Internet addiction disorder: Difference between revisions

Internet addiction disorder
Internet addiction disorder
	Internet addiction might be a subset of broader forms of addiction to technology.
Specialty	Psychiatry

Browse history interactively

← Previous edit Next edit →

Content deleted Content added

VisualWikitext

Inline

Revision as of 05:07, 8 March 2018

Internet addiction disorder, also known as problematic Internet use or pathological Internet use, refers to excessive Internet use that interferes with daily life. Addiction, defined by Webster Dictionary as a "compulsive need for and use of a habit-forming substance characterized by tolerance and by well-defined physiological symptoms upon withdrawal", was traditionally used to depict a person's dependence on substance. More recently, the concept has been applied to behavioral dependence^[1] including internet use.^[2] The problem of Internet addiction evolves together with the development and spread of Internet. As adolescents (12–17 years) and emerging adults (18–29 years) access the Internet more than any other age groups and undertake a higher risk of overuse of Internet, the problem of Internet addiction disorder is most relevant to young people.^[3]

Excessive use of Internet has been found by various studies to disrupt individuals' time use and have a series of health consequences. But the existence of Internet addiction as a mental disorder is not yet well recognized. The current version of Diagnostic and Statistical Manual of Mental Disorders (DSM-V) noted that Internet gaming disorder is a condition that requires more research in order to be considered as a full disorder in 2013.^[4]

Terminology

The notion of "Internet Addictive Disorder" was initially conjured up by Dr. Ivan K. Goldberg in 1995 as a joke to parody the complexity and rigidity of 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."^[5]

The definition of Internet addiction disorder has troubled researcher ever since its inception. In general, no standardized definition has been provided despite that the phenomenon has received extensive public and scholar recognition.^[6]^[7] Below are some of the commonly used definitions.

In 1998, Dr. Jonathan J. Kandell defined Internet addiction as "a psychological dependence on the Internet, regardless of the type of activity once logged on."^[8]

English psychologist Mark D. Griffiths (1998) conceived Internet addiction as a subtype of broader technology addiction, and also a subtype of behavioral addictions.^[9]

Dr. Keith W. Beard (2005) articulate 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]".^[10]

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.^[7] 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.

Diagnosis

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.

Difficulties

Given the newness of Internet and the inconsistent definition of Internet addiction disorder, practical diagnosis is far from clearcut. With the first research initiated by Kimberly S. Young in 1996, the scientific study of Internet addiction has merely existed for 20 years.^[11] A few obstacles are present in creating an applicable diagnostic method of 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 be an integral or necessary part of human lives. The addictive or problematic use of internet is thus easily masked or justified.^[12] 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, anti-social behavior that has very little social redeeming value. Many so-called Internet addicts do not suffer from the same damage to health and relationships that are common to established addictions.^[13]
High comorbidity: Internet addiction is often accompanied by other psychiatric disorders such as personality disorder and mental retardation.^[12]^[14]^[15]^[16]^[17] It is found that Internet addiction is accompanied by other DSM-IV diagnosis 86% of the time.^[18] 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).^[19] Another study in South Korea found an average of 1.5 other diagnoses among adolescent internet addicts.^[18] Further, it is noted in the United States that many patients only resort to medical help when he/she is in trouble with other disorders.^[12]^[18] 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.^[20] 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,^[18]^[21] neither DSM-IV (1995) nor DSM-V (2013) consider Internet addiction as a mental disorder.^[22] It is worth noting, though, a subcategory of IAD, Internet gaming disorder is listed in DSM-V as a condition that requires more research in order to be considered as a full disorder in May 2013.^[23]^[22]^[24] The WHO's draft 11th Revision of the International Classification of Diseases (ICD-11) scheduled for publication in 2018 also include gaming disorder.^[25] There is still considerable controversy over whether IAD should be included in the DSM-V and recognized as a mental disease in general.^[26]

Screening instruments

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.^[27]

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.”^[27] 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:^[28]^[29]^[30]

Preoccupation with the Internet;
A need for increased time spent online to achieve the same amount of satisfaction;
Repeated efforts to curtail Internet use;
Irritability, depression, or mood lability when Internet use is limited;
Staying online longer than anticipated;
Putting a job or relationship in jeopardy to use Internet;
Lying to others about how much time is spent online; and
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.^[31]

Young further extended her 8-question YDQ assessment to the now most widely used Internet Addiction Test (IAT),^[28]^[32]^[33] which consists of 20 items with each on a 5-point Likert scale. Questions included on the IAT expand upon Young's earlier 8-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 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),^[28] the Internet-Related Addictive Behavior Inventory (IRABI),^[34] the Chinese Internet Addiction Inventory (CIAI),^[35] the Korean Internet Addiction Self-Assessment Scale (KS Scale),^[36] the Compulsive Internet Use Scale (CIUS),^[37] the Generalized Problematic Internet Use Scale (GPIUS),^[38] the Internet Consequences Scale (ICONS),^[39] and the Problematic Internet Use Scale (PIUS).^[40] 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.^[41]^[42]^[43]

Although the various screening methods are developed from diverse contexts, four dimensions manifest themselves across all instruments:^[18]^[44]

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 equipments, increased internet use, and more applications/softwares;
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.^[44]^[45] Based on Young's Internet Addiction Test (IAT),^[28] 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.^[44] The Internet Process Addiction Test (IPAT)^[44] is created to measure the processes to which individuals are addicted.

Screening methods that heavily rely on DSM criteria has 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.^[46] As a consequence of studies being conducted in divergent contexts, studies constantly modify scales for their own purposes, thereby imposing further challenge to the standardization in assessing Internet addiction disorder.^[27]

Single-question instruments

Some scholars and practitioners also attempt to define Internet addiction by a single question, typically the time-use of Internet.^[19]^[47] The extent to which Internet use can cause negative health consequences is, however, not clear from such a measure.^[27] The latter of which is critical to whether IAD should be defined as a mental disorder.

A multidimensional construct

A conceptual model of PIU has been developed based on primary data collected from addiction researchers,^[48] psychologists, and health providers as well as older adolescents themselves.^[49] That study identified seven concepts, or clusters, that make up PIU using a concept mapping approach.^[50] These seven clusters are: psychosocial risk factors; physical impairment; emotional impairment; social and functional impairment; risky Internet use; impulsive Internet use; and Internet use dependence. The last three constructs have not been previously identified. Risky Internet use are behaviors that increase risks of adverse consequences. It is not just the amount of time spent on the Internet that puts an adolescent at risk; how the time is spent is also an important consideration. The impulsive use construct describes an inability to maintain balance or control of internet use in relation to everyday life. Finally, the dependent use construct reflects the more severe symptoms that are typically associated with addictions, such as withdrawal symptoms. Thus, internet addiction may represent a severe form of PIU.^[49]

Other research also stresses the fact that the Internet addiction disorder is not a unidimensional but a multidimensional construct. Various facets of Internet use must be differentiated because of their differential predictors, mechanisms and consequences.^[51] Online activities which, if done in person, would normally be considered troublesome, such as compulsive gambling, or shopping, are sometimes called net compulsions.^[52]

Classification

Internet addiction disorder is not listed in the latest DSM manual (DSM-5, 2013),^[53] which is commonly used by psychiatrists. Gambling disorder is the only behavioural (non-substance related) addiction included in DSM-5. However Internet gaming disorder is listed in Section III, Conditions for Further Study, as a disorder requiring further study.^[53]

Jerald J. Block, M.D. has argued that Internet addiction should be included as a disorder in the DSM-5. However, Block observed that diagnosis was complicated because 86% of study subjects showing symptoms also exhibited other diagnosable mental health disorders.^[54]

Early investigation and research

The first quantitative journal study results of Internet use as possible addiction were published in 1996 by Penn State researcher, Steven John Thompson.^[55] in the Penn State McNair Journal.^[55] Thompson was a McNair Scholar who began his empirical Internet addiction research in 1995 with focus on the mass media effects of the Internet on society. Thompson's research, also evaluating dependency, was presented at the McNair Conference at SUNY Buffalo, and at the Penn State McNair Conference in 1996. While Thompson's study abstract was accepted at the annual Association for Education in Mass Communication and Journalism Convention in Chicago in 1997,^[56] the research was not formally presented due to non-attendance.

Since there was no available statistical tool for determining addiction at the Internet level in 1995, Thompson created a repurposed CAGE model for alcohol addiction to apply in Internet addiction with the first online Internet addiction survey questionnaire called McSurvey, referencing his McNair research scholar status therein.

Thompson academically surveyed over 100 people in 1995 who claimed online addiction at the time, and, after winnowing down viable participant response to a value of N=32, concluded in his published "Internet Connectivity: Addiction and Dependency Study"^[55] that Internet addiction, while needing more research, was often the way people felt rather than what was actually transpiring clinically, with his research results statistically confirming that the newness of the Internet, its empowerment of the individual with learning and knowledge, along with online community development and relationships, was why people were spending inordinate amounts of time on the Internet. Thompson's research indicated that, as with substance abuse, people with a propensity towards a particular addiction, such as pornography, may be capable of transferring that propensity into the new medium of the Internet appliance, but that did not indicate addiction to the Internet appliance.

While Thompson never conducted another formal quantitative study on Internet addiction, Thompson updated his seminal Internet addiction research 15 years later with a formal plenary presentation at the First International Forum on Media and Information Literacy^[57] held at Sidi Mohamed Ben Abdellah University in Fez, Morocco in 2011, where he was an informal contributor to UNESCO's Declaration on Media and Information Literacy adopted by Fez International Forum.^[58] With the unveiling of the 2011 updated research into Internet addiction and dependency, Thompson indicated that Internet addiction has been supplanted by dependency as a very real and pervasive societal issue that is not only not going away, but resulting in new structures and nomenclatures rooted in human enhancement technologies, ideas further explored in the Preface to his 2014 reference book Global Issues and Ethical Considerations in Human Enhancement Technologies.^[59]

Issues with identifying diagnostic criteria

The addiction to 'cyber sex', 'cyber relationships', 'net compulsions', 'information and research' and 'computer gaming' are categories explained by Young 1999, that relate to the 'broad' term Internet addiction.^[60] The addictive stimulus associated with an 'Internet addiction' is technically a rewarding and reinforcing stimulus which is transmitted via the internet, as opposed to exposure or access to the Internet itself; hence, "Internet addiction" is a misnomer.

Tolerance is seen as one of the most important criteria required to be considered addicted. Many have difficulty fathoming that a person can build up tolerance to the internet because it is not a substance. This tolerance can take the form of constantly needing to upgrade a computer, and faster internet speeds. This idea has been growing and being explored to being a possibility.^[61]

There are a variety of stimuli online that users could be addicted to rather than the Internet itself, which include communication, gaming, shopping, cyber-relations and anonymity, and so it is argued that users 'just use the Internet excessively as a medium to fuel other addictions'.^[62]

A study carried out by Young discovered that over half of people considered 'Internet-dependent' were new users of the Internet, and are therefore more 'inclined' to use to the Internet regularly. She also discusses the fact that 'Non-dependent' users had been using the Internet for more than a year, suggesting that over use of the Internet could 'wear off over time'.^[63]^[64]

It is difficult to detect and diagnose someone with 'Internet addiction' as it is a 'highly promoted tool'.^[65]

Net compulsions

Compulsive online gaming, online gambling, and use of online auction sites are all classed as categories of Internet Addiction that are said to often result in financial and job-related problems.^[66] Internet users can become easily addicted to these types of online activity, rather than the Internet itself.

The ACE model helps to explain compulsive online use.^[52]

Accessibility. Because of the convenience of the Internet, users now have easy and immediate access to gambling, shopping and gaming at any time of day, without the hassles of everyday life (e.g. travelling or queues).^[67]^[68]

Control. Users are in control of their own online activity. With the use of newer technology such as tablet computers and smartphones, users can go to the bathroom or another private place to engage with the Internet, without others knowing about it.^[69]^[70]

Excitement. Internet users often get an excited feeling of a 'rush' or a "buzz" that they get when winning an online auction, a video game or online gambling. Gambling, gaming and online bidding all provide positive feedback that can result in addictive behaviour. Users will use the net as a way of gaining this emotion.^[71]^[72]

Internet users can become addicted to playing online games, gambling and shopping through the feeling it gives them. These online activities can create the feeling of convenience, independence and excitement, which makes the user want to do it again.

Internet addiction and pornography

Young (1999),^[73]^[74] a founding member of The Centre for On-Line Addiction, claims Internet addiction is a broad term that covers a wide variety of behaviors and impulse control problems. She claims this is categorized by five specific subtypes including:

Cybersexual addiction: compulsive use of adult websites for cybersex and cyberporn.
Cyber-relationship addiction: Over-involvement in online relationships.
Net compulsions: Obsessive online gambling, shopping or day-trading.
Information overload: Compulsive web surfing or database searches.
Computer addiction: Obsessive computer game playing.

Hypersexuality has become an enduring focus of empirical consideration in recent years (Kafka, 2010)^[75] The study of compulsive Internet pornography use as a subdomain of hypersexuality has also become a prevalent empirical focus in recent years. Internet pornography use is increasingly common in Western cultures (Carroll et al. 2008).^[76] In tandem with this increase, the mental health community has witnessed a dramatic rise in problematic Internet pornography use (Manning, 2006; Warden et al. 2004; Owens, Behun, Manning, & Reid, 2012).^[77]^[78]^[79]

Joshua B. Grubbs, a specialist in addictive behavior patterns, outlines in the article "Internet Pornography Use: Perceived Addiction"^[80] that at present there is no widely accepted means of defining or assessing problematic Internet pornography use and the notion of Internet pornography addiction is still highly controversial.

