This study examined the association between adverse childhood experiences (ACEs) and digital media overuse among Korean adolescents using Bronfenbrenner's ecological systems theory. A secondary analysis of the Panel Study on Korean Children (n = 1,316) was conducted. Overall, 63.1% reported at least one ACE, and 56.6% met criteria for digital media overuse. In adjusted logistic regression models, having three or more ACEs was significantly associated with higher odds of digital media overuse (3 ACEs: adjusted odds ratio [aOR] = 1.97, 95% confidence interval [CI] = 1.14–3.41, p = .015; 4 ACEs: aOR = 3.81, 95% CI = 1.69–8.58, p < .001). Older age, female sex, and better school adjustment were associated with lower odds, whereas higher maternal parenting stress and academic stress were associated with greater odds. These findings support ACE-informed, family-centered prevention strategies within school health systems.
AdlerN. E.EpelE. S.CastellazzoG.IckovicsJ. R. (2000). Relationship of subjective and objective social status with psychological and physiological functioning: Preliminary data in healthy White women. Health Psychology, 19(6), 586–592. https://doi.org/10.1037/0278-6133.19.6.586
2.
Al-MamunF.HabibA. A.AlmerabM. M.SoraciP.MamunM. A. (2025). Adverse childhood experiences and mental health: The mediating role of perceived social support and coping strategies. BMC Psychiatry, 25(1), Article 836. https://doi.org/10.1186/s12888-025-07262-9
3.
ArmsdenG. C.GreenbergM. T. (1987). The inventory of parent and peer attachment: Individual differences and their relationship to psychological well-being in adolescence. Journal of Youth and Adolescence, 16(5), 427–454. https://doi.org/10.1007/BF02202939
4.
AyturS. A.CarlinoS.BernardF.WestK.DobrzyckiV.MalikR. (2022). Social-ecological theory, substance misuse, adverse childhood experiences, and adolescent suicidal ideation: Applications for community–academic partnerships. Journal of Community Psychology, 50(1), 265–284. https://doi.org/10.1002/jcop.22560
5.
BanninkR.PearceA.HopeS. (2016). Family income and young adolescents’ perceived social position: Associations with self-esteem and life satisfaction in the UK millennium cohort study. Archives of Disease in Childhood, 101(10), 917–921. https://doi.org/10.1136/archdischild-2015-309651
6.
BlockJ.KremenA. M. (1996). IQ And ego-resiliency: Conceptual and empirical connections and separateness. Journal of Personality and Social Psychology, 70(2), 349–361. https://doi.org/10.1037/0022-3514.70.2.349
7.
BronfenbrennerU. (1979). The ecology of human development: Experiments by nature and design. Harvard University Press.
8.
Centers for Disease Control and Prevention. (2024). About adverse childhood experiences. U.S. Department of Health and Human Services. https://www.cdc.gov/aces/about/index.html
9.
ChenM.TianN.ChangQ. (2022). Adverse childhood experiences, sexual orientation, and depressive symptoms among Chinese college students: An ecological framework analysis. Child Abuse & Neglect, 134, Article 105881. https://doi.org/10.1016/j.chiabu.2022.105881
10.
DarnaiG.PerlakiG.ZsidóA. N.InhófO.OrsiG.HorváthR.NagyS. A.LábadiB.TényiD.KovácsN.DócziT.DemetrovicsZ.JanszkyJ. (2019). Internet addiction and functional brain networks: Task-related fMRI study. Scientific Reports, 9(1), Article 15777. https://doi.org/10.1038/s41598-019-52296-1
11.
DomoffS. E.BorgenA. L.WilkeN.Hiles HowardA. (2021). Adverse childhood experiences and problematic media use: Perceptions of caregivers of high-risk youth. International Journal of Environmental Research and Public Health, 18(13), 6725. https://doi.org/10.3390/ijerph18136725
12.
FelittiV. J.AndaR. F.NordenbergD.WilliamsonD. F.SpitzA. M.EdwardsV.MarksJ. S. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The adverse childhood experiences (ACE) study. American Journal of Preventive Medicine, 14(4), 245–258. https://doi.org/10.1016/S0749-3797(98)00017-8
13.
ForsterM.RogersC. J.TinocoS.BenjaminS.LustK.GrigsbyT. J. (2023). Adverse childhood experiences and alcohol related negative consequence among college student drinkers. Addictive Behaviors, 136, 107484. https://doi.org/10.1016/j.addbeh.2022.107484
14.
