Internet addiction disorder

Problematic internet use or pathological internet use, is generally defined as problematic, compulsive use of the internet, that results in significant impairment in an individual's function in various life domains over a prolonged period of time. Young people are at particular risk of developing internet addiction disorder,[1] with case studies highlighting students whose academic performance plummets as they spend more and more time online. Some also experience health consequences from loss of sleep,[2] as they stay up later and later to chat online, check for social network status updates or to reach the next game levels.[3]

Problematic Internet Use (colloquially "Internet addiction disorder")
Addicted to the Internet.jpg
An 2009 flyer for an internet addiction support group in New York City.
Specialty

Excessive Internet use has not been recognised as a disorder by the World Health Organization, the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) or the International Classification of Diseases (ICD-11). However, the diagnosis of gaming disorder has been included in the ICD-11. Controversy around the diagnosis includes whether the disorder is a separate clinical entity, or a manifestation of underlying psychiatric disorders. Research has approached the question from a variety of viewpoints, with no universally standardised or agreed definitions, leading to difficulties in developing evidence based recommendations.

As adolescents (12–19 years) and emerging adults (20–29 years) access the Internet more than any other age groups and undertake a higher risk of overuse of the Internet, the problem of Internet behavior disorder is most relevant to young people.[4]

ConsequencesEdit

Mental health consequencesEdit

A longitudinal study of Chinese high school students (2010) suggests that individuals with moderate to severe risk of Internet addiction are 2.5 times more likely to develop depressive symptoms than their IAD-free counterparts.[5] Another longitudinal study of high school students from Helsinki found that problematic internet usage and depressive symptoms may produce a positive feedback loop. Problematic internet usage is also associated with increased risk of substance abuse.[6]

Social consequencesEdit

The best-documented evidence of Internet addiction so far is time-disruption, which subsequently results in interference with regular social life, including academic, professional performance and daily routines.[7] Some studies also reveal that IAD can lead to disruption of social relationships in Europe and Taiwan.[8][9] It is, however, also noted by others that IAD is beneficial for peer relations in Taiwan.[10]

Dr. Keith W. Beard (2005) states that "an individual is addicted when an individual's psychological state, which includes both mental and emotional states, as well as their scholastic, occupational and social interactions, is impaired by the overuse of [Internet]".[11]

As a result of its complex nature, some scholars do not provide a definition of Internet addiction disorder and throughout time, different terms are used to describe the same phenomenon of excessive Internet use.[12] Internet addiction disorder is used interchangeably with problematic Internet use, pathological Internet use, and Internet addictive disorder. In some cases, this behavior is also referred to as Internet overuse, problematic computer use, compulsive Internet use, Internet abuse, harmful use of the Internet, and Internet dependency.

Signs and symptomsEdit

Physical symptomsEdit

Physical symptoms include a weakened immune system due to lack of sleep, loss of exercise, and increased risk for carpal tunnel syndrome and eye and back strain.[13]

Symptoms of withdrawal might include agitation, depression, anger and anxiety when the person is away from technology. These psychological symptoms might even turn into physical symptoms such as rapid heartbeat, tense shoulders and shortness of breath.[13]

Related disordersEdit

 
People using their smartphones.

Online gambling addictionEdit

According to David Hodgins, a professor of psychology at the University of Calgary, online gambling is considered to be as serious as pathological gambling. It is known as an "isolated disorder" which means that those who have a gambling problem prefer to separate themselves from interruptions and distractions. Because gambling is available online, it increases the opportunity for problem gamblers to indulge in gambling without social influences swaying their decisions. This is why this disorder has become more a problem at this date in time and is why it is so difficult to overcome. The opportunity to gamble online is almost always available in this century opposed to only having the opportunity in a public forum at casinos for example. Online gambling has become quite popular especially with today's adolescents. Today's youth has a greater knowledge of modern software and search engines along with a greater need for extra money. So not only is it easier for them to find opportunities to gamble over any subject, but the incentive to be granted this money is desperately desired.[citation needed]

Online gaming addiction (Internet gaming disorder)Edit

Video game addiction is a known issue around the world. Incidence and severity grew in the 2000s, with the advent of broadband technology, games allowing for the creation of avatars, 'second life' games, and MMORPGs (massive multiplayer online role playing games). World of Warcraft has the largest MMORPG community online and there have been a number of studies about the addictive qualities of the game. Addicts of the game range from children to mature adults. A well-known example is Ryan van Cleave, a university professor whose life declined as he became involved in online gaming.[14] Andrew Doan, a physician with a research background in neuroscience, battled his own addictions with video games, investing over 20,000 hours of playing games over a period of nine years.[15]

Online gaming addiction may be considered in terms of B.F. Skinner's theory of operant conditioning, which claims that the frequency of a given behavior is directly linked to rewarding and punishment of that behavior. If a behavior is rewarded, it is more likely to be repeated. If it is punished, it becomes suppressed.[16]

Orzack, a clinical psychologist at McLean Hospital in Massachusetts claims that 40 percent of World of Warcraft (WoW) players are addicted. Orzack says that the best way to optimize the desired behavior in the subject is to provide rewards for correct behavior, and then adjust the number of times the subject is required to exhibit that behavior before a reward is provided. For instance, if a rat must press a bar to receive food, then it will press faster and more often if it does not know how many times it needs to press the bar. An equivalent in World of Warcraft would be purple (epic) loot drops.[17] Players in World of Warcraft will often spend weeks hunting for a special item which is based on a chance system, sometimes with only a 0.01% chance of it being dropped by a slain monster. The rarity of the item and difficulty of acquiring the item gives the player a status amongst their peers once they obtain the item.

Jim Rossignol, a finance journalist who reports on Internet gaming has described how he overcame his own addiction and channeled his compulsion into a desirable direction as a reporter of Internet gaming and gaming culture.[18]

Pornography addiction (problematic Internet pornography use)Edit

Universally accepted diagnostic criteria do not exist for pornography addiction or problematic Internet pornography viewing.[19] Pornography addiction is often defined operationally by the frequency of pornography viewing and negative consequences.[20] The only diagnostic criteria for a behavioral addiction in the current Diagnostic and Statistical Manual of Mental Disorders are for pathological gambling, and they are similar to those for substance abuse and dependence, such as preoccupation with the behavior, diminished ability to control the behavior, tolerance, withdrawal, and adverse psychosocial consequences. Diagnostic criteria have been proposed for other behavioral addictions, and these are usually also based on established diagnoses for substance abuse and dependence.[21]

A proposed diagnosis for hypersexual disorder includes pornography as a subtype of this disorder. It included such criteria as time consumed by sexual activity interfering with obligations, repetitive engagement in sexual activity in response to stress, repeated failed attempts to reduce these behaviors, and distress or impairment of life functioning.[22] A study on problematic Internet pornography viewing used the criteria of viewing Internet pornography more than three times a week during some weeks, and viewing causing difficulty in general life functioning.[19]

According to the American Society of Addiction Medicine, some psychological and behavioral changes characteristic of addiction brain changes include addictive cravings, impulsiveness, weakened executive function, desensitization, and dysphoria.[23] BOLD fMRI results have shown that individuals diagnosed with compulsive sexual behavior (CSB) show enhanced cue reactivity in brain regions associated traditionally with drug-cue reactivity.[24][25] These regions include the amygdala and the ventral striatum.[24][25] Men without CSB who had a long history of viewing pornography exhibited a less intense response to pornographic images in the left ventral putamen, possibly suggestive of desensitization.[24] ASAMs position is inconsistent with the American Association of Sex Educators, Counselors, and Therapists, who cite lack of strong evidence for such classification, describing ASAM as not informed by "accurate human sexuality knowledge".[26]

Neuropsychopharmacological and psychological research on pornography addiction conducted between 2015 and 2021 have concluded that most studies have been focused entirely or almost exclusively on men in anonymous settings, and the findings are contradicting.[25][27][28][29] Some researches support the idea that pornography addiction qualifies as a form of behavioral addiction into the umbrella construct of hypersexual behavior and/or a subset of compulsive sexual behavior (CSB),[27][28][29] and should be treated as such,[28][29] whereas others have detected the increased activation of ventral striatal reactivity in men for cues predicting erotic but not monetary rewards and cues signaling erotic pictures, therefore suggesting similarities between pornography addiction and conventional addiction disorders.[25][27]

Some clinicians and support organizations recommend voluntary use of Internet content-control software, internet monitoring, or both, to manage problematic online pornography use.[30][31][32] Sex researcher Alvin Cooper and colleagues suggested several reasons for using filters as a therapeutic measure, including curbing accessibility that facilitates problematic behavior and encouraging clients to develop coping and relapse prevention strategies.[30] Cognitive therapist Mary Anne Layden suggested that filters may be useful in maintaining environmental control.[32] Internet behavior researcher David Delmonico stated that, despite their limitations, filters may serve as a "frontline of protection."[31]

Despite the fact that pornography is being indicted as a public health crisis in the United States and elsewhere,[33][34] with problematic Internet and online pornography use reported to constitute an increasing burden in public mental health since the 2000s, psychopathological models and diagnostic criteria have lacked consensus, and the body of evidence on the effectiveness of therapeutic approaches is still scarce.[27] In consequence of the COVID-19 pandemic (2020-2021), problematic Internet pornography use and Internet addiction disorder have become difficult to cope for individuals who have adopted this lifestyle and have developed a dependence on these activities as an essential part of their lives, owing to elongated periods of staying at home due to self-isolation.[27]

Communication addiction disorder (compulsive talking)Edit

Communication addiction disorder (CAD) is a supposed behavioral disorder related to the necessity of being in constant communication with other people, even when there is no practical necessity for such communication. CAD has been linked to Internet addiction.[35] Users become addicted to the social elements of the Internet, such as Facebook and YouTube. Users become addicted to one-on-one or group communication in the form of social support, relationships, and entertainment. However, interference with these activities can result in conflict and guilt. This kind of addiction is called problematic social media use.