Cyber-relationship addiction

Cyber-relationship addiction is one impulse-control problem that is covered within the Internet addiction disorder. It has been supported by different articles over the years, including Ramdhonee's "Psychological impact of internet usage on children and adolescents"^[81] and Young's Internet addiction: Symptoms, evaluation and treatment.^[74]

A cyber-relationship addiction has been described as the addiction to social networking in all forms. Social networking such as Facebook, and online dating services along with many other communication platforms create a place to communicate with new people. Virtual online friends start to gain more communication and importance over time to the person becoming more important than real-life family and friends.^[66]

Cyber-relationships are in essence a virtual relationship or form of communication between two people. Visuals are removed as it is communication through text, all you know of a person is what they are communicating to you and what is displayed on their profile. Some people "will be attracted to the silent, less visually stimulating, non-tactile quality of text relationships – which may be true for some people struggling to contain the over-stimulation of past trauma. A person's ambivalence about intimacy may be expressed in text communication because it is a paradoxical blend of allowing people to be honest and feel close while maintaining their distance. People suffering with social anxiety or issues regarding shame and guilt may be drawn to text relationships because they cannot be seen. Some people even prefer text because it enables them to avoid the issue of physical appearance which they find distracting or irrelevant to the relationship. Without the distraction of in-person cues, they feel they can connect more directly to the mind and soul of the other person. Text becomes a transitional space, an extension of their mind that blends with the extension of the other person's mind".^[82]

Issues within cyber-relationship addiction

Cyber-relationships can often be more intense than real-life relationships, causing addiction to the relationship. With the ability to create whole new personas, people can often deceive the person they are communicating with. Everyone is looking for the perfect companion but the perfect companion online is not always the perfect companion in real life. Although two people can commit to a cyber-relationship, while offline, one of them could possibly not be the person they are claiming to be online.

Causes and effects

Kimberly S. Young^[83] says that prior research links internet addiction disorder with existing mental health issues, most commonly depression. Young states that the disorder has significant effects socially, psychologically and occupationally.

According to a Korean study into the disorder, pathological use of the internet results in negative life consequences such as job loss, marriage breakdown, financial debt, and academic failure. 70% of internet users in Korea are reported to play online games, 18% of which are diagnosed as game addicts. The authors of the article conducted a study using Kimberly Young's questionnaire. The study showed that the majority of those who met the requirements of internet addiction disorder suffered from interpersonal difficulties and stress and that those addicted to online games specifically responded that they hoped to avoid reality.^[84]

Young^[71] states that 52% of the respondents to her own study said that they were following recovery programs for other addictions. These included alcoholism, chemical dependency, compulsive gambling, or chronic overeating. These participants could see the same excessive behaviour, the need for a crutch to help them relax, in their use of the Internet, that they had exhibited in prior addictions. Though they believed that Internet addiction was not as serious as alcoholism, they still felt disheartened that a new addiction had substituted for the old one. Young^[85] also discusses the findings of Maressa Hecht-Orzack of McLean Hospital who set up a service for computer and Internet addiction^[86] in the spring of 1996. Orzack noted that primarily depression and bipolar disorder in its depressive swing were co-morbid features of pathological Internet use, along with this Orzack indicated that referrals received were from various clinics throughout the hospital rather than direct self-referrals for Internet addiction.

At the same time, Internet Addictive Behaviour has notable negative effects for adolescents, including poor academic performance. Similarly, this dysfunctional internet behaviour causes adolescents to suffer from increased social isolation.^[87]

Determining the cause of excessive Internet use as it relates to negative outcomes may require a consideration of moderating factors. For example, excessive use accompanied by the cognitive factor of high preoccupation with the Internet (excessive thinking about the Internet) has been found to be related to greater amounts of negative outcomes.^[88]

Internet addiction disorder has also been found to correlate positively with damaged self-esteem, which underlying mechanism parallels that of clinical conditions such as bulimia nervosa caused by the constant comparison to others on their social media feeds.^[89] This occurrence of compulsions may be attributed to an automatic defense mechanism in which the individual avoids anxiety.^[90]

A 2009 study suggested that brain structural changes were present in those classified by the researchers as Internet addicted, similar to those classified as chemically addicted.^[91]

A current study on the effects of online internet gaming reveals how excessive internet addiction could significantly impair a student's brain. For this study, the researchers selected seventeen subjects with online gaming addiction and another seventeen naive internet users who rarely used the internet. Using a magnetic resonance imaging scanner, they performed a scan to "acquire 3-dimensional T1-weighted images" of the subject's brain. The results of the scan revealed that online gaming addiction "impairs gray and white matter integrity in the orbitofrontal cortex of the prefrontal regions of the brain".^[92] According to Keath Low, psychotherapist, the orbitofrontal cortex "has a major impact on our ability to perform such tasks as planning, prioritizing, paying attention to and remembering details, and controlling our emotions".^[93] As a result, these online gaming addicts are incapable of prioritizing their life or setting a goal and accomplishing it because of the impairment of their orbitofrontal cortex.

An online study of over 17,000 people, done by David Greenfield in conjunction with ABCNews.com, was presented at the 1999 American Psychological Association meetings in Boston, MA^[94] found approximately 5.9% met the criteria for an Internet addiction diagnosis. Several factors including dissociation (time distortion, disinhibition, ease-of-access, and content variables) contributed to compulsive Internet use; results of the study were published in CyberPsychology and Behavior^[95] and later included in Greenfield's 1999 book Virtual Addiction.^[96]

Studies, surveys, tests and questionnaires

A number of online surveys and questionnaires have been created to measure the amount and type of internet use an individual undertakes. A 1995 quantitative online questionnaire may be the first published in an academic journal.^[55] The Internet Addiction Test,^[97]^[98]^[99] the Chen Internet Addiction Scale,^[100]^[101] the Compulsive Internet Use Scale,^[102] the Problematic And Risky Internet Use Screening Scale,^[49]^[103] and Generalized Problematic Internet Use Scale^[104] are later measures of usage levels.^[105]^[106]^[107]

Problematic Internet use (PIU) is defined as an addictive behavior with extreme or poorly-controlled fixation, desires, or actions concerning computer use and Internet access that may lead to harm or anguish.^[108] Some individuals prefer online interaction to face-to-face encounters.^[103]^[109]

Non-supportive studies

There are those researchers who say that Internet addiction disorder is not a true addiction and may in fact be no more than a symptom of other, existing disorders.^[110]^[111] An overbroad description of addiction leaves open the possibility of every compensatory behavior being declared an addiction. For example, a person who has lengthy telephone conversations with a friend to avoid an unpleasant situation could be declared "addicted to the telephone" with equal validity as a person who chats on the Internet with the same underlying goal.

Most, if not all "Internet addicts", already fall under existing diagnostic labels.^[112] 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.^[113] IAD is compared to food addiction, in which patients overeat as a form of self-medication for depression, anxiety, etc., without actually being truly addicted to eating. It is possible that a person could have a pathological relationship with a specific aspect of the Internet, such as bidding on online auctions, viewing pornography, online gaming, or online gambling (which is included under the existing pathological gambling), but that does not make the Internet medium itself addictive. For example,^[114] whether gambling is done on a computer or face-to-face does not affect whether or not it is pathological; a person with poor impulse control can lose sleep over a suspenseful novel or favorite television show or a computer game or the temptation to click on another web link.

Also, there are significant and critical differences between common Internet activities (e-mail, chatting, web surfing) and pathological gambling, which the IAD notion heavily parallels. The Internet is largely a pro-social, interactive, and information-driven medium, while gambling is seen as a single, anti-social behavior that has very little social redeeming value. Many so-called Internet addicts do not suffer from the same damage to health and relationships that are common to established addictions.^[112] There is also no research to support the association between Internet addiction and attention deficit hyperactivity disorder (ADHD).

A complete review of the Internet addiction research by Byun et al. in 2008 demonstrated significant, multiple flaws in most studies in this area. In that article, the researchers wrote, "The analysis showed that previous studies have utilized inconsistent criteria to define Internet addicts, applied recruiting methods that may cause serious sampling bias, and examined data using primarily exploratory rather than confirmatory data analysis techniques to investigate the degree of association rather than causal relationships among variables."^[115] However, a significant amount of research has been released since 2008, partly as a result of the American Psychiatric Association's inclusion of internet and gaming use disorder as a condition of further study.

Screening

A short 11-question Internet game screen called the BIGS^[116] was developed by reSTART to assist in the screening of problematic video game and Internet use.

Screening for problematic use in individuals due the ever-changing digital landscape. Researchers Northrup, Lapierre, Kirk and Rae developers of the Internet Process Addiction Test (IPAT)^[117] propose that tools measure different processes utilized over the Internet, such as video game play, social networking, sexual activity and web surfing, may be more helpful than a measure of Internet addiction itself, as the Internet is simply a medium which facilities a variety of interactions, some of which are highly addictive, and others less so.^{[citation needed]}

Treatment

Cash, Rae and Winkler, in a paper titled "Internet Addiction: A brief summary of research and practice", describe early interventions used in the treatment of Internet addiction (IAD), and Internet Gaming Disorder (IGD).^[118]

Cognitive Behavior Therapy is designed to help individuals learn how to control their thoughts and feelings. This control is to prevent harmful functions that may trigger impulses to escape into the virtual world. The therapy is setup for three stages. The first stage is to instruct the patient to identify there is a problem and how much a problem computers are creating. Identification is done by using a log to document duration, events, day, of online activity. This can be used to show in black and white how much time is spent online and to help create a realistic goal for patients to strive for. Using this log the patients interact with a therapist to make a schedule for online activity to promote new healthier habits. The second aspect of the treatment program is more for the cognitive aspect, as in, digging into what triggers the excessive online activity. The third phase is to confront or resolve the issues in the patient's life that lead to them seeking escape things via the Internet.^[119]

One source states that a major reason the Internet is so appealing is the lack of limits and the absence of accountability.^[120]

Professionals generally agree that, for Internet overuse, controlled use is a more practical goal than total abstinence.^[121]

Families in the People's Republic of China have turned to unlicensed training camps that offer to "wean" their children, often in their teens, from overuse of the Internet. The training camps have been associated with the death of at least one youth.^[122] In November 2009, the government of the People's Republic of China banned physical punishment to "wean" teens from the Internet. Electro-shock therapy had already been banned.^[123]

In August 2013, researchers at the MIT Media Lab developed a USB-connected keyboard accessory that would "punish" users – with a small electric jolt – who spent too much time on a particular website.^[124]

In July 2014, an internet de-addiction center was started in Delhi, the capital city of India by a non profit organization, Uday Foundation. The Foundation provides counseling to the children and teens with internet addiction disorder.^[125]^[126]^[127]^[128]^[129]

In August 2009, ReSTART, a United States-based residential treatment center for "problematic digital media use, internet addiction, and video game addiction", opened near Seattle, Washington, United States.^[130] It offers a 7- to 12-week intensive program for adolescents and adults intended to help people set device limits, and address digital distractions.^[131]

In 2005, Professor Kiesler called Internet addiction a fad illness. In her view, she said, television addiction is worse. She added that she was completing a study of heavy Internet users, which showed the majority had sharply reduced their time on the computer over the course of a year, indicating that even problematic use was self-corrective.^[132]

Epidemiology

Over the past decade, the concept of Internet addiction has grown in terms of acceptance as a legitimate clinical disorder often requiring treatment.^[133] Researchers are divided over whether Internet addiction is a disorder on its own or a symptom of another underlying disorder. There is also debate over whether it should be classified as an impulse-control disorder or an obsessive-compulsive disorder rather than an addiction.^[134]

While the existence of Internet addiction is debated, self-proclaimed sufferers are resorting to the courts for redress.^[135] In one American case (Pacenza v. IBM Corp.), the plaintiff argued he was illegally dismissed from his employment in violation of the Americans with Disabilities Act because of Internet addiction triggered by Vietnam War-related post-traumatic stress disorder (PTSD).^[136]^[137] The case was dismissed by the United States District Court for the Southern District of New York and affirmed on appeal to the United States Court of Appeals, Second Circuit in 2010 (case summarized in Glaser & Carroll, 2007).^[138]

About 25% of users fulfill Internet addiction criteria within the first six months of using the Internet. Many individuals initially report feeling intimidated by the computer but gradually feel a sense of "competency and exhilaration from mastering the technology and learning to navigate the applications quickly by visual stimulation" (Beard 374). The feeling of exhilaration can be explained by the way IAD sufferers often describe themselves as: bold, outgoing, open-minded, intellectually prideful, and assertive.^[139]

According to a study by Kathy Scherer, a psychologist from the University of Texas at Austin, "13% of college internet users fit the criteria for Internet addicts" (Scherer 1997). In her study, Scherer enlisted the help of 531 college students. She discovered that "72% of the Internet addicted students were men" (Scherer 1997).^[140]

The China Communist Youth League claimed in 2007 that over 17% of Chinese citizens between 13 and 17 were addicted to the Internet.^[141]

