I
nte
rna
t
io
na
l J
o
urna
l o
f
P
u
bli
c
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ea
lt
h Science
(
I
J
P
H
S)
Vo
l.
1
3
,
No
.
4
,
Dec
em
b
er
20
24
,
p
p
.
1
6
4
7
~
1
6
5
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I
SS
N:
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h
s
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v
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2
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J
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:
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ttp
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//
ijp
h
s
.
ia
esco
r
e.
co
m
Rela
tions
hip be
t
ween an
x
iety,
lon
eliness
,
a
nd sl
eep
-
diso
rders
with
so
cia
l me
dia
a
ddiction a
mo
ng
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lescent
Rik
a
Sa
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a
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y:
R
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ed
No
v
12
,
2
0
2
3
R
ev
is
ed
Mar
22
,
2
0
2
4
Acc
ep
ted
Ap
r
24
,
2
0
2
4
In
th
e
d
ig
i
tal
e
ra
,
so
c
ial
m
e
d
ia
u
sa
g
e
h
a
s
b
e
c
o
m
e
a
n
in
te
g
ra
l
p
a
rt
o
f
d
a
il
y
li
fe
,
p
a
rti
c
u
larly
a
m
o
n
g
a
d
o
les
c
e
n
ts.
Th
is
stu
d
y
in
v
e
stig
a
tes
th
e
re
latio
n
sh
ip
b
e
twe
e
n
a
n
x
iety
,
lo
n
e
li
n
e
ss
,
sle
e
p
d
is
o
rd
e
rs,
a
n
d
so
c
ial
m
e
d
ia
a
d
d
icti
o
n
a
m
o
n
g
a
d
o
les
c
e
n
ts.
A
c
ro
ss
-
s
e
c
t
io
n
a
l
stu
d
y
in
v
o
l
v
in
g
2
9
0
X
a
n
d
XI
-
g
ra
d
e
stu
d
e
n
ts
u
t
il
ize
d
sta
n
d
a
rd
ize
d
in
str
u
m
e
n
ts:
t
h
e
Be
rg
e
n
S
o
c
ial
M
e
d
ia
Ad
d
icti
o
n
S
c
a
le
(BS
M
AS),
Z
u
n
g
S
e
lf
-
Ra
ti
n
g
An
x
iety
S
c
a
le
(S
AS/
S
RAS),
UCLA
Lo
n
e
li
n
e
ss
S
c
a
le
Ve
rsio
n
3
,
a
n
d
P
it
ts
b
u
r
g
h
S
lee
p
Qu
a
l
it
y
In
d
e
x
(P
S
QI).
Bi
v
a
riate
a
n
a
ly
sis
wa
s
c
o
n
d
u
c
te
d
u
si
n
g
th
e
C
hi
-
sq
u
a
re
tes
t
(p
<
0
.
0
5
).
F
in
d
in
g
s
re
v
e
a
led
1
0
.
7
%
se
v
e
re
so
c
ial
m
e
d
ia
a
d
d
icti
o
n
,
2
1
.
4
%
se
v
e
re
a
n
x
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,
4
.
8
%
sig
n
ifi
c
a
n
t
l
o
n
e
li
n
e
ss
,
a
n
d
7
4
.
5
%
p
o
o
r
sle
e
p
q
u
a
li
ty
.
S
ig
n
ifi
c
a
n
t
a
ss
o
c
iatio
n
s
we
re
fo
u
n
d
b
e
twe
e
n
a
n
x
iety
(
p
=
0
.
0
1
3
),
lo
n
e
li
n
e
ss
(p
=
0
.
0
1
0
)
,
sle
e
p
d
ist
u
r
b
a
n
c
e
(p
=
0
.
0
3
3
),
a
n
d
so
c
ial
m
e
d
ia
a
d
d
icti
o
n
.
Hig
h
e
r
a
n
x
iety
,
lo
n
e
li
n
e
ss
,
a
n
d
p
o
o
r
sle
e
p
q
u
a
li
t
y
c
o
rre
late
with
in
c
re
a
se
d
su
sc
e
p
ti
b
i
li
ty
to
so
c
ial
m
e
d
ia
a
d
d
icti
o
n
a
m
o
n
g
a
d
o
les
c
e
n
ts.
Th
is
u
n
d
e
rsc
o
re
s
th
e
i
m
p
o
rtan
ce
o
f
a
d
d
re
ss
in
g
p
sy
c
h
o
l
o
g
ica
l
we
ll
-
b
e
in
g
i
n
i
n
terv
e
n
ti
o
n
s
a
ime
d
a
t
m
it
ig
a
ti
n
g
so
c
ial
m
e
d
ia ad
d
icti
o
n
.
K
ey
w
o
r
d
s
:
Ad
o
lescen
t
An
x
iety
L
o
n
elin
ess
Sleep
d
is
o
r
d
er
So
cial
m
ed
ia
ad
d
ictio
n
T
h
is i
s
a
n
o
p
e
n
a
c
c
e
ss
a
rticle
u
n
d
e
r th
e
CC B
Y
-
SA
li
c
e
n
se
.
C
o
r
r
e
s
p
o
nd
ing
A
uth
o
r
:
R
ik
a
Sar
f
ik
a
Dep
ar
tm
en
t o
f
Me
n
tal
Hea
lth
an
d
C
o
m
m
u
n
ity
,
Facu
lty
o
f
N
u
r
s
in
g
,
Un
iv
e
r
s
itas
An
d
alas
Pad
an
g
,
W
est Su
m
atr
a,
I
n
d
o
n
esia
E
m
ail:
r
ik
asar
f
ik
a@
n
r
s
.
u
n
an
d
.
ac
.
id
1.
I
NT
RO
D
UCT
I
O
N
T
h
e
escalatin
g
p
r
ev
alen
ce
o
f
s
o
cial
m
ed
ia
ad
d
ictio
n
p
r
esen
ts
a
cr
itical
co
n
ce
r
n
g
lo
b
ally
,
with
r
ep
o
r
te
d
ca
s
es su
r
g
in
g
f
iv
ef
o
l
d
o
v
er
th
e
p
ast f
o
u
r
y
ea
r
s
[
1
]
.
I
n
d
o
n
esia,
in
p
ar
ticu
lar
,
h
as
witn
ess
ed
a
n
o
tab
le
i
n
cr
ea
s
e
in
I
n
ter
n
et
u
s
ag
e,
ac
ce
n
tu
atin
g
th
e
im
p
er
ativ
e
f
o
r
v
ig
ilan
t
m
o
n
ito
r
in
g
o
f
s
o
cial
m
ed
ia
co
n
s
u
m
p
tio
n
to
m
itig
ate
ad
d
ictio
n
r
is
k
s
[
2
]
.
T
h
e
p
h
e
n
o
m
en
o
n
o
f
s
o
cial
m
ed
ia
ad
d
ictio
n
m
a
n
if
ests
as
in
d
iv
id
u
als
s
u
cc
u
m
b
in
g
to
p
r
o
lo
n
g
ed
p
er
io
d
s
o
n
th
ese
p
latf
o
r
m
s
,
d
r
iv
en
b
y
in
ten
s
e
in
ter
est,
lack
o
f
s
elf
-
co
n
tr
o
l,
an
d
a
d
ea
r
th
o
f
co
n
s
tr
u
ctiv
e
ac
tiv
ities
[
3
]
,
[
4
]
.
Pre
v
io
u
s
r
esear
ch
in
d
icate
s
th
at
ad
o
lescen
ts
s
p
en
d
in
g
4
-
6
h
o
u
r
s
d
aily
o
n
s
o
cial
m
ed
ia
ar
e
at
r
is
k
o
f
ad
d
ictio
n
,
wh
ile
th
o
s
e
ex
ce
ed
in
g
s
ix
h
o
u
r
s
f
all
in
to
th
e
ad
d
icted
ca
teg
o
r
y
[
5
]
.
I
n
d
i
v
id
u
als ag
ed
1
8
-
2
5
co
n
s
titu
te
th
e
m
o
s
t
ac
tiv
e
s
o
cial
m
ed
ia
u
s
er
s
,
p
r
im
ar
ily
u
tili
zin
g
it
f
o
r
co
m
m
u
n
icatio
n
p
u
r
p
o
s
es
[
6
]
.