Social network addiction is a dependence of people by connection, updating, and control of their and their friend's social network page.[36] For some people, in fact, the only important thing is to have a lot of friends in the network regardless if they are offline or only virtual; this is particularly true for teenagers as a reinforcement of egos.[37][38] Sometimes teenagers use social networks to show their idealized image to the others.[39] However, other studies claim that people are using social networks to communicate their real personality and not to promote their idealized identity.[40]

Virtual reality addictionEdit

Virtual-reality addiction is an addiction to the use of virtual reality or virtual, immersive environments. Currently, interactive virtual media (such as social networks) are referred to as virtual reality,[41] whereas future virtual reality refers to computer-simulated, immersive environments or worlds. Experts warn about the dangers of virtual reality,[42] and compare the use of virtual reality (both in its current and future form) to the use of drugs, bringing with these comparisons the concern that, like drugs, users could possibly become addicted to virtual reality.[citation needed]

Video streaming addictionEdit

Video streaming addiction is an addiction to watching video content online. This can include TV shows, movies, short video clips and other content. Each person's experience is unique but people who have this addiction may also display addictive relationship with offline video content too (such as television, DVDs, VHS tapes, etc.) Addicts often display binge behaviour. With more development of binging sites such as Netflix, Stan, and Foxtel, more people start binging movies and TV shows everyday, only contributing to this addiction.

Risk factorsEdit

Interpersonal difficultiesEdit

It is argued that interpersonal difficulties such as introversion, social problems,[43] and poor face-to-face communication skills[44] often lead to internet addiction. Internet-based relationships offer a safe alternative for people with aforementioned difficulties to escape from the potential rejections and anxieties of interpersonal real-life contact.[45]

Social supportEdit

Individuals who lack sufficient social connection and social support are found to run a higher risk of Internet addiction. They resort to virtual relationships and support to alleviate their loneliness.[46][47] As a matter of fact, the most prevalent applications among Internet addicts are chat rooms, interactive games, instant messaging, or social media.[45] Some empirical studies reveal that conflict between parents and children and not living with mother significantly associated with IA after one year.[48] Protective factors such as quality communication between parents and children[49] and positive youth development[50] are demonstrated, in turn, to reduce the risk of IA.

Psychological factorsEdit

Prior addictive or psychiatric history are found to influence the likelihood of being addicted to the Internet.[48][51] Some individuals with prior psychiatric problems such as depression and anxiety turn to compulsive behaviors to avoid the unpleasant emotions and situation of their psychiatric problems and regard being addicted to the Internet a safer alternative to substance addictive tendency. But it is generally unclear from existing research which is the cause and which is the effect partially due to the fact that comorbidity is common among Internet addicts.

The most common co-morbidities that have been linked to IAD are major depression and attention deficit hyperactivity disorder (ADHD). The rate of ADHD and IAD associating is as high as 51.6%.[52]

Internet addicts with no previous significant addictive or psychiatric history are argued to develop an addiction to some of the features of Internet use: anonymity, easy accessibility, and its interactive nature.[45]

Neurobiological factorsEdit

Like most other psychopathological conditions, Internet addiction belongs to the group of multifactorial polygenic disorders. For each specific case, there is a unique combination of inherited characteristics (nervous tissue structure, secretion, degradation, and reception of neuromediators), and many are extra-environment factors (family-related, social, and ethnic-cultural). One of the main challenges in the development of the bio-psychosocial model of Internet addiction is to determine which genes and neuromediators are responsible for increased addiction susceptibility.  This article incorporates text by Sergey Tereshchenko and Edward Kasparov available under the CC BY 4.0 license. [53]

Other factorsEdit

Parental educational level, age at first use of the Internet, and the frequency of using social networking sites and gaming sites are found to be positively associated with excessive Internet use among adolescents in some European countries, as well as in the USA.[8][54]

DiagnosisEdit

Diagnosis of Internet addiction disorder is empirically difficult. Various screening instruments have been employed to detect Internet addiction disorder. Current diagnoses are faced with multiple obstacles.

DifficultiesEdit

Given the newness of the Internet and the inconsistent definition of Internet addiction disorder, practical diagnosis is far from clear-cut. With the first research initiated by Kimberly S. Young in 1996, the scientific study of Internet addiction has merely existed for more than 20 years.[55] A few obstacles are present in creating an applicable diagnostic method for Internet addiction disorder.

  • Wide and extensive use of the Internet: Diagnosing Internet addiction is often more complex than substance addiction as internet use has largely evolved into being an integral or necessary part of human lives. The addictive or problematic use of the internet is thus easily masked or justified.[45] Also, the Internet is largely a pro-social, interactive, and information-driven medium, while other established addiction behaviors such as gambling are often seen as a single, antisocial behavior that has very little socially redeeming value. Many so-called Internet addicts do not experience the same damage to health and relationships that are common to established addictions.[56]
  • High comorbidity: Internet addiction is often accompanied by other psychiatric disorders such as personality disorder and intellectual disability.[45][57][58][59][60] It is found that Internet addiction is accompanied by other DSM-IV diagnosis 86% of the time.[61] In one study conducted in South Korea, 30% of the identified Internet addicts have accompanying symptoms such as anxiety or depression and another 30% have a second disorder such as attention deficit hyperactivity disorder (ADHD).[62] Another study in South Korea found an average of 1.5 other diagnoses among adolescent internet addicts.[61] Further, it is noted in the United States that many patients only resort to medical help when experiencing difficulties they attribute to other disorders.[45][61] For many individuals, overuse or inappropriate use of the Internet is a manifestation of their depression, social anxiety disorders, impulse control disorders, or pathological gambling.[63] It generally remains unclear from existing literature whether other psychiatric disorders is the cause or manifest of Internet addiction.

Despite the advocacy of categorizing Internet addiction as an established illness,[61][64] neither DSM-IV (1995) nor DSM-5 (2013) considers Internet addiction as a mental disorder.[65] A subcategory of IAD, Internet gaming disorder is listed in DSM-5 as a condition that requires more research in order to be considered as a full disorder in May 2013.[65][66][67] The WHO's draft 11th Revision of the International Classification of Diseases (ICD-11) scheduled for publication in 2018 also include gaming disorder.[68] There is still considerable controversy over whether IAD should be included in the DSM-5 and recognized as a mental disease in general.[69]

Screening instrumentsEdit

DSM-based instruments

Most of the criteria utilized by research are adaptations of listed mental disorders (e.g., pathological gambling) in the Diagnostic and Statistical Manual of Mental Disorders (DSM) handbook.[12]

Dr. Ivan K. Goldberg, who first broached the concept of Internet addiction, adopted a few criteria for IAD on the basis of DSM-IV, including “hoping to increase time on the network” and “dreaming about the network.”[12] By adapting the DSM-IV criteria for pathological gambling, Dr. Kimberly S. Young (1998) proposed one of the first integrated sets of criteria, Diagnostic Questionnaire (YDQ), to detect Internet addiction. A person who fulfills any five of the eight adapted criteria would be regarded as Internet addicted:[70][71]

  1. Preoccupation with the Internet;
  2. A need for increased time spent online to achieve the same amount of satisfaction;
  3. Repeated efforts to curtail Internet use;
  4. Irritability, depression, or mood lability when Internet use is limited;
  5. Staying online longer than anticipated;
  6. Putting a job or relationship in jeopardy to use the Internet;
  7. Lying to others about how much time is spent online; and
  8. Using the Internet as a means of regulating mood.

While Young's YDQ assessment for IA has the advantage of simplicity and ease of use, Keith W. Beard and Eve M. Wolf (2001) further asserted that all of the first five (in the order above) and at least one of the final three criteria (in the order above) be met to delineate Internet addiction in order for a more appropriate and objective assessment.[72]

Young further extended her eight-question YDQ assessment to the now most widely used Internet Addiction Test (IAT),[70][73][74] which consists of 20 items with each on a five-point Likert scale. Questions included on the IAT expand upon Young's earlier eight-question assessment in greater detail and include questions such as "Do you become defensive or secretive when anyone asks you what you do online?" and "Do you find yourself anticipating when you go online again?". A complete list of questions can be found in Dr. Kimberly S. Young's 1998 book Caught in the Net: How to Recognize the Signs of Internet Addiction and A Winning Strategy for Recovery and Drs. Laura Widyanto and Mary McMurran's 2004 article titled The Psychometric Properties of the Internet Addiction Test. The Test score ranges from 20 to 100 and a higher value indicates a more problematic use of the Internet:

  • 20–39 = average Internet users,
  • 40–69 = potentially problematic Internet users, and
  • 70–100 = problematic Internet users.