HaoF.LiP.LiangZ.GengJ. (2024). The association between childhood adverse experiences and internet addiction: A meta-analysis. Acta Psychologica, 246, Article 104270. https://doi.org/10.1016/j.actpsy.2024.104270
15.
HeoD.KimS. (2022). The influence of parents’ self-esteem on media device addiction in late-school-age children: The mediating effects of marital conflict and children’s self-esteem. Journal of Korean Academy of Nursing, 52(4), 421–436. https://doi.org/10.4040/jkan.22036
JacksonD. B.TestaA.FoxB. (2021). Adverse childhood experiences and digital media use among U.S. Children. American Journal of Preventive Medicine, 60(4), 462–470. https://doi.org/10.1016/j.amepre.2020.10.019
18.
JeongH.YimH. W.LeeS. Y.LeeH. K.PotenzaM. N.KwonJ. H.KooH. J.KweonY. S.BhangS. Y.ChoiJ. S. (2018). Discordance between self-report and clinical diagnosis of Internet gaming disorder in adolescents. Scientific Reports, 8(1), Article 10084. https://doi.org/10.1038/s41598-018-28478-8
19.
KangH.KiP. (2023). The association between adverse childhood experiences and children’s media device addiction. Korean Journal of Health Psychology, 28(5), 999–1021. https://doi.org/10.17315/kjhp.2023.28.5.004
KesslerR. C.AndrewsG.ColpeL. J.HiripiE.MroczekD. K.NormandS. L.ZaslavskyA. M. (2002). Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychological Medicine, 32(6), 959–976. https://doi.org/10.1017/S0033291702006074
KumD. J.BangK. S. (2023). Health behavior and social-emotional health status of school-aged children according to their experience with atopic dermatitis diagnosis: Based on the 12th (2019) panel study on Korean children. Children, 10(2), 288. https://doi.org/10.3390/children10020288
29.
LamN.FairweatherS.LewerD.PrescottM.UndugodaP.DickersonJ.GilbodyS.WadmanR. (2024). The association between adverse childhood experiences and mental health, behaviour, and educational performance in adolescence: A systematic scoping review. PLOS Mental Health, 1(5), e0000165. https://doi.org/10.1371/journal.pmen.0000165
30.
LeeK. (2005). A study of middle-school students’ school adjustment constructs. Korean Journal of Psychology, 17(2), 383–398.
31.
LinS.MastrokoukouS.LongobardiC. (2023). Social relationships and social media addiction among adolescents: Variable-centered and person-centered approaches. Computers in Human Behavior, 147, Article 107840. https://doi.org/10.1016/j.chb.2023.107840
32.
LuP.QiuJ.HuangS.WangX.HanS.ZhuS.NingY.ZengF. F.YuanY. (2025). Interventions for digital addiction: Umbrella review of meta-analyses. Journal of Medical Internet Research, 27, e59656. https://doi.org/10.2196/59656
33.
MadiganS.DeneaultA. A.RacineN.ParkJ.ThiemannR.ZhuJ.NevilleR. D. (2023). Adverse childhood experiences: A meta-analysis of prevalence and moderators among half a million adults in 206 studies. World Psychiatry, 22(3), 463–471. https://doi.org/10.1002/wps.21122
34.
MloukiI.MajdoubM.HarizE.SiliniA.MrabetH. E.RezgN.El MhamdiS. (2024). Gender differences in adverse childhood experiences, resilience and internet addiction among Tunisian students: Exploring the mediation effect. PLOS Global Public Health, 4(1), e0002556. https://doi.org/10.1371/journal.pgph.0002556
35.
MontagC.WegmannE.SariyskaR.DemetrovicsZ.BrandM. (2021). How to overcome taxonomical problems in the study of internet use disorders and what to do with “smartphone addiction”?Journal of Behavioral Addictions, 9(4), 908–914. https://doi.org/10.1556/2006.8.2019.59
NiuL.GaoQ.XieM.YipT.GunnarM. R.WangW.XuQ.ZhangY.LinD. (2025). Association of childhood adversity with HPA axis activity in children and adolescents: A systematic review and meta-analysis. Neuroscience & Biobehavioral Reviews, 172, Article 106124. https://doi.org/10.1016/j.neubiorev.2025.106124
38.
OhD. L.JermanP.Silvério MarquesS.KoitaK.Purewal BoparaiS. K.Burke HarrisN.BucciM. (2018). Systematic review of pediatric health outcomes associated with childhood adversity. BMC Pediatrics, 18(1), Article 83. https://doi.org/10.1186/s12887-018-1037-7
39.