E
x
ce
s
s
iv
e
s
o
cial
m
ed
ia
u
s
e
am
o
n
g
ad
o
lescen
ts
ca
n
lead
t
o
d
etr
im
en
tal
ef
f
ec
ts
,
in
clu
d
in
g
n
eg
lect
o
f
ac
ad
em
ic
r
esp
o
n
s
ib
ilit
ies,
d
ec
r
ea
s
ed
s
tu
d
y
tim
e,
co
m
p
r
o
m
is
ed
ac
ad
em
ic
p
er
f
o
r
m
an
ce
,
n
e
g
ativ
e
ef
f
ec
ts
o
n
m
e
n
tal
an
d
p
h
y
s
ical
h
ea
lth
,
an
d
d
ec
r
ea
s
ed
s
leep
q
u
al
ity
[
7
]
-
[
9
]
,
[
1
0
]
.
Ad
o
lescen
ts
'
u
s
e
o
f
s
o
cial
m
e
d
ia
ca
n
h
av
e
a
n
eg
ativ
e
im
p
ac
t if
th
ey
ca
n
n
o
t c
o
n
tr
o
l th
eir
u
s
e
o
f
s
o
cial
m
ed
ia
[
1
1
]
,
[
1
2
]
.
Dep
e
n
d
en
c
e
o
n
s
o
cial
m
ed
ia
ca
n
r
esu
lt
in
ad
v
er
s
e
ef
f
ec
ts
ex
p
er
ien
c
ed
b
y
ad
o
lescen
ts
.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SS
N
:
2
2
5
2
-
8
8
0
6
I
n
t J Pu
b
lic
Hea
lth
Sci
,
Vo
l.
1
3
,
No
.
4
,
Dec
em
b
er
20
24
:
1
6
4
7
-
1
6
5
5
1648
Ad
o
lescen
ts
b
ec
o
m
e
in
d
if
f
er
e
n
t
to
th
eir
r
esp
o
n
s
ib
ilit
ies
as
s
t
u
d
en
ts
,
wh
ich
r
esu
lts
in
d
elay
s
in
co
llectin
g
s
ch
o
o
l
ass
ig
n
m
en
ts
,
r
ed
u
ce
d
s
tu
d
y
ti
m
e,
an
d
s
ch
o
o
l
ac
h
iev
em
en
t
ex
p
er
ien
ce
s
a
d
r
asti
c
d
ec
lin
e
b
ec
au
s
e
ad
o
lescen
ts
ar
e
b
u
s
y
s
p
en
d
in
g
th
eir
tim
e
a
cc
ess
in
g
s
o
cial
m
ed
ia
[
1
3
]
.
T
h
e
ad
d
ictiv
e
n
atu
r
e
o
f
s
o
cial
m
ed
ia,
esp
ec
ially
f
o
r
teen
ag
er
s
with
p
o
o
r
s
elf
-
co
n
t
r
o
l,
ca
n
lead
t
o
o
v
er
d
e
p
en
d
e
n
c
e
an
d
n
eg
ativ
e
co
n
s
eq
u
en
ce
s
[
1
4
]
.
Ad
d
itio
n
all
y
,
s
o
cial
m
ed
ia
ad
d
ictio
n
h
as
b
e
en
lin
k
ed
t
o
n
eg
ativ
e
im
p
ac
ts
o
n
m
e
n
tal
h
ea
lth
am
o
n
g
u
n
d
er
g
r
ad
u
ate
n
u
r
s
in
g
s
tu
d
en
ts
[
1
5
]
.
R
ec
en
t
s
tu
d
ies
h
av
e
r
ev
ea
le
d
th
at
s
o
cial
m
ed
ia
is
an
i
n
teg
r
al
p
ar
t
o
f
ad
o
lescen
ts
'
liv
es.
I
n
a
s
u
r
v
e
y
co
n
d
u
cte
d
o
n
Am
er
ican
ad
o
le
s
ce
n
ts
ag
ed
1
3
to
1
7
,
it
was
d
is
co
v
er
ed
th
at
9
0
%
o
f
th
e
s
tu
d
en
ts
r
ep
o
r
ted
u
s
in
g
s
o
cial
m
ed
ia.
Ad
d
itio
n
ally
,
3
5
%
o
f
th
e
s
tu
d
en
ts
u
s
ed
s
o
cial
m
ed
ia
f
r
e
q
u
en
tly
ea
ch
d
ay
[
1
6
]
.
I
n
an
o
th
er
s
tu
d
y
co
n
d
u
cte
d
in
E
ast
An
g
lia,
E
n
g
lan
d
,
it
was
f
o
u
n
d
t
h
at
9
7
.
6
%
o
f
f
em
ale
ad
o
lescen
t
s
tu
d
e
n
ts
ag
ed
1
6
to
1
9
u
s
e
s
o
cial
m
ed
ia.
Of
th
o
s
e,
2
7
% u
s
e
s
o
cial
m
ed
ia
co
n
tin
u
ally
,
w
h
ile
6
8
.
3
% d
o
n
o
t set a
tim
e
lim
it f
o
r
it.
Fin
ally
,
a
s
tu
d
y
co
n
d
u
cted
o
n
7
2
s
tu
d
en
ts
f
o
u
n
d
th
at
4
8
.
6
%
o
f
ad
o
lescen
ts
h
ad
h
ig
h
lev
els
o
f
s
o
cia
l
m
ed
ia
ad
d
ictio
n
,
wh
ile
5
1
.
4
%
h
ad
lo
w
lev
els
[
1
7
]
.
T
h
ese
f
in
d
i
n
g
s
d
em
o
n
s
tr
ate
th
e
p
e
r
v
asiv
e
n
atu
r
e
o
f
s
o
cial
m
ed
ia
an
d
h
ig
h
lig
h
t
th
e
im
p
o
r
tan
ce
o
f
m
o
n
ito
r
i
n
g
i
ts
u
s
e
to
av
o
id
p
o
ten
tial a
d
d
ict
io
n
.
T
h
e
2
0
2
2
I
n
d
o
n
esia
Natio
n
al
Ad
o
lescen
t
Me
n
tal
Hea
lt
h
Su
r
v
ey
(
I
-
NAM
HS)
h
ig
h
lig
h
ted
th
e
p
r
ev
alen
ce
o
f
an
x
iety
d
is
o
r
d
er
s
am
o
n
g
ad
o
lescen
ts
,
in
d
icatin
g
a
co
m
m
o
n
o
cc
u
r
r
en
ce
o
f
a
n
x
iety
-
r
elate
d
is
s
u
es
in
th
is
p
o
p
u
latio
n
[
1
8
]
.
I
n
d
iv
id
u
als
with
s
o
cial
an
x
iety
d
is
o
r
d
er
ten
d
t
o
en
g
ag
e
m
o
r
e
f
r
eq
u
e
n
tly
an
d
ac
tiv
ely
o
n
s
o
cial
m
ed
ia
p
latf
o
r
m
s
[
1
9
]
.
T
h
is
h
eig
h
ten
ed
s
o
cial
m
ed
ia
u
s
ag
e
am
o
n
g
in
d
iv
i
d
u
als
with
s
o
cial
an
x
iety
ca
n
p
o
ten
tially
lead
to
in
ter
n
et
a
d
d
ictio
n
o
r
r
elian
ce
o
n
s
o
cial
m
e
d
ia
as a
c
o
p
in
g
m
ec
h
an
is
m
f
o
r
an
x
iety
[
2
0
]
,
[
2
1
]
.
A
n
atio
n
al
s
u
r
v
e
y
in
I
ce
lan
d
r
ep
o
r
ted
t
h
at
8
5
%
o
f
a
d
o
lescen
t
f
em
ales
an
d
6
9
%
o
f
ad
o
lesc
en
t
b
o
y
s
a
g
ed
1
4
t
o
1
6
y
ea
r
s
ex
p
e
r
ien
ce
d
an
x
iety
[
2
2
]
.
