.1.237.
Young, K., Abreu, C., 2011. Internet Addiction. A Handbook and Guide to Evaluation and
Treatment. John Wiley & Sons, Hoboken, NJ.
Zhang, Y., Qin, X., Ren, P., 2018. Adolescents’ academic engagement mediates the
association between internet addiction and academic achievement: the moderating
effect of classroom achievement norm. Comput. Hum. Behav. 89, 299–307. https://
doi.org/10.1016/j.chb.2018.08.018.
Zhou, X., Wu, X., Zhen, R., 2017. Understanding the relationship between social support
and posttraumatic stress disorder/posttraumatic growth among adolescents after
Ya’an earthquake: the role of emotion regulation. Psychol. Trauma Theory Res.
Pract. Policy 9 (2), 214–221. https://doi.org/10.1037/tra0000213.
Zimet, G.D., Dahlem, N.W., Zimet, S.G., Farley, G.K., 1988. The multidimensional scale
of perceived social support. J. Pers. Assess. 52 (1), 30–41. https://doi.org/10.1207/
s15327752jpa5201_2.