Yao Gan ¹ Li Kuang ^1* Xiaoming Xu ¹ Ming Ai ¹ Jinglan He ¹ Wo Wang ² Su Hong ¹ Jianmei Chen ¹ Jun Cao ¹ Qi Zhang ¹

• ¹ First Affiliated Hospital of Chongqing Medical University, Chongqing, China
• ² University-Town Hospital of Chongqing Medical University, Chongqing, China

Objective To explore the risk factors affecting adolescents’ Internet addiction behavior and build a prediction model for adolescents’ Internet addiction behavior based on machine learning algorithms. Methods A total of 4461 high school students in Chongqing were selected using stratified cluster sampling, and questionnaires were administered. Based on the presence of Internet addiction behavior, students were categorized into an Internet addiction group (n=1210) and a non-Internet addiction group (n=3115). Gender, age, residence type, and other data were compared between the groups, and independent risk factors for adolescent Internet addiction were analyzed using a logistic regression model. Six methods—multi-level perceptron, random forest, K-nearest neighbor, support vector machine, logistic regression, and extreme gradient boosting—were used to construct the model. The model’s indicators under each algorithm were compared, evaluated with a confusion matrix, and the optimal model was selected. Result: The proportion of male adolescents, urban household registration, and scores on the family function, planning, action, and cognitive subscales, along with psychoticism, introversion-extroversion, neuroticism, somatization, obsessive-compulsiveness, interpersonal sensitivity, depression, anxiety, hostility, paranoia, and psychosis, were significantly higher in the Internet addiction group than in the non-Internet addiction group (P < 0.05). No significant differences were found in age or only-child status (P > 0.05). Statistically significant variables were analyzed using a logistic regression model, revealing that gender, household registration type, and scores on planning, action, introversion-extroversion, psychoticism, neuroticism, cognitive, obsessive-compulsive, depression, and hostility scales are independent risk factors for adolescent Internet addiction. The area under the curve (AUC) for multi-level perceptron, random forest, K-nearest neighbor, support vector machine, logistic regression, and extreme gradient boosting models were 0.843, 0.817, 0.778, 0.846, 0.847, and 0.836, respectively, with extreme gradient boosting showing the best predictive performance among these models. Conclusion The detection rate of Internet addiction is higher in males than in females, and adolescents with impulsive, extroverted, psychotic, neurotic, obsessive, depressive, and hostile traits are more prone to developing Internet addiction. While the overall performance of the machine learning models for predicting adolescent Internet addiction is moderate, the extreme gradient boosting method outperforms others, effectively identifying risk factors and enabling targeted interventions.