Problematic Internet Use Among Primary School Children: A Narrative Review of Its Conceptualization and Associated Socioecological Factors

1. Introduction

The expansion of the Internet and digital technologies has facilitated their incorporation into virtually every area of everyday life. Consequently, the daily use of these resources has become common practice among the general population, transforming the ways in which people communicate, learn, engage in leisure activities, and socialize. This phenomenon is particularly relevant during childhood and adolescence, stages in which the Internet, video games, social media, and mobile devices constitute common settings for interaction and entertainment. Although these technologies offer important opportunities for development, their excessive or maladaptive use may have harmful effects on children’s well-being. It is therefore essential to conceptually delimit the phenomenon of problematic Internet use.

In this context, problematic Internet use (PIU) is considered an umbrella term encompassing excessive, compulsive, or maladaptive patterns of use of digital technologies associated with online environments [1,2,3]. This concept includes various problematic behaviors characterized by loss of control and the persistence of the behavior despite its negative consequences, such as Internet gaming disorder, problematic social media use, compulsive online buying, problematic pornography use, cyberchondria, and online gambling [1,3,4]. In children, it is particularly important to distinguish between these subtypes to avoid conceptual confusion, particularly between problematic Internet use, Internet addiction, and problematic social media use [5]. Table 1 provides a summary of these concepts and their main differences.

Nevertheless, the literature continues to show considerable terminological and conceptual heterogeneity in describing problematic Internet-related behaviors. The absence of unified diagnostic criteria has led to multiple approaches focused on specific behaviors. Internet addiction is not recognized as a distinct formal diagnosis in either the DSM-5-TR or the ICD-11. Internet gaming disorder is included in the DSM-5-TR as a condition for further study, whereas the ICD-11 formally recognizes gaming disorder, encompassing both online and offline gaming [6,7]. This terminological and conceptual heterogeneity makes it difficult to compare studies, estimate prevalence, and develop preventive and therapeutic interventions [8,9]. In this regard, several authors support the usefulness of PIU as an integrative category that encompasses different problematic digital behaviors while acknowledging their specific characteristics. This approach promotes greater conceptual consistency and better adaptation to a constantly evolving technological environment [3].

Although most research on problematic Internet use has focused on adolescence and later developmental stages, childhood—particularly the primary education stage (approximately 6–12 years of age)—represents an especially relevant period for its study. During this stage, digital use habits begin to develop and become established, and many of them may persist and intensify in later stages of development. In this regard, restricting the present review exclusively to primary school children avoids grouping together child, adolescent, and adult populations, whose developmental characteristics, psychosocial needs, and patterns of technology use differ considerably. Therefore, identifying the risk and protective factors associated with problematic Internet use at this developmental stage is essential for designing preventive strategies and early interventions before these patterns become firmly established.

According to Bronfenbrenner’s ecological model [10], children’s behavior results from the interaction among multiple systems of influence. When applied to problematic Internet use, this model suggests that children’s digital behavior depends not only on individual characteristics but also on family dynamics, peer relationships, the school context, and the characteristics of the digital environment [10,11,12]. Figure 1 graphically represents the interaction among these ecological levels in relation to Internet use during childhood.

Despite growing interest in PIU, the evidence concerning primary school children remains conceptually fragmented, with studies employing heterogeneous terminology and frequently examining associated factors within isolated developmental contexts. The present review addresses this fragmentation by jointly examining the conceptualization of PIU and organizing its associated factors across multiple socioecological levels. Accordingly, this narrative review aims to synthesize recent evidence on Internet use and its problematic manifestations among primary school children from a socioecological perspective. Specifically, it seeks to (1) examine the main conceptualizations and manifestations of Internet use described in this population and (2) identify the individual, peer, family, school, and digital factors associated with higher or lower levels of PIU. By integrating conceptual analysis with a socioecological organization of the evidence, this review seeks to provide a more comprehensive understanding of PIU during primary education and inform future research and preventive initiatives.

2. Materials and Methods

2.1. Review Design and Research Questions

This study was designed as a narrative review informed by a structured and focused literature search. The search was conducted to enhance the transparency of the literature identification process and obtain a current body of evidence relevant to the review objectives. However, the study was not designed as a systematic or scoping review and did not aim to provide an exhaustive identification of all potentially eligible publications or to estimate pooled effect sizes. Consistent with a narrative review approach, the findings were synthesized descriptively and interpretively.

