Internet addiction and depressive symptoms among nursing students: A network analysis with implications for nursing...

Internet addiction and depressive symptoms co-occur frequently among nursing students, threatening their well-being and academic success in a demanding educational environment. The underlying symptom dynamics, however, remain unclear. Network analysis can identify key symptom interactions, providing an empirical basis for targeted interventions and support strategies within nursing education.

This study aimed to (1) identify central symptoms within the Internet addiction-depressive symptom network, (2) detect bridge symptoms connecting distinct symptom clusters, and (3) examine gender-specific network patterns among nursing students.

A multicenter cross-sectional study.

Fourteen universities across seven major geographical regions of China.

6019 nursing students recruited through two-stage sampling.

Data were collected between April and July 2024 using the 6-item Internet Addiction Test and the 9-item Patient Health Questionnaire. Network analysis was performed to estimate symptom networks, identify central and bridge symptoms, and examine gender-specific patterns.

Analysis of 5984 valid responses revealed a stable network comprising 15 nodes with 80 non-zero edges. Fatigue/low energy (Expected Influence [EI] = 1.497) and Internet preoccupation (EI = 1.211) emerged as the most central symptoms in the network, while offline emotional dysregulation (bridge EI = 0.234) served as the primary bridge symptom. Gender comparisons revealed significant structural differences (P = 0.049); regarding local connectivity patterns, males showed stronger connections in behavioral control failure and physiological-emotional instability, and females exhibited elevated connectivity in academic impairment and self-concept preservation.

Fatigue/low energy and Internet preoccupation emerged as central symptoms, with offline emotional dysregulation as the primary bridge. Gender-specific network patterns demonstrated distinct symptom interactions, suggesting that targeted interventions should be designed respectively for males and females. These findings advance understanding of symptom-level dynamics and provide evidence-based implications for developing targeted psychological and behavioral interventions within nursing education to enhance students' mental health, academic success, and professional development.