Public concern, interest in, and the study of, Internet over use can be attributed to the fact that it has become increasingly difficult to distinguish between the online and offline worlds. The Internet has tremendous potential to affect the emotions of humans and in turn, alter our self-perception and anxiety levels.^[142]^[143]

According to Maressa Orzack, director of the Computer Addiction Study at Harvard University's McLean Hospital, between 5% and 10% of Web surfers suffer some form of Web dependency.^[144]

According to the Center for Internet Addiction Recovery (whose director is Kimberly S. Young,^[145] a researcher who has lobbied for the recognition of net abuse as a distinct clinical disorder), "Internet addicts suffer from emotional problems such as depression and anxiety-related disorders and often use the fantasy world of the Internet to psychologically escape unpleasant feelings or stressful situations."^[146] More than half are also addicted to alcohol, drugs, tobacco, or sex.^[147]

Mark Griffiths states that "[t]he way of determining whether nonchemical (i.e., behavioral) addictions are addictive in a nonmetaphorical sense is to compare them against clinical criteria for other established drug-ingested addictions", and although his data is dated, and may no longer represent average Internet use accurately, Griffiths comes to the conclusion that the Internet does meet that criteria for addiction in a small number of users.^[148]

Scientists have found that compulsive Internet use can produce morphological changes in the structure of the brain.^[149] A study which analyzed Chinese college students who had been classified as computer addicts by the study designers and who used a computer around 10 hours a day, 6 days a week, found reductions in the sizes of the dorsolateral prefrontal cortex, rostral anterior cingulate cortex, supplementary motor area and parts of the cerebellum compared to students deemed "not addicted" by the designers.^[149] It has been theorized that these changes reflect learning-type cognitive optimizations for using computers more efficiently, but also impaired short-term memory and decision-making abilities—including ones in which may contribute to the desire to stay online instead of be in the real world.^[150]

Patricia Wallace PhD, Senior Director, Information Technology and CTY Online, at the Johns Hopkins University Center for Talented Youth argues^[151] that based on the case histories that have surfaced, no one denies that excessive involvement with certain psychological spaces on the net can have serious effects on a person's life. She explains that, at a large university in New York, the dropout rate among freshmen newcomers rose dramatically as their investment in computers and Internet access increased, and the administrators learned that 43% of the dropouts were staying up all night on the Internet.

Related disorders

Online gambling addiction

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.

Online gaming addiction (Internet gaming disorder)

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 on-line 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.^[152] Andrew Doan, MD, PhD, 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.^[153]

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 behaviour is directly linked to rewarding and punishment of that behavior. If a behaviour is rewarded, it is more likely to be repeated. If it is punished, it becomes suppressed.^[154]

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 behaviour in the subject is to provide rewards for correct behaviour, and then adjust the number of times the subject is required to exhibit that behaviour 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 doesn't know how many times it needs to press the bar. An equivalent in World of Warcraft would be purple (epic) loot drops.^[155] 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.

Online Gamers Anonymous, an American non-profit organization formed in 2002, is a twelve-step, self-help, support and recovery organization for gamers and their loved ones who are suffering from the adverse effects of addictive computer gaming. It offers resources such as discussion forums, online chat meetings, Skype meetings and links to other resources.^[156] Internet and Technology Addicts Anonymous (ITAA) founded in 2009, is a 12-step program supporting users coping with digital distractions.

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.^[157]

Communication addiction disorder (compulsive talking)

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 had been linked to Internet addiction.^[158] 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 social network addiction.

Social network addiction is a dependence of people by connection, updating and control of their and their friends social network page.^[159] The correlation between the social network use and a decreasing of offline social relationships is a complex issue, depending not only from the time spent on them but also from the motivation in using them.^[160] 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.^[161]^[162] Sometimes teenagers use social networks to show their idealized image to the others.^[163] They generally start using social networks to improve face-to-face relationships. However, some of them use these tools as a showcase creating an idealized image to be accepted by groups and to reach a big number of friends. They spend a reduced time for face-to-face relationships, passing instead at least six hours per day on social networks.^[160] However, other studies claim that people are using social networks to communicate their real personality and not to promote their idealized identity.^[164]

Virtual reality addiction

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,^[165] whereas future virtual reality refers to computer-simulated, immersive environments or worlds. Experts warn about the dangers of virtual reality, 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]}

International Network Into Problematic Internet Usage

European Union under its Horizon 2020 umbrella has just launched a new United Kingdom-led four year European Cooperation in Science and Technology (COST) Action Programme (CA 16207), to advance networked interdisciplinary research into problematic internet usage across Europe and beyond. The first steps will be to reach consensus on the reliable definition of the problem, devise age-appropriate assessment instruments to measure its severity, plan studies to clarify its clinical course and impact on health and quality of life as well as to clarify the underpinning brain-based mechanisms to support the development of screening biomarkers to identify those who are vulnerable before the problematic use becomes too entrenched and ultimately to identify targets to guide the development of new and effective interventions. The Action welcomes research-active scientists working in the field. Actions website Net&Me is due to be launched by the end of Feb 2018.