An adapted PECOS framework was used as an organizational tool to define the scope of the review and structure the research questions:

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P (Population): Children enrolled in primary or elementary education.

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E (Exposure): Individual, family, socioemotional, peer, school, and digital factors potentially associated with Internet use and its problematic manifestations.

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C (Comparator): Where applicable, children with lower versus higher levels of the factors examined or with lower versus higher levels of problematic Internet use. A formal comparison group was not required for inclusion.

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O (Outcomes): Measures of Internet use and its problematic manifestations, together with the reported associations between these outcomes and the factors examined.

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S (Study design): Quantitative empirical studies employing observational or quasi-experimental designs, including cross-sectional, case-control, cohort, and longitudinal studies.

Based on this framework, the review addressed the following research questions: (1) How are Internet use and its problematic manifestations conceptualized among primary school children? and (2) Which individual and contextual factors are associated with higher or lower levels of problematic Internet use from a socioecological perspective?

2.2. Literature Search

The literature search was conducted between 7 and 12 June 2026 in APA PsycInfo, Web of Science Core Collection, and PubMed. The search terms were organized into three thematic groups: (1) Internet-related outcomes and digital experiences, including cybervictimization, Internet use, Internet addiction, problematic Internet use, online gaming, Internet gaming disorder, social media use, problematic social media use, fear of missing out (FoMO), smartphone use, and problematic smartphone use; (2) individual, interpersonal, and contextual factors, including protective factors, emotional intelligence, emotional competence, emotional literacy, emotion regulation, digital skills, social skills, social support, family support, peer support, parental mediation, digital literacy, resilience, self-esteem, school connectedness, school climate, teacher support, community support, and neighborhood cohesion; and (3) population-related terms, including children, elementary school, primary school, and school-age.

Terms within each thematic group were combined using the Boolean operator OR, and the three groups were combined using AND. The syntax and search fields were adapted to the indexing structure of each database.

The search was restricted to studies published between 2021 and 2026. This purposive time frame was selected because children’s Internet use occurs within a rapidly changing technological context characterized by continuing changes in digital platforms, devices, and patterns of use. This decision was also consistent with the temporal dimension of the chronosystem in Bronfenbrenner’s ecological model and with the review’s objective of synthesizing recent evidence.

2.3. Eligibility Criteria

Studies were eligible when they were quantitative empirical investigations focused on children identified as primary or elementary school students. Because the chronological boundaries of primary education vary across countries and educational systems, educational stage rather than a predetermined age range was used as the principal population criterion. Eligibility was therefore based on the authors’ identification of the participants as primary or elementary school students, including when their exact ages were not reported or when the age distribution extended beyond the typical boundaries of primary education.

Studies involving mixed primary- and secondary-school populations were excluded unless findings for the primary school subgroup were reported separately. Eligible studies were also required to assess Internet use or one of its problematic manifestations and at least one potentially associated individual, family, socioemotional, peer, school, or digital factor.

Nonempirical publications, qualitative studies, reviews, meta-analyses, book chapters, conference abstracts, and studies that did not focus specifically on primary school populations were excluded.

2.4. Study Selection and Narrative Synthesis

The study selection process comprised three stages: title screening, abstract assessment, and full-text review. The database searches identified 232 records. Following title and abstract screening, 37 articles were retained for full-text assessment. During the full-text review, 19 studies were excluded because they did not meet the population, educational-stage, or other eligibility criteria. These studies were excluded primarily because they included adolescent or secondary-school populations without reporting separate findings for primary school children. Consequently, 18 studies were included in the narrative synthesis.

The selection process was conducted by two reviewers working independently. Disagreements regarding eligibility were resolved through discussion and consensus with the rest of authors.

Relevant information was extracted and descriptively charted from each study, including country, sample characteristics, educational stage or age, study design, terminology and construct assessed, associated variables, and principal findings. Data charting was conducted by two reviewers.

The narrative synthesis was conducted in two stages. First, the terminology used to conceptualize Internet use and its problematic manifestations was compared across studies. Second, the reported associated factors were organized according to their direction of association and their socioecological level, including individual, peer, family, school, and digital factors.

