Profiles of Exposure to Co-Occurrence of Child Maltreatment and Parental Mental Illness and Their Association with Adolescent Internet Addiction: The Mediating Role of Emotion Regulation

Background and Purpose: The co-occurrence of child maltreatment and parental mental illness represents a particularly detrimental form of adverse childhood experiences (ACEs), and is associated with poor behavioral and developmental outcomes. Both parental mental illness and child maltreatment are well-established risk factors for Internet addiction. However, their joint occurrence remains underexamined. The Compensatory Use of Internet Framework posits that individuals may engage in excessive internet use to cope with negative emotions or unmet needs arising from adverse life conditions (Kardefelt-Winther, 2014). Guided by this framework, this study aimed to examine: (1) whether distinct patterns of co-occurring child maltreatment and parental mental illness could be identified; (2) Whether these patterns were associated with differential risk for Internet addiction; and (3) whether emotion regulation mediated the associations.

Methods: Data were drawn from a survey of 8,704 seventh-grade students (ages 12–13) in an urban city in Taiwan. A paper-based questionnaire assessed sociodemographic characteristics and validated measures of ACEs, including parental mental illness, emotional neglect, emotional abuse, physical abuse, physical neglect, and sexual abuse, as well as Internet addiction and emotion regulation (cognitive reappraisal and expressive suppression).

Latent class analysis (LCA) was conducted to identify patterns of co-occurring exposure to parental mental illness and child maltreatment. Chi-square tests were used to examine sociodemographic differences across identified classes. Finally, regression-based mediation analyses were performed to assess the associations between latent class membership and Internet addiction, as well as the mediating role of emotion regulation in these associations.

Results: A 3-class model was identified. The smallest class (0.44%), “High Exposure”, was characterized by parental mental illness and high probabilities of nearly all types of child maltreatment. The largest class (91.5%), “No Exposure,” included adolescents with little or no exposure to these adversities. The third class (8.04%), “Moderate Exposure”, included youth who experienced parental mental illness, along with significant emotional abuse, neglect, and physical abuse. Significant sociodemographic differences emerged across classes: adolescents with higher socioeconomic status were more likely to be in the "No Exposure" class, while those with lower socioeconomic status were predominantly found in the "High Exposure" class.

After accounting for socioeconomic status and sex, the adjusted regression model indicated that adolescents in the “Moderate Exposure” class had significantly higher Internet addiction compared to those in the “No Exposure” class (β = 0.205, 95% CI [0.137, 0.272], p < .001), whereas the “High Exposure” class was not significantly different from the “No Exposure” class. Mediation analyses indicated that lower cognitive reappraisal significantly mediated the relationship between adversity class and Internet addiction (ACME = 0.034, 95% CI [0.011, 0.063], p < .001), whereas expressive suppression was not a significant mediator.

Conclusion and Implications: Study findings highlight heterogeneity in children’ exposure to co-occurring child maltreatment and parental mental illness and suggest that specific adversity profiles may confer greater risk for Internet addiction. Cognitive reappraisal may be one mechanism linking family adversity to problematic Internet use. Results underscore the importance of trauma-informed, developmentally responsive social work practice that addresses both family adversity and adolescents’ Internet addiction.