1. Introduction
ccess to the Internet is increasingly easy due to advances in mobile technology and the prevalence of smartphones [1, 2]. Social Network Sites (SNSs) are virtual communities where users can create individual public profiles, interact with real-life friends, and meet other people based on shared interests [3].
Compared to the general population, teenagers and students are the most frequent users of SNSs [4]. Kuss & Griffiths also found that between 55% and 82% of teenagers and young adults use SNSs regularly [5]. Kim and et al.’s study has shown that seeking friends, social support, information, and entertainment were found to be the most significant motivations for SNSs usage in a sample of 589 undergraduate students [6].
 Addiction to SNSs is an international issue with numerous Methods of measurement [7]. The transition from normal to problematic SNSs use occurs when SNS is viewed by the individual as an important (or even exclusive) mechanism to relieve stress, loneliness, or depression [8]. 
Tang & Koh’s study showed that 29.5% of Singaporean college students possess SNS addiction [10]. Early maladaptive schema evolves in early childhood through negative experiences with key characters in one’s life. Maladaptive schemas are the cognitive infrastructures that lead to the formation of irrational beliefs. Early maladaptive schema has a profound effect on thought, feeling, behaviors, and the way people interact with others [14]. Maladaptive schemas are not directly responsible for personality disorders, although, they increase one’s vulnerability toward disorders [15]. Therefore, a hypothesis was formulated: there is a significant relationship between the early maladaptive schema and SNSs addiction.
Given the concerns outlined above, the present study attempted to find an academic answer to the above hypothesis. Such knowledge will also inform more effective intervention of problematic use of SNSs, and prevention of the development of addiction to SNSs among medical and allied health students.
2. Methods
This cross-sectional study was performed on medical and allied medical science students of Semnan University of Medical Sciences in 2019. Sampling was done by stratified random. The sample size was 384 people based on the Cochran formula. In this study, Yang Schema Questionnaire and Mobile-based Social Network Addiction Questionnaire were used as data collection tools.
3. Results
A total of 215 students (61.4%) had at least one early maladaptive schema, while 135 (38.6%) had no maladaptive schema (Table 1). 



The mean score of early maladaptive schemas for students was 188.22±41.66 and 45 (12.9%) of them had a score higher than average. The mean (or median) score for all domains (except the guided by others/attention) in students with addiction to social networks was higher so that the difference in the scheme of detachment and exclusion (P=0.004), guided by others (P=0.024), and self-regulation and impaired performance (P=0.002) were significant. The female gender (OR=0.35, P=0.021), age over 21 years (OR=0.56, P<0.001), the formation of the schema of recognition (OR=0.54, P=0.01), and the formation of the schema entitlement (OR=0.47, P=0.002) with the reduction and the formation of the schema of social isolation/emotional inhibition (OR=2.94, P=0.006) was accompanied with increasing of the chance of being addicted to social networks.
4. Discussion
The results of this study, on the one hand, showed that social network addiction is a complex phenomenon that is related to psychological, social, and cultural factors; on the other hand, it showed the depth and complexity of early maladaptive schemas in challenges and phenomena among young people, especially students. Given the emergence of new technologies in the future, these results enable us to further root out future trends among young people and develop strategies for intervention programs such as schema therapy to prevent and treat the problems among young people. Thus, educational institutions can guide the use of social networks among students to improve education.
Ethical Considerations
Compliance with ethical guidelines
The study approved by Ethics Committee of Semnan University of Medical Sciences (IR.SEMUMS.REC.1396.140). 
Funding
The research was supported by Semnan University of Medical Sciences (Grant No.: 1457).
Authors contributions
Study design: Mehdi Kahouei, Masoumeh Alimohammadi; Acquisition of data: Fatemeh Paknazar, Ghazaleh Mosayebi; Data analysis: Fatemeh Paknazar; Interpreting the results: Mehdi Kahouei, Masoumeh Alimohammadi; Writing – review & editing, approve the final version of the manuscript: All authors.
Conflicts of interest
The authors declared no conflict of interests.
Acknowledgements
We would like to thank the Clinical Research Development Unit of Kowsar and Amir-al-Momenin Educational, Research and Therapeutic Centers of Semnan University of Medical Sciences for providing facilities to this work.


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