問題性網路使用已成為重要的公共衛生議題，尤其在東亞年輕成年人族群中更受到關注。隨著數位化快速發展，人們參與各式線上活動的頻率日益增加。儘管已有大量研究指出，問題性網路使用與心理困擾及生活品質下降密切相關，但在特定類型問題性網路使用的測量、其與心理健康影響後果之間的作用機制；以及不同地區間的差異方面，仍存在重要研究缺口。因此，本論文透過三項相互關聯的研究，結合心理計量驗證、作用機制探討與跨地區比較分析，以深化對問題性網路使用的理解。
本論文包含三項研究。第一項研究以臺灣與香港大學生為樣本，檢驗特定網路使用疾患診斷標準評估量表（Assessment of Criteria for Specific Internet-use Disorders, ACSID-11）繁體中文版之心理計量特性。驗證性因素分析結果支持其預設之四因子結構，且量表在不同性別與地區間皆展現良好的信度與測量恆等性。
第二項研究以個體－情感－認知－執行交互作用模型（Interaction of PersonAffect-Cognition-Execution, I-PACE）為理論基礎，進一步探討心理困擾、特定問題性網路使用與生活品質之間的關係。研究結果顯示，多種成癮性網路行為（如網路遊戲、社群媒體使用及網路購物）在心理困擾與生活品質之間具有顯著中介效果，心理困擾會透過特定問題性網路使用的程度，進而降低個體在多個生活品質面向上的表現。此外，不同地區之間亦呈現部分差異。
第三項研究進一步整合前述研究成果，透過探討知覺體重污名(perceived weight stigma)與內化體重污名(internalized weight stigma)在特定問題性網路使用與心理困擾之間的中介作用，以增進對問題性網路使用影響心理適應結果之認知與行為機制的理解。研究對象涵蓋臺灣、香港及中國大陸地區。結果顯示，知覺體重污名與內化體重污名皆能顯著中介大多數特定問題性網路使用與心理困擾之間的關聯。
綜合而言，本論文研究結果為ACSID-11於華語族群中的應用提供了有力的實證支持，並進一步指出生活品質與體重污名是與特定問題性網路使用相關的重要結果變項與作用機制。此外，研究亦揭示不同地區在問題性網路行為相關心理歷程上的共通性與差異性。這些發現顯示針對特定問題性網路使用的介入，除了著重於減少問題性行為本身之外，亦應關注污名、生活品質等更廣泛的心理社會因素，以促進個體的心理健康與福祉。

Problematic internet use (PIU) has emerged as a significant public health concern, particularly among young adults in East Asia, where rapid digitalization has increased engagement in diverse online activities. Despite growing evidence linking PIU to psychological distress and reduced quality of life (QoL), important gaps remain regarding the measurement of specific PIU, the mechanisms underlying these associations, and cross-regional differences. This dissertation aims to address these gaps through three interrelated studies integrating psychometric validation, mechanism exploration, and cross-cultural analysis.
The first study evaluated the psychometric properties of the Traditional Chinese version of the Assessment of Criteria for Specific Internet-use Disorders (ACSID-11) among university students in Taiwan and Hong Kong. Confirmatory factor analyses supported the proposed four-factor structure, and the scale demonstrated satisfactory reliability and measurement invariance across gender and region.
The second study further examined the relationships among psychological distress, specific PIU, and QoL based on the Interaction of Person-Affect-Cognition-Execution (I-PACE) model. Results demonstrate that various addictive online behaviors significantly mediate the negative impact of psychological distress on multiple QoL domains, with some cross-regional variations.
The third study synthesizes these findings to advance understanding of the cognitive and behavioral mechanisms linking PIU to psychological adjustment outcomes by investigating perceived and internalized weight stigma as mediators linking various forms of specific PIU to psychological distress across Taiwan, Hong Kong, and China. Findings revealed that both perceived and internalized weight stigma significantly mediated the associations between most forms of specific PIU and psychological distress.
Collectively, the findings provide robust evidence supporting the use of the ACSID-11 in Chinese-speaking populations and extend the literature by identifying QoL and weight stigma as important outcomes and mechanisms associated with specific PIU. The results also highlight regional similarities and differences in the psychological processes underlying problematic internet behaviors. These findings suggest that interventions targeting specific PIU should not only focus on reducing problematic behaviors but also address broader psychosocial factors, including stigma and QoL, to promote psychological well-being.

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