Terms such as risk factor and protective factor were retained when they reflected the terminology used in the original studies. Nevertheless, the findings were interpreted primarily as associations, particularly when derived from cross-sectional studies. No meta-analysis was conducted because of the conceptual, methodological, and measurement heterogeneity of the included studies. A formal risk-of-bias instrument was not applied; however, the study designs and their methodological limitations were considered in the narrative interpretation of the evidence.

3. Results

The results of the 18 studies included in this narrative review are presented in four sections. First, the main study characteristics are summarized, including their geographical distribution, research design, and the digital-use constructs assessed. Second, the terminology used to classify and conceptualize Internet use and its problematic manifestations in childhood is examined. Third, variables associated with higher levels of or a greater likelihood of problematic Internet use are synthesized across individual, family, peer, school, and digital domains. Finally, variables associated with lower levels of or a lower likelihood of problematic Internet use are presented across the relevant socioecological domains. Given the heterogeneity in terminology, outcome measures, and study designs, the findings are reported through narrative synthesis and are interpreted primarily as associations rather than causal relationships.

3.1. Study Characteristics

The studies included in this review were conducted across a diverse range of countries: six studies were carried out in China [13,14,15,16,17,18], four in Turkey [19,20,21,22], three in Spain [23,24,25], and one study each in Latvia [26], Lebanon [27], South Korea [28], Indonesia [29], and Poland [30].

Regarding study design, 12 studies employed cross-sectional designs [13,14,15,17,18,19,23,24,25,27,29,30]. Two studies employed case-control designs [20,21]. Three studies employed longitudinal designs [16,26,28], one of which was a cohort study [28]. Finally, one study employed a quasi-experimental pretest–posttest design with a control group [22].

Regarding the topics addressed, the studies used heterogeneous terminology to conceptualize children’s digital behavior. Seven studies assessed Internet addiction [13,14,15,17,18,22,29]. In addition, four constructs were each examined in two studies: Internet use [19,25], risky Internet use [20,21], problematic smartphone use [28,30], and problematic Internet use [23,24]. Finally, four topics were examined in one study each: children’s compulsive Internet use [26], child problematic media use [27], problematic video game use [23], and Internet gaming disorder [16]. Because Bautista-Alcaine et al. [23] examined both problematic Internet use and problematic video game use, the number of thematic classifications exceeds the total number of included studies.

3.2. Classification and Conceptualization of PIU in Childhood

The studies included in this review used heterogeneous terminology to assess Internet use and its various problematic manifestations in childhood, reflecting the lack of conceptual consensus in this field.

At the first level, the studies examined broader patterns of use, employing the terms Internet use [19,25] and risky Internet use [20,21], focusing on the frequency and intensity of digital technology use and the associated risk behaviors.

At the second level, the studies assessed forms of problematic use using terms such as children’s compulsive Internet use [26], child problematic media use [27], problematic Internet use [23,24], problematic smartphone use [28,30], and problematic video game use [23]. These constructs refer to excessive or maladaptive patterns of use without necessarily implying the presence of a clinical disorder.

Finally, several studies examined constructs framed in terms of addictive behaviors, including Internet addiction [13,14,15,17,18,22,29] and Internet gaming disorder [16]. These terms were retained as reported in the original studies and should not be interpreted as equivalent diagnostic categories.

3.3. Risk Factors Associated with Problematic Internet Use

3.3.1. Family and Digital Factors

Eight studies identified family-related variables associated with higher levels of or a greater likelihood of problematic Internet use [13,14,15,21,24,26,27,28]. These included emotional abuse [13], parental smartphone dependence or addiction [15,27], inconsistent parenting practices characterized by a lack of clear rules [26], authoritarian parenting [14], permissive parenting [28], indirect pathways involving permissive parenting [14], insecure attachment to parents [24], and parent–child conflict [15,21,27].

At the digital level, two studies reported associations between patterns of Internet use and problematic Internet use [23,29]. Recreational online activities, including social networking, gaming, and watching videos or films, were associated with higher levels of Internet addiction [29]. Similarly, problematic video game use and more time spent online on school days were associated with higher levels of problematic Internet use [23].

3.3.2. Individual and Peer Factors

At the individual level, eight studies identified associations between problematic Internet use and various personal and socioemotional variables [13,16,17,20,21,24,28,30]. These included social anxiety symptoms [30], poorer social skills [20,30], lower subjective well-being [17], an ADHD diagnosis or ADHD-related symptoms [20,21,28], emotional dysregulation [13], maladaptive cognitive emotion regulation strategies, including rumination, catastrophizing, and other-blame [24], and higher sensation seeking, which strengthened the association between deviant peer affiliation and Internet gaming addiction [16].