Over time, a considerable number of screening instruments have been developed to diagnose Internet addiction, including the Internet Addiction Test (IAT),[70] the Internet-Related Addictive Behavior Inventory (IRABI),[75] the Chinese Internet Addiction Inventory (CIAI),[76] the Korean Internet Addiction Self-Assessment Scale (KS Scale),[77] the Compulsive Internet Use Scale (CIUS),[78] the Generalized Problematic Internet Use Scale (GPIUS),[79] the Internet Consequences Scale (ICONS),[80] and the Problematic Internet Use Scale (PIUS).[81] Among others, the Internet Addiction Test (IAT) by Young (1998) exhibits good internal reliability and validity and has been used and validated worldwide as a screening instrument.[82][83][74]

Although the various screening methods are developed from diverse contexts, four dimensions manifest themselves across all instruments:[61][84]

  • Excessive use: compulsive Internet use and excessive online time-use;
  • Withdrawal symptoms: withdrawal symptoms including feelings such as depression and anger, given restricted Internet use;
  • Tolerance: the need for better equipment, increased internet use, and more applications/software;
  • Negative repercussions: Internet use caused negative consequences in various aspects, including problematic performance in social, academic, or work domains.

More recently, researchers Mark D. Griffiths (2000) and Dr. Jason C. Northrup and colleagues (2015) claim that Internet per se is simply the medium and that the people are in effect addicted to processes facilitated by the Internet.[84][85] Based on Young's Internet Addiction Test (IAT),[70] Northrup and associates further decompose the internet addiction measure into four addictive processes: Online video game playing, online social networking, online sexual activity, and web surfing.[84] The Internet Process Addiction Test (IPAT)[84] is created to measure the processes to which individuals are addicted.

Screening methods that heavily rely on DSM criteria have been accused of lacking consensus by some studies, finding that screening results generated from prior measures rooted in DSM criteria are inconsistent with each other.[9] As a consequence of studies being conducted in divergent contexts, studies constantly modify scales for their own purposes, thereby imposing a further challenge to the standardization in assessing Internet addiction disorder.[12]

Single-question instruments

Some scholars and practitioners also attempt to define Internet addiction by a single question, typically the time-use of the Internet.[62][86] The extent to which Internet use can cause negative health consequences is, however, not clear from such a measure.[12] The latter of which is critical to whether IAD should be defined as a mental disorder.

Neuroimaging techniquesEdit

Emergent neuroscience studies investigated the influence of problematic, compulsive use of the internet on the human brain.[87] Following anecdotal reports and the conclusion by Dr. Kimberly S. Young (1998),[71] neuroimaging studies revealed that IAD contributes to structural and functional abnormalities in the human brain, similar to other behavioral and substance additions. Therefore, objective non-invasive neuroimaging can contribute to the preliminary diagnosis and treatment of IAD.[87][88]

Electroencephalography-based diagnosis

Using Electroencephalography (EEG) readings allows identifying abnormalities in the electrical activity of the human brain caused by IAD. Studies revealed that individuals with IAD predominantly demonstrate increased activity in the theta and gamma band and decreased delta, alpha, and beta activity.[89][90][91][92][93] Following these findings, studies identified a correlation between the differences in the EEG readings and the severity of IAD, as well as the extent of impulsivity and inattention.[89][91][92]

ClassificationEdit

As many scholars have pointed out, the Internet serves merely as a medium through which tasks of divergent nature can be accomplished.[84][85] Treating disparate addictive behaviors under the same umbrella term is highly problematic.[94]

Dr. Kimberly S. Young (1999) asserts that Internet addiction is a broad term which can be decomposed into several subtypes of behavior and impulse control problems, namely,[95]

For a more detailed description of related disorders please refer to the related disorders section above.

TreatmentEdit

Current interventions and strategies used as treatments for Internet addiction stem from those practiced in substance abuse disorder. In the absence of "methodologically adequate research", treatment programs are not well corroborated.[96] Psychosocial treatment is the approach most often applied.[69] In practice, rehab centers usually devise a combination of multiple therapies.[76]

Psychosocial treatmentEdit

Cognitive behavioral therapy

The cognitive behavioral therapy with Internet addicts (CBT-IA) is developed in analogy to therapies for impulse control disorder.[45][97]

Several key aspects are embedded in this therapy:[98][99]

  • Learning time management strategies;
  • Recognizing the benefits and potential harms of the Internet;
  • Increasing self-awareness and awareness of others and one's surroundings;
  • Identifying "triggers" of Internet "binge behavior", such as particular Internet applications, emotional states, maladaptive cognitions, and life events;
  • Learning to manage emotions and control impulses related to accessing the Internet, such as muscles or breathing relaxation training;
  • Improving interpersonal communication and interaction skills;
  • Improving coping styles;
  • Cultivating interests in alternative activities.

Three phases are implemented in the CBT-IA therapy:[45][97]

  1. Behavior modification to control Internet use: Examine both computer behavior and non-computer behavior and manage Internet addicts' time online and offline;
  2. Cognitive restructuring to challenge and modify cognitive distortions: Identify, challenge, and modify the rationalizations that justify excessive Internet use;
  3. Harm reduction therapy to address co-morbid issues: Address any co-morbid factors associated with Internet addiction, sustain recovery, and prevent relapse.

Symptom management of CBT-IA treatment has been found to sustain six months post-treatment.[45]

Motivational interviewing

The motivational interviewing approach is developed based on therapies for alcohol abusers.[45][99] This therapy is a directive, patient-centered counseling style for eliciting behavior change through helping patients explore and resolve ambivalence with a respectful therapeutic manner. It does not, however, provide patients with solutions or problem solving until patients' decision to change behaviors.[98]

Several key elements are embedded in this therapy:[45]

  • Asking open-ended questions;
  • Giving affirmations;
  • Reflective listening

Other psychosocial treatment therapies include reality therapy, Naikan cognitive psychotherapy, group therapy, family therapy, and multimodal psychotherapy.[98]

MedicationEdit

IAD may be associated with a co-morbidity, so treating a related disorder may also help in the treatment of IAD. When individuals with IAD were treated with certain antidepressants, the time online was reduced by 65% and cravings of being online also decreased. The antidepressants that have been most successful are selective serotonin reuptake inhibitors (SSRIs) such as escitalopram and the atypical antidepressant bupropion. A psychostimulant, methylphenidate, was also found to have beneficial effects.[52] However, the available evidence on treatment of IAD is of very low quality at this time and well-designed trials are needed.[100]

PrevalenceEdit

Research-based prevalence rate of Internet addiction
Country or region Rate or population Sample Year Inst­rument
Global 6%[73] A meta-analysis-based estimate 1994–2012 YDQ & IAT
Asia
Asia 20%[101]
Pakistan 9%[102] 231 Medical students 2020 IAT
China 10.4%[103] 10,158 adolescents 2016 IAT
Hong Kong 17–26.7%[104] Over 3000 high school students 2009–2015 IAT
Taiwan 13.8%[105] 1708 high school students n.a. YDQ
South Korea 2.1%[61] An estimate based on Korean population aged 6–19 years 2006
Japan 2.0%[106] 853 adolescents aged 12–15 years 2014 IAT
Europe
Europe 4.4%[107] 11,956 adolescents in 11 European countries 2009–2010 YDQ
Germany 1.5 million[108] An estimate based on German population n.a.
Spain 16.3%[109] 40,955 school adolescents aged 12–17 years 2016 PIUS-a
Norway 0.7%[110] 3399 individuals aged 16–74 years 2007 YDQ
UK 18.3%[111] 371 college students n.a. PIUS
Russia 7.1%[2] 4,615 adolescents aged 12–18 years 2019 CIAS
North America
USA 0.3–0.7%[112] 2513 adults 2004 Non-standard

Different samples, methodologies, and screening instruments are employed across studies.

TerminologyEdit

The notion of "Internet addictive disorder" was initially conjured up by Ivan K. Goldberg in 1995 as a joke to parody the complexity and rigidity of the American Psychiatric Association's (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM). In his first narration, Internet addictive disorder was described as having the symptoms of "important social or occupational activities that are given up or reduced because of Internet use", "fantasies or dreams about the Internet," and "voluntary or involuntary typing movements of the fingers."[113]

The definition of Internet addiction disorder has troubled researchers ever since its inception. In general, no standardized definition has been provided despite that the phenomenon has received extensive public and scholar recognition.[7][12] Below are some of the commonly used definitions.

In 1998, Jonathan J. Kandell defined Internet addiction as "a psychological dependence on the Internet, regardless of the type of activity once logged on."[114]

English psychologist Mark D. Griffiths (1998) conceived Internet addiction as a subtype of broader technology addiction, and also a subtype of behavioral addictions.[115]

SocietyEdit

Anonymous 12 Step Recovery Programs for Media and Internet AddictionEdit

1. Internet and Technology Addicts Anonymous (ITAA), founded in 2017, is a 12-step program supporting users coping with the problems resulting from compulsive internet and technology use.[116] Some common sub-addictions include smartphone addiction, binge watching addiction, and social media addiction. There are face-to-face meetings in some cities. Telephone / online meetings take place every day of the week, at various times (and in various languages) that allow people worldwide to attend. Similar to 12-step fellowships such as Overeaters Anonymous, Workaholics Anonymous, or Sex and Love Addicts Anonymous, most members do not define sobriety as avoiding all technology use altogether. Instead, most ITAA members come up with their own definitions of abstinence or problem behaviors, such as not using the computer or internet at certain hours or locations or not going to certain websites or categories of websites that have proven problematic in the past. Meetings provide a source of live support for people, to share struggles and victories, and to learn to better function in life once less of it is spent on problematic technology use.

