Introduction: Based on the theoretical frameworks of the Theory of Triadic Influence (TTI), this longitudinal study was designed to examine the mediating role of avoidance/emotion-focused coping in the relationship between distress tolerance and problematic Internet use (PIU) in a large representative sample of senior high school students in Taiwan. Methods: Through a 1-year follow-up design, 2170 participants were recruited from high schools throughout Taiwan using both stratified and cluster sampling in time 1 (T1), and 1832 students were followed-up 1 year later (T2). Results: Structure equation modeling and bootstrap analyses results showed that after controlling for PIU measured at T1, PIU (T2) was significantly predicted by distress tolerance (T1) and fully mediated through avoidance/emotion-focused coping (T2). Conclusions: The results not only support the TTI framework, but can also serve as a reference to help educational agencies and mental health organizations create policies and design programs that will help in the prevention of PIU among adolescents. The mediating role of avoidance/emotion-focused coping in the relationship between distress tolerance and PIU was discussed.
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