At the peer level, three studies identified associations between problematic Internet use and interpersonal variables, including poorer peer relationships and peer victimization [17,18] and deviant peer affiliation [16]. In the latter study, the association between deviant peer affiliation and Internet gaming addiction was significant among children with higher levels of sensation seeking.

3.4. Protective Factors Associated with Problematic Internet Use

3.4.1. Family and School Factors

Eight studies identified family-related variables associated with lower levels of or a lower likelihood of problematic Internet use [14,17,23,24,25,26,28,29]. These included positive parent–child relationships [17,26], restrictive parental mediation [29], parental supervision [23,28,29], secure parental attachment [24], authoritative parenting [14], and greater parental digital competence [25].

At the school level, a positive school climate was indirectly associated with lower levels of Internet gaming addiction over time through reduced deviant peer affiliation [16].

3.4.2. Individual, Behavioral, and Peer Factors

Four studies identified individual, behavioral, and peer-related factors associated with lower levels of problematic Internet use [17,18,22,28]. These included greater subjective well-being [17], participation in traditional children’s games [22], positive communication with peers [28], and higher resilience, which buffered the association between peer relationship difficulties and Internet addiction [18].

Additionally, Ayaz-Alkaya and Akca [19] found that more frequent participation in traditional children’s games was associated with shorter Internet-use sessions and less daily Internet use. However, this study assessed general Internet use rather than problematic Internet use.

4. Discussion

The present narrative review aimed to examine the different ways in which problematic Internet use (PIU) has been conceptualized and to synthesize the available evidence on the main risk and protective factors associated with this phenomenon among primary school children. Overall, the conceptualizations identified in the reviewed studies can be organized along a continuum of severity, ranging from general Internet use to risky, problematic, and addiction-related patterns of use. The findings further indicate that PIU, used as an umbrella term, is associated with a combination of individual, family, peer, school, and digital factors that may be related to either a greater or lower likelihood of problematic use. Consistent with the principles of the ecological model [31], these factors operate interdependently across children’s developmental contexts. Accordingly, the discussion first addresses the classification and conceptualization of PIU in childhood, followed by the risk and protective factors identified across the different socioecological domains. The clinical and practical implications, limitations, and directions for future research are then considered.

4.1. Classification and Conceptualization of PIU in Childhood

This review revealed considerable terminological heterogeneity in descriptions of children’s digital behavior, reflecting a lack of consensus regarding the conceptualization of problematic Internet use (PIU), a limitation widely acknowledged in the literature [3,5,8]. The included studies used a wide range of terms to describe different forms of engagement with digital environments, ranging from general patterns of Internet use [19,25] to problematic and addiction-related manifestations [13,14,15,16,17,18,20,21,22,23,24,26,27,28,29,30]. Although many of these constructs overlap substantially, they can be differentiated according to the specific digital behavior to which they refer, and the level of severity attributed to them.

In this regard, children’s digital behaviour may be better understood from a dimensional perspective than as a set of independent categories with clearly defined boundaries. Previous evidence suggests that different forms of Internet use can be organized along a continuum of severity, ranging from non-problematic use through intermediate levels of excessive or risky use to problematic and pathological or addiction-related patterns [32,33]. Figure 2 illustrates this proposed conceptual classification.

At the lower end of the continuum is adaptive Internet use, understood as functional use that is compatible with adequate daily functioning and consistent with children’s developmental needs. From this perspective, time spent online does not, in itself, constitute an indicator of problematic use but should instead be interpreted in relation to its context [32,34].

A second level would comprise excessive Internet use and risky online behaviors. These patterns may increase children’s vulnerability to potentially harmful situations in digital environments, such as sharing personal information or interacting with strangers [35]. However, the evidence suggests that there is no clearly defined boundary between these risk-related behaviors and more problematic patterns of use, further supporting a dimensional understanding of the phenomenon [33].

Problematic Internet use would be located at the next level. PIU is understood as an umbrella term encompassing excessive or maladaptive patterns of use associated with negative consequences for personal, social, family, or academic functioning, without necessarily implying the presence of an addictive disorder [5]. This level includes constructs such as problematic Internet use, problematic smartphone use, problematic social media use, and problematic video game use, which may share underlying mechanisms but differ in the specific digital activity through which they are manifested [3].