Fu
r
th
er
m
o
r
e,
an
o
th
e
r
s
tu
d
y
f
o
u
n
d
th
at
7
4
%
o
f
r
esp
o
n
d
en
ts
u
s
e
s
o
cial
m
ed
ia
n
etwo
r
k
in
g
s
ites
r
eg
u
lar
ly
[
2
3
]
.
T
h
e
h
ig
h
lev
el
o
f
c
o
n
n
ec
tiv
ity
in
th
e
u
s
e
o
f
s
o
cial
m
ed
ia
am
o
n
g
to
d
a
y
'
s
y
o
u
n
g
g
en
e
r
atio
n
m
ea
n
s
th
at
th
ese
p
latf
o
r
m
s
ar
e
co
n
s
id
er
e
d
to
b
e
co
n
tr
ib
u
tin
g
to
th
e
l
o
n
elin
ess
ep
id
em
ic
[
1
7
]
.
I
n
d
iv
i
d
u
als
wh
o
u
s
e
s
o
cial
m
ed
ia
h
av
e
d
if
f
icu
lty
s
o
cializin
g
d
ir
ec
tly
wit
h
o
th
er
s
in
th
e
r
ea
l w
o
r
ld
b
ec
au
s
e
th
ey
p
r
ef
er
s
o
cial
m
ed
ia.
T
h
ey
also
b
ec
o
m
e
q
u
iet
in
th
e
r
ea
l
wo
r
ld
,
d
o
n
'
t
ca
r
e
ab
o
u
t
th
e
en
v
ir
o
n
m
e
n
t,
an
d
ar
e
s
elf
is
h
[
2
4
]
,
[
2
5
]
.
L
o
n
elin
ess
p
r
o
b
lem
s
o
f
ten
o
cc
u
r
in
ad
o
les
ce
n
ts
,
with
r
esear
ch
s
h
o
win
g
h
ig
h
lev
els
o
f
l
o
n
elin
ess
am
o
n
g
f
em
ale
ad
o
lescen
ts
in
E
n
g
lan
d
[
2
6
]
.
Pro
l
o
n
g
e
d
an
d
u
n
h
ea
lth
y
in
ter
n
et
u
s
e
ca
n
ex
ac
er
b
ate
f
ee
lin
g
s
o
f
lo
n
eli
n
ess
o
v
er
tim
e
[
2
7
]
.
Ad
d
itio
n
ally
,
in
d
iv
id
u
als
with
h
ig
h
e
r
lev
els
o
f
lo
n
elin
ess
m
ay
en
g
a
g
e
in
ex
ce
s
s
iv
e
in
ter
n
et
u
s
e
as
a
co
p
in
g
m
ec
h
an
is
m
,
lead
in
g
to
a
c
y
cle
o
f
lo
n
elin
ess
an
d
in
ter
n
et
ad
d
ictio
n
[
2
8
]
.
Fu
r
th
er
m
o
r
e,
r
esear
ch
h
as
i
n
d
icate
d
a
s
ig
n
if
ican
t
r
elatio
n
s
h
ip
b
etwe
en
in
ter
n
et
ad
d
ictio
n
,
lo
n
elin
e
s
s
,
an
d
s
leep
q
u
ality
am
o
n
g
s
tu
d
en
ts
,
h
i
g
h
lig
h
tin
g
th
e
in
ter
co
n
n
ec
ted
n
ess
o
f
th
es
e
f
ac
to
r
s
in
in
f
lu
en
cin
g
s
tu
d
en
t
s
'
well
-
b
ein
g
[
2
9
]
.
I
n
ad
d
itio
n
,
b
ased
o
n
th
e
Glo
b
al
Su
r
v
ey
,
ap
p
r
o
x
im
ately
6
.
1
2
%
o
f
I
n
d
o
n
esian
teen
ag
er
s
r
e
p
o
r
ted
ex
p
er
ien
ci
n
g
lo
n
elin
ess
with
in
th
e
p
ast
y
ea
r
[
3
0
]
.
Fu
r
th
er
m
o
r
e,
an
o
th
e
r
s
tu
d
y
r
ev
ea
led
t
h
at
u
p
to
6
.
5
%
o
f
teen
ag
e
g
ir
ls
h
av
e
en
c
o
u
n
ter
ed
f
ee
lin
g
s
o
f
lo
n
elin
ess
[
3
1
]
.
T
h
ese
f
i
n
d
in
g
s
h
ig
h
lig
h
t
th
e
p
r
ev
alen
ce
o
f
lo
n
elin
ess
am
o
n
g
a
d
o
lescen
ts
an
d
th
e
n
ee
d
f
o
r
f
u
r
th
er
r
esear
ch
an
d
in
ter
v
e
n
tio
n
s
to
ad
d
r
ess
th
is
is
s
u
e.
T
h
e
r
elatio
n
s
h
ip
b
etwe
en
s
o
cial
m
ed
ia
u
s
e
an
d
s
leep
q
u
ality
in
ad
o
lescen
ts
h
as
b
ee
n
ex
ten
s
iv
ely
s
tu
d
ied
.
R
esear
ch
b
y
Sh
im
o
g
a
et
a
l
.
[
3
2
]
an
d
Sco
tt
et
a
l
.
[
3
3
]
f
o
u
n
d
ass
o
ciatio
n
s
b
etwe
en
f
r
e
q
u
en
t
s
o
cial
m
ed
ia
u
s
e
an
d
p
o
o
r
s
leep
q
u
ality
o
r
i
n
ad
eq
u
ate
s
leep
p
atter
n
s
in
ad
o
lescen
ts
.
Similar
ly
,
s
tu
d
ies
b
y
L
o
n
g
o
b
ar
d
i
et
a
l
.
[
3
4
]
a
n
d
Var
g
h
ese
et
a
l
.
[
3
5
]
e
m
p
h
asized
th
at
n
ig
h
ttime
s
o
cial
m
ed
ia
u
s
e
was
lin
k
ed
to
lo
w
er
s
leep
q
u
ality
an
d
s
h
o
r
ter
s
leep
d
u
r
atio
n
i
n
ad
o
l
escen
ts
[
3
4
]
,
[
3
5
]
.
Mo
r
e
o
v
er
,
th
e
s
tu
d
y
b
y
Sü
m
e
n
an
d
E
v
g
i̇
n
[
3
6
]
r
ev
ea
led
th
at
s
o
cial
m
ed
ia
u
s
e
was
ass
o
ci
ated
with
p
o
o
r
s
leep
q
u
ality
,
an
x
iety
,
d
e
p
r
ess
io
n
,
a
n
d
l
o
w
s
elf
-
esteem
in
ad
o
lescen
ts
.
Ad
d
itio
n
ally
,
r
es
ea
r
ch
b
y
Ni
&
W
h
iteh
o
u
s
e
[
3
7
]
in
d
icate
d
th
at
m
o
r
e
f
r
e
q
u
en
t
s
o
cial
m
ed
ia
u
s
ag
e
was c
o
r
r
elate
d
with
h
ig
h
e
r
lev
els o
f
s
leep
d
ep
r
iv
atio
n
an
d
d
e
p
r
ess
iv
e
s
y
m
p
to
m
s
am
o
n
g
y
o
u
n
g
ad
o
lescen
ts
.
A
d
o
l
e
s
c
e
n
t
s
s
p
e
n
d
m
u
c
h
t
i
m
e
u
s
i
n
g
s
o
c
i
al
m
e
d
i
a
,
i
n
cl
u
d
i
n
g
a
t
n
i
g
h
t
a
n
d
d
a
y
.
T
h
i
s
c
a
n
i
n
t
e
r
r
u
p
t
t
h
e
s
l
ee
p
p
r
o
c
e
s
s
,
s
o
t
h
e
q
u
a
l
i
t
y
a
n
d
p
a
t
te
r
n
o
f
s
l
e
e
p
c
o
u
l
d
b
e
b
e
t
t
e
r
.