References

^ Holden, Constance (2001-11-02). "'Behavioral' Addictions: Do They Exist?". Science. 294 (5544): 980–982. doi:10.1126/science.294.5544.980. ISSN 0036-8075. PMID 11691967.
^ S., Young, Kimberly (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.{{cite book}}: CS1 maint: multiple names: authors list (link)
^ Anderson, E. L.; 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.
^ Campanella, M.; Mucci, F.; Baroni, S.; Nardi, L.; Marazziti, D. (2015). "Prevalence of Internet Addiction: A Pilot Study in a Group of Italian Students" (PDF). Clinical Neuropsychiatry. 4: 90–93.
^ Wallis, David (1997-01-06). "Just Click No". The New Yorker. ISSN 0028-792X. Retrieved 2018-02-21.
^ Chou, Chien; Condron, Linda; Belland, John C. (2005-12-01). "A Review of the Research on Internet Addiction". Educational Psychology Review. 17 (4): 363–388. doi:10.1007/s10648-005-8138-1. ISSN 1040-726X.
^ ^a ^b Byun, Sookeun; Ruffini, Celestino; Mills, Juline E.; Douglas, Alecia C.; Niang, Mamadou; Stepchenkova, Svetlana; Lee, Seul Ki; Loutfi, Jihad; Lee, Jung-Kook (2008-12-10). "Internet Addiction: Metasynthesis of 1996–2006 Quantitative Research". CyberPsychology & Behavior. 12 (2): 203–207. doi:10.1089/cpb.2008.0102. ISSN 1094-9313.
^ Kandell, Jonathan J. (1998-01-01). "Internet Addiction on Campus: The Vulnerability of College Students". CyberPsychology & Behavior. 1 (1): 11–17. doi:10.1089/cpb.1998.1.11. ISSN 1094-9313.
^ "PsycNET". psycnet.apa.org. Retrieved 2018-02-21.
^ Beard, Keith W. (2005-02-01). "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. ISSN 1094-9313.
^ Brand, Matthias (2017). 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.
^ ^a ^b ^c Young, Kimberly (2017). 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.
^ Kershaw, Sarah (2005-12-01). "Hooked on the Web: Help Is on the Way". The New York Times. ISSN 0362-4331. Retrieved 2018-02-28.
^ Ko, Chih-Hung; Yen, Ju-Yu; Chen, Cheng-Sheng; Chen, Cheng-Chung; Yen, Cheng-Fang (2008/02). "Psychiatric Comorbidity of Internet Addiction in College Students: An Interview Study". CNS Spectrums. 13 (2): 147–153. doi:10.1017/S1092852900016308. ISSN 1092-8529. {{cite journal}}: Check date values in: |date= (help)
^ Floros, Georgios; Siomos, Konstantinos; Stogiannidou, Ariadni; Giouzepas, Ioannis; Garyfallos, Georgios. "Comorbidity of psychiatric disorders with Internet addiction in a clinical sample: The effect of personality, defense style and psychopathology". Addictive Behaviors. 39 (12): 1839–1845. doi:10.1016/j.addbeh.2014.07.031.
^ Shapira, Nathan A.; Goldsmith, Toby D.; Keck, Paul E.; Khosla, Uday M.; McElroy, Susan L. "Psychiatric features of individuals with problematic internet use". Journal of Affective Disorders. 57 (1–3): 267–272. doi:10.1016/s0165-0327(99)00107-x.
^ Black, D. W.; 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): 839–844. ISSN 0160-6689. PMID 10665630.
^ ^a ^b ^c ^d ^e Block, Jerald J. (2008-03-01). "Issues for DSM-V: Internet Addiction". American Journal of Psychiatry. 165 (3): 306–307. doi:10.1176/appi.ajp.2007.07101556. ISSN 0002-953X.
^ ^a ^b Stone, Richard (2009-06-26). "China Reins in Wilder Impulses in Treatment of 'Internet Addiction'". Science. 324 (5935): 1630–1631. doi:10.1126/science.324_1630. ISSN 0036-8075. PMID 19556477.
^ Hawi, Nazir S. "Internet addiction among adolescents in Lebanon". Computers in Human Behavior. 28 (3): 1044–1053. doi:10.1016/j.chb.2012.01.007.
^ Bai, Ya-Mei; Lin, Chao-Cheng; Chen, Jen-Yeu (2001-10-01). "Internet Addiction Disorder Among Clients of a Virtual Clinic". Psychiatric Services. 52 (10): 1397–1397. doi:10.1176/appi.ps.52.10.1397. ISSN 1075-2730.
^ ^a ^b "DSM-5". www.psychiatry.org. Retrieved 2018-02-19.
^ Campanella, M.; Mucci, F.; Baroni, S.; Nardi, L.; Marazziti, D. (2015). "Prevalence of Internet Addiction: A Pilot Study in a Group of Italian Students" (PDF). Clinical Neuropsychiatry. 4: 90–93.
^ Lopez-Fernandez, Olatz (2015-09-01). "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. ISSN 2196-2952.
^ "Gaming disorder". World Health Organization. Retrieved 2018-03-02.
^ Weinstein, Aviv; Lejoyeux, Michel (2010). "Internet Addiction or Excessive Internet Use" (PDF). The American Journal of Drug and Alcohol Abuse. 36: 277–283.
^ ^a ^b ^c ^d Byun, Sookeun; Ruffini, Celestino; Mills, Juline E.; Douglas, Alecia C.; Niang, Mamadou; Stepchenkova, Svetlana; Lee, Seul Ki; Loutfi, Jihad; Lee, Jung-Kook (2008-12-10). "Internet Addiction: Metasynthesis of 1996–2006 Quantitative Research". CyberPsychology & Behavior. 12 (2): 203–207. doi:10.1089/cpb.2008.0102. ISSN 1094-9313.
^ ^a ^b ^c ^d S., Young, Kimberly (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.{{cite book}}: CS1 maint: multiple names: authors list (link)
^ Young, Kimberly S. (1998-01-01). "Internet Addiction: The Emergence of a New Clinical Disorder". CyberPsychology & Behavior. 1 (3): 237–244. doi:10.1089/cpb.1998.1.237. ISSN 1094-9313.
^ Yellowlees, Peter M.; Marks, Shayna. "Problematic Internet use or Internet addiction?". Computers in Human Behavior. 23 (3): 1447–1453. doi:10.1016/j.chb.2005.05.004.
^ Beard, Keith W.; Wolf, Eve M. (2001-06-01). "Modification in the Proposed Diagnostic Criteria for Internet Addiction". CyberPsychology & Behavior. 4 (3): 377–383. doi:10.1089/109493101300210286. ISSN 1094-9313.
^ Cheng, Cecilia; Li, Angel Yee-lam (2014-12-01). "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): 755–760. doi:10.1089/cyber.2014.0317. ISSN 2152-2715.
^ Widyanto, Laura; McMurran, Mary. "The Psychometric Properties of the Internet Addiction Test". CyberPsychology & Behavior. 7 (4): 443–450. doi:10.1089/cpb.2004.7.443.
^ Brenner, V. (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): 879–882.
^ Huang, Zheng; Wang, Mo; Qian, Mingyi; Zhong, Jie; Tao, Ran (2007-12-01). "Chinese Internet Addiction Inventory: Developing a Measure of Problematic Internet Use for Chinese College Students". CyberPsychology & Behavior. 10 (6): 805–812. doi:10.1089/cpb.2007.9950. ISSN 1094-9313.
^ Heo, Jongho; Oh, Juhwan; Subramanian, S. V.; Kim, Yoon; Kawachi, Ichiro (2014-02-05). "Addictive Internet Use among Korean Adolescents: A National Survey". PLOS ONE. 9 (2): e87819. doi:10.1371/journal.pone.0087819. ISSN 1932-6203.{{cite journal}}: CS1 maint: unflagged free DOI (link)
^ Meerkerk, G.-J.; Van Den Eijnden, R. J. J. M.; Vermulst, A. A.; Garretsen, H. F. L. (2008-12-10). "The Compulsive Internet Use Scale (CIUS): Some Psychometric Properties". CyberPsychology & Behavior. 12 (1): 1–6. doi:10.1089/cpb.2008.0181. ISSN 1094-9313.
^ Caplan, Scott E. "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.
^ Clark, Deborah J.; Frith, Karen H. (September 2005). "The Development and Initial Testing of the Internet Consequences Scales (ICONS)". CIN: Computers, Informatics, Nursing. 23 (5): 285. ISSN 1538-2931.
^ Demetrovics, Zsolt; Szeredi, Beatrix; Rózsa, Sándor (2008-05-01). "The three-factor model of Internet addiction: The development of the Problematic Internet Use Questionnaire". Behavior Research Methods. 40 (2): 563–574. doi:10.3758/BRM.40.2.563. ISSN 1554-351X.
^ Chang, Man Kit; Law, Sally Pui Man. "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.
^ Widyanto, Laura; Griffiths, Mark D.; Brunsden, Vivienne (2010-11-10). "A Psychometric Comparison of the Internet Addiction Test, the Internet-Related Problem Scale, and Self-Diagnosis". Cyberpsychology, Behavior, and Social Networking. 14 (3): 141–149. doi:10.1089/cyber.2010.0151. ISSN 2152-2715.
^ Widyanto, Laura; McMurran, Mary (2004-08-01). "The Psychometric Properties of the Internet Addiction Test". CyberPsychology & Behavior. 7 (4): 443–450. doi:10.1089/cpb.2004.7.443. ISSN 1094-9313.
^ ^a ^b ^c ^d Northrup, Jason C.; Lapierre, Coady; Kirk, Jeffrey; Rae, Cosette (2015-07-28). "The Internet Process Addiction Test: Screening for Addictions to Processes Facilitated by the Internet". Behavioral Sciences. 5 (3): 341–352. doi:10.3390/bs5030341.{{cite journal}}: CS1 maint: unflagged free DOI (link)
^ Griffiths, M. (2000). "Internet addiction-time to be taken seriously?". Addiction research. 8(5): 413–418.
^ Chou, Chien; Hsiao, Ming-Chun. "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.
^ Soule, L. C.; Shell, L. W.; Kleen, B. A. (2003). "Exploring Internet addiction: Demographic characteristics and stereotypes of heavy Internet users". Journal of Computer Information Systems. 44(1): 64–73.
^ Kim, Sunny Jung; Byrne, Sahara (2011). "Conceptualizing personal web usage in work contexts: A preliminary framework". Computers in Human Behavior. 27 (6): 2271. doi:10.1016/j.chb.2011.07.006.
^ ^a ^b ^c Moreno MA, Jelenchick LA, Christakis DA (2013). "Problematic internet use among older adolescents: A conceptual framework". Computers and Human Behavior. 29 (4): 1879–1887. doi:10.1016/j.chb.2013.01.053.
^ Trochim, W.; Kane, M (2005). "Concept mapping: An introduction to structured conceptualization in health care". International Journal for Quality in Health Care. 17 (3): 187–91. doi:10.1093/intqhc/mzi038. PMID 15872026.
^ Pawlikowski, M. et al. (in press, 2013). Pathological internet use: It is a multidimensional and not a unidimensional construct. Addiction Research & Theory.
^ ^a ^b "Types of Internet addiction". Retrieved 2014-01-30.
^ ^a ^b American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (Fifth ed.). Arlington, VA: American Psychiatric Publishing. pp. 797–798. ISBN 978-0-89042-555-8.
^ Block, Jerald J. (2008). "Issues for DSM-V: Internet Addiction". American Journal of Psychiatry. 165 (3): 306–7. doi:10.1176/appi.ajp.2007.07101556. PMID 18316427.
^ ^a ^b ^c ^d Thompson SJ (1996). "Internet Connectivity: Addiction and Dependency Study". The Penn State McNair Journal. 3 (Summer): 137–154.
^ Association for Education in Mass Communication and Journalism Convention in Chicago in 1997 [1]
^ Thompson, S.J. (2011). "Endless Empowerment and Existence: From Virtual Literacy to Online Permanence in Presence. First International Forum on Media and Information Literacy". Fez, Morocco: Sidi Mohamed Ben Abdellah University. {{cite journal}}: Cite journal requires |journal= (help)
^ "Declaration on Media and Information Literacy adopted by Fez International Forum".
^ Thompson, Steven John, ed. (2014). "Preface". Global issues and ethical considerations in human enhancement technologies. Advances in Human and Social Aspects of Technology. Hershey, PA: IGI Global. xvi–xx. ISBN 978-1-4666-6010-6. {{cite book}}: External link in |chapterurl= (help); Unknown parameter |chapterurl= ignored (|chapter-url= suggested) (help); Unknown parameter |nopp= ignored (|no-pp= suggested) (help)
^ Widyanto, Laura; Griffiths, Mark (2006). "'Internet Addiction': A Critical Review". International Journal of Mental Health and Addiction. 4: 31. doi:10.1007/s11469-006-9009-9.
^ "Internet Addiction Disorder." Human Diseases and Conditions, edited by Donna Batten, et al., 3rd ed., vol. 2, Charles Scribner's Sons, 2017, pp. 1107-1112. Gale Virtual Reference Library, http://go.galegroup.com/ps/i.do?p=GVRL&sw=w&u=jcl_jccc&v=2.1&it=r&id=GALE%7CCX3630000238&sid=summon&asid=8d4da08c384d2bb3126830d4e1f5f7b6. Accessed 26 Apr. 2017.
^ Griffiths, Mark (2009). "Internet Addiction - Time to be Taken Seriously?". Addiction Research. 8 (5): 413. doi:10.3109/16066350009005587.
^ Yellowlees, Peter M.; Marks, Shayna (2007). "Problematic Internet use or Internet addiction?". Computers in Human Behavior. 23 (3): 1447–53. doi:10.1016/j.chb.2005.05.004. INIST 18464918.
^ M. Grohol, O. (2014). "Internet Addiction and Online Addiction". Retrieved 14 March 2014.
^ Young, K. S.; Rodgers, R. C. (1998). Internet Addiction: Personality Traits Associated with Its Development. [e-book] (PDF). p. 1. Retrieved 14 March 2014.
^ ^a ^b Saisan, J.; Smith, M.; Robinson, L.; Segal, J. (2014). "Internet and Computer Addiction: Signs, Symptoms, and Treatment". Archived from the original on 18 September 2014. Retrieved 14 March 2014.
^ "Conversation Agent - Valeria Maltoni: Internet Delivers Convenience via Speed and Cognitive Ease". sationagent.com. 2013. Retrieved 14 March 2014.
^ Sinclair, D. (2014). "Making the Most of the Internet - Convenience". Retrieved 14 March 2014.
^ Pea, R.; Maldonado, H. (2006). "WILD for learning: Interacting through new computing devices anytime, anywhere" (PDF). In K. Sawyer (ed.). The Cambridge Handbook of the Learning Sciences. New York: Cambridge University Press. pp. 852–886.
^ "My Internet - Secret and Fast". Play.google.com. 2014. Retrieved 14 March 2014.
^ ^a ^b Young, K. S. (1998). Caught in the Net. New York: John Wiley. ISBN 0471191590.
^ Young, Kimberly (2009). "Understanding Online Gaming Addiction and Treatment Issues for Adolescents". The American Journal of Family Therapy. 37 (5): 355–72. doi:10.1080/01926180902942191.
^ Young, Kimberly S. (1999). "The Research and Controversy Surrounding Internet Addiction". CyberPsychology & Behavior. 2 (5): 381. doi:10.1089/cpb.1999.2.381.
^ ^a ^b Young, K. (1999). "Internet addiction: Symptoms, evaluation and treatment". In L. VandeCreek; T. Jackson (eds.). Innovations in clinical practice: A source book (PDF). Vol. 17. Sarasota, Florida: Professional Resource Press. pp. 19–31.^{[dead link]}
^ Kalichman, Seth C.; Rompa, David (1995). "Sexual Sensation Seeking and Sexual Compulsivity Scales: Validity, and Predicting HIV Risk Behavior". Journal of Personality Assessment. 65 (3): 586. doi:10.1207/s15327752jpa6503_16. PMID 8609589.
^ Carroll, J. S.; Padilla-Walker, L. M.; Nelson, L. J.; Olson, C. D.; McNamara Barry, C.; Madsen, S. D. (2008). "Generation XXX: Pornography Acceptance and Use Among Emerging Adults". Journal of Adolescent Research. 23: 6. doi:10.1177/0743558407306348.
^ Manning, Jill C. (2006). "The Impact of Internet Pornography on Marriage and the Family: A Review of the Research". Sexual Addiction & Compulsivity. 13 (2–3): 131. doi:10.1080/10720160600870711.
^ Warden, Narelle L.; Phillips, James G.; Ogloff, James R. P. (2004). "Internet Addiction". Psychiatry, Psychology and Law. 11 (2): 280. doi:10.1375/pplt.2004.11.2.280.
^ Owens, Eric W.; Behun, Richard J.; Manning, Jill C.; Reid, Rory C. (2012). "The Impact of Internet Pornography on Adolescents: A Review of the Research". Sexual Addiction & Compulsivity. 19: 99. doi:10.1080/10720162.2012.660431.
^ Grubbs, Joshua B.; Volk, Fred; Exline, Julie J.; Pargament, Kenneth I. (2013). "Internet Pornography Use: Perceived Addiction, Psychological Distress, and the Validation of a Brief Measure". Journal of Sex & Marital Therapy. 41: 83. doi:10.1080/0092623x.2013.842192.
^ Ramdhonee, Psychological Impact of Internet usage on Children.pdfK (2014). "Psychological Impacts of Internet usage of Children/ Adolescents" (PDF). pp. 1–10. Archived from the original (PDF) on 7 September 2012. Retrieved 14 Mar 2014. {{cite web}}: Unknown parameter |deadurl= ignored (|url-status= suggested) (help)
^ Suler, J (2004). "The psychology of text relationships". Online counseling: A handbook for mental health professionals. pp. 19–50.
^ Young, Kimberly S.; Rogers, Robert C. (1998). "The Relationship Between Depression and Internet Addiction". CyberPsychology & Behavior. 1: 25. doi:10.1089/cpb.1998.1.25.
^ Whang, Leo Sang-Min; Lee, Sujin; Chang, Geunyoung (2003). "Internet Over-Users' Psychological Profiles: A Behavior Sampling Analysis on Internet Addiction". CyberPsychology & Behavior. 6 (2): 143. doi:10.1089/109493103321640338.
^ Young, K. S. (1999). "Internet Addiction: Symptoms, Evaluation, and Treatment". In VandeCreek, L.; Jackson, T. L. (eds.). Innovations in Clinical Practice. Vol. 17. Professional Resource Press.
^ "Service for Computer and Internet addiction". Archived from the original on 2012-04-29. {{cite web}}: Unknown parameter |deadurl= ignored (|url-status= suggested) (help)
^ Tsitsika, Artemis; Janikian, Mari; Schoenmakers, Tim M.; Tzavela, Eleni C.; Olafsson, Kjartan; Wójcik, Szymon; Macarie, George Florian; Tzavara, Chara; Richardson, Clive (August 2014). "Internet addictive behavior in adolescence: a cross-sectional study in seven European countries". Cyberpsychology, Behavior and Social Networking. 17 (8): 528–535. doi:10.1089/cyber.2013.0382. ISSN 2152-2723. PMID 24853789.
^ Caplan, Scott E.; High, Andrew C. (2006). "Beyond Excessive Use: The Interaction between Cognitive and Behavioral Symptoms of Problematic Internet Use". Communication Research Reports. 23 (4): 265. doi:10.1080/08824090600962516.
^ Rollero, C. 2013, "Men and women facing objectification: The effects of media models on well-being, self-esteem and ambivalent sexism", REVISTA DE PSICOLOGIA SOCIAL, vol. 28, no. 3, pp. 373-382.
^ Stieger, Stefan; Burger, Christoph (2010). "Implicit and Explicit Self-Esteem in the Context of Internet Addiction". Cyberpsychology, Behavior, and Social Networking. 13 (6): 681. doi:10.1089/cyber.2009.0426.
^ Zhou, Yan; Lin, Fu-Chun; Du, Ya-Song; Qin, Ling-di; Zhao, Zhi-min; Xu, Jian-Rong; Lei, Hao (2011). "Gray matter abnormalities in Internet addiction: A voxel-based morphometry study". European Journal of Radiology. 79 (1): 92–5. doi:10.1016/j.ejrad.2009.10.025. PMID 19926237.
^ Weng, C. B.; Qian, R. B.; Fu, X. M.; Lin, B; Ji, X. B.; Niu, C. S.; Wang, Y. H. (2012). "A voxel-based morphometric analysis of brain gray matter in online game addicts". Zhonghua yi xue za zhi. 92 (45): 3221–3. PMID 23328472.
^ Low, Keath. "Executive functions and ADD - ADHD. What are executive functions? How do executive functions relate to ADD - ADHD?". About.com.
^ 10
^ 11
^ 12
^ Young, K. (2009). "Internet Addiction Test".
^ Ferraro, Giovanni; Caci, Barbara; d'Amico, Antonella; Blasi, Marie Di (2007). "Internet Addiction Disorder: An Italian Study". CyberPsychology & Behavior. 10 (2): 170. doi:10.1089/cpb.2006.9972.
^ Young, K. (2011). "Clinical Assessment of Internet-Addicted Clients". In Young, K.; Nabuco do Abreu, C. (eds.). Internet Addiction. Hoboken: John Wiley & Sons Inc. doi:10.1002/9781118013991.ch2.
^ Chen S.H.; et al. (2003). "Development of Chinese Internet Addiction Scale and its psychometric study". Chin J Psychol. 45: 279–294.
^ Mak, Kwok-Kei; Lai, Ching-Man; Ko, Chih-Hung; Chou, Chien; Kim, Dong-Il; Watanabe, Hiroko; Ho, Roger C. M. (2014). "Psychometric Properties of the Revised Chen Internet Addiction Scale (CIAS-R) in Chinese Adolescents". Journal of Abnormal Child Psychology. 42 (7): 1237. doi:10.1007/s10802-014-9851-3. PMID 24585392.
^ Meerkerk, G.-J.; Van Den Eijnden, R. J. J. M.; Vermulst, A. A.; Garretsen, H. F. L. (2009). "The Compulsive Internet Use Scale (CIUS): Some Psychometric Properties". CyberPsychology & Behavior. 12: 1. doi:10.1089/cpb.2008.0181.
^ ^a ^b Lauren Jelenchick. "The Problematic and Risky Internet Use Screening Scale (PRIUSS) for Adolescents and Young Adults: Initial Scale Development and Refinement" (PDF). Retrieved 14 March 2014.
^ Caplan, Scott E (2002). "Problematic Internet use and psychosocial well-being: Development of a theory-based cognitive–behavioral measurement instrument". Computers in Human Behavior. 18 (5): 553. doi:10.1016/S0747-5632(02)00004-3.
^ Joinson, A. N. (2003). Understanding the Psychology of Internet Behaviour. Houndmills: Palgrave Macmillan.
^ Griffiths, M. D. (1998). "Internet addiction: does it really exist?". In Gackenbach, J. (ed.). Psychology and the Internet. New York: Academic Press. pp. 61–75.
^ Griffiths, Mark (2009). "Internet Addiction - Time to be Taken Seriously?". Addiction Research. 8 (5): 413–8. doi:10.3109/16066350009005587.
^ David Greenfield. "Problematic Internet Use: Young people and the online world are synonymous, but when does it become excessive?". Centre for Internet Behaviour. Retrieved 14 March 2014.^{[self-published source?]}
^ Caplan, Scott E. (2003). "Preference for Online Social Interaction: A Theory of Problematic Internet Use and Psychosocial Well-Being". Communication Research. 30 (6): 625–48. doi:10.1177/0093650203257842.
^ Tapper, Josh (2013-02-01). "Internet addicts face constant temptation, non-believers". Toronto Star. Retrieved 2013-12-08. Yet, many researchers contend internet addiction cannot exist on its own. They say it is most likely a symptom of ...
^ "Experts debate Internet addiction". Physorg.com. 2006-11-14. Retrieved 2009-08-09.
^ ^a ^b Kershaw, Sarah (December 1, 2005). "Hooked on the Web: Help Is on the Way". New York Times.
^ Hawi, Nazir S. (2012). "Internet addiction among adolescents in Lebanon". Computers in Human Behavior. 28 (3): 1044–53. doi:10.1016/j.chb.2012.01.007. INIST 25647439.
^ "Press Release #4 at netaddiction.com". Archived from the original on December 17, 2008. {{cite web}}: Unknown parameter |deadurl= ignored (|url-status= suggested) (help)
^ Byun, Sookeun; Ruffini, Celestino; Mills, Juline E.; Douglas, Alecia C.; Niang, Mamadou; Stepchenkova, Svetlana; Lee, Seul Ki; Loutfi, Jihad; Lee, Jung-Kook; Atallah, Mikhail; Blanton, Marina (2009). "Internet Addiction: Metasynthesis of 1996–2006 Quantitative Research". CyberPsychology & Behavior. 12 (2): 203. doi:10.1089/cpb.2008.0102.
^ "Brief Internet Game Screen (BIGS) Survey". www.surveymonkey.com. Retrieved 2016-10-16.
^ Northrup, Jason; Lapierre, Coady; Kirk, Jeffrey; Rae, Cosette (2015). "The Internet Process Addiction Test: Screening for Addictions to Processes Facilitated by the Internet". Behavioral Sciences. 5 (3): 341. doi:10.3390/bs5030341. PMID 26226007.{{cite journal}}: CS1 maint: unflagged free DOI (link)
^ Cash, Hilarie; d. Rae, Cosette; h. Steel, Ann; Winkler, Alexander (2012). "Internet Addiction: A Brief Summary of Research and Practice". Current Psychiatry Reviews. 8 (4): 292–298. doi:10.2174/157340012803520513. PMC 3480687. PMID 23125561.
^ Przepiorka, Aneta Małgorzata; Blachnio, Agata; Miziak, Barbara; Czuczwar, Stanisław Jerzy (2014). "Clinical approaches to treatment of Internet addiction". Pharmacological Reports. 66 (2): 187–91. doi:10.1016/j.pharep.2013.10.001. PMID 24911068.
^ "Internet addiction and lack of accountability". internet-addiction-guide.com. 2010-12-07. Retrieved 2011-07-06.
^ Young, Kimberly S. (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.
^ Krajnak, Deb (2009-08-19). "China probe of abuse at Web addiction camp". CNN. Retrieved 2009-08-20.
^ Yu Le; Emma Graham-Harrison (November 5, 2009). "China bans physical punishment for Internet addicts". Reuters India. Retrieved 2009-11-11.
^ Slice of MIT. "MIT Researchers Develop a Shocking Treatment for Facebook Addiction" Retrieved 2013-09-05.
^ "Delhi gets its first internet de-addiction centre". The Times of India, July 22, 2014. Retrieved June 24, 2015
^ "Delhi's first internet de-addiction centre helps children log out of the virtual world". Hindustan Times, August 03, 2014 . Retrieved June 24, 2015
^ "Tied to the Internet?". Deccan Herald. Retrieved June 24, 2015
^ "internet de-addiction centres in Delhi, Bangalore battle India's newest lifestyle disease". Scroll.in, September 15, 2014. Retrieved June 24, 2015
^ "Let's Talk About Tech, Baby". The Sunday Guardian, April 25, 2015. Retrieved June 24, 2015
^ Geranios, Nicholas K. (September 3, 2009). "Internet addiction center opens in US". Yahoo. Associated Press.
^ "Internet addiction center opens in US". Khaleejtimes.com. 2009-09-07. Retrieved 2009-11-11.
^ Kershaw, Sarah (1 December 2005). "Hooked on the Web: Help Is on the Way" – via NYTimes.com.
^ Young, K. S.; Nabuco de Abreu, C., eds. (2011). Internet addiction, A handbook and guide to evaluation and treatment. Hoboken: John Wiley & Sons, Inc.
^ Winkler, Alexander; Dörsing, Beate; Rief, Winfried; Shen, Yuhui; Glombiewski, Julia A. (2013). "Treatment of internet addiction: A meta-analysis". Clinical Psychology Review. 33 (2): 317. doi:10.1016/j.cpr.2012.12.005. PMID 23354007.
^ "Pacenza vs. IBM Corp". Retrieved 1 March 2007.
^ "Internet Addiction: The Next Disability". LRP Publications. February 28, 2007. Retrieved 2009-01-31.
^ "Update: Pacenza v. IBM-Lawsuit alleges Internet sex chat addiction is entitled to ADA protection - Overlawyered". Overlawyered.
^ "Pacenza v. IBM Corporation". Pacenza v. IBM Corporation, No. 09-2025-cv. Retrieved 12 February 2014.
^ Beard, Keith W.; Wolf, Eve M. (2001). "Modification in the Proposed Diagnostic Criteria for Internet Addiction". CyberPsychology & Behavior. 4 (3): 377–83. doi:10.1089/109493101300210286. PMID 11710263.
^ Scherer, Kathy (1997). "College Life On-Line: Healthy and Unhealthy Internet Use". Journal of College Student Development.
^ Lee, Hattie (January 11, 2007). "17% of Youth Addicted To Internet". Pacific Epoch. Archived from the original on January 15, 2007.
^ Horstman, Judith (2009). The Scientific American Day in the Life of Your Brain. Jossey-Bass / Wiley. ISBN 978-0470376232.
^ Kalwar, S. K.; Heikkinen, K. (2009). "Study of human anxiety on the Internet". Human-Computer Interaction. New Trends. Lecture Notes in Computer Science. Springer Berlin Heidelberg. pp. 69–76. doi:10.1007/978-3-642-02574-7_8. ISBN 978-3-642-02573-0.
^ Goldman, Lea (2005-09-05). "This Is Your Brain on Clicks". Forbes. Retrieved 2007-07-17.
^ Young, K. (2009). "Issues for Internet Addiction as a New Diagnosis in the DSM-V". Washington, District of Columbia, US: American Psychological Association. {{cite journal}}: Cite journal requires |journal= (help) Retrieved from PsycEXTRA database.
^ "Frequently Asked Questions". Netaddiction.com. Retrieved 2014-01-30.
^ "Frequently Asked Questions". Netaddiction.com. Archived from the original on July 21, 2009. Retrieved 2009-08-09. {{cite web}}: Unknown parameter |deadurl= ignored (|url-status= suggested) (help)
^ Griffiths, Mark (1998). "Internet addiction: Does it really exist?". In J. Gackenbach (ed.). Psychology and the Internet: Intrapersonal, Interpersonal, and Transpersonal Applications (PDF). New York: Academic Press. pp. 61–75.
^ ^a ^b Yuan, Kai; Qin, Wei; Wang, Guihong; Zeng, Fang; Zhao, Liyan; Yang, Xuejuan; Liu, Peng; Liu, Jixin; Sun, Jinbo; von Deneen, Karen M.; Gong, Qiyong; Liu, Yijun; Tian, Jie (2011). "Microstructure Abnormalities in Adolescents with Internet Addiction Disorder". PLoS ONE. 6 (6): e20708. Bibcode:2011PLoSO...620708Y. doi:10.1371/journal.pone.0020708. PMID 21677775.{{cite journal}}: CS1 maint: unflagged free DOI (link)
^ "High wired: Does addictive internet use restructure the brain?". Retrieved 2011-06-19.
^ Wallace, P. (2001). The Psychology of the Internet (paperback ed.). Cambridge: Cambridge University Press.
^ Lush, Tamara (29 August 2011). "At war with World of Warcraft". The Guardian. London. Retrieved 2012-03-15.
^ Andrew Doan; Brooke Strickland. "About". hooked-on-games.com.
^ "The Virtual Skinner Box". Retrieved 2012-03-15.
^ Reimer, Jeremy (August 2006). "Doctor claims 40 percent of World of Warcraft players are addicted". ARS Technica. Retrieved 2012-03-15.
^ "Online Gamers Anonymous [12-step support group]".
^ Rossignol, Jim (2009). The Gaming Life: Travels in Three Cities. University of Michigan Press. ISBN 9780472033973.
^ Walther, J.B. (1999) "Communication Addiction Disorder: Concern over media, behavior and effects [APA conference talk]".
^ Echeburua E.; de Corral P. (2010). "Addiction to new technologies and to online social networking in young people: A new challenge". Adicciones. 22: 91–95.
^ ^a ^b Guzzo Fernando, Tiziana Guzzo; Ferri, Fernando; Grifoni, Patrizia (2013). "Social Network's Effects on Italian Teenager's Life". Journal of Next Generation Information Technology. 4 (3): 54–62. doi:10.4156/jnit.vol4.issue3.7.
^ Hutson M. (2009). "Facebook Friends: Too Many, Too Few?" Retrieved 10 March 2012
^ Buffardi, L. E.; Campbell, W. K. (2008). "Narcissism and Social Networking Web Sites". Personality and Social Psychology Bulletin. 34 (10): 1303–14. doi:10.1177/0146167208320061. PMID 18599659.
^ Manago, Adriana M.; Graham, Michael B.; Greenfield, Patricia M.; Salimkhan, Goldie (2008). "Self-presentation and gender on My Space". Journal of Applied Developmental Psychology. 29 (6): 446. doi:10.1016/j.appdev.2008.07.001.
^ Ambady N., Skowronski J. (2008). "First impressions". New York Guilford.^{[page needed]}
^ William H. Davidow (31 Jul 2012). "Interactive technologies give us a quick fix, and that's not a good thing". IEEE Spectrum. Retrieved 29 Nov 2015.