Finally, at the higher-severity end of the continuum are constructs framed in terms of addictive behavior, such as Internet addiction and Internet gaming disorder. These constructs refer to patterns characterized by a significant loss of control, clinically relevant functional impairment, and symptoms resembling those of behavioral addictions [36,37]. However, these terms should not be interpreted as equivalent formal diagnostic categories. Internet addiction is not recognized as a distinct diagnosis in either the DSM-5-TR or the ICD-11. Internet gaming disorder is included in the DSM-5-TR as a condition for further study, whereas the ICD-11 formally recognizes gaming disorder [6,7].

Taken together, these findings reveal considerable terminological and conceptual diversity in the literature on children’s digital behavior. This heterogeneity hinders comparisons across studies and supports the usefulness of problematic Internet use (PIU) as an umbrella term capable of integrating different problematic manifestations of digital behavior while preserving their specific characteristics [2,8].

Therefore, the evidence suggests that the classification of PIU should not be based exclusively on symptom severity. Several authors have proposed incorporating motives for use and the ecological context in which Internet use occurs, recognizing that children’s digital behavior emerges from dynamic interactions among multiple individual, family, school, and social systems throughout development [32,38,39]. From this perspective, the severity continuum should be complemented by an ecological analysis of the personal and contextual factors that may increase or reduce the likelihood of PIU.

4.2. Risk Factors Associated with Problematic Internet Use

4.2.1. Family and Digital Factors

The primary school years represent an important developmental period during which the family context plays a fundamental role in children’s socioemotional development and the acquisition of healthy habits. However, the evidence synthesized in this review indicates that family-related variables may also be associated with a greater likelihood of problematic Internet use. Specifically, the included studies associated PIU with emotional abuse, parental smartphone dependence or addiction, inconsistent parenting practices characterized by a lack of clear rules, authoritarian parenting, direct or indirect pathways involving permissive parenting, insecure parental attachment, and parent–child conflict [13,14,15,21,24,26,27,28].

These findings are consistent with previous evidence indicating that dysfunctional family relationships and lower-quality emotional bonds are associated with higher levels of problematic Internet, social media, and video game use [40,41,42,43]. Such family contexts may be characterized by insecure attachment, conflictual or abusive interactions, and inconsistent or authoritarian parenting practices, which may hinder family functioning and the establishment of consistent guidance regarding technology use [44]. In these circumstances, children may turn to the Internet to compensate for unmet emotional needs or manage emotional distress arising from the family environment, consistent with compensatory models of problematic Internet use [36,45].

The role of digital technology is not limited to children’s behavior but also extends to parents’ own technology use. Parental computer and Internet use may shape children’s digital behavior through monitoring, mediation, and behavioral modeling [46]. Because parents are important behavioral models during childhood, frequent parental smartphone or Internet use, combined with limited mediation or permissive digital parenting, may contribute to the normalization of high levels of digital engagement and potentially to the development of maladaptive use patterns among children [47,48,49].

Regarding digital factors, this review found that certain patterns of use were associated with higher levels of PIU, particularly recreational online activities and more time spent online on school days [23,29]. These findings are consistent with previous literature suggesting that risk is associated not only with the amount of time spent online but also with the type, purpose, and context of the digital activity [50]. From this perspective, concern may arise not from digital activities themselves, but when their use displaces other experiences that are important for child development, such as play, physical activity, sleep, or face-to-face social interactions [32,36].

In particular, problematic video game use was associated with higher levels of PIU in one of the included cross-sectional studies [23]. This association may be interpreted in relation to the immediate rewards, continuous progression, and recurrent reinforcement characteristic of many online games, which may facilitate the development and maintenance of compulsive patterns of use among vulnerable individuals [36,37,51]. This finding is compatible with locating gaming-related problems within the broader spectrum of problematic Internet-related behaviors. However, problematic video game use and Internet gaming disorder should not be treated as interchangeable constructs.

4.2.2. Individual and Peer Factors

This review identified associations between problematic Internet use and several personal, socioemotional, and peer-related variables. These included social anxiety, poorer social skills, lower subjective well-being, an ADHD diagnosis or ADHD-related symptoms, emotional dysregulation, maladaptive cognitive emotion regulation strategies, poorer peer relationships, peer victimization, deviant peer affiliation, and higher sensation seeking, which strengthened the association between deviant peer affiliation and Internet gaming addiction [13,16,17,18,20,21,24,28,30].