W
h
e
n
t
h
e
y
a
r
e
a
b
o
u
t
t
o
s
t
a
r
t
s
l
ee
p
i
n
g
,
t
h
e
f
a
c
t
i
s
t
h
a
t
a
d
o
l
e
s
c
e
n
ts
s
t
i
ll
i
g
n
o
r
e
n
o
t
i
f
i
c
a
t
i
o
n
s
f
r
o
m
s
o
c
i
al
m
e
d
i
a
a
t
a
n
y
t
i
m
e
,
w
h
i
c
h
h
as
a
n
i
m
p
a
c
t
o
n
q
u
a
l
i
t
y
s
le
e
p
.
M
a
n
y
a
d
o
l
e
s
c
e
n
ts
w
il
l
f
i
n
d
i
t
d
i
f
f
i
c
u
lt
t
o
c
o
n
c
e
n
t
r
a
t
e
d
u
e
t
o
l
a
c
k
o
f
S
l
e
e
p
.
E
f
f
e
c
t
p
s
y
c
h
o
l
o
g
ic
a
l
l
a
ck
o
f
S
l
e
e
p
r
e
s
u
l
ts
i
n
h
y
p
e
r
a
c
t
i
v
i
t
y
,
l
a
c
k
o
f
s
e
l
f
-
c
o
n
t
r
o
l
,
e
m
o
t
i
o
n
s
,
l
a
c
k
o
f
a
g
i
l
i
t
y
,
i
r
r
i
t
a
b
i
li
t
y
,
a
n
d
a
n
n
o
y
a
n
c
e
[
3
8
]
,
[
3
9
]
.
I
n
t
h
e
p
r
e
v
i
o
u
s
s
t
u
d
y
o
n
5
7
6
a
d
o
l
e
s
c
e
n
ts
i
n
I
r
an
,
3
4
.
8
%
o
f
s
t
u
d
e
n
t
s
w
e
n
t
t
o
b
ed
a
t
1
a
.
m
.
,
3
6
.
6
%
c
o
u
l
d
f
a
l
l
as
le
e
p
a
f
t
e
r
1
5
m
i
n
u
t
e
s
,
a
n
d
2
6
.
3
%
s
l
e
p
t
o
n
l
y
s
i
x
h
o
u
r
s
a
d
a
y
[
4
0
]
.
R
e
s
ea
r
c
h
c
o
n
d
u
c
t
ed
o
n
a
d
o
l
e
s
c
e
n
t
g
i
r
l
s
i
n
E
n
g
l
a
n
d
f
o
u
n
d
t
h
a
t
7
3
%
o
f
a
d
o
l
e
s
c
e
n
ts
we
r
e
s
l
e
e
p
-
d
e
p
r
i
v
e
d
[
1
7
]
.
T
h
e
p
r
e
v
i
o
u
s
f
i
n
d
i
n
g
s
s
u
g
g
e
s
t
a
s
i
g
n
i
f
i
c
a
n
t
ass
o
c
i
a
tio
n
b
e
t
w
e
e
n
a
n
x
i
e
t
y
a
n
d
s
o
c
i
a
l
m
e
d
i
a
a
d
d
i
c
ti
o
n
a
n
d
b
e
t
w
e
e
n
l
o
n
e
li
n
e
s
s
a
n
d
s
o
ci
a
l
m
e
d
i
a
a
d
d
i
c
t
i
o
n
a
n
d
s
l
e
e
p
d
is
tu
r
b
a
n
c
e
[
4
1
]
.
Desp
ite
th
e
g
r
o
win
g
b
o
d
y
o
f
li
ter
atu
r
e
d
o
c
u
m
en
tin
g
th
e
in
d
i
v
id
u
al
im
p
ac
ts
o
f
s
o
cial
m
ed
ia
ad
d
ictio
n
,
th
er
e
r
em
ai
n
s
a
p
au
city
o
f
r
ese
ar
ch
e
x
p
lo
r
in
g
t
h
e
in
ter
p
lay
b
e
twee
n
s
o
cial
m
ed
ia
ad
d
ictio
n
,
lo
n
elin
ess
,
an
x
iety
,
an
d
s
leep
d
is
tu
r
b
an
ce
a
m
o
n
g
ad
o
lescen
ts
.
A
d
d
r
ess
in
g
th
is
g
ap
in
k
n
o
wled
g
e
is
cr
u
c
ial
f
o
r
d
ev
elo
p
in
g
co
m
p
r
eh
e
n
s
iv
e
in
ter
v
e
n
tio
n
s
aim
ed
at
m
itig
atin
g
th
e
m
u
lt
if
ac
eted
im
p
ac
ts
o
f
s
o
cial
m
ed
ia
ad
d
ictio
n
o
n
ad
o
lescen
t
well
-
b
ein
g
.
T
h
er
e
f
o
r
e,
th
e
aim
o
f
th
is
s
tu
d
y
i
s
to
ex
am
in
e
th
e
r
elatio
n
s
h
i
p
b
etwe
en
a
n
x
iety
,
lo
n
elin
ess
,
s
leep
d
is
o
r
d
er
s
,
an
d
s
o
cial
m
ed
ia
ad
d
ictio
n
am
o
n
g
ad
o
lescen
ts
.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
n
t J
Pu
b
lic
Hea
lth
Sci
I
SS
N:
2252
-
8
8
0
6
R
ela
tio
n
s
h
ip
b
etw
ee
n
a
n
xiety
,
lo
n
elin
ess
,
a
n
d
s
leep
-
d
is
o
r
d
ers
w
ith
s
o
cia
l m
ed
ia
a
d
d
ictio
n
…
(
R
ika
S
a
r
fika
)
1649
2.
M
E
T
H
O
D
2
.
1
.
Desig
n
T
h
is
q
u
an
titativ
e
r
esear
ch
s
tu
d
y
,
u
tili
zin
g
a
cr
o
s
s
-
s
ec
tio
n
al
ap
p
r
o
ac
h
,
was
co
n
d
u
cted
at
Pu
b
lic
Sen
io
r
Hig
h
Sch
o
o
l
9
Pad
an
g
an
d
f
o
cu
s
ed
o
n
s
tu
d
en
ts
in
g
r
ad
es
X
an
d
XI
wh
o
u
s
e
s
o
cial
m
e
d
ia
an
d
wer
e
willin
g
p
ar
ticip
an
ts
.
T
h
e
p
a
r
ticip
an
ts
wer
e
s
elec
ted
u
s
in
g
co
n
v
en
ien
ce
s
am
p
lin
g
tech
n
iq
u
es.
T
h
e
e
s
tim
ated
s
am
p
le
s
ize
was
d
eter
m
in
ed
u
s
in
g
th
e
Slo
v
in
f
o
r
m
u
la,
co
n
s
id
er
in
g
a
p
o
p
u
latio
n
o
f
a
p
p
r
o
x
im
ately
7
9
9
s
t
u
d
en
ts
,
a
5
%
m
a
r
g
in
o
f
er
r
o
r
,
an
d
a
9
9
%
co
n
f
i
d
en
ce
lev
el,
r
esu
ltin
g
in
a
m
in
im
u
m
r
eq
u
ir
e
d
s
am
p
le
s
ize
o
f
2
6
4
p
ar
ticip
an
ts
.
T
o
m
itig
ate
p
o
ten
tial
d
r
o
p
o
u
t
r
ate
s
,
1
0
%
was
ad
d
ed
to
th
e
ca
lcu
lated
s
am
p
le
s
ize,
b
r
in
g
in
g
th
e
f
in
al
s
am
p
le
s
ize
to
2
9
0
s
tu
d
en
ts
[
4
2
]
.
2
.
2
.
Da
t
a
c
o
llect
io
n
Data
co
llectio
n
was
co
n
d
u
cted
m
eticu
lo
u
s
ly
to
en
s
u
r
e
th
e
v
alid
ity
an
d
r
eliab
ilit
y
o
f
th
e
g
ath
er
ed
in
f
o
r
m
atio
n
.
T
h
e
r
esear
ch
to
o
k
p
lace
in
Ma
y
2
0
2
3
,
with
m
eticu
lo
u
s
p
lan
n
in
g
a
n
d
co
o
r
d
i
n
atio
n
am
o
n
g
th
e
r
esear
ch
team
m
em
b
e
r
s
.