OlweusD. (1996). The revised Olweus bully/victim questionnaire. Research Center for Health Promotion, Bergen: University of Bergen.
40.
PetruccelliK.DavisJ.BermanT. (2019). Adverse childhood experiences and associated health outcomes: A systematic review and meta-analysis. Child Abuse & Neglect, 97, Article 104127. https://doi.org/10.1016/j.chiabu.2019.104127
41.
RomerD.MorenoM. (2017). Digital media and risks for adolescent substance abuse and problematic gambling. Pediatrics, 140(Suppl. 2), S102–S106. https://doi.org/10.1542/peds.2016-1758L
SenaratneD. N. S.ThakkarB.SmithB. H.HalesT. G.MarryatL.ColvinL. A. (2024). The impact of adverse childhood experiences on multimorbidity: A systematic review and meta-analysis. BMC Medicine, 22(1), 315. https://doi.org/10.1186/s12916-024-03505-w
45.
ShutzmanB.GershyN. (2023). Children’s excessive digital media use, mental health problems, and the protective role of parenting during COVID-19. Computers in Human Behavior, 139, Article 107559. https://doi.org/10.1016/j.chb.2022.107559
46.
SoaresS.SantosA. C.FragaS. (2022). Adverse childhood experiences, bullying, inflammation and BMI in 10-year-old children: The biological embodiment. PLOS ONE, 17(8), e0273329. https://doi.org/10.1371/journal.pone.0273329
47.
SohnS. Y.ReesP.WildridgeB.KalkN. J.CarterB. (2019). Prevalence of problematic smartphone usage and associated mental health outcomes amongst children and young people: A systematic review, meta-analysis and GRADE of the evidence. BMC Psychiatry, 19(1), Article 356. https://doi.org/10.1186/s12888-019-2350-x
48.
SwedoE. A.PampatiS.AndersonK. N., et al. (2024). Adverse childhood experiences and health conditions and risk behaviors among high school students—youth risk behavior survey, United States, 2023. MMWR Supplements, 73(Suppl. 4), 39–49. https://doi.org/10.15585/mmwr.su7304a5
49.
SypniewskiR. (2016). Motivational interviewing: A practical intervention for school nurses to engage in trauma informed care. NASN School Nurse, 31(1), 40–44. https://doi.org/10.1177/1942602X15576777
50.
TheopilusY.Al MahmudA.DavisH.OctaviaJ. R. (2024). Preventive interventions for Internet addiction in young children: Systematic review. JMIR Mental Health, 11, e56896. https://doi.org/10.2196/56896
51.
TomodaA.NishitaniS.TakiguchiS.FujisawaT. X.SugiyamaT.TeicherM. H. (2025). The neurobiological effects of childhood maltreatment on brain structure, function, and attachment. European Archives of Psychiatry and Clinical Neuroscience, 275(7), 1939–1958. https://doi.org/10.1007/s00406-024-01779-y
WeissmanM. M.OrvaschelH.PadianN. (1980). Children’s symptom and social functioning self-report scales: Comparison of mothers’ and children’s reports. Journal of Nervous and Mental Disease, 168(12), 736–740. https://doi.org/10.1097/00005053-198012000-00005
54.
YangH. M.KimH. R. (2024). Father–child attachment on children’s screen time: Mediating role of ego resilience. BMC Pediatrics, 24(1), 672. https://doi.org/10.1186/s12887-024-05148-5
YounH.LeeS. I.LeeS. H.KimJ. Y.KimJ. H.ParkE. J.ParkJ. S.BhangS. Y.LeeM. S.LeeY. J.ChoiS. C.ChoiT. Y.LeeA. R.KimD. J. (2018). Exploring the differences between adolescents’ and parents’ ratings on adolescents’ smartphone addiction. Journal of Korean Medical Science, 33(52), e347. https://doi.org/10.3346/jkms.2018.33.e347
57.
YunJ.HanG.SonH. (2022). Protective and risk factors of problematic smartphone use in preteens using panel study on Korean children. Frontiers in Psychiatry, 13, Article 981357. https://doi.org/10.3389/fpsyt.2022.981357
58.
ŽmavcM.HorvatJ.ŽidanM.SelakŠ (2025). The effectiveness of school-based interventions to reduce problematic digital technology use and screen time: A systematic review and meta-analysis. Journal of Behavioral Addictions, 14(2), 571–589. https://doi.org/10.1556/2006.2025.00043