Taken together, these findings suggest that socioemotional difficulties may represent markers of vulnerability to PIU. First, poorer social skills and social anxiety may be associated with greater reliance on online interaction. One possible explanation is that children with fewer social competencies may perceive online interactions as safer and more controllable than face-to-face relationships. This preference may be associated with a greater likelihood of developing problematic patterns of Internet use, particularly when digital environments are used to meet social needs that remain unmet offline [52,53,54].

Second, emotion regulation emerged as another potentially relevant explanatory mechanism. The included studies associated emotional dysregulation and maladaptive cognitive emotion regulation strategies with higher levels of PIU [13,24]. More broadly, recent evidence suggests that children and adolescents experiencing greater difficulty managing negative emotions or higher levels of psychological distress may be more likely to use the Internet as a coping or emotion-regulation strategy. However, the direction of this relationship remains unclear, and the available longitudinal evidence does not support a uniformly unidirectional pathway from emotional difficulties to PIU [55].

Peer relationships also appear to play an important role. In the included studies, poorer peer relationships, peer victimization, and deviant peer affiliation were associated with higher levels of problematic Internet-related behaviors [16,17,18]. Peer victimization was also associated with lower subjective well-being, which partially mediated its relationship with Internet addiction [17]. These findings suggest that some children experiencing peer difficulties may turn to online environments as a means of coping or social compensation, although the observational nature of most of the evidence prevents causal conclusions.

An ADHD diagnosis or ADHD-related symptoms were also associated with higher levels of PIU. Attention difficulties, impulsivity, and self-regulation difficulties may make highly stimulating digital activities that provide immediate gratification particularly appealing. Some children with ADHD-related symptoms may also use digital environments to compensate for difficulties in their offline peer relationships. Nevertheless, the available evidence indicates that associations between ADHD symptoms and digital media use may be reciprocal rather than exclusively unidirectional [56,57].

Finally, sensation seeking should be interpreted as a moderating variable rather than as an independent risk factor in the included evidence. Wei and Xu [16] found that the association between deviant peer affiliation and Internet gaming addiction was significant among children with higher levels of sensation seeking. This moderating pattern is consistent with theoretical models emphasizing interactions between personal predispositions and contextual influences [36], as well as with previous research linking sensation seeking to online gaming addiction [58].

4.3. Protective Factors Associated with Problematic Internet Use

4.3.1. Family and School Factors

The evidence synthesized in this review indicates that children’s access to and use of digital technologies during the primary school years are strongly shaped by the family context. Research conducted across childhood and adolescence suggests that parents influence Internet use through rules, behavioral modeling, and mediation practices [59,60]. In this regard, the review identified authoritative parenting, parental supervision and mediation, positive parent–child relationships, secure attachment to parents, and greater parental digital competence as family-related variables associated with lower levels of or a lower likelihood of PIU [14,17,23,24,25,26,28,29].

These findings are broadly consistent with previous evidence suggesting that parental mediation operates within a broader family context characterized by secure attachment, open communication, emotional support, a positive family climate, and clear and consistent rules [40,42,54,61]. However, the evidence does not indicate that active parental mediation is uniformly effective, as its associations with children’s digital outcomes may vary according to the mediation strategy and outcome examined. From this perspective, supervision should not be understood solely as a strategy for controlling or restricting use, but also as an educational process through which parents guide children in developing digital skills and online self-regulation [62,63]. Such guidance may support the development of more autonomous and responsible use of digital environments over time. Accordingly, learning to use the Internet adaptively and internalizing appropriate boundaries may be associated with a lower likelihood of developing maladaptive patterns of use [32]. Parental guidance may also be relevant to broader online-safety outcomes, including involvement in cyberbullying [64,65]. Taken together, these findings highlight the family as an important potential protective context during this developmental stage.

At the school level, one longitudinal study found that a positive school climate was associated with lower levels of Internet gaming addiction one year later, partly through lower deviant peer affiliation [16]. This finding is broadly consistent with previous research suggesting that a safe school environment, characterized by positive student–teacher relationships and a strong sense of school belonging, is associated with children’s emotional well-being and psychosocial adjustment [66,67,68,69]. A positive school climate may also facilitate healthy peer relationships and provide opportunities for face-to-face interaction [66,69]. School climate and connectedness have also been associated with lower levels of problematic smartphone and social media use, although some of this evidence comes from adolescent samples [70]. Therefore, these findings support the relevance of the school context, while indicating that further research specifically involving primary school children is needed.