External links

[1] Holden, Constance (2001-11-02). "'Behavioral' Addictions: Do They Exist?". Science. 294 (5544): 980–982. doi:10.1126/science.294.5544.980. ISSN 0036-8075. PMID 11691967.

[:03-2] S., Young, Kimberly (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.{{cite book}}: CS1 maint: multiple names: authors list (link)

[3] Anderson, E. L.; 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.

[:352-4] Campanella, M.; Mucci, F.; Baroni, S.; Nardi, L.; Marazziti, D. (2015). "Prevalence of Internet Addiction: A Pilot Study in a Group of Italian Students" (PDF). Clinical Neuropsychiatry. 4: 90–93.

[5] Wallis, David (1997-01-06). "Just Click No". The New Yorker. ISSN 0028-792X. Retrieved 2018-02-21.

[:33-6] Chou, Chien; Condron, Linda; Belland, John C. (2005-12-01). "A Review of the Research on Internet Addiction". Educational Psychology Review. 17 (4): 363–388. doi:10.1007/s10648-005-8138-1. ISSN 1040-726X.

[:212-7] Byun, Sookeun; Ruffini, Celestino; Mills, Juline E.; Douglas, Alecia C.; Niang, Mamadou; Stepchenkova, Svetlana; Lee, Seul Ki; Loutfi, Jihad; Lee, Jung-Kook (2008-12-10). "Internet Addiction: Metasynthesis of 1996–2006 Quantitative Research". CyberPsychology & Behavior. 12 (2): 203–207. doi:10.1089/cpb.2008.0102. ISSN 1094-9313.