Prio
r
to
th
e
co
m
m
e
n
ce
m
en
t
o
f
d
at
a
co
llectio
n
,
eth
ical
clea
r
an
ce
was
o
b
tain
ed
f
r
o
m
th
e
r
elev
an
t
r
esear
ch
eth
ics
co
m
m
ittee
to
en
s
u
r
e
co
m
p
lian
ce
with
eth
ical
s
tan
d
ar
d
s
in
r
esear
ch
in
v
o
lv
in
g
h
u
m
an
p
ar
ticip
an
ts
.
T
h
e
p
r
im
ar
y
r
ese
ar
ch
er
was c
lo
s
ely
ass
is
ted
b
y
a
q
u
alif
ied
g
u
id
an
c
e
an
d
co
u
n
s
elin
g
teac
h
er
f
r
o
m
Pu
b
lic
Sen
io
r
Hig
h
Sch
o
o
l
9
P
ad
an
g
,
wh
o
p
r
o
v
id
e
d
v
alu
a
b
l
e
in
s
ig
h
ts
an
d
s
u
p
p
o
r
t
th
r
o
u
g
h
o
u
t
th
e
d
ata
co
llectio
n
p
r
o
ce
s
s
.
Ad
d
itio
n
ally
,
t
h
r
ee
tr
ain
ed
e
n
u
m
er
at
o
r
s
wer
e
r
e
cr
u
ited
a
n
d
th
o
r
o
u
g
h
ly
b
r
ief
ed
o
n
th
e
r
esear
c
h
o
b
jectiv
es,
d
ata
co
llectio
n
p
r
o
ce
d
u
r
es,
an
d
eth
ical
co
n
s
id
er
atio
n
s
.
Du
r
in
g
d
ata
co
lle
ctio
n
,
s
tan
d
ar
d
ized
in
s
tr
u
m
en
ts
an
d
p
r
o
t
o
co
ls
wer
e
em
p
lo
y
e
d
to
m
ain
tain
c
o
n
s
is
ten
cy
an
d
ac
cu
r
ac
y
in
d
ata
g
ath
er
in
g
.
T
h
e
p
ar
ticip
an
ts
,
co
n
s
is
tin
g
o
f
s
tu
d
en
ts
in
g
r
ad
es
X
an
d
XI
f
r
o
m
Pu
b
lic
Sen
io
r
Hig
h
Sch
o
o
l
9
Pad
an
g
,
wer
e
ap
p
r
o
ac
h
ed
with
tr
an
s
p
ar
en
c
y
r
eg
ar
d
in
g
th
e
p
u
r
p
o
s
e
an
d
n
atu
r
e
o
f
th
e
r
esear
ch
.
I
n
f
o
r
m
ed
co
n
s
en
t
was
o
b
tain
ed
f
r
o
m
ea
c
h
p
ar
ticip
an
t
o
r
th
ei
r
l
eg
al
g
u
ar
d
ian
s
p
r
io
r
to
th
eir
i
n
v
o
lv
em
en
t i
n
th
e
s
tu
d
y
.
2
.
3
.
Da
t
a
a
na
ly
s
is
T
h
e
co
llected
d
ata
u
n
d
er
wen
t
r
ig
o
r
o
u
s
an
aly
s
is
em
p
l
o
y
in
g
b
o
th
d
escr
ip
tiv
e
an
d
in
f
er
en
tial
s
tatis
tical
tech
n
iq
u
es.
Un
iv
ar
iate
d
ata
a
n
aly
s
is
was
in
itially
p
er
f
o
r
m
e
d
to
p
r
o
v
id
e
a
c
o
m
p
r
e
h
en
s
iv
e
d
escr
ip
tio
n
o
f
ea
ch
v
ar
iab
le
u
n
d
er
in
v
esti
g
atio
n
,
in
clu
d
in
g
an
x
iet
y
,
lo
n
elin
ess
,
s
leep
d
is
tu
r
b
an
ce
,
an
d
s
o
cia
l
m
ed
ia
ad
d
ictio
n
.
Descr
ip
tiv
e
s
tati
s
tics
s
u
ch
as
f
r
eq
u
en
c
y
d
is
tr
ib
u
tio
n
s
,
p
er
ce
n
tag
es,
m
ea
n
s
,
an
d
s
tan
d
ar
d
d
ev
iatio
n
s
wer
e
co
m
p
u
ted
to
s
u
m
m
ar
ize
th
e
ch
ar
ac
ter
is
tics
an
d
d
is
tr
ib
u
tio
n
o
f
th
e
v
a
r
iab
les.
Fu
r
th
e
r
m
o
r
e,
t
o
ex
p
lo
r
e
th
e
r
elatio
n
s
h
ip
s
b
etwe
en
v
ar
iab
le
s
,
th
e
C
hi
-
s
q
u
ar
e
test
was
em
p
lo
y
ed
as
a
s
tatis
tical
to
o
l.
T
h
e
s
ig
n
if
ican
ce
le
v
el
was set a
t p
<0
.
0
5
t
o
d
eter
m
in
e
th
e
p
r
esen
ce
o
f
s
tatis
tically
s
i
g
n
if
ican
t a
s
s
o
ciatio
n
s
b
etwe
en
v
ar
iab
les.
T
h
e
u
s
e
o
f
in
f
e
r
en
tial
s
tatis
tics
f
ac
ilit
ated
th
e
ex
a
m
in
atio
n
o
f
p
o
te
n
tial
co
r
r
elatio
n
s
a
n
d
d
ep
en
d
en
cies
am
o
n
g
th
e
v
ar
iab
les,
th
er
eb
y
co
n
t
r
ib
u
tin
g
to
a
d
ee
p
e
r
u
n
d
er
s
tan
d
in
g
o
f
th
e
r
esear
ch
p
h
en
o
m
en
a.
2
.
4
.
Resea
rc
h
i
ns
t
rum
ent
T
h
is
s
tu
d
y
u
s
ed
q
u
esti
o
n
n
air
e
s
o
n
s
o
cial
m
ed
ia
u
s
e,
an
x
iety
,
lo
n
elin
ess
,
an
d
s
leep
d
is
o
r
d
er
s
.
2
.
4
.
1
.
So
cia
l m
edia
us
e
qu
estio
nn
a
ire
Qu
esti
o
n
n
air
e
s
o
cial
m
ed
ia
ad
d
ictio
n
r
ef
e
r
s
to
th
e
B
er
g
en
S
o
cial
Me
d
ia
Ad
d
ictio
n
Scale
(
B
SMA
S).
Qu
esti
o
n
n
air
e
T
h
is
was
d
ev
el
o
p
ed
b
y
[
4
3
]
wh
ic
h
is
a
m
o
d
if
icatio
n
o
f
th
e
Q
u
esti
o
n
n
air
e
F
ac
eb
o
o
k
A
d
d
ictio
n
Scale
(
B
FAS)
[
4
4
]
.
T
h
e
B
SMAS
q
u
esti
o
n
n
air
e
h
as
alr
e
ad
y
u
n
d
er
g
o
n
e
v
alid
atio
n
a
n
d
r
eliab
ilit
y
test
in
g
co
n
d
u
cte
d
b
y
An
d
r
ea
s
s
en
,
y
ie
ld
in
g
a
C
r
o
n
b
ac
h
'
s
Alp
h
a
s
co
r
e
o
f
a=
0
.
8
8
.
T
h
is
in
d
icate
s
th
at
th
e
to
o
l p
o
s
s
ess
es
s
tr
o
n
g
r
eliab
ilit
y
.
T
h
e
s
co
r
in
g
s
y
s
tem
ca
teg
o
r
izes
i
n
d
iv
id
u
a
ls
a
s
ad
d
icted
if
th
eir
s
co
r
e
is
≥
6
0
,
as
h
a
v
in
g
a
m
ed
iu
m
le
v
el
o
f
ad
d
ictio
n
if
t
h
eir
s
co
r
e
f
alls
b
etwe
en
4
2
-
6
5
,
an
d
as
n
o
t
h
a
v
in
g
an
a
d
d
icti
o
n
if
th
eir
s
co
r
e
is
<4
2
.