4.3.2. Individual, Behavioral, and Peer Factors

The evidence synthesized in this review identified several personal, behavioral, and peer-related variables associated with lower levels of or a lower likelihood of problematic Internet use. Specifically, positive peer communication [28], participation in traditional children’s games [22], and resilience [18] emerged as potentially protective resources. Ayaz-Alkaya and Akca [19] also found that participation in traditional games was associated with lower levels of general Internet use; however, this study did not assess problematic Internet use and therefore provides only indirect evidence.

Social skills may also constitute a relevant socioemotional resource. However, Przepiorka et al. [30] examined the relationships among social skills, problematic smartphone use, somatic symptoms, and academic performance using a cross-sectional mediation model; consequently, its findings should not be interpreted as demonstrating that stronger social skills independently protect against PIU. Previous literature has nevertheless identified associations between social competence and problematic or addictive Internet-related behaviors [54]. According to Caplan’s model [52], psychosocial difficulties may contribute to a preference for online rather than face-to-face social interaction. From this perspective, stronger offline social skills could facilitate satisfactory face-to-face relationships and reduce reliance on online environments to meet social needs. Nevertheless, this explanatory mechanism was not directly tested in the study by Przepiorka et al. [30].

Positive peer communication was also associated with a lower likelihood of problematic smartphone use [28]. Communication characterized by mutual respect, listening, and the discussion of concerns and problems may provide children with emotional and social support, potentially reducing the need to use the Internet as a compensatory means of social interaction. This interpretation is consistent with previous evidence showing that positive peer relationships are associated with lower levels of PIU and more favorable socioemotional outcomes. However, this previous evidence primarily concerns adolescents, and the overall association between peer relationships and PIU appears to be relatively small [71].

Participation in traditional children’s games represents a further potentially protective behavioral factor. In the quasi-experimental study by Kacar and Ayaz-Alkaya [22], an eight-week traditional-games intervention was followed by reductions in daily and weekly Internet use and improvements in social skills compared with the control group. In addition, Ayaz-Alkaya and Akca [19] found that children who participated in traditional games reported shorter Internet-use sessions and less daily Internet use. However, the latter study assessed general Internet use rather than PIU and used a cross-sectional design. These activities may offer healthy leisure alternatives that promote physical activity, motor development, and face-to-face social interaction [72]. Nevertheless, reductions in Internet or screen time should not be interpreted as equivalent to reductions in PIU.

Finally, resilience emerged as another relevant protective resource. Zhou et al. [18] found that resilience buffered the association between peer relationship difficulties and Internet addiction, with this association being weaker among children with higher levels of resilience. Resilience may facilitate more adaptive coping with social adversity and stress, thereby reducing reliance on the Internet as a means of emotional regulation. This interpretation is consistent with previous evidence showing a negative association between resilience and PIU [73]. However, this relationship should not be interpreted as causal, as most of the studies synthesized in that meta-analysis used cross-sectional designs.

4.4. Limitations and Future Research

This narrative review provides a broad synthesis of the available evidence concerning the conceptualization of PIU and the factors associated with it among primary school children.

Nevertheless, several limitations should be considered when interpreting the findings. First, as is generally the case with narrative reviews, there is an inherent risk of bias in the selection and interpretation of the included studies. Second, most of the studies employed observational designs, predominantly cross-sectional, limiting the ability to establish causal relationships and understand the developmental course of problematic Internet use during childhood. Only three longitudinal studies—including one cohort study—and one quasi-experimental study were identified. Future research should therefore make greater use of longitudinal designs to examine the stability and developmental trajectories of PIU, as well as the prospective relationships between risk and protective factors and PIU across development. Furthermore, although the included studies were conducted in different cultural settings, their geographical distribution was uneven, and sociocultural differences in children’s digital behavior may limit the generalizability of the findings. Further evidence from more diverse populations is therefore needed.