[8] Kandell, Jonathan J. (1998-01-01). "Internet Addiction on Campus: The Vulnerability of College Students". CyberPsychology & Behavior. 1 (1): 11–17. doi:10.1089/cpb.1998.1.11. ISSN 1094-9313.

[9] "PsycNET". psycnet.apa.org. Retrieved 2018-02-21.

[10] Beard, Keith W. (2005-02-01). "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. ISSN 1094-9313.

[11] Brand, Matthias (2017). 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.

[:3-12] Young, Kimberly (2017). 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.

[13] Kershaw, Sarah (2005-12-01). "Hooked on the Web: Help Is on the Way". The New York Times. ISSN 0362-4331. Retrieved 2018-02-28.

[14] Ko, Chih-Hung; Yen, Ju-Yu; Chen, Cheng-Sheng; Chen, Cheng-Chung; Yen, Cheng-Fang (2008/02). "Psychiatric Comorbidity of Internet Addiction in College Students: An Interview Study". CNS Spectrums. 13 (2): 147–153. doi:10.1017/S1092852900016308. ISSN 1092-8529. {{cite journal}}: Check date values in: |date= (help)

[15] Floros, Georgios; Siomos, Konstantinos; Stogiannidou, Ariadni; Giouzepas, Ioannis; Garyfallos, Georgios. "Comorbidity of psychiatric disorders with Internet addiction in a clinical sample: The effect of personality, defense style and psychopathology". Addictive Behaviors. 39 (12): 1839–1845. doi:10.1016/j.addbeh.2014.07.031.

[16] Shapira, Nathan A.; Goldsmith, Toby D.; Keck, Paul E.; Khosla, Uday M.; McElroy, Susan L. "Psychiatric features of individuals with problematic internet use". Journal of Affective Disorders. 57 (1–3): 267–272. doi:10.1016/s0165-0327(99)00107-x.

[17] Black, D. W.; 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): 839–844. ISSN 0160-6689. PMID 10665630.

[:4-18] Block, Jerald J. (2008-03-01). "Issues for DSM-V: Internet Addiction". American Journal of Psychiatry. 165 (3): 306–307. doi:10.1176/appi.ajp.2007.07101556. ISSN 0002-953X.

[:10-19] Stone, Richard (2009-06-26). "China Reins in Wilder Impulses in Treatment of 'Internet Addiction'". Science. 324 (5935): 1630–1631. doi:10.1126/science.324_1630. ISSN 0036-8075. PMID 19556477.

[20] Hawi, Nazir S. "Internet addiction among adolescents in Lebanon". Computers in Human Behavior. 28 (3): 1044–1053. doi:10.1016/j.chb.2012.01.007.

[21] Bai, Ya-Mei; Lin, Chao-Cheng; Chen, Jen-Yeu (2001-10-01). "Internet Addiction Disorder Among Clients of a Virtual Clinic". Psychiatric Services. 52 (10): 1397–1397. doi:10.1176/appi.ps.52.10.1397. ISSN 1075-2730.

[:5-22] "DSM-5". www.psychiatry.org. Retrieved 2018-02-19.

[:35-23] Campanella, M.; Mucci, F.; Baroni, S.; Nardi, L.; Marazziti, D. (2015). "Prevalence of Internet Addiction: A Pilot Study in a Group of Italian Students" (PDF). Clinical Neuropsychiatry. 4: 90–93.

[24] Lopez-Fernandez, Olatz (2015-09-01). "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. ISSN 2196-2952.

[25] "Gaming disorder". World Health Organization. Retrieved 2018-03-02.

[:23-26] Weinstein, Aviv; Lejoyeux, Michel (2010). "Internet Addiction or Excessive Internet Use" (PDF). The American Journal of Drug and Alcohol Abuse. 36: 277–283.

[:21-27] Byun, Sookeun; Ruffini, Celestino; Mills, Juline E.; Douglas, Alecia C.; Niang, Mamadou; Stepchenkova, Svetlana; Lee, Seul Ki; Loutfi, Jihad; Lee, Jung-Kook (2008-12-10). "Internet Addiction: Metasynthesis of 1996–2006 Quantitative Research". CyberPsychology & Behavior. 12 (2): 203–207. doi:10.1089/cpb.2008.0102. ISSN 1094-9313.

[:02-28] S., Young, Kimberly (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.{{cite book}}: CS1 maint: multiple names: authors list (link)

[29] Young, Kimberly S. (1998-01-01). "Internet Addiction: The Emergence of a New Clinical Disorder". CyberPsychology & Behavior. 1 (3): 237–244. doi:10.1089/cpb.1998.1.237. ISSN 1094-9313.

[30] Yellowlees, Peter M.; Marks, Shayna. "Problematic Internet use or Internet addiction?". Computers in Human Behavior. 23 (3): 1447–1453. doi:10.1016/j.chb.2005.05.004.

[31] Beard, Keith W.; Wolf, Eve M. (2001-06-01). "Modification in the Proposed Diagnostic Criteria for Internet Addiction". CyberPsychology & Behavior. 4 (3): 377–383. doi:10.1089/109493101300210286. ISSN 1094-9313.

[:24-32] Cheng, Cecilia; Li, Angel Yee-lam (2014-12-01). "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): 755–760. doi:10.1089/cyber.2014.0317. ISSN 2152-2715.

[33] Widyanto, Laura; McMurran, Mary. "The Psychometric Properties of the Internet Addiction Test". CyberPsychology & Behavior. 7 (4): 443–450. doi:10.1089/cpb.2004.7.443.

[34] Brenner, V. (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): 879–882.

[:22-35] Huang, Zheng; Wang, Mo; Qian, Mingyi; Zhong, Jie; Tao, Ran (2007-12-01). "Chinese Internet Addiction Inventory: Developing a Measure of Problematic Internet Use for Chinese College Students". CyberPsychology & Behavior. 10 (6): 805–812. doi:10.1089/cpb.2007.9950. ISSN 1094-9313.

[36] Heo, Jongho; Oh, Juhwan; Subramanian, S. V.; Kim, Yoon; Kawachi, Ichiro (2014-02-05). "Addictive Internet Use among Korean Adolescents: A National Survey". PLOS ONE. 9 (2): e87819. doi:10.1371/journal.pone.0087819. ISSN 1932-6203.{{cite journal}}: CS1 maint: unflagged free DOI (link)

[37] Meerkerk, G.-J.; Van Den Eijnden, R. J. J. M.; Vermulst, A. A.; Garretsen, H. F. L. (2008-12-10). "The Compulsive Internet Use Scale (CIUS): Some Psychometric Properties". CyberPsychology & Behavior. 12 (1): 1–6. doi:10.1089/cpb.2008.0181. ISSN 1094-9313.

[38] Caplan, Scott E. "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.

[39] Clark, Deborah J.; Frith, Karen H. (September 2005). "The Development and Initial Testing of the Internet Consequences Scales (ICONS)". CIN: Computers, Informatics, Nursing. 23 (5): 285. ISSN 1538-2931.

[40] Demetrovics, Zsolt; Szeredi, Beatrix; Rózsa, Sándor (2008-05-01). "The three-factor model of Internet addiction: The development of the Problematic Internet Use Questionnaire". Behavior Research Methods. 40 (2): 563–574. doi:10.3758/BRM.40.2.563. ISSN 1554-351X.

[:2-41] Chang, Man Kit; Law, Sally Pui Man. "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.

[42] Widyanto, Laura; Griffiths, Mark D.; Brunsden, Vivienne (2010-11-10). "A Psychometric Comparison of the Internet Addiction Test, the Internet-Related Problem Scale, and Self-Diagnosis". Cyberpsychology, Behavior, and Social Networking. 14 (3): 141–149. doi:10.1089/cyber.2010.0151. ISSN 2152-2715.

[43] Widyanto, Laura; McMurran, Mary (2004-08-01). "The Psychometric Properties of the Internet Addiction Test". CyberPsychology & Behavior. 7 (4): 443–450. doi:10.1089/cpb.2004.7.443. ISSN 1094-9313.

[:12-44] Northrup, Jason C.; Lapierre, Coady; Kirk, Jeffrey; Rae, Cosette (2015-07-28). "The Internet Process Addiction Test: Screening for Addictions to Processes Facilitated by the Internet". Behavioral Sciences. 5 (3): 341–352. doi:10.3390/bs5030341.{{cite journal}}: CS1 maint: unflagged free DOI (link)

[:34-45] Griffiths, M. (2000). "Internet addiction-time to be taken seriously?". Addiction research. 8(5): 413–418.

[46] Chou, Chien; Hsiao, Ming-Chun. "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.

[47] Soule, L. C.; Shell, L. W.; Kleen, B. A. (2003). "Exploring Internet addiction: Demographic characteristics and stereotypes of heavy Internet users". Journal of Computer Information Systems. 44(1): 64–73.

[48] Kim, Sunny Jung; Byrne, Sahara (2011). "Conceptualizing personal web usage in work contexts: A preliminary framework". Computers in Human Behavior. 27 (6): 2271. doi:10.1016/j.chb.2011.07.006.

[Moreno_MA_1887-49] Moreno MA, Jelenchick LA, Christakis DA (2013). "Problematic internet use among older adolescents: A conceptual framework". Computers and Human Behavior. 29 (4): 1879–1887. doi:10.1016/j.chb.2013.01.053.

[50] Trochim, W.; Kane, M (2005). "Concept mapping: An introduction to structured conceptualization in health care". International Journal for Quality in Health Care. 17 (3): 187–91. doi:10.1093/intqhc/mzi038. PMID 15872026.

[51] Pawlikowski, M. et al. (in press, 2013). Pathological internet use: It is a multidimensional and not a unidimensional construct. Addiction Research & Theory.

[netaddiction.com-52] "Types of Internet addiction". Retrieved 2014-01-30.

[dsm-5-53] American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (Fifth ed.). Arlington, VA: American Psychiatric Publishing. pp. 797–798. ISBN 978-0-89042-555-8.

[Blockbit-54] Block, Jerald J. (2008). "Issues for DSM-V: Internet Addiction". American Journal of Psychiatry. 165 (3): 306–7. doi:10.1176/appi.ajp.2007.07101556. PMID 18316427.

[Thompson-55] Thompson SJ (1996). "Internet Connectivity: Addiction and Dependency Study". The Penn State McNair Journal. 3 (Summer): 137–154.

[56] Association for Education in Mass Communication and Journalism Convention in Chicago in 1997 [1]

[57] Thompson, S.J. (2011). "Endless Empowerment and Existence: From Virtual Literacy to Online Permanence in Presence. First International Forum on Media and Information Literacy". Fez, Morocco: Sidi Mohamed Ben Abdellah University. {{cite journal}}: Cite journal requires |journal= (help)

[58] "Declaration on Media and Information Literacy adopted by Fez International Forum".

[59] Thompson, Steven John, ed. (2014). "Preface". Global issues and ethical considerations in human enhancement technologies. Advances in Human and Social Aspects of Technology. Hershey, PA: IGI Global. xvi–xx. ISBN 978-1-4666-6010-6. {{cite book}}: External link in |chapterurl= (help); Unknown parameter |chapterurl= ignored (|chapter-url= suggested) (help); Unknown parameter |nopp= ignored (|no-pp= suggested) (help)

[60] Widyanto, Laura; Griffiths, Mark (2006). "'Internet Addiction': A Critical Review". International Journal of Mental Health and Addiction. 4: 31. doi:10.1007/s11469-006-9009-9.

[61] "Internet Addiction Disorder." Human Diseases and Conditions, edited by Donna Batten, et al., 3rd ed., vol. 2, Charles Scribner's Sons, 2017, pp. 1107-1112. Gale Virtual Reference Library, http://go.galegroup.com/ps/i.do?p=GVRL&sw=w&u=jcl_jccc&v=2.1&it=r&id=GALE%7CCX3630000238&sid=summon&asid=8d4da08c384d2bb3126830d4e1f5f7b6. Accessed 26 Apr. 2017.

[62] Griffiths, Mark (2009). "Internet Addiction - Time to be Taken Seriously?". Addiction Research. 8 (5): 413. doi:10.3109/16066350009005587.

[63] Yellowlees, Peter M.; Marks, Shayna (2007). "Problematic Internet use or Internet addiction?". Computers in Human Behavior. 23 (3): 1447–53. doi:10.1016/j.chb.2005.05.004. INIST 18464918.

[64] M. Grohol, O. (2014). "Internet Addiction and Online Addiction". Retrieved 14 March 2014.

[65] Young, K. S.; Rodgers, R. C. (1998). Internet Addiction: Personality Traits Associated with Its Development. [e-book] (PDF). p. 1. Retrieved 14 March 2014.

[Helpguide-66] Saisan, J.; Smith, M.; Robinson, L.; Segal, J. (2014). "Internet and Computer Addiction: Signs, Symptoms, and Treatment". Archived from the original on 18 September 2014. Retrieved 14 March 2014.

[67] "Conversation Agent - Valeria Maltoni: Internet Delivers Convenience via Speed and Cognitive Ease". sationagent.com. 2013. Retrieved 14 March 2014.

[68] Sinclair, D. (2014). "Making the Most of the Internet - Convenience". Retrieved 14 March 2014.

