Objective: The aim of this study was to identify correlates that might constitute risk factors for Problematic Internet
Use (PIU) among urban Tunisian high school students.
Methods: This cross-sectional study was carried out on 587 secondary school students, aged 14 to 20 years. They were recruited
from seven secondary schools randomly selected in the urban area of Sfax. The self-administered Young's 8-item
questionnaire was used in this survey. To identify an associated video game addiction, Fisher’s 9-item questionnaire was
used. The Hospital Anxiety and Depression (HAD) scale was administered to screen for anxiety and depression symptoms.
Results: Individual risk factors were a lack of social activity (p=0.008), anxiety symptoms (p=0.000), an associated video
game addiction (p=0.000), and the problematic consumption of tobacco (p=0.038) and alcohol (p=0.005). PIU was also
significantly associated with poor relationships within the family (p=0.000), an interest in advertising on the Internet
(p=0.02), time spent surfing the Internet per day (p=0.000), and mothers’ employment as mid to high level executives
(p=0.003). Parental limitations on amount of time spent on the Internet emerged as an important protective factor
Conclusion: The identification of risk factors can help to identify individuals who may be at high risk, and alert mental
health providers to be careful to screen these patients for PIU. Total avoidance of the Internet is unrealistic and inadvisable,
but a preventive outreach for youth, their families and health professionals may help to limit the onset of PIU among