T
h
e
I
n
d
o
n
esian
v
e
r
s
io
n
o
f
th
e
B
er
g
e
n
So
cial
Me
d
ia
Ad
d
ictio
n
Scale
(
B
SMAS)
h
as
also
u
n
d
er
g
o
n
e
v
alid
ity
test
in
g
at
th
e
Da
n
H
ea
lth
I
n
s
titu
te
J
ak
ar
ta
T
ec
h
n
o
lo
g
y
,
with
a
to
tal
o
f
2
0
p
ar
ti
cip
an
ts
.
T
h
e
r
esu
lts
in
d
icate
th
at
1
8
o
u
t
o
f
th
e
1
8
s
tatem
en
ts
wer
e
d
ee
m
ed
v
alid
b
ec
au
s
e
th
e
ca
lcu
lated
'
r
'
(
co
r
r
elatio
n
co
ef
f
icien
t)
was g
r
ea
ter
th
an
th
e
'
r
tab
le'
v
al
u
e.
2
.
4
.
2
.
Anx
iet
y
q
ues
t
io
nn
a
ire
T
h
e
Z
u
n
g
Self
-
R
atin
g
An
x
iet
y
Scale
(
Z
SAS/
Z
S
R
AS)
is
an
an
x
iety
ass
ess
m
en
t
to
o
l
th
at
was
d
ev
elo
p
e
d
b
y
co
n
s
id
er
i
n
g
th
e
s
y
m
p
to
m
s
o
f
wo
r
r
y
o
u
tlin
e
d
in
th
e
Diag
n
o
s
tic
an
d
Statis
tical
Ma
n
u
al
o
f
Me
n
tal
Dis
o
r
d
er
s
(
DSM
-
I
I
)
.
T
h
e
Z
SAS/
Z
SR
A
S
q
u
esti
o
n
n
air
e
h
as
alr
ea
d
y
b
ee
n
a
d
ap
ted
an
d
s
tan
d
ar
d
i
ze
d
f
o
r
u
s
e
in
th
e
I
n
d
o
n
esian
co
n
tex
t,
an
d
its
v
alid
ity
an
d
r
eliab
ilit
y
h
av
e
b
ee
n
ass
ess
ed
.
T
h
e
v
alid
ity
o
f
ea
ch
item
in
th
e
q
u
esti
o
n
n
air
e
r
an
g
ed
f
r
o
m
a
m
in
im
u
m
o
f
0
.
6
6
3
to
a
m
ax
im
u
m
o
f
0
.
9
1
8
.
T
h
e
r
eliab
ilit
y
te
s
t y
ield
ed
a
r
esu
lt
o
f
0
.
8
2
9
,
in
d
icatin
g
th
at
th
e
q
u
esti
o
n
n
air
e
is
r
eliab
le
f
o
r
m
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s
p
o
n
d
en
ts
r
ep
o
r
ted
Evaluation Warning : The document was created with Spire.PDF for Python.
I
n
t J
Pu
b
lic
Hea
lth
Sci
I
SS
N:
2252
-
8
8
0
6
R
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ip
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(
R
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1651
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Rela
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lee
p dis
o
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a
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o
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l m
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T
h
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d
ata
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in
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icate
s
th
at
1
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d
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t
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in
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m
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ex
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ad
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h
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C
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am
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Similar
ly
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r
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is
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ar
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r
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ip
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ab
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3
.
R
elatio
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s
h
ip
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x
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n
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,
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leep
d
is
o
r
d
er
s
,
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d
s
o
cial
m
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ad
d
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n
in
a
d
o
lescen
ts
Sen
io
r
Hig
h
Sch
o
o
l 9
Pad
a
n
g
(
n
=2
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0
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r
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t
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d
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Dis
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T
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x
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lo
n
elin
ess
,
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leep
d
is
o
r
d
er
s
,
an
d
s
o
cial
m
ed
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ad
d
ictio
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am
o
n
g
ad
o
lescen
ts
h
as
b
ee
n
a
s
u
b
je
ct
o
f
r
ec
en
t
r
esear
ch
,
p
ar
ticu
l
ar
ly
f
o
cu
s
in
g
o
n
h
i
g
h
s
ch
o
o
l
s
tu
d
en
ts
.
A
s
tu
d
y
co
n
d
u
cte
d
am
o
n
g
ad
o
lescen
ts
at
Sen
io
r
Hig
h
Sch
o
o
l
9
Pad
an
g
r
e
v
ea
led
a
s
ig
n
i
f
ican
t
a
s
s
o
ciatio
n
b
etwe
en
an
x
iety
a
n
d
s
o
cial
m
ed
ia
ad
d
i
ctio
n
,
with
a
n
o
tab
le
p
r
o
p
o
r
tio
n
o
f
r
esp
o
n
d
en
ts
ex
p
er
ien
cin
g
m
ild
an
x
iety
a
n
d
m
o
d
er
ate
s
o
cial
m
ed
ia
ad
d
icti
o
n
.
T
h
is
f
in
d
i
n
g
u
n
d
e
r
s
co
r
es
t
h
e
in
ter
co
n
n
ec
ted
n
ess
o
f
m
en
t
al
h
ea
lth
f
ac
to
r
s
an
d
s
o
cial
m
ed
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h
ab
its
am
o
n
g
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o
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ts
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An
x
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ch
ar
ac
ter
ized
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y
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y
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p
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s
s
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ch
as
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r
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d
u
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ea
s
e,
h
as
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ee
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id
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tifi
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as
a
k
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co
n
tr
ib
u
to
r
to
s
o
cial
m
ed
ia
ad
d
ictio
n
am
o
n
g
ad
o
lescen
ts
[
4
8
]
.
T
h
e
s
tu
d
y
co
n
d
u
cte
d
at
Pu
b
lic
Sen
io
r
Hig
h
Sch
o
o
l
9
Pad
an
g
alig
n
s
with
p
r
ev
io
u
s
r
esear
ch
i
n
d
icatin
g
th
at
an
x
iety
p
lay
s
a
cr
u
cial
r
o
le
in
ad
o
lescen
ts
'
en
g
ag
em
e
n
t w
ith
s
o
cial
m
ed
ia
p
latf
o
r
m
s
.
M
o
r
eo
v
e
r
,
th
e
im
p
ac
t o
f
ex
ce
s
s
iv
e
s
o
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m
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u
s
e
o
n
s
leep
q
u
ali
ty
an
d
m
en
tal
h
ea
lth
h
as
b
ee
n
a
f
o
cu
s
o
f
i
n
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esti
g
atio
n
.
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d
ies
h
av
e
s
h
o
wn
th
at
p
r
o
b
lem
atic
s
o
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m
ed
ia
u
s
ag
e
ca
n
lead
to
s
leep
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is
tu
r
b
an
ce
s
,
in
s
o
m
n
ia,
an
d
o
th
er
m
en
tal
h
ea
lth
is
s
u
es
am
o
n
g
a
d
o
lesce
n
ts
.
T
h
e
ass
o
ciatio
n
b
etwe
en
s
o
cial
m
ed
ia
a
d
d
ictio
n
an
d
s
l
ee
p
d
is
o
r
d
e
r
s
h
as
b
ee
n
h
ig
h
li
g
h
ted
i
n
v
ar
i
o
u
s
s
tu
d
i
es,
em
p
h
asizin
g
th
e
n
ee
d
to
ad
d
r
ess
th
e
n
eg
ativ
e
co
n
s
eq
u
en
ce
s
o
f
e
x
ce
s
s
iv
e
s
o
cial
m
ed
ia
u
s
e
o
n
ad
o
le
s
ce
n
ts
'
well
-
b
ein
g
.
Fu
r
th
er
m
o
r
e
,
th
e
p
r
ev
alen
ce
o
f
s
o
cial
m
ed
ia
a
d
d
ictio
n
a
m
o
n
g
a
d
o
lescen
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h
as
r
aised
co
n
ce
r
n
s
ab
o
u
t
its
im
p
licatio
n
s
f
o
r
m
en
tal
h
ea
lth
.
