ADHD 與網路成癮之關係：以心理韌性為中介變項

Abstract

研究背景：隨著網際網路的快速發展與短影音的普及流行，現代生活型態已經產生巨大轉變，同時也帶來不斷攀升的網路依賴風險。全球研究顯示，網路成癮的平均盛行率高達14.22%，而台灣12至17歲青少年的網路沉迷傾向更呈現逐年上升的趨勢。注意力不足過動症（ADHD）已被確立為網路成癮的高風險因子，然而，關於 ADHD 如何影響網路成癮行為的具體機制，特別是心理韌性等正向心理因子在其中扮演的角色，目前仍缺乏充分的探討與實證研究。

研究目的：本研究旨在確認 ADHD 與網路成癮之間的相關性，並探討心理韌性在 ADHD 與網路成癮之間的中介作用。

研究方法：本研究採次級資料庫分析，資料來源為國民健康署委託辦理之「臺灣出生世代研究」（Taiwan Birth Cohort Study, TBCS），使用第3、4、6、8與11波資料，涵蓋受試者年齡從3至17歲。最終納入 3,731 位青少年樣本，其中曾被專業人士告知有ADHD傾向者約有78名。本研究以 ADHD 傾向作為自變項，網路成癮行為為依變項，心理韌性作為中介變項，並控制孩童性別、家庭結構、家庭年收入、雙親教育程度、青少年憂鬱症狀、兒童時期心理韌性及兒童時期看電視時長等潛在干擾變項。統計分析部分，描述性統計與雙變項分析採用SAS 9.4進行處理；中介效果則透過SPSS 29 搭配PROCESS模組進行分析。

研究結果：具有 ADHD 傾向與否與網路成癮行為之間的總效應未達統計顯著水準（總效果：β = -0.4，95% CI = [-1.57, 0.77]，p = 0.50），顯示 ADHD 與青少年網路成癮傾向之間的關係可能受到其他潛在因素的影響。進一步的中介分析結果發現，心理韌性在其中扮演了顯著的中介角色（間接效果：β = 0.23，95% CI = [0.09, 0.40]）。由於 ADHD 對網路成癮的直接效果亦未達顯著水準（直接效果：β = -0.62，95% CI = [-1.79, 0.56]），整體關係呈現純間接中介效果（Indirect-Only Mediation）。結果指出，ADHD 對網路成癮的影響並非直接產生，而是透過降低個體的心理韌性，進而間接提升其網路成癮風險。

結論：本研究驗證心理韌性在 ADHD 與網路成癮之間具顯著中介效果，補足現有文獻中對正向心理因子作為網路成癮影響機制探討之不足。結果顯示，ADHD 對網路成癮的影響並非直接作用，而是透過降低個體的心理韌性間接產生影響。此一發現突顯心理韌性作為保護因子的重要性，未來介入策略可考慮將其納入 ADHD 青少年的行為預防與心理健康促進方案中，以降低其發展出問題性網路使用行為的風險。

Background: With the rapid development of the internet and the widespread popularity of short videos, modern lifestyles have undergone significant transformations, accompanied by an increasing risk of internet dependence. Global research indicates that the average prevalence rate of internet addiction is as high as 14.22%, and among adolescents aged 12 to 17 in Taiwan, the tendency toward internet overuse continues to rise. Attention-Deficit/Hyperactivity Disorder (ADHD) has been identified as a high-risk factor for internet addiction; however, the specific mechanisms through which ADHD influences internet addictive behaviors—particularly the role of positive psychological factors such as resilience—remain insufficiently explored in empirical studies.

Purpose: This study aims to examine the association between ADHD and internet addiction and to explore the mediating role of resilience in this relationship.

Methods: This study adopted a secondary data analysis approach using data from the Taiwan Birth Cohort Study (TBCS), a nationwide longitudinal project commissioned by the Health Promotion Administration. Data from the 3rd, 4th, 6th, 8th, and 11th waves were utilized, covering participants from age 3 to 17. A total of 3,731 adolescent samples were included in the final analysis, among whom 78 were reported by primary caregivers as having been identified by professionals as having ADHD tendencies. In this study, ADHD tendency was used as the independent variable, internet addiction behavior as the dependent variable, and psychological resilience as the mediating variable. Control variables included child’s gender, family structure, household income, parental education level, adolescent depressive symptoms, childhood psychological resilience, and time spent watching television in early childhood. Descriptive statistics and bivariate analyses were conducted using SAS 9.4, while the mediation analysis was performed using SPSS 29 with the PROCESS macro.

Results: The total effect of ADHD diagnosis on internet addiction was not statistically significant (total effect: β = -0.40, 95% CI = [-1.57, 0.77], p = 0.50), suggesting that the relationship between ADHD and adolescent internet addiction may be influenced by other potential factors. However, the mediation analysis revealed that resilience played a significant mediating role in this relationship (indirect effect: β = 0.23, 95% CI = [0.09, 0.40]). Since the direct effect of ADHD on internet addiction was also not significant (direct effect: β = -0.62, 95% CI = [-1.79, 0.56]), the overall pattern indicated an indirect-only mediation effect. These findings suggest that the influence of ADHD on internet addiction is not direct, but rather occurs indirectly through a reduction in resilience.

Conclusion: This study confirms the significant mediating role of resilience in the relationship between ADHD and internet addiction, filling a gap in the literature regarding the influence of positive psychological factors on problematic internet use. The findings highlight the importance of resilience as a protective factor. Future intervention strategies targeting adolescents with ADHD should incorporate resilience-building components to reduce the risk of developing problematic internet use behaviors.