2. Media Addicts Anonymous (MAA) is a 12-step program focused on recovery from media addiction. All forms of media sobriety are supported, including abstinence from electronic media, films, radio, newspapers, magazines, books, and music.[117]

NoSurfEdit

The NoSurf Reddit community[118] maintains a list of resources and strategies helpful for people trying to decrease their internet usage. This includes lists of software programs that people use to control which sites they visit and when, as well as a discussion group that takes place on Discord.

Public concernEdit

Internet addiction has raised great public concern in Asia and some countries consider Internet addiction as one of the major issues that threatens public health, in particular among adolescents.[61][98]

ChinaEdit

Internet addiction is commonly referred to as "electronic opium"[119] or "electronic heroin" in China.[120] The government of the People's Republic of China was the first country to formally classify Internet addiction a clinical disorder by recognizing "Clinical Diagnostic Criteria for Internet Addiction" in 2008.[121][122] The government has enacted several policies to regulate adolescents' Internet use, including limiting daily gaming time to 3 hours and requiring users' identification in online video games.[123]

Mistreatment and abuse in China

In the absence of guidance from China's Health Ministry and a clear definition of Internet addiction, dubious treatment clinics have sprouted up in the country.[62] As part of the treatment, some clinics and camps impose corporal punishment upon patients of Internet addiction and some conducted electroconvulsive therapy (ECT) against patients, the latter of which has caused wide public concern and controversy.[62][124] Several forms of mistreatment have been well-documented by news reports.

One of the most commonly used treatments for Internet-addicted adolescents in China is inpatient care, either in a legal or illegal camp. It is reported that children were sent to these camps against their will. Some are seized and bound by staff of the camp, some are drugged by their parents, and some are tricked into treatment.[122][125][126][127]

In many camps and clinics, corporal punishment is frequently used in the treatment of Internet addiction disorder. The types of corporal punishment practiced include, but not limited to, kilometers-long hikes, intense squats, standing, starving, and confinement.[62][128][129][130] After physical abuse caused the death of an adolescent at a treatment camp in 2009, the Chinese government officially prohibited the use physical violence in such places.[131] However, multiple cases of abuse and deaths at such facilities continue to be reported.[citation needed]

Among Internet addiction rehab centers that use corporal punishment in treatment, Yuzhang Academy in Nanchang, Jiangxi Province, is the most notorious. In 2017, the academy was accused of using severe corporal punishment against students, the majority of which are Internet addicts. Former students claimed that the academy hit problematic students with iron rulers, "whip them with finger-thick steel cables", and lock students in small cells week long.[132] Several suicidal cases emerged under the great pressure.[133]

In November 2017, the academy stopped operating after extensive media exposure and police intervention.[134]

Electroconvulsive therapy

In China, electroconvulsive therapy (ECT) is legally used for schizophrenia and mood disorders. Its use in treating adolescent Internet addicts has raised great public concern and stigmatized the legal use of ECT.[135]

The most reported and controversial clinic treating Internet addiction disorder is perhaps the Linyi Psychiatric Hospital in Shandong Province.[62] Its center for Internet addiction treatment was established in 2006 by Yang Yongxin.[136] Various interviews of Yongxin Yang confirm that Yang has created a special therapy, xingnao ("brain-waking") therapy, to treat Internet addiction. As part of the therapy, electroconvulsive therapy is implemented with currents of 1–5 milliampere.[137] As Yang put it, the electroconvulsive therapy only involves sending a small current through the brain and will not harm the recipient.[138] As a psychiatric hospital, patients are deprived of personal liberty and are subject to electroconvulsive treatment at the will of hospital staffs.[124] And before admission, parents have to sign contracts in which they deliver their guardianship of kids partially to the hospital and acknowledge that their kids will receive ECT.[124] Frequently, ECT is employed as a punishment method upon patients who breaks any of the center's rules, including "eating chocolate, locking the bathroom door, taking pills before a meal and sitting on Yang's chair without permission".[124] It is reported in a CCTV-12 segment that a DX-IIA electroconvulsive therapy machine is utilized to correct Internet addiction. The machine was, later on, revealed to be illegal, inapplicable to minor[139][140] and can cause great pain and muscle spasm to recipients.[62] Many former patients in the hospital later on stood out and reported that the ECT they received in the hospital was extremely painful, tore up their head,[126] and even caused incontinence.[136][141] An Interview of the Internet addiction treatment center in Linyi Psychiatric Hospital is accessible via the following link. Since neither the safety nor the effectiveness of the method was clear, the Chinese Ministry of Health banned electroconvulsive therapy in treating Internet addiction disorder in 2009.[138][142]

Drug

In Yang's clinic, patients are forced to take psychiatric medication[125] in addition to Jiewangyin, a type of medication invented by himself. Neither the effectiveness nor applicability of the medication has been assessed, however.

Physical abuse and death

At clinics and rehab centers, at least 12 cases of physical abuse have been revealed by media in the recent years including seven deaths.[143][144]

In 2009, a 15-year-old, Senshan Deng, was found dead eight hours after being sent to an Internet-addiction center in Nanning, Guangxi Province. It is reported that the teenager was beaten by his trainers during his stay in the center.[122]

In 2009, another 14-year-old teenager, Liang Pu, was taken to hospital with water in the lungs and kidney failure after a similar attack in Sichuan Province.[131]

In 2014, a 19-year-old, Lingling Guo, died in an Internet-addiction center with multiple injuries on head and neck in Zhengzhou, Henan Province.[122]

In 2016, after escaping from an Internet addiction rehab center, a 16-year-old girl tied and starved her mother to death in revenge of the being sent to treatment in Heilongjiang Province.[122]

In August 2017, an 18-year-old boy, Li Ao, was found dead with 20 external scars and bruises two days after his parents sent him to a military-style boot camp in Fuyang city, Anhui Province.[145]

South KoreaEdit

Being almost universally connected to the Internet and boasting online gaming as a professional sport, South Korea deems Internet addiction one of the most serious social issues[146] and describes it as a "national crisis".[147] Nearly 80% of the South Korean population have smartphones. According to government data, about two million of the country's population (less than 50 million) have Internet addiction problem, and approximately 680,000 10–19-year-old teenagers are addicted to the Internet, accounting for roughly 10% of the teenage population.[148] Even the very young generation are faced with the same problem: Approximately 40% of South Korean children between age three to five are using smartphones over three times per week. According to experts, if children are constantly stimulated by smartphones during infancy period, their brain will struggle to balance growth and the risk of Internet addiction.[149]

It is believed that due to Internet addiction, many tragic events have happened in South Korea: A mother, tired of playing online games, killed her three-year-old son. A couple, obsessed with online child-raising games, left their young daughter die of malnutrition. A 15-year-old teenager killed his mother for not letting him play online games and then committed suicide.[150] One Internet gaming addict stabbed his sister after playing violent games. Another addict killed one and injured seven others.[147]

In response, the South Korea government has launched the first Internet prevention center in the world, the Jump Up Internet Rescue School, where the most severely addicted teens are treated with full governmental financial aid.[147] As of 2007, the government has built a network of 140 Internet-addiction counseling centers besides treatment programs at around 100 hospitals.[151] Typically, counselor- and instructor-led music therapy and equine therapy and other real-life group activities including military-style obstacle courses and therapeutic workshops on pottery and drumming are used to divert IAs' attention and interest from screens.[147][151]

In 2011, the Korean government introduced the "Shutdown law", also known as the "Cinderella Act", to prevent children under 16 years old from playing online games from midnight (12:00) to 6 a.m.[148]

JapanEdit

In Japan, internet addiction disorder has manifested into the citizens primarily affecting the youth and adolescent population. In the male youth the internet addiction shows a trend in increased time in gaming on their devices while the female youth shows trends in social media use. The smartphone and internet addiction in Japan has become detrimental to the society by affecting social interactions between people and their communication. They become used to interacting over the internet and their phones that it deteriorates some of their social skills over time.[152]

Many cases of social withdrawal have been occurring in Japan since the late 1990s which inclines people to stay indoors most of the time. The term used for this is hikikomori, and it primarily affects the youth of Japan in that they are less inclined to leave their residences. Internet addiction can contribute to this effect because of how it diminishes social interactions and gives young people another reason to stay at home for longer. Many of the hikikomori people in Japan are reported to have friends in their online games, so they will experience a different kind of social interaction which happens in a virtual space.[153]