R
esear
ch
h
as
in
d
icate
d
th
at
s
o
cial
m
ed
ia
ad
d
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n
ca
n
lead
to
n
e
g
ativ
e
o
u
tco
m
es
s
u
ch
as
d
e
p
r
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,
l
o
n
elin
ess
,
an
d
p
o
o
r
s
elf
-
esteem
am
o
n
g
ad
o
lescen
ts
.
Un
d
er
s
tan
d
in
g
t
h
e
co
m
p
lex
Evaluation Warning : The document was created with Spire.PDF for Python.
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in
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Sen
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g
h
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l
9
Pa
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o
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t
h
e
s
ig
n
if
ican
t
r
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ip
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n
d
s
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cial
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d
ia
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ictio
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izin
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t
h
e
im
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ac
t
o
f
m
en
tal
h
ea
lth
f
ac
t
o
r
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o
n
s
o
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d
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its
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s
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ar
e
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ts
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lth
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r
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io
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eth
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u
p
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a
p
p
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m
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9
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itio
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ally
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u
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1
4
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o
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8
5
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%
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p
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ce
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m
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d
7
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1
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p
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ce
d
s
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e
lo
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Pre
v
i
u
s
s
tu
d
y
h
a
v
e
also
h
ig
h
lig
h
t
t
h
e
cr
itical
r
o
le
o
f
lo
n
elin
ess
in
lin
k
in
g
p
ee
r
p
h
u
b
b
in
g
to
ad
o
lescen
t
m
o
b
ile
s
o
cial
m
ed
ia
a
d
d
ictio
n
[
4
9
]
.
in
cr
ea
s
ed
s
o
cial
m
ed
ia
u
s
e
is
a
s
s
o
ciate
d
with
h
ig
h
er
l
ev
els
o
f
lo
n
elin
ess
[
5
0
]
,
[
5
1
]
.
So
cial
m
ed
ia
p
latf
o
r
m
s
ca
n
p
r
o
v
id
e
o
p
p
o
r
tu
n
ities
f
o
r
s
o
cial
co
n
n
ec
tio
n
an
d
s
u
p
p
o
r
t,
b
u
t
ex
ce
s
s
iv
e
u
s
e
o
r
p
ass
iv
e
en
g
ag
em
e
n
t
with
s
o
cial
m
ed
ia
m
ay
co
n
tr
ib
u
te
to
f
ee
lin
g
s
o
f
lo
n
elin
ess
[
5
2
]
.
Ad
o
lescen
ts
wh
o
f
ee
l
lo
n
ely
will
p
r
ef
er
s
o
cial
m
ed
ia
to
en
jo
y
th
e
f
r
ee
d
o
m
o
f
an
o
n
y
m
ity
,
c
o
m
p
en
s
ate
f
o
r
we
ak
s
o
cial
s
k
ills
,
an
d
r
e
d
u
ce
f
ee
lin
g
s
o
f
lo
n
elin
ess
.
T
h
is
m
ea
n
s
lo
n
ely
in
d
i
v
id
u
als
will
ac
ce
s
s
s
o
cial
m
ed
ia
to
s
ee
k
co
m
f
o
r
t
in
m
ak
in
g
s
o
cial
co
n
tacts
.
T
h
er
e
f
o
r
e,
f
ac
to
r
s
s
u
ch
as
in
d
iv
id
u
al
d
if
f
er
en
ce
s
,
s
p
ec
if
ic
s
o
cial
m
ed
ia
p
latf
o
r
m
s
u
s
ed
,
an
d
th
e
co
n
tex
t
o
f
u
s
e
ca
n
in
f
lu
en
ce
th
e
r
elatio
n
s
h
ip
b
etwe
en
s
o
cial
m
ed
ia
u
s
e
an
d
lo
n
elin
ess
.
T
h
e
r
elatio
n
s
h
ip
b
etwe
en
s
lee
p
d
is
o
r
d
e
r
s
an
d
s
o
cial
m
ed
ia
a
d
d
ictio
n
am
o
n
g
ad
o
lescen
ts
al
s
o
h
as
b
ee
n
a
s
u
b
ject
o
f
in
ter
est in
th
is
r
esear
ch
.
T
h
is
f
in
d
i
n
g
u
n
d
er
s
co
r
e
s
th
e
im
p
ac
t o
f
s
leep
d
is
tu
r
b
an
ce
s
o
n
ad
o
lescen
ts
'
en
g
ag
em
e
n
t
with
s
o
cial
m
ed
i
a
p
latf
o
r
m
s
.
T
h
e
r
esear
ch
co
n
d
u
cted
at
SMA
N
9
Pad
an
g
a
lig
n
s
with
p
r
ev
io
u
s
s
tu
d
ies
th
at
h
av
e
h
i
g
h
lig
h
ted
t
h
e
lin
k
b
etwe
en
p
o
o
r
s
leep
q
u
ality
an
d
h
ig
h
s
o
cial
m
ed
ia
u
s
ag
e.
Fo
r
in
s
tan
ce
,
a
s
tu
d
y
in
th
e
wester
n
r
eg
io
n
o
f
T
u
r
k
ey
f
o
u
n
d
th
at
s
o
cial
m
ed
ia
ad
d
ictio
n
in
h
ig
h
s
ch
o
o
l
s
tu
d
en
ts
d
ec
r
ea
s
es
s
tu
d
en
ts
’
s
leep
ef
f
icien
cy
(
p
<
0
.
0
5
)
[
3
6
]
.
An
o
th
er
s
tu
d
y
in
I
r
an
s
tated
th
at
th
er
e
was
a
s
ig
n
if
ican
t
r
elatio
n
s
h
ip
b
etwe
en
p
o
o
r
s
leep
q
u
ality
an
d
h
ig
h
u
s
e
o
f
s
o
cial
m
ed
ia
[
4
0
]
.
Ad
o
lescen
ts
wh
o
s
tr
u
g
g
le
with
s
leep
an
d
tu
r
n
to
s
o
cial
m
ed
ia
,
esp
ec
ially
at
n
ig
h
t,
m
ay
in
ad
v
e
r
ten
tly
d
ev
elo
p
s
o
cial
m
e
d
ia
a
d
d
ictio
n
d
u
e
to
co
n
tin
u
o
u
s
en
g
ag
em
e
n
t w
ith
o
n
lin
e
p
latf
o
r
m
s
with
o
u
t r
eg
a
r
d
f
o
r
tim
e
co
n
s
tr
ain
ts
.
4.
CO
NCLU
SI
O
N
A
Sen
io
r
Hig
h
Sch
o
o
l
9
Pad
an
g
s
tu
d
y
aim
ed
to
d
eter
m
in
e
th
e
co
r
r
elatio
n
b
etwe
en
an
x
iety
,
l
o
n
elin
ess
,
s
leep
d
is
o
r
d
er
s
,
an
d
s
o
cial
m
e
d
ia
ad
d
ictio
n
.
T
h
e
r
esear
ch
er
s
co
n
clu
d
e
d
th
at
1
0
.
7
%
o
f
ad
o
lescen
ts
h
av
e
a
h
ea
v
y
s
o
cial
m
ed
ia
ad
d
ictio
n
,
2
1
.
4
%
h
av
e
s
ev
er
e
an
x
i
ety
,
4
.
8
%
h
av
e
lo
n
elin
ess
,
an
d
th
e
m
ajo
r
ity
o
f
a
d
o
lescen
ts
s
h
av
e
p
o
o
r
s
leep
q
u
ality
7
4
.
5
%.
T
h
e
C
h
i
-
s
q
u
ar
e
test
r
esu
lts
co
n
clu
d
ed
a
s
ig
n
i
f
ican
t
r
elatio
n
s
h
ip
b
etwe
en
an
x
iety
with
s
o
cial
m
ed
ia
p
=0
.
0
1
3
,
lo
n
elin
ess
with
s
o
cial
n
etwo
r
k
s
p
=0
.
0
1
0
,
an
d
s
leep
d
is
o
r
d
e
r
s
with
s
o
cial
n
etwo
r
k
in
g
p
=0
.
