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The trajectory of psychological distress and problematic Internet gaming among primary school boys: a longitudinal study across different periods of COVID-19 in China

  • I-Hua Chen1
  • Yi-Ching Lin2,*,
  • Chung-Ying Lin3
  • Wen-Chao Wang4
  • Jeffrey H. Gamble5,*,

1Chinese Academy of Education Big Data, Qufu Normal University, 273165 Qufu, Shandong, China

2Department of Early Childhood and Family Education, College of Education, National Taipei University of Education, 10671 Taipei, Taiwan

3Institute of Allied Health Sciences, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 701401 Tainan, Taiwan

4Experimental Teaching Department, Guizhou University of Finance and Economics, 550025 Guiyang, Guizhou, China

5Department of Foreign Languages, National Chiayi University, Minhsiung County, 62103 Chiayi, Taiwan

DOI: 10.31083/j.jomh1803070 Vol.18,Issue 3,March 2022 pp.1-14

Submitted: 26 October 2021 Accepted: 03 December 2021

Published: 31 March 2022

(This article belongs to the Special Issue COVID-19 impact on men's mental health)

*Corresponding Author(s): Yi-Ching Lin E-mail:
*Corresponding Author(s): Jeffrey H. Gamble E-mail:


Background: Children are a vulnerable population in terms of the impact of COVID-19 on their psychological well-being. When restricted to their homes, children are susceptible to problematic Internet gaming (PG). Primary school boys are particularly at risk of PG, which may lead to negative psychological effects, such as distress. Emerging research has identified perceived weight stigma (PWS) as a variable closely associated with both PG and psychological distress, particularly during the COVID-19 pandemic. The purpose of this study was to evaluate the trajectory of psychological distress among this vulnerable population from a longitudinal perspective, evaluating the role of PG and PWS. Methods: Self-report measures were used to assess psychological distress, PG, and PWS among primary school boys (grades 4 to grade 6; N = 283). Data were collected across three waves: before the pandemic, during school closure, and following the lifting of restrictions. Results: The trajectory of psychological distress among primary school boys was concave, indicating their mental health was negatively impacted during home restriction but recovered after the lockdown ended (linear change = 0.98, p < 0.01; quadratic change = –0.19, p < 0.01). PG was a significant covariate in terms of the trajectory of psychological distress (b = 0.02, p < 0.01). Moreover, baseline values for PWS were shown to have a negative direct effect on mental health before the pandemic (b = 0.05, p < 0.01), and moderated the time factor for boys’ psychological distress over time (b of PWS × linear change = 0.04, p = 0.006; b of PWS × Quadratic change was negative at –0.01, p = 0.002). Conclusions: Although mental health gradually improved as home restrictions subsided, future studies are required to address changes in mental health upon return to school for students reporting higher levels of weight stigma.


Psychological distress; Problematic Internet gaming; COVID-19; Perceived weight stigma; Longitudinal study

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I-Hua Chen,Yi-Ching Lin,Chung-Ying Lin,Wen-Chao Wang,Jeffrey H. Gamble. The trajectory of psychological distress and problematic Internet gaming among primary school boys: a longitudinal study across different periods of COVID-19 in China. Journal of Men's Health. 2022. 18(3);1-14.


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