See alsoEdit

ReferencesEdit

  1. ^ Tomczyk Ł, Solecki R (July 2019). "Problematic internet use and protective factors related to family and free time activities among young people". Educational Sciences: Theory & Practice. 19 (3): 1–13. doi:10.12738/estp.2019.3.001.
  2. ^ a b Tereshchenko S, Kasparov E, Smolnikova M, Shubina M, Gorbacheva N, Moskalenko O (October 2021). "Internet Addiction and Sleep Problems among Russian Adolescents: A Field School-Based Study". International Journal of Environmental Research and Public Health. 18 (19): 10397. doi:10.3390/ijerph181910397. PMC 8507923. PMID 34639694.
  3. ^ Wallace P (January 2014). "Internet addiction disorder and youth: There are growing concerns about compulsive online activity and that this could impede students' performance and social lives". EMBO Reports. 15 (1): 12–6. doi:10.1002/embr.201338222. PMC 4303443. PMID 24398129.
  4. ^ Anderson EL, Steen E, Stavropoulos V (2017). "Internet use and Problematic Internet Use: A systematic review of longitudinal research trends in adolescence and emergent adulthood". International Journal of Adolescence and Youth. 22 (4): 430–454. doi:10.1080/02673843.2016.1227716. S2CID 152003110.
  5. ^ Lam LT, Peng ZW (October 2010). "Effect of pathological use of the internet on adolescent mental health: a prospective study". Archives of Pediatrics & Adolescent Medicine. 164 (10): 901–6. doi:10.1001/archpediatrics.2010.159. PMID 20679157.
  6. ^ Lejtenyi P. "Problematic internet use and teen depression are closely linked, new Concordia study finds". Concordia University. Retrieved 4 April 2021.
  7. ^ a b Chou, Chien; Condron, Linda; Belland, John C. (1 December 2005). "A Review of the Research on Internet Addiction". Educational Psychology Review. 17 (4): 363–388. doi:10.1007/s10648-005-8138-1. S2CID 7014879.
  8. ^ a b Tsitsika A, Janikian M, Schoenmakers TM, Tzavela EC, Olafsson K, Wójcik S, et al. (August 2014). "Internet addictive behavior in adolescence: a cross-sectional study in seven European countries". Cyberpsychology, Behavior and Social Networking. 17 (8): 528–35. doi:10.1089/cyber.2013.0382. PMID 24853789. S2CID 27117970.
  9. ^ a b Chou C, Hsiao MC (2000). "Internet addiction, usage, gratification, and pleasure experience: the Taiwan college students' case". Computers & Education. 35 (1): 65–80. doi:10.1016/s0360-1315(00)00019-1.
  10. ^ Chin-Chung L, Tsai SS (1999). Internet Addiction among High Schoolers in Taiwan. Annual meeting of American Psychological Association, August 20–24, 1999, Boston, MA.
  11. ^ Beard KW (February 2005). "Internet addiction: a review of current assessment techniques and potential assessment questions". Cyberpsychology & Behavior. 8 (1): 7–14. doi:10.1089/cpb.2005.8.7. PMID 15738688.
  12. ^ a b c d e f Byun S, Ruffini C, Mills JE, Douglas AC, Niang M, Stepchenkova S, et al. (April 2009). "Internet addiction: metasynthesis of 1996-2006 quantitative research". Cyberpsychology & Behavior. 12 (2): 203–7. doi:10.1089/cpb.2008.0102. PMID 19072075. S2CID 16743234.
  13. ^ a b Rosen, Larry D., et al. "Social Networking Is Addictive and Can Lead to Psychological Disorders." Are Social Networking Sites Harmful?, edited by Noah Berlatsky, Greenhaven Press, 2015.
  14. ^ Lush T (29 August 2011). "At war with World of Warcraft". The Guardian. London. Associated Press. Retrieved 2012-03-15.
  15. ^ Doan A, Strickland B. "About". hooked-on-games.com.
  16. ^ "The Virtual Skinner Box". Retrieved 2012-03-15.
  17. ^ Reimer J (August 2006). "Doctor claims 40 percent of World of Warcraft players are addicted". ARS Technica. Retrieved 2012-03-15.
  18. ^ Rossignol J (2009). The Gaming Life: Travels in Three Cities. University of Michigan Press. ISBN 9780472033973.
  19. ^ a b Twohig, M. P.; Crosby, J. M. (2010). "Acceptance and Commitment Therapy as a Treatment for Problematic Internet Pornography Viewing". Behavior Therapy. 41 (3): 285–295. doi:10.1016/j.beth.2009.06.002. PMID 20569778.
  20. ^ Duffy, A; Dawson, DL; das Nair, R (May 2016). "Pornography Addiction in Adults: A Systematic Review of Definitions and Reported Impact" (PDF). The Journal of Sexual Medicine. 13 (5): 760–77. doi:10.1016/j.jsxm.2016.03.002. PMID 27114191.
  21. ^ Grant, J. E.; Potenza, M. N.; Weinstein, A.; Gorelick, D. A. (2010). "Introduction to Behavioral Addictions". The American Journal of Drug and Alcohol Abuse. 36 (5): 233–241. doi:10.3109/00952990.2010.491884. PMC 3164585. PMID 20560821.
  22. ^ Kafka, M. P. (2009). "Hypersexual Disorder: A Proposed Diagnosis for DSM-V" (PDF). Archives of Sexual Behavior. 39 (2): 377–400. doi:10.1007/s10508-009-9574-7. PMID 19937105. S2CID 2190694.
  23. ^ "ASAM Definition of Addiction". 19 April 2011. Retrieved 7 November 2016.
  24. ^ a b c Kraus, Shane W.; Voon, Valerie; Potenza, Marc N. (December 2016). "Should compulsive sexual behavior be considered an addiction?". Addiction (Abingdon, England). 111 (12): 2097–2106. doi:10.1111/add.13297. ISSN 0965-2140. PMC 4990495. PMID 26893127. S2CID 11261106.
  25. ^ a b c d Gola, Mateusz; Wordecha, Małgorzata; Sescousse, Guillaume; Lew-Starowicz, Michał; Kossowski, Bartosz; Wypych, Marek; Makeig, Scott; Potenza, Marc N.; Marchewka, Artur (September 2017). "Can Pornography be Addictive? An fMRI Study of Men Seeking Treatment for Problematic Pornography Use" (PDF). Neuropsychopharmacology. Springer Nature. 42 (10): 2021–2031. doi:10.1038/npp.2017.78. eISSN 1740-634X. ISSN 0893-133X. OCLC 815994337. PMC 5561346. PMID 28409565. S2CID 13759729. Archived (PDF) from the original on 20 March 2019. Retrieved 1 August 2021.
  26. ^ "AASECT Position on Sex Addiction". April 2018. Retrieved 25 April 2019. AASECT 1) does not find sufficient empirical evidence to support the classification of sex addiction or porn addiction as a mental health disorder, and 2) does not find the sexual addiction training and treatment methods and educational pedagogies to be adequately informed by accurate human sexuality knowledge.
  27. ^ a b c d e Awan, Hashir A.; Aamir, Alifyah; Diwan, Mufaddal N.; Ullah, Irfan; Pereira-Sanchez, Victor; Ramalho, Rodrigo; Orsolini, Laura; Ojeahere, Margaret I.; Ransing, Ramdas; Vadsaria, Aftab K.; Virani, Sanya (March 2021). Fujiwara, Hironobu (ed.). "Internet and Pornography Use During the COVID-19 Pandemic: Presumed Impact and What Can Be Done". Frontiers in Psychiatry. Frontiers Media. 12 (623508): 623508. doi:10.3389/fpsyt.2021.623508. eISSN 1664-0640. PMC 8007884. PMID 33796031. S2CID 232234421.
  28. ^ a b c de Alarcón, Rubén; de la Iglesia, Javier I.; Casado, Nerea M.; Montejo, Angel L. (January 2019). "Online Porn Addiction: What We Know and What We Don't—A Systematic Review". Journal of Clinical Medicine. MDPI. 8 (1: Novel Research in Sexuality and Mental Health): 91. doi:10.3390/jcm8010091. eISSN 2077-0383. PMC 6352245. PMID 30650522. S2CID 58578935.
  29. ^ a b c Love, Todd; Laier, Christian; Brand, Matthias; Hatch, Linda; Hajela, Raju (September 2015). "Neuroscience of Internet Pornography Addiction: A Review and Update". Behavioral Sciences. MDPI. 5 (3: Addictive Behaviors: Assessment and Treatment): 388–433. doi:10.3390/bs5030388. eISSN 2076-328X. PMC 4600144. PMID 26393658. S2CID 16085514.
  30. ^ a b Cooper, Alvin; Putnam, Dana E.; Planchon, Lynn A.; Boies, Sylvain C. (1999). "Online sexual compulsivity: Getting tangled in the net". Sexual Addiction & Compulsivity. 6 (2): 79–104. doi:10.1080/10720169908400182.
  31. ^ a b Delmonico, David L. (1997). "Cybersex: High tech sex addiction". Sexual Addiction & Compulsivity. 4 (2): 159–167. doi:10.1080/10720169708400139.
  32. ^ a b Layden, Mary Anne (September 2005). "Cyber Sex Addiction" (PDF). Advances in Cognitive Therapy: 1–2, 4–5.[permanent dead link]