[69] Pea, R.; Maldonado, H. (2006). "WILD for learning: Interacting through new computing devices anytime, anywhere" (PDF). In K. Sawyer (ed.). The Cambridge Handbook of the Learning Sciences. New York: Cambridge University Press. pp. 852–886.

[70] "My Internet - Secret and Fast". Play.google.com. 2014. Retrieved 14 March 2014.

[Caught_in_the_Net-71] Young, K. S. (1998). Caught in the Net. New York: John Wiley. ISBN 0471191590.

[72] Young, Kimberly (2009). "Understanding Online Gaming Addiction and Treatment Issues for Adolescents". The American Journal of Family Therapy. 37 (5): 355–72. doi:10.1080/01926180902942191.

[73] Young, Kimberly S. (1999). "The Research and Controversy Surrounding Internet Addiction". CyberPsychology & Behavior. 2 (5): 381. doi:10.1089/cpb.1999.2.381.

[Young,_K._pp._19-74] Young, K. (1999). "Internet addiction: Symptoms, evaluation and treatment". In L. VandeCreek; T. Jackson (eds.). Innovations in clinical practice: A source book (PDF). Vol. 17. Sarasota, Florida: Professional Resource Press. pp. 19–31.^{[dead link]}

[75] Kalichman, Seth C.; Rompa, David (1995). "Sexual Sensation Seeking and Sexual Compulsivity Scales: Validity, and Predicting HIV Risk Behavior". Journal of Personality Assessment. 65 (3): 586. doi:10.1207/s15327752jpa6503_16. PMID 8609589.

[76] Carroll, J. S.; Padilla-Walker, L. M.; Nelson, L. J.; Olson, C. D.; McNamara Barry, C.; Madsen, S. D. (2008). "Generation XXX: Pornography Acceptance and Use Among Emerging Adults". Journal of Adolescent Research. 23: 6. doi:10.1177/0743558407306348.

[77] Manning, Jill C. (2006). "The Impact of Internet Pornography on Marriage and the Family: A Review of the Research". Sexual Addiction & Compulsivity. 13 (2–3): 131. doi:10.1080/10720160600870711.

[78] Warden, Narelle L.; Phillips, James G.; Ogloff, James R. P. (2004). "Internet Addiction". Psychiatry, Psychology and Law. 11 (2): 280. doi:10.1375/pplt.2004.11.2.280.

[79] Owens, Eric W.; Behun, Richard J.; Manning, Jill C.; Reid, Rory C. (2012). "The Impact of Internet Pornography on Adolescents: A Review of the Research". Sexual Addiction & Compulsivity. 19: 99. doi:10.1080/10720162.2012.660431.

[80] Grubbs, Joshua B.; Volk, Fred; Exline, Julie J.; Pargament, Kenneth I. (2013). "Internet Pornography Use: Perceived Addiction, Psychological Distress, and the Validation of a Brief Measure". Journal of Sex & Marital Therapy. 41: 83. doi:10.1080/0092623x.2013.842192.

[81] Ramdhonee, Psychological Impact of Internet usage on Children.pdfK (2014). "Psychological Impacts of Internet usage of Children/ Adolescents" (PDF). pp. 1–10. Archived from the original (PDF) on 7 September 2012. Retrieved 14 Mar 2014. {{cite web}}: Unknown parameter |deadurl= ignored (|url-status= suggested) (help)

[82] Suler, J (2004). "The psychology of text relationships". Online counseling: A handbook for mental health professionals. pp. 19–50.

[83] Young, Kimberly S.; Rogers, Robert C. (1998). "The Relationship Between Depression and Internet Addiction". CyberPsychology & Behavior. 1: 25. doi:10.1089/cpb.1998.1.25.

[84] Whang, Leo Sang-Min; Lee, Sujin; Chang, Geunyoung (2003). "Internet Over-Users' Psychological Profiles: A Behavior Sampling Analysis on Internet Addiction". CyberPsychology & Behavior. 6 (2): 143. doi:10.1089/109493103321640338.

[85] Young, K. S. (1999). "Internet Addiction: Symptoms, Evaluation, and Treatment". In VandeCreek, L.; Jackson, T. L. (eds.). Innovations in Clinical Practice. Vol. 17. Professional Resource Press.

[86] "Service for Computer and Internet addiction". Archived from the original on 2012-04-29. {{cite web}}: Unknown parameter |deadurl= ignored (|url-status= suggested) (help)

[87] Tsitsika, Artemis; Janikian, Mari; Schoenmakers, Tim M.; Tzavela, Eleni C.; Olafsson, Kjartan; Wójcik, Szymon; Macarie, George Florian; Tzavara, Chara; Richardson, Clive (August 2014). "Internet addictive behavior in adolescence: a cross-sectional study in seven European countries". Cyberpsychology, Behavior and Social Networking. 17 (8): 528–535. doi:10.1089/cyber.2013.0382. ISSN 2152-2723. PMID 24853789.

[88] Caplan, Scott E.; High, Andrew C. (2006). "Beyond Excessive Use: The Interaction between Cognitive and Behavioral Symptoms of Problematic Internet Use". Communication Research Reports. 23 (4): 265. doi:10.1080/08824090600962516.

[89] Rollero, C. 2013, "Men and women facing objectification: The effects of media models on well-being, self-esteem and ambivalent sexism", REVISTA DE PSICOLOGIA SOCIAL, vol. 28, no. 3, pp. 373-382.

[90] Stieger, Stefan; Burger, Christoph (2010). "Implicit and Explicit Self-Esteem in the Context of Internet Addiction". Cyberpsychology, Behavior, and Social Networking. 13 (6): 681. doi:10.1089/cyber.2009.0426.

[91] Zhou, Yan; Lin, Fu-Chun; Du, Ya-Song; Qin, Ling-di; Zhao, Zhi-min; Xu, Jian-Rong; Lei, Hao (2011). "Gray matter abnormalities in Internet addiction: A voxel-based morphometry study". European Journal of Radiology. 79 (1): 92–5. doi:10.1016/j.ejrad.2009.10.025. PMID 19926237.

[92] Weng, C. B.; Qian, R. B.; Fu, X. M.; Lin, B; Ji, X. B.; Niu, C. S.; Wang, Y. H. (2012). "A voxel-based morphometric analysis of brain gray matter in online game addicts". Zhonghua yi xue za zhi. 92 (45): 3221–3. PMID 23328472.

[93] Low, Keath. "Executive functions and ADD - ADHD. What are executive functions? How do executive functions relate to ADD - ADHD?". About.com.

[94] 10

[95] 11

[96] 12

[97] Young, K. (2009). "Internet Addiction Test".

[98] Ferraro, Giovanni; Caci, Barbara; d'Amico, Antonella; Blasi, Marie Di (2007). "Internet Addiction Disorder: An Italian Study". CyberPsychology & Behavior. 10 (2): 170. doi:10.1089/cpb.2006.9972.

[Young-99] Young, K. (2011). "Clinical Assessment of Internet-Addicted Clients". In Young, K.; Nabuco do Abreu, C. (eds.). Internet Addiction. Hoboken: John Wiley & Sons Inc. doi:10.1002/9781118013991.ch2.

[Chen-100] Chen S.H.; et al. (2003). "Development of Chinese Internet Addiction Scale and its psychometric study". Chin J Psychol. 45: 279–294.

[Mak-101] Mak, Kwok-Kei; Lai, Ching-Man; Ko, Chih-Hung; Chou, Chien; Kim, Dong-Il; Watanabe, Hiroko; Ho, Roger C. M. (2014). "Psychometric Properties of the Revised Chen Internet Addiction Scale (CIAS-R) in Chinese Adolescents". Journal of Abnormal Child Psychology. 42 (7): 1237. doi:10.1007/s10802-014-9851-3. PMID 24585392.

[meerkerk-102] Meerkerk, G.-J.; Van Den Eijnden, R. J. J. M.; Vermulst, A. A.; Garretsen, H. F. L. (2009). "The Compulsive Internet Use Scale (CIUS): Some Psychometric Properties". CyberPsychology & Behavior. 12: 1. doi:10.1089/cpb.2008.0181.

[Jelenchick-103] Lauren Jelenchick. "The Problematic and Risky Internet Use Screening Scale (PRIUSS) for Adolescents and Young Adults: Initial Scale Development and Refinement" (PDF). Retrieved 14 March 2014.

[104] Caplan, Scott E (2002). "Problematic Internet use and psychosocial well-being: Development of a theory-based cognitive–behavioral measurement instrument". Computers in Human Behavior. 18 (5): 553. doi:10.1016/S0747-5632(02)00004-3.

[105] Joinson, A. N. (2003). Understanding the Psychology of Internet Behaviour. Houndmills: Palgrave Macmillan.

[106] Griffiths, M. D. (1998). "Internet addiction: does it really exist?". In Gackenbach, J. (ed.). Psychology and the Internet. New York: Academic Press. pp. 61–75.

[107] Griffiths, Mark (2009). "Internet Addiction - Time to be Taken Seriously?". Addiction Research. 8 (5): 413–8. doi:10.3109/16066350009005587.

[pdfok.com-108] David Greenfield. "Problematic Internet Use: Young people and the online world are synonymous, but when does it become excessive?". Centre for Internet Behaviour. Retrieved 14 March 2014.^{[self-published source?]}

[Caplan-109] Caplan, Scott E. (2003). "Preference for Online Social Interaction: A Theory of Problematic Internet Use and Psychosocial Well-Being". Communication Research. 30 (6): 625–48. doi:10.1177/0093650203257842.

[110] Tapper, Josh (2013-02-01). "Internet addicts face constant temptation, non-believers". Toronto Star. Retrieved 2013-12-08. Yet, many researchers contend internet addiction cannot exist on its own. They say it is most likely a symptom of ...

[111] "Experts debate Internet addiction". Physorg.com. 2006-11-14. Retrieved 2009-08-09.

[autogenerated3-112] Kershaw, Sarah (December 1, 2005). "Hooked on the Web: Help Is on the Way". New York Times.

[113] Hawi, Nazir S. (2012). "Internet addiction among adolescents in Lebanon". Computers in Human Behavior. 28 (3): 1044–53. doi:10.1016/j.chb.2012.01.007. INIST 25647439.

[114] "Press Release #4 at netaddiction.com". Archived from the original on December 17, 2008. {{cite web}}: Unknown parameter |deadurl= ignored (|url-status= suggested) (help)

[CPandB-115] Byun, Sookeun; Ruffini, Celestino; Mills, Juline E.; Douglas, Alecia C.; Niang, Mamadou; Stepchenkova, Svetlana; Lee, Seul Ki; Loutfi, Jihad; Lee, Jung-Kook; Atallah, Mikhail; Blanton, Marina (2009). "Internet Addiction: Metasynthesis of 1996–2006 Quantitative Research". CyberPsychology & Behavior. 12 (2): 203. doi:10.1089/cpb.2008.0102.

[116] "Brief Internet Game Screen (BIGS) Survey". www.surveymonkey.com. Retrieved 2016-10-16.

[117] Northrup, Jason; Lapierre, Coady; Kirk, Jeffrey; Rae, Cosette (2015). "The Internet Process Addiction Test: Screening for Addictions to Processes Facilitated by the Internet". Behavioral Sciences. 5 (3): 341. doi:10.3390/bs5030341. PMID 26226007.{{cite journal}}: CS1 maint: unflagged free DOI (link)

[118] Cash, Hilarie; d. Rae, Cosette; h. Steel, Ann; Winkler, Alexander (2012). "Internet Addiction: A Brief Summary of Research and Practice". Current Psychiatry Reviews. 8 (4): 292–298. doi:10.2174/157340012803520513. PMC 3480687. PMID 23125561.

[119] Przepiorka, Aneta Małgorzata; Blachnio, Agata; Miziak, Barbara; Czuczwar, Stanisław Jerzy (2014). "Clinical approaches to treatment of Internet addiction". Pharmacological Reports. 66 (2): 187–91. doi:10.1016/j.pharep.2013.10.001. PMID 24911068.

[120] "Internet addiction and lack of accountability". internet-addiction-guide.com. 2010-12-07. Retrieved 2011-07-06.

[121] Young, Kimberly S. (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.

[:0-122] Krajnak, Deb (2009-08-19). "China probe of abuse at Web addiction camp". CNN. Retrieved 2009-08-20.

[:1-123] Yu Le; Emma Graham-Harrison (November 5, 2009). "China bans physical punishment for Internet addicts". Reuters India. Retrieved 2009-11-11.

[124] Slice of MIT. "MIT Researchers Develop a Shocking Treatment for Facebook Addiction" Retrieved 2013-09-05.

[125] "Delhi gets its first internet de-addiction centre". The Times of India, July 22, 2014. Retrieved June 24, 2015

[126] "Delhi's first internet de-addiction centre helps children log out of the virtual world". Hindustan Times, August 03, 2014 . Retrieved June 24, 2015

[127] "Tied to the Internet?". Deccan Herald. Retrieved June 24, 2015

[128] "internet de-addiction centres in Delhi, Bangalore battle India's newest lifestyle disease". Scroll.in, September 15, 2014. Retrieved June 24, 2015

[129] "Let's Talk About Tech, Baby". The Sunday Guardian, April 25, 2015. Retrieved June 24, 2015

[130] Geranios, Nicholas K. (September 3, 2009). "Internet addiction center opens in US". Yahoo. Associated Press.

