The Association between Problematic Internet Use, Resilience, and Fatigue in First-Year Medical College Students in China: A Moderated Mediation Model

Background: Resilience is crucial for medical college students to thrive in the highly stressful environment of medical education. However, the prevalence of problematic internet use (PIU) in this population may negatively impact their resilience. This study investigated the influence of problematic online gaming (PG) and problematic social media use (PSMU) on the resilience of medical college students in China. Methods: A sample of 5075 first-year medical college students from four Chinese universities was studied. PG served as the independent variable, resilience as the dependent variable, fatigue as the mediator, and PSMU as the moderator. Structural equation modeling was conducted using LISREL 8.80. Additionally, a moderated mediation model was evaluated using the jAMM module in jamovi 2.6.13. Results: The study's findings revealed significant negative correlations between resilience and the variables of PG, PSMU, and fatigue. Fatigue mediated the relationship between PG and resilience (B = -0.04, 95% CI = [-0.05, -0.03]). PSMU moderated the direct relationship between PG and resilience with the interaction term PG x PSMU significant (B = -0.004, t = -6.501, p < 0.001) and the first stage (PG -> fatigue) of the mediation with PG x PSMU significant (B = 0.055, t = 8.351, p < 0.001). The detrimental effects of PG on resilience were more pronounced among individuals with lower levels of PSMU. Conclusion: This study concluded that addressing PIU, particularly PG, is essential for fostering resilience in medical college students. While PSMU itself is maladaptive, the underlying social media engagement may serve a protective role through social support in mitigating the adverse effects of PG on resilience.