  33. ^ Nelson, Kimberly M.; Rothman, Emily F. (February 2020). Morabia, Alfredo (ed.). "Should Public Health Professionals Consider Pornography a Public Health Crisis?". American Journal of Public Health. American Public Health Association. 110 (2): 151–153. doi:10.2105/AJPH.2019.305498. ISSN 1541-0048. PMC 6951382. PMID 31913670. S2CID 210121251.
  34. ^ Rothman, Emily F. (2021). "Pornography as a US Public Health Problem". Pornography and Public Health. Oxford and New York: Oxford University Press. pp. 1–15. doi:10.1093/oso/9780190075477.003.0001. ISBN 9780190075477. LCCN 2021013439.
  35. ^ Walther, J.B. (1999) "Communication Addiction Disorder: Concern over media, behavior and effects [APA conference talk]".
  36. ^ Echeburúa E, de Corral P (2010). "[Addiction to new technologies and to online social networking in young people: A new challenge]". Adicciones. 22 (2): 91–5. doi:10.20882/adicciones.196. PMID 20549142.
  37. ^ Hutson M. (2009). "Facebook Friends: Too Many, Too Few?" Retrieved 10 March 2012
  38. ^ Buffardi LE, Campbell WK (October 2008). "Narcissism and social networking Web sites". Personality & Social Psychology Bulletin. 34 (10): 1303–14. CiteSeerX 10.1.1.464.5684. doi:10.1177/0146167208320061. PMID 18599659. S2CID 5740594.
  39. ^ Manago AM, Graham MB, Greenfield PM, Salimkhan G (2008). "Self-presentation and gender on My Space". Journal of Applied Developmental Psychology. 29 (6): 446–458. doi:10.1016/j.appdev.2008.07.001.
  40. ^ Ambady N., Skowronski J. (2008). "First impressions". New York Guilford.[page needed]
  41. ^ Davidow, William H. (31 July 2012). "Virtual Reality Is Addictive and Unhealthy". IEEE Spectrum.
  42. ^ "The dangers of virtual reality gaming" (Press release). reSTART. 7 January 2016.
  43. ^ Ebeling-Witte S, Frank ML, Lester D (October 2007). "Shyness, Internet use, and personality". Cyberpsychology & Behavior. 10 (5): 713–6. doi:10.1089/cpb.2007.9964. PMID 17927542. S2CID 23484450.
  44. ^ Leung L (April 2007). "Stressful life events, motives for Internet use, and social support among digital kids". Cyberpsychology & Behavior. 10 (2): 204–14. doi:10.1089/cpb.2006.9967. PMID 17474837. S2CID 14499167.
  45. ^ a b c d e f g h i j k Young K (2017). "The Evolution of Internet Addiction Disorder". Internet Addiction. Studies in Neuroscience, Psychology and Behavioral Economics. Springer, Cham. pp. 3–18. doi:10.1007/978-3-319-46276-9_1. ISBN 9783319462752.
  46. ^ Morahan-Martin J (1999-10-01). "The relationship between loneliness and internet use and abuse". Cyberpsychology & Behavior. 2 (5): 431–9. doi:10.1089/cpb.1999.2.431. PMID 19178216.
  47. ^ Hardie, Elizabeth; Tee, Ming Yi (2007). "Excessive Internet Use: The Role of Personality, Loneliness and Social Support Networks in Internet Addiction" (PDF). Australian Journal of Emerging Technologies & Society. 5 (1): 34–47.
  48. ^ a b Ko CH, Yen JY, Chen CS, Yeh YC, Yen CF (October 2009). "Predictive values of psychiatric symptoms for internet addiction in adolescents: a 2-year prospective study". Archives of Pediatrics & Adolescent Medicine. 163 (10): 937–43. doi:10.1001/archpediatrics.2009.159. PMID 19805713.
  49. ^ van den Eijnden RJ, Spijkerman R, Vermulst AA, van Rooij TJ, Engels RC (January 2010). "Compulsive internet use among adolescents: bidirectional parent-child relationships". Journal of Abnormal Child Psychology. 38 (1): 77–89. doi:10.1007/s10802-009-9347-8. PMC 2809946. PMID 19728076.
  50. ^ Yu L, Shek DT (June 2013). "Internet addiction in Hong Kong adolescents: a three-year longitudinal study". Journal of Pediatric and Adolescent Gynecology. 26 (3 Suppl): S10-7. doi:10.1016/j.jpag.2013.03.010. hdl:10397/8135. PMID 23683821.
  51. ^ Cho SM, Sung MJ, Shin KM, Lim KY, Shin YM (August 2013). "Does psychopathology in childhood predict internet addiction in male adolescents?". Child Psychiatry and Human Development. 44 (4): 549–55. doi:10.1007/s10578-012-0348-4. PMID 23242708. S2CID 26245088.
  52. ^ a b Przepiorka AM, Blachnio A, Miziak B, Czuczwar SJ (April 2014). "Clinical approaches to treatment of Internet addiction". Pharmacological Reports. 66 (2): 187–91. doi:10.1016/j.pharep.2013.10.001. PMID 24911068.
  53. ^ Tereshchenko, Sergey; Kasparov, Edward (June 2019) [June 2019]. "Neurobiological Risk Factors for the Development of Internet Addiction in Adolescents". Behavioral Sciences. 9 (6): 62. doi:10.3390/bs9060062. PMC 6616486. PMID 31207886.   This article incorporates text available under the CC BY 4.0 license.
  54. ^ Ramachandran S (2015-10-01). "Technology: Smart tablet or just a new drug? (Lessons for use of technology with children)". The Essayist.
  55. ^ Brand M (2017). "Theoretical Models of the Development and Maintenance of Internet Addiction". Internet Addiction. Studies in Neuroscience, Psychology and Behavioral Economics. Springer, Cham. pp. 19–34. doi:10.1007/978-3-319-46276-9_2. ISBN 9783319462752.
  56. ^ Kershaw, Sarah (1 December 2005). "Hooked on the Web: Help Is on the Way". The New York Times.
  57. ^ Ko CH, Yen JY, Chen CS, Chen CC, Yen CF (February 2008). "Psychiatric comorbidity of internet addiction in college students: an interview study". CNS Spectrums. 13 (2): 147–53. doi:10.1017/S1092852900016308. PMID 18227746. S2CID 3101800.
  58. ^ Floros G, Siomos K, Stogiannidou A, Giouzepas I, Garyfallos G (December 2014). "Comorbidity of psychiatric disorders with Internet addiction in a clinical sample: the effect of personality, defense style and psychopathology". Addictive Behaviors. 39 (12): 1839–45. doi:10.1016/j.addbeh.2014.07.031. PMID 25129172.
  59. ^ Shapira NA, Goldsmith TD, Keck PE, Khosla UM, McElroy SL (2000). "Psychiatric features of individuals with problematic internet use". Journal of Affective Disorders. 57 (1–3): 267–72. doi:10.1016/s0165-0327(99)00107-x. PMID 10708842.
  60. ^ Black DW, Belsare G, Schlosser S (December 1999). "Clinical features, psychiatric comorbidity, and health-related quality of life in persons reporting compulsive computer use behavior". The Journal of Clinical Psychiatry. 60 (12): 839–44. doi:10.4088/jcp.v60n1206. PMID 10665630.
  61. ^ a b c d e f g Block JJ (March 2008). "Issues for DSM-V: internet addiction". The American Journal of Psychiatry. 165 (3): 306–7. doi:10.1176/appi.ajp.2007.07101556. PMID 18316427. S2CID 36268291.
  62. ^ a b c d e f g Stone R (June 2009). "Science in society. China reins in wilder impulses in treatment of 'Internet addiction'". Science. 324 (5935): 1630–1. Bibcode:2009Sci...324.1630S. doi:10.1126/science.324_1630. PMID 19556477.
  63. ^ Hawi NS (2012). "Internet addiction among adolescents in Lebanon". Computers in Human Behavior. 28 (3): 1044–1053. doi:10.1016/j.chb.2012.01.007.
  64. ^ Bai YM, Lin CC, Chen JY (October 2001). "Internet addiction disorder among clients of a virtual clinic". Psychiatric Services. 52 (10): 1397. doi:10.1176/appi.ps.52.10.1397. PMID 11585966.
  65. ^ a b "DSM-5". www.psychiatry.org. Retrieved 2018-02-19.
  66. ^ Marazziti, D.; Mucci, F.; Vanelli, F.; Renda, N.; Baroni, S.; Piccinni, A. (2017). "Prevalence of Internet Addiction: A Pilot Study in a Group of Italian Students". European Psychiatry. 41 (S1): s248. doi:10.1016/j.eurpsy.2017.02.030. S2CID 44793385.
  67. ^ Lopez-Fernandez, Olatz (1 September 2015). "How Has Internet Addiction Research Evolved Since the Advent of Internet Gaming Disorder? An Overview of Cyberaddictions from a Psychological Perspective". Current Addiction Reports. 2 (3): 263–271. doi:10.1007/s40429-015-0067-6. S2CID 21736591.
  68. ^ "Gaming disorder". World Health Organization. Retrieved 2018-03-02.
  69. ^ a b Weinstein A, Lejoyeux M (September 2010). "Internet addiction or excessive internet use". The American Journal of Drug and Alcohol Abuse. 36 (5): 277–83. CiteSeerX 10.1.1.1025.8525. doi:10.3109/00952990.2010.491880. PMID 20545603. S2CID 17713327.