0
3
3
.
Ho
p
ef
u
lly
,
th
e
s
ch
o
o
l
will
b
e
ab
le
to
cr
ea
te
a
p
o
licy
r
eg
ar
d
in
g
u
s
in
g
s
o
cial
m
ed
ia
in
th
e
s
ch
o
o
l
en
v
ir
o
n
m
en
t,
p
r
o
h
ib
itin
g
s
tu
d
en
ts
f
r
o
m
u
s
in
g
ce
ll
p
h
o
n
es
d
u
r
in
g
lear
n
in
g
an
d
o
n
l
y
allo
w
in
g
s
tu
d
en
ts
to
u
s
e
ce
ll
p
h
o
n
es
d
u
r
i
n
g
b
r
ea
k
tim
e.
I
t
is
h
o
p
ed
t
h
at
th
e
s
ch
o
o
l
wi
ll
also
p
r
o
v
id
e
co
u
n
s
elin
g
r
eg
ar
d
in
g
th
e
p
r
o
b
lem
o
f
s
o
cial
m
ed
ia
a
d
d
ictio
n
am
o
n
g
ad
o
lescen
ts
in
th
e
s
ch
o
o
l e
n
v
ir
o
n
m
en
t,
c
o
u
n
s
elin
g
f
o
r
m
en
tal
h
ea
lth
s
er
v
ices
in
th
e
s
ch
o
o
l
e
n
v
ir
o
n
m
en
t,
a
n
d
im
p
lem
e
n
tin
g
s
elf
-
h
elp
s
tr
ateg
ies.
Help
b
o
o
k
to
o
v
er
c
o
m
e
lo
n
elin
ess
in
ad
o
lescen
ts
u
s
in
g
s
to
r
y
wr
itin
g
tech
n
iq
u
es,
as
well
as
co
llab
o
r
atin
g
with
h
ea
lth
w
o
r
k
er
s
to
p
r
o
v
id
e
h
ea
lth
ed
u
ca
tio
n
a
b
o
u
t sleep
h
y
g
ien
e
to
o
v
er
c
o
m
e
s
leep
d
is
o
r
d
er
s
i
n
s
tu
d
en
ts
.
RE
F
E
R
E
NC
E
S
[
1
]
S.
-
Q
.
M
e
n
g
e
t
a
l
.
,
“
G
l
o
b
a
l
p
r
e
v
a
l
e
n
c
e
o
f
d
i
g
i
t
a
l
a
d
d
i
c
t
i
o
n
i
n
g
e
n
e
r
a
l
p
o
p
u
l
a
t
i
o
n
:
A
s
y
st
e
ma
t
i
c
r
e
v
i
e
w
a
n
d
me
t
a
-
a
n
a
l
y
s
i
s,
”
C
l
i
n
i
c
a
l
Psy
c
h
o
l
o
g
y
R
e
v
i
e
w
,
v
o
l
.
9
2
,
p
.
1
0
2
1
2
8
,
M
a
r
.
2
0
2
2
,
d
o
i
:
1
0
.
1
0
1
6
/
j
.
c
p
r
.
2
0
2
2
.
1
0
2
1
2
8
.
[
2
]
R
.
A
.
N
a
su
t
i
o
n
,
D
.
A
r
n
i
t
a
,
L.
S
.
L.
R
u
s
n
a
n
d
i
,
E
.
Q
o
d
a
r
i
a
h
,
P
.
R
u
d
i
t
o
,
a
n
d
M
.
F
.
N
.
S
i
n
a
g
a
,
“
D
i
g
i
t
a
l
mas
t
e
r
y
i
n
I
n
d
o
n
e
si
a
:
t
h
e
o
r
g
a
n
i
z
a
t
i
o
n
a
n
d
i
n
d
i
v
i
d
u
a
l
c
o
n
t
r
a
s
t
,
”
J
o
u
rn
a
l
o
f
Ma
n
a
g
e
m
e
n
t
D
e
v
e
l
o
p
m
e
n
t
,
v
o
l
.
3
9
,
n
o
.
4
,
p
p
.
3
5
9
–
3
9
0
,
M
a
y
2
0
2
0
,
d
o
i
:
1
0
.
1
1
0
8
/
J
M
D
-
03
-
2
0
1
9
-
0
0
8
1
.
[
3
]
M
.
Ta
t
e
n
o
e
t
a
l
.
,
“
I
n
t
e
r
n
e
t
a
d
d
i
c
t
i
o
n
,
s
martp
h
o
n
e
a
d
d
i
c
t
i
o
n
,
a
n
d
h
i
k
i
k
o
mo
r
i
t
r
a
i
t
i
n
j
a
p
a
n
e
se
y
o
u
n
g
a
d
u
l
t
:
so
c
i
a
l
i
s
o
l
a
t
i
o
n
a
n
d
s
o
c
i
a
l
n
e
t
w
o
r
k
,
”
Fr
o
n
t
i
e
rs
i
n
Psy
c
h
i
a
t
ry
,
v
o
l
.
1
0
,
Ju
l
.
2
0
1
9
,
d
o
i
:
1
0
.
3
3
8
9
/
f
p
sy
t
.
2
0
1
9
.
0
0
4
5
5
.
[
4
]
E.
B
o
z
z
o
l
a
e
t
a
l
.
,
“
Th
e
u
se
o
f
s
o
c
i
a
l
m
e
d
i
a
i
n
c
h
i
l
d
r
e
n
a
n
d
a
d
o
l
e
sc
e
n
t
s
:
s
c
o
p
i
n
g
r
e
v
i
e
w
o
n
t
h
e
p
o
t
e
n
t
i
a
l
r
i
sk
s
,
”
I
n
t
e
r
n
a
t
i
o
n
a
l
J
o
u
r
n
a
l
o
f
En
v
i
r
o
n
m
e
n
t
a
l
Re
s
e
a
r
c
h
a
n
d
P
u
b
l
i
c
H
e
a
l
t
h
,
v
o
l
.
1
9
,
n
o
.
1
6
,
p
.
9
9
6
0
,
A
u
g
.
2
0
2
2
,
d
o
i
:
1
0
.
3
3
9
0
/
i
j
e
r
p
h
1
9
1
6
9
9
6
0
.
[
5
]
R
.
H
a
a
n
d
a
n
d
Z
.
S
h
u
w
a
n
g
,
“
T
h
e
r
e
l
a
t
i
o
n
s
h
i
p
b
e
t
w
e
e
n
s
o
c
i
a
l
m
e
d
i
a
a
d
d
i
c
t
i
o
n
a
n
d
d
e
p
r
e
ss
i
o
n
:
a
q
u
a
n
t
i
t
a
t
i
v
e
st
u
d
y
a
mo
n
g
u
n
i
v
e
r
s
i
t
y
st
u
d
e
n
t
s
i
n
K
h
o
s
t
,
A
f
g
h
a
n
i
s
t
a
n
,
”
I
n
t
e
rn
a
t
i
o
n
a
l
J
o
u
r
n
a
l
o
f
A
d
o
l
e
s
c
e
n
c
e
a
n
d
Y
o
u
t
h
,
v
o
l
.
2
5
,
n
o
.
1
,
p
p
.
7
8
0
–
7
8
6
,
D
e
c
.
2
0
2
0
,
d
o
i
:
1
0
.
1
0
8
0
/
0
2
6
7
3
8
4
3
.
2
0
2
0
.
1
7
4
1
4
0
7
.
[
6
]
J.
M
.
H
a
d
d
a
d
e
t
a
l
.
,
“
T
h
e
I
mp
a
c
t
o
f
S
o
c
i
a
l
M
e
d
i
a
o
n
C
o
l
l
e
g
e
M
e
n
t
a
l
H
e
a
l
t
h
D
u
r
i
n
g
t
h
e
C
O
V
I
D
-
1
9
P
a
n
d
e
m
i
c
:
a
M
u
l
t
i
n
a
t
i
o
n
a
l
R
e
v
i
e
w
o
f
t
h
e
Ex
i
st
i
n
g
L
i
t
e
r
a
t
u
r
e
,
”
C
u
rre
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