An additional limitation is that none of the studies included in this review examined community-level factors, revealing an important gap in the available evidence. Future research should therefore examine the characteristics of the environments in which children develop beyond their families and schools. Previous literature suggests that neighborhood characteristics, access to safe public and green spaces, and opportunities to participate in recreational and social activities may facilitate in-person play, well-being, and peer interaction, thereby representing potential contextual resources for promoting a more balanced range of leisure activities [74,75]. It is also plausible that access to sporting, cultural, and recreational activities, together with safe community environments that facilitate peer interaction, may help reduce screen exposure and promote healthy leisure alternatives. However, these potential community-level resources have not been directly examined in relation to PIU among primary school children. Implementation challenges should also be considered. Children’s increasing interest in digital entertainment, together with limited access to suitable spaces and resources, may make efforts to reduce screen time more difficult [72]. Moreover, reductions in screen time should not automatically be interpreted as reductions in PIU, as these constructs are conceptually distinct.

In conclusion, the available evidence highlights the need for further research on PIU using more robust methodological designs, particularly longitudinal studies, as well as more consistent and standardized assessment instruments. These advances would facilitate comparisons across studies, provide a more precise understanding of the mechanisms involved in the development of PIU, and support the design of preventive strategies and interventions tailored to the needs of children.

4.5. Clinical and Practical Implications

Problematic Internet use is a complex phenomenon that requires preventive strategies and interventions addressing the different developmental contexts in which children participate. Accordingly, preventive efforts should not be framed solely in terms of replacing or restricting digital activities. Rather, coordinated action by families and schools may promote responsible technology use while complementing digital engagement with social, physical, cultural, and recreational activities.

Children’s increasingly early access to the Internet, video games, smartphones, and other digital devices highlights the need to implement psychoeducational programs in schools involving students, families, and teachers. These initiatives should promote healthy and balanced use of digital technologies, strengthen digital literacy and broader digital competencies, provide information about the risks and benefits of online environments, and encourage age-appropriate patterns of use. Providing children with opportunities for meaningful offline experiences and promoting a balanced range of leisure activities may help reduce excessive reliance on digital environments and the likelihood of developing PIU.

Interventions should address the modifiable factors identified in this review and should be implemented across clinical, public health, and educational settings. Figure 3 summarizes the protective factors identified across the different levels of intervention, which may represent potential targets for preventive programs aimed at promoting children’s health and well-being in their daily lives.

5. Conclusions

In summary, problematic Internet use (PIU) represents an increasingly relevant area of concern because digital technologies are becoming progressively embedded in the everyday lives of children. The studies included in this review provide relevant evidence addressing the two objectives established.

Regarding the first objective, the findings reveal considerable terminological and conceptual heterogeneity surrounding PIU. PIU may serve as an umbrella term encompassing excessive or maladaptive patterns of use across different digital activities while preserving the distinctions among specific constructs. Furthermore, the constructs identified in the literature can be conceptually organized along a continuum of severity, ranging from adaptive Internet use to risky use, various manifestations of problematic use, and, finally, constructs framed in addictive terms, such as Internet addiction and Internet gaming disorder. However, these latter constructs should not be interpreted as equivalent formal diagnostic categories.

Regarding the second objective, the evidence suggests that PIU is associated not exclusively with individual characteristics but with the interplay of multiple family, socioemotional, peer, school, and digital factors. Positive parent–child relationships, parental supervision, positive peer communication, resilience, participation in traditional children’s games, and a positive school climate were associated with lower levels of or a lower likelihood of problematic use. Nevertheless, the evidence concerning traditional games included both PIU and general Internet use, while the school-level evidence was derived from only one included study. Conversely, family conflict, authoritarian, permissive, or inconsistent parenting practices, parental technology dependence, peer victimization, insecure parental attachment, and emotional and behavioral difficulties were associated with higher levels of or a greater likelihood of problematic digital technology use.

In conclusion, this review contributes to clarifying the conceptual diversity surrounding PIU and synthesizes the available evidence on its main risk and protective factors among primary school children. However, given the predominance of cross-sectional designs and the conceptual and methodological heterogeneity of the included studies, the findings should be interpreted cautiously and should not be regarded as evidence of causal relationships. Nevertheless, the findings support the adoption of a socioecological perspective to understand the phenomenon and design preventive strategies and interventions addressing the different developmental contexts in which children participate, particularly the family, school, peer, and digital contexts. Such strategies should promote balanced, responsible, and developmentally appropriate digital engagement rather than focusing exclusively on restricting screen time. Future research should employ longitudinal designs and more standardized assessment instruments and should examine community-level factors, which remain largely absent from the available evidence.