  70. ^ a b c d Young KS (1998). Caught in the net: how to recognize the signs of Internet addiction—and a winning strategy for recovery. New York: J. Wiley. ISBN 9780471191599. OCLC 38130573.[page needed]
  71. ^ a b Young, Kimberly S. (1 January 1998). "Internet Addiction: The Emergence of a New Clinical Disorder". CyberPsychology & Behavior. 1 (3): 237–244. doi:10.1089/cpb.1998.1.237.
  72. ^ Beard, Keith W.; Wolf, Eve M. (June 2001). "Modification in the Proposed Diagnostic Criteria for Internet Addiction". CyberPsychology & Behavior. 4 (3): 377–383. doi:10.1089/109493101300210286. PMID 11710263. S2CID 40907675.
  73. ^ a b Cheng C, Li AY (December 2014). "Internet addiction prevalence and quality of (real) life: a meta-analysis of 31 nations across seven world regions". Cyberpsychology, Behavior and Social Networking. 17 (12): 755–60. doi:10.1089/cyber.2014.0317. PMC 4267764. PMID 25489876.
  74. ^ a b Widyanto L, McMurran M (August 2004). "The psychometric properties of the internet addiction test". Cyberpsychology & Behavior. 7 (4): 443–50. doi:10.1089/cpb.2004.7.443. PMID 15331031. S2CID 8052698.
  75. ^ Brenner V (June 1997). "Psychology of computer use: XLVII. Parameters of Internet use, abuse and addiction: the first 90 days of the Internet Usage Survey". Psychological Reports. 80 (3 Pt 1): 879–82. doi:10.2466/pr0.1997.80.3.879. PMID 9198388. S2CID 43237173.
  76. ^ a b Huang Z, Wang M, Qian M, Zhong J, Tao R (December 2007). "Chinese Internet addiction inventory: developing a measure of problematic Internet use for Chinese college students". Cyberpsychology & Behavior. 10 (6): 805–11. doi:10.1089/cpb.2007.9950. PMID 18085968.
  77. ^ Heo J, Oh J, Subramanian SV, Kim Y, Kawachi I (2014-02-05). "Addictive internet use among Korean adolescents: a national survey". PLOS ONE. 9 (2): e87819. Bibcode:2014PLoSO...987819H. doi:10.1371/journal.pone.0087819. PMC 3914839. PMID 24505318.
  78. ^ Meerkerk GJ, Van Den Eijnden RJ, Vermulst AA, Garretsen HF (February 2009). "The Compulsive Internet Use Scale (CIUS): some psychometric properties". Cyberpsychology & Behavior. 12 (1): 1–6. doi:10.1089/cpb.2008.0181. hdl:2066/77299. PMID 19072079.
  79. ^ Caplan SE (2010). "Theory and measurement of generalized problematic Internet use: A two-step approach". Computers in Human Behavior. 26 (5): 1089–1097. doi:10.1016/j.chb.2010.03.012.
  80. ^ Clark DJ, Frith KH (September 2005). "The development and initial testing of the Internet Consequences Scales (ICONS)". Computers, Informatics, Nursing. 23 (5): 285–91. doi:10.1097/00024665-200509000-00013. PMID 16166831. S2CID 43342374.
  81. ^ Demetrovics Z, Szeredi B, Rózsa S (May 2008). "The three-factor model of Internet addiction: the development of the Problematic Internet Use Questionnaire". Behavior Research Methods. 40 (2): 563–74. doi:10.3758/BRM.40.2.563. PMID 18522068. S2CID 22920306.
  82. ^ Chang MK, Law SP (2008). "Factor structure for Young's Internet Addiction Test: A confirmatory study". Computers in Human Behavior. 24 (6): 2597–2619. doi:10.1016/j.chb.2008.03.001.
  83. ^ Widyanto L, Griffiths MD, Brunsden V (March 2011). "A psychometric comparison of the Internet Addiction Test, the Internet-Related Problem Scale, and self-diagnosis" (PDF). Cyberpsychology, Behavior and Social Networking. 14 (3): 141–9. doi:10.1089/cyber.2010.0151. PMID 21067282.
  84. ^ a b c d e Northrup JC, Lapierre C, Kirk J, Rae C (July 2015). "The Internet Process Addiction Test: Screening for Addictions to Processes Facilitated by the Internet". Behavioral Sciences. 5 (3): 341–52. doi:10.3390/bs5030341. PMC 4600140. PMID 26226007.
  85. ^ a b Griffiths M (2000). "Internet addiction-time to be taken seriously?". Addiction Research. 8 (5): 413–418. doi:10.3109/16066350009005587. S2CID 146471881.
  86. ^ Soule LC, Shell LW, Kleen BA (2003). "Exploring Internet addiction: Demographic characteristics and stereotypes of heavy Internet users". Journal of Computer Information Systems. 44 (1): 64–73. doi:10.1080/08874417.2003.11647553 (inactive 28 February 2022).{{cite journal}}: CS1 maint: DOI inactive as of February 2022 (link)
  87. ^ a b Yuan K, Qin W, Liu Y, Tian J (November 2011). "Internet addiction: Neuroimaging findings". Communicative & Integrative Biology. 4 (6): 637–9. doi:10.4161/cib.17871. PMC 3306323. PMID 22448301.
  88. ^ Müller-Putz, Gernot; Riedl, René; C, Selina (1 November 2015). "Electroencephalography (EEG) as a Research Tool in the Information Systems Discipline: Foundations, Measurement, and Applications". Communications of the Association for Information Systems. 37 (1). doi:10.17705/1CAIS.03746.
  89. ^ a b Lee J, Hwang JY, Park SM, Jung HY, Choi SW, Kim DJ, et al. (April 2014). "Differential resting-state EEG patterns associated with comorbid depression in Internet addiction". Progress in Neuro-Psychopharmacology & Biological Psychiatry. 50: 21–6. doi:10.1016/j.pnpbp.2013.11.016. PMID 24326197. S2CID 23750266.
  90. ^ Burleigh TL, Griffiths MD, Sumich A, Wang GY, Kuss DJ (August 2020). "Gaming disorder and internet addiction: A systematic review of resting-state EEG studies" (PDF). Addictive Behaviors. 107: 106429. doi:10.1016/j.addbeh.2020.106429. PMID 32283445. S2CID 215758373.
  91. ^ a b Gross J, Baumgartl H, Buettner R (2020-08-10). "A Novel Machine Learning Approach for High-Performance Diagnosis of Premature Internet Addiction Using the Unfolded EEG Spectra". AMCIS 2020 Proceedings.
  92. ^ a b Choi JS, Park SM, Lee J, Hwang JY, Jung HY, Choi SW, et al. (September 2013). "Resting-state beta and gamma activity in Internet addiction". International Journal of Psychophysiology. Psychophysiology in Australasia - ASP conference - November 28–30, 2012. 89 (3): 328–33. doi:10.1016/j.ijpsycho.2013.06.007. PMID 23770040.
  93. ^ Yu, Hongqiang; Zhao, Xin; Li, Ning; Wang, Mingshi; Zhou, Peng (October 2009). "Effect of excessive Internet use on the time–frequency characteristic of EEG". Progress in Natural Science. 19 (10): 1383–1387. doi:10.1016/j.pnsc.2008.11.015.
  94. ^ Kuss D, Lopez-Fernandez O (2016). "Internet-use related addiction: The state of the art of clinical research". European Psychiatry. 33: S303. doi:10.1016/j.eurpsy.2016.01.1038. S2CID 148064363.
  95. ^ Young KS (1999-10-01). "The research and controversy surrounding internet addiction". Cyberpsychology & Behavior. 2 (5): 381–3. doi:10.1089/cpb.1999.2.381. PMID 19178209.
  96. ^ Petersen, K. U.; Weymann, N.; Schelb, Y.; Thiel, R.; Thomasius, R. (2009). "Pathologischer Internetgebrauch – Epidemiologie, Diagnostik, komorbide Störungen und Behandlungsansätze" [Pathological Internet use--epidemiology, diagnostics, co-occurring disorders and treatment]. Fortschritte der Neurologie · Psychiatrie (in German). 77 (5): 263–271. doi:10.1055/s-0028-1109361. PMID 19418384.
  97. ^ a b Young KS (October 2007). "Cognitive behavior therapy with Internet addicts: treatment outcomes and implications". Cyberpsychology & Behavior. 10 (5): 671–9. doi:10.1089/cpb.2007.9971. PMID 17927535. S2CID 13951774.
  98. ^ a b c d Huang XQ, Li MC, Tao R (October 2010). "Treatment of internet addiction". Current Psychiatry Reports. 12 (5): 462–70. doi:10.1007/s11920-010-0147-1. PMID 20697848. S2CID 21592685.
  99. ^ a b Orzack MH, Voluse AC, Wolf D, Hennen J (June 2006). "An ongoing study of group treatment for men involved in problematic Internet-enabled sexual behavior". Cyberpsychology & Behavior. 9 (3): 348–60. doi:10.1089/cpb.2006.9.348. PMID 16780403.
  100. ^ Zajac K, Ginley MK, Chang R, Petry NM (December 2017). "Treatments for Internet gaming disorder and Internet addiction: A systematic review". Psychol Addict Behav. 31 (8): 979–994. doi:10.1037/adb0000315. PMC 5714660. PMID 28921996.
  101. ^ Adams M (2016). Internet addiction : prevalence, risk factors and health effects. Adams, Margaret E. Hauppauge, New York. ISBN 9781536104363. OCLC 961923990.
  102. ^ Ansar, Farrukh; Ali, Waqar; Zareef, Adil; Masud, Noman; Zahab, Sawar; Iftikhar, Huma (17 December 2020). "Internet Addiction and Its Relationship with Depression and Academic Performance: A Cross-Sectional Study at a Medical School in Pakistan". International Journal of Medical Students. 8 (3): 251–256. doi:10.5195/ijms.2020.740.
  103. ^ Wu XS, Zhang ZH, Zhao F, Wang WJ, Li YF, Bi L, et al. (October 2016). "Prevalence of Internet addiction and its association with social support and other related factors among adolescents in China". Journal of Adolescence. 52: 103–11. doi:10.1016/j.adolescence.2016.07.012. PMID 27544491.
  104. ^ Shek DT, Yu L (February 2016). "Adolescent Internet Addiction in Hong Kong: Prevalence, Change, and Correlates". Journal of Pediatric and Adolescent Gynecology. 29 (1 Suppl): S22-30. doi:10.1016/j.jpag.2015.10.005. hdl:10397/62018. PMID 26461526.
  105. ^ Yang SC, Tung CJ (2007). "Comparison of Internet addicts and non-addicts in Taiwanese high school". Computers in Human Behavior. 23 (1): 79–96. doi:10.1016/j.chb.2004.03.037.
  106. ^ Kawabe K, Horiuchi F, Ochi M, Oka Y, Ueno S (September 2016). "Internet addiction: Prevalence and relation with mental states in adolescents". Psychiatry and Clinical Neurosciences. 70 (9): 405–12. doi:10.1111/pcn.12402. PMID 27178110. S2CID 31236193.
  107. ^ Durkee T, Kaess M, Carli V, Parzer P, Wasserman C, Floderus B, et al. (December 2012). "Prevalence of pathological internet use among adolescents in Europe: demographic and social factors". Addiction. 107 (12): 2210–22. doi:10.1111/j.1360-0443.2012.03946.x. PMID 22621402.
  108. ^ Wölfling K, Bühler M, Leménager T, Mörsen C, Mann K (September 2009). "[Gambling and internet addiction: review and research agenda]". Der Nervenarzt (in German). 80 (9): 1030–9. doi:10.1007/s00115-009-2741-1. PMID 19697001.
  109. ^ Gómez P, Rial A, Braña T, Golpe S, Varela J (April 2017). "Screening of Problematic Internet Use Among Spanish Adolescents: Prevalence and Related Variables". Cyberpsychology, Behavior and Social Networking. 20 (4): 259–267. doi:10.1089/cyber.2016.0262. PMID 28394211.
  110. ^ Bakken IJ, Wenzel HG, Götestam KG, Johansson A, Oren A (April 2009). "Internet addiction among Norwegian adults: a stratified probability sample study". Scandinavian Journal of Psychology. 50 (2): 121–7. doi:10.1111/j.1467-9450.2008.00685.x. PMID 18826420.
  111. ^ Niemz K, Griffiths M, Banyard P (December 2005). "Prevalence of pathological Internet use among university students and correlations with self-esteem, the General Health Questionnaire (GHQ), and disinhibition" (PDF). Cyberpsychology & Behavior. 8 (6): 562–70. doi:10.1089/cpb.2005.8.562. PMID 16332167.
  112. ^ Aboujaoude E, Koran LM, Gamel N, Large MD, Serpe RT (October 2006). "Potential markers for problematic internet use: a telephone survey of 2,513 adults". CNS Spectrums. 11 (10): 750–5. doi:10.1017/S1092852900014875. PMID 17008818. S2CID 31582999.
  113. ^ Wallis, David (5 January 1997). "Just Click No". The New Yorker.
  114. ^ Kandell, Jonathan J. (1 January 1998). "Internet Addiction on Campus: The Vulnerability of College Students". CyberPsychology & Behavior. 1 (1): 11–17. doi:10.1089/cpb.1998.1.11.
  115. ^ Griffiths, M. (1998). "Internet addiction: Does it really exist?". In Gackenbach, J. (ed.). Psychology and the Internet: Intrapersonal, interpersonal, and transpersonal implications. Academic Press. pp. 61–75.
  116. ^ "Internet and Technology Addicts Anonymous". Internet and Technology Addicts Anonymous. Retrieved 2018-10-10.
  117. ^ "Media Addicts Anonymous". Media Addicts Anon. Retrieved 2022-05-11.
  118. ^ "R/nosurf - the Beginner's Guide to NoSurf (Essential Reading, Success Stories, Guides, FAQ and more!)". NoSurf Sub-reddit. 2 September 2018. Retrieved 2018-10-10.
  119. ^ Bax T (2013-08-15). Youth and Internet Addiction in China. Routledge. ISBN 9781135096953.
  120. ^ Phillips T (2017-08-28). "'Electronic heroin': China's boot camps get tough on internet addicts". The Guardian. Retrieved 2018-02-20.
  121. ^ "我国首个《网络成瘾临床诊断标准》通过专家论证". www.gov.cn. Retrieved 2018-03-02.
  122. ^ a b c d e Wang, Amy B. (14 August 2017). "A teen checked into an Internet-addiction camp in China. He was dead two days later". Washington Post.
  123. ^ "China moves to zap online game addiction". Financial Times. 2005-08-23. Retrieved 2018-02-20.
  124. ^ a b c d "暗访杨永信网瘾戒治中心:杨永信和传销一个样-搜狐健康". health.sohu.com. Retrieved 2018-02-20.
  125. ^ a b ""戒网专家"电击治网瘾惹争议". zqb.cyol.com. Retrieved 2018-02-19.
  126. ^ a b "一个网戒中心的生态系统". zqb.cyol.com. Retrieved 2018-02-19.
  127. ^ "It's the addiction gripping thousands of Chinese teenagers". NewsComAu. Retrieved 2018-02-20.
  128. ^ Krajnak D. "China probe of abuse at Web addiction camp". www.cnn.com. CNN. Retrieved 2018-02-20.
  129. ^ "我在'网瘾集中营'的生活". zqb.cyol.com. Retrieved 2018-02-19.
  130. ^ "南方周末 - 86条规定". www.infzm.com. Retrieved 2018-02-19.
  131. ^ a b Reuters Staff. "China bans physical punishment for Internet addicts". IN. Retrieved 2018-02-21.
  132. ^ "南昌豫章书院深陷"暴力门" 学生称"绝望"". jx.ifeng.com. Retrieved 2018-02-20.
  133. ^ Tencent VFE Team. "独家专访引爆豫章书院事件当事人:曾被铁棍打 吞牙膏自杀未遂_网罗天下_腾讯视频". v.qq.com (in Chinese (China)). Retrieved 2018-02-20.
  134. ^ "南昌豫章书院学生陆续被接走,警方正调查书院是否涉嫌违法_教育家_澎湃新闻-The Paper". www.thepaper.cn. Retrieved 2018-02-20.
  135. ^ Tang YL, Jiang W, Ren YP, Ma X, Cotes RO, McDonald WM (December 2012). "Electroconvulsive therapy in China: clinical practice and research on efficacy". The Journal of ECT. 28 (4): 206–12. doi:10.1097/yct.0b013e31825957b1. PMID 22801297. S2CID 2743272.
  136. ^ a b "杨永信网瘾中心再追踪:女孩唱舞娘也遭电击_科技_腾讯网". tech.qq.com. Retrieved 2018-02-20.
  137. ^ "南方周末 - "电击"可治网瘾?卫生部叫停". www.infzm.com. Retrieved 2018-02-20.
  138. ^ a b Branigan T (2009-07-14). "China bans electric shock treatment used to 'cure' young internet addicts". The Guardian. Retrieved 2018-02-20.
  139. ^ 网易. "杨永信"神话"破灭背后的媒体漩涡_网易新闻". discover.news.163.com. Archived from the original on 2018-03-08. Retrieved 2018-02-19.
  140. ^ 网易. "《新闻调查》曝光杨永信电击真相_网易科技". tech.163.com. Archived from the original on 2010-03-03. Retrieved 2018-02-20.
  141. ^ "经济半小时:杨永信网戒中心入账可达8100万_互联网_科技时代_新浪网". tech.sina.com.cn. Retrieved 2018-02-20.
  142. ^ "卫生部通知停止电刺激治疗"网瘾"技术临床应用". www.gov.cn. Retrieved 2018-02-19.
  143. ^ Kuo L. "China's cure for teenage internet addiction is worse than the supposed disease". Quartz. Retrieved 2018-02-20.
  144. ^ chinanews. "盘点12起被曝光戒网瘾学校事件:9成涉体罚 致7人亡-中新网". www.chinanews.com. Retrieved 2018-02-20.
  145. ^ "China 'internet addict' death sparks fury". BBC News. 2017-08-14. Retrieved 2018-02-20.
  146. ^ Leonard, Tom (19 November 2007). "First boot camp for internet-addicted teenagers". The Telegraph. Archived from the original on 2022-01-12.
  147. ^ a b c d "Korea's Internet Addicts". News. Retrieved 2018-02-27.
  148. ^ a b "Horses to the rescue of Korea's Internet-addicted teens". Reuters. 2013. Retrieved 2018-02-27.
  149. ^ Smith L. "Internet-addicted teens are being sent to rehab to "get clean"". www.kidspot.com.au. Retrieved 2018-02-20.
  150. ^ Fifield, Anna (24 January 2016). "In South Korea, a rehab camp for Internet-addicted teenagers". Washington Post.
  151. ^ a b Fackler, Martin (18 November 2007). "In Korea, a Boot Camp Cure for Web Obsession". The New York Times.
  152. ^ Tateno M, Teo AR, Ukai W, Kanazawa J, Katsuki R, Kubo H, Kato TA (2019-07-10). "Internet Addiction, Smartphone Addiction, and Hikikomori Trait in Japanese Young Adult: Social Isolation and Social Network". Frontiers in Psychiatry. 10: 455. doi:10.3389/fpsyt.2019.00455. PMC 6635695. PMID 31354537.
  153. ^ Kato TA, Kanba S, Teo AR (August 2019). "Hikikomori: Multidimensional understanding, assessment, and future international perspectives". Psychiatry and Clinical Neurosciences. 73 (8): 427–440. doi:10.1111/pcn.12895. PMID 31148350. S2CID 171093449.

Further readingEdit