[131] "Internet addiction center opens in US". Khaleejtimes.com. 2009-09-07. Retrieved 2009-11-11.

[autogenerated2-132] Kershaw, Sarah (1 December 2005). "Hooked on the Web: Help Is on the Way" – via NYTimes.com.

[133] Young, K. S.; Nabuco de Abreu, C., eds. (2011). Internet addiction, A handbook and guide to evaluation and treatment. Hoboken: John Wiley & Sons, Inc.

[134] Winkler, Alexander; Dörsing, Beate; Rief, Winfried; Shen, Yuhui; Glombiewski, Julia A. (2013). "Treatment of internet addiction: A meta-analysis". Clinical Psychology Review. 33 (2): 317. doi:10.1016/j.cpr.2012.12.005. PMID 23354007.

[Man_Suing_IBM_Over_Chat_Room_Firing-135] "Pacenza vs. IBM Corp". Retrieved 1 March 2007.

[136] "Internet Addiction: The Next Disability". LRP Publications. February 28, 2007. Retrieved 2009-01-31.

[137] "Update: Pacenza v. IBM-Lawsuit alleges Internet sex chat addiction is entitled to ADA protection - Overlawyered". Overlawyered.

[Pacenza_v._IBM_Corporation,_No._09-2025-cv-138] "Pacenza v. IBM Corporation". Pacenza v. IBM Corporation, No. 09-2025-cv. Retrieved 12 February 2014.

[Beard_and_Wolf-139] Beard, Keith W.; Wolf, Eve M. (2001). "Modification in the Proposed Diagnostic Criteria for Internet Addiction". CyberPsychology & Behavior. 4 (3): 377–83. doi:10.1089/109493101300210286. PMID 11710263.

[140] Scherer, Kathy (1997). "College Life On-Line: Healthy and Unhealthy Internet Use". Journal of College Student Development.

[141] Lee, Hattie (January 11, 2007). "17% of Youth Addicted To Internet". Pacific Epoch. Archived from the original on January 15, 2007.

[Horstman-142] Horstman, Judith (2009). The Scientific American Day in the Life of Your Brain. Jossey-Bass / Wiley. ISBN 978-0470376232.

[143] Kalwar, S. K.; Heikkinen, K. (2009). "Study of human anxiety on the Internet". Human-Computer Interaction. New Trends. Lecture Notes in Computer Science. Springer Berlin Heidelberg. pp. 69–76. doi:10.1007/978-3-642-02574-7_8. ISBN 978-3-642-02573-0.

[144] Goldman, Lea (2005-09-05). "This Is Your Brain on Clicks". Forbes. Retrieved 2007-07-17.

[youngk2009-145] Young, K. (2009). "Issues for Internet Addiction as a New Diagnosis in the DSM-V". Washington, District of Columbia, US: American Psychological Association. {{cite journal}}: Cite journal requires |journal= (help) Retrieved from PsycEXTRA database.

[146] "Frequently Asked Questions". Netaddiction.com. Retrieved 2014-01-30.

[autogenerated1-147] "Frequently Asked Questions". Netaddiction.com. Archived from the original on July 21, 2009. Retrieved 2009-08-09. {{cite web}}: Unknown parameter |deadurl= ignored (|url-status= suggested) (help)

[148] Griffiths, Mark (1998). "Internet addiction: Does it really exist?". In J. Gackenbach (ed.). Psychology and the Internet: Intrapersonal, Interpersonal, and Transpersonal Applications (PDF). New York: Academic Press. pp. 61–75.

[pmid21677775-149] Yuan, Kai; Qin, Wei; Wang, Guihong; Zeng, Fang; Zhao, Liyan; Yang, Xuejuan; Liu, Peng; Liu, Jixin; Sun, Jinbo; von Deneen, Karen M.; Gong, Qiyong; Liu, Yijun; Tian, Jie (2011). "Microstructure Abnormalities in Adolescents with Internet Addiction Disorder". PLoS ONE. 6 (6): e20708. Bibcode:2011PLoSO...620708Y. doi:10.1371/journal.pone.0020708. PMID 21677775.{{cite journal}}: CS1 maint: unflagged free DOI (link)

[150] "High wired: Does addictive internet use restructure the brain?". Retrieved 2011-06-19.

[151] Wallace, P. (2001). The Psychology of the Internet (paperback ed.). Cambridge: Cambridge University Press.

[152] Lush, Tamara (29 August 2011). "At war with World of Warcraft". The Guardian. London. Retrieved 2012-03-15.

[153] Andrew Doan; Brooke Strickland. "About". hooked-on-games.com.

[154] "The Virtual Skinner Box". Retrieved 2012-03-15.

[doctor-155] Reimer, Jeremy (August 2006). "Doctor claims 40 percent of World of Warcraft players are addicted". ARS Technica. Retrieved 2012-03-15.

[156] "Online Gamers Anonymous [12-step support group]".

[157] Rossignol, Jim (2009). The Gaming Life: Travels in Three Cities. University of Michigan Press. ISBN 9780472033973.

[158] Walther, J.B. (1999) "Communication Addiction Disorder: Concern over media, behavior and effects [APA conference talk]".

[159] Echeburua E.; de Corral P. (2010). "Addiction to new technologies and to online social networking in young people: A new challenge". Adicciones. 22: 91–95.

[Guzzo1-160] Guzzo Fernando, Tiziana Guzzo; Ferri, Fernando; Grifoni, Patrizia (2013). "Social Network's Effects on Italian Teenager's Life". Journal of Next Generation Information Technology. 4 (3): 54–62. doi:10.4156/jnit.vol4.issue3.7.

[161] Hutson M. (2009). "Facebook Friends: Too Many, Too Few?" Retrieved 10 March 2012

[162] Buffardi, L. E.; Campbell, W. K. (2008). "Narcissism and Social Networking Web Sites". Personality and Social Psychology Bulletin. 34 (10): 1303–14. doi:10.1177/0146167208320061. PMID 18599659.

[163] Manago, Adriana M.; Graham, Michael B.; Greenfield, Patricia M.; Salimkhan, Goldie (2008). "Self-presentation and gender on My Space". Journal of Applied Developmental Psychology. 29 (6): 446. doi:10.1016/j.appdev.2008.07.001.

[164] Ambady N., Skowronski J. (2008). "First impressions". New York Guilford.^{[page needed]}

[165] William H. Davidow (31 Jul 2012). "Interactive technologies give us a quick fix, and that's not a good thing". IEEE Spectrum. Retrieved 29 Nov 2015.

[1]

[2]

[3]

[4]

[5]

[6]

[7]

[8]

[9]

[10]

[11]

[12]

[13]

[14]

[15]

[16]

[17]

[18]

[19]

[20]

[21]

[22]

[23]

[24]

[25]

[26]

[27]

[28]

[29]

[30]

[31]

[32]

[33]

[34]

[35]

[36]

[37]

[38]

[39]

[40]

[41]

[42]

[43]

[44]

[45]

[46]

[47]

[48]

[49]

[50]

[51]

[52]

[53]

[54]

[55]

[56]

[57]

[58]

[59]

[60]

[61]

[62]

[63]

[64]

[65]

[66]

[67]

[68]

[69]

[70]

[71]

[72]

[73]

[74]

[75]

[76]

[77]

[78]

[79]

[80]

[81]

[82]

[83]

[84]

[85]

[86]

[87]

[88]

[89]

[90]

[91]

[92]

[93]

[94]

[95]

[96]

[97]

[98]

[99]

[100]

@@ Line 7: / Line 7: @@
 }}
-'''Internet addiction disorder''', also known as '''problematic Internet use''' or '''pathological Internet use (PIU)''',<ref name="Moreno MA 1887">{{cite journal |vauthors=Moreno MA, Jelenchick LA, Christakis DA | year = 2013 | title = Problematic internet use among older adolescents: A conceptual framework | url = | journal = Computers and Human Behavior | volume = 29 | issue = 4| pages = 1879–1887 | doi = 10.1016/j.chb.2013.01.053 }}</ref> refers to excessive [[Internet]] use that interferes with daily life.<ref name="CPandB"/> '''Addiction,''' defined by Webster Dictionary as a "compulsive need for and use of a habit-forming substance characterized by tolerance and by well-defined physiological symptoms upon withdrawal", was traditionally used to depict a person's dependence on substance. More recently, the concept has been applied to behavioral dependence including internet use. The problem of Internet addiction evolves together with the development and spread of Internet. As adolescents (12–17 years) and emerging adults (18–29 years) access the Internet more than any other age groups and undertake a higher risk of overuse of Internet, the problem of Internet addiction disorder is most relevant to young people.
+'''Internet addiction disorder''', also known as '''problematic Internet use''' or '''pathological Internet use''', refers to excessive [[Internet]] use that interferes with daily life. '''Addiction,''' defined by Webster Dictionary as a "compulsive need for and use of a habit-forming substance characterized by tolerance and by well-defined physiological symptoms upon withdrawal", was traditionally used to depict a person's dependence on substance. More recently, the concept has been applied to behavioral dependence<ref>{{Cite journal|last=Holden|first=Constance|date=2001-11-02|title='Behavioral' Addictions: Do They Exist?|url=http://science.sciencemag.org/content/294/5544/980|journal=Science|language=en|volume=294|issue=5544|pages=980–982|doi=10.1126/science.294.5544.980|issn=0036-8075|pmid=11691967}}</ref> including internet use.<ref name=":03">{{Cite book|url=https://www.worldcat.org/oclc/38130573|title=Caught in the net : how to recognize the signs of Internet addiction--and a winning strategy for recovery|last=S.|first=Young, Kimberly|date=1998|publisher=J. Wiley|isbn=9780471191599|location=New York|oclc=38130573}}</ref> The problem of Internet addiction evolves together with the  development and spread of Internet. As adolescents (12–17 years) and emerging adults (18–29 years) access the Internet more than any other age groups and undertake a higher risk of overuse of Internet, the problem of Internet addiction disorder is most relevant to young people.<ref>{{Cite journal|last=Anderson|first=E. L.|last2=Steen|first2=E.|last3=Stavropoulos|first3=V.|date=2017|title=Internet use and Problematic Internet Use: A systematic review of longitudinal research trends in adolescence and emergent adulthood|url=https://www.tandfonline.com/doi/full/10.1080/02673843.2016.1227716|journal=International Journal of Adolescence and Youth|volume=22(4)|pages=430-454|via=}}</ref>
-Excessive use of Internet has been found by various studies to disrupt individuals' time use and have a series of health consequences. But the existence of Internet addiction as a mental disorder is not yet well recognized. The current version of ''[[DSM-5|Diagnostic and Statistical Manual of Mental Disorders (DSM-V)]]'' noted that Internet gaming disorder is a condition that requires more research in order to be considered as a full disorder in 2013.
+Excessive use of Internet has been found by various studies to disrupt individuals' time use and have a series of health consequences. But the existence of Internet addiction as a mental disorder is not yet well recognized. The current version of ''[[DSM-5|Diagnostic and Statistical Manual of Mental Disorders (DSM-V)]]'' noted that Internet gaming disorder is a condition that requires more research in order to be considered as a full disorder in 2013.<ref name=":352">{{Cite journal|last=Campanella|first=M.|last2=Mucci|first2=F.|last3=Baroni|first3=S.|last4=Nardi|first4=L.|last5=Marazziti|first5=D.|date=2015|title=Prevalence of Internet Addiction: A Pilot Study in a Group of Italian Students|script-title=|url=https://pdfs.semanticscholar.org/723c/c63367664ab92115bfa4f6ba02b71346f4bb.pdf|journal=Clinical Neuropsychiatry|volume=4|pages=90-93|citeseerx=|via=}}</ref>
 ==Terminology==
-The notion of "Internet Addictive Disorder" was initially conjured up by Dr. Ivan K. Goldberg in 1995 as a joke to parody the complexity and rigidity of [[American Psychiatric Association|American Psychiatric Association's (APA)]]"[[Diagnostic and Statistical Manual of Mental Disorders|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."
+The notion of "Internet Addictive Disorder" was initially conjured up by Dr. Ivan K. Goldberg in 1995 as a joke to parody the complexity and rigidity of [[American Psychiatric Association|American Psychiatric Association's (APA)]] "[[Diagnostic and Statistical Manual of Mental Disorders|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."<ref>{{Cite news|url=https://www.newyorker.com/magazine/1997/01/13/just-click-no|title=Just Click No|last=Wallis|first=David|date=1997-01-06|work=The New Yorker|access-date=2018-02-21|language=en|issn=0028-792X}}</ref>
-The definition of Internet addiction disorder has troubled researcher ever since its inception. In general, no standardized definition has been provided despite that the phenomenon has received extensive public and scholar recognition. Below are some of the commonly used definitions.
+The definition of Internet addiction disorder has troubled researcher ever since its inception. In general, no standardized definition has been provided despite that the phenomenon has received extensive public and scholar recognition.<ref name=":33">{{Cite journal|last=Chou|first=Chien|last2=Condron|first2=Linda|last3=Belland|first3=John C.|date=2005-12-01|title=A Review of the Research on Internet Addiction|url=https://link.springer.com/article/10.1007/s10648-005-8138-1|journal=Educational Psychology Review|language=en|volume=17|issue=4|pages=363–388|doi=10.1007/s10648-005-8138-1|issn=1040-726X}}</ref><ref name=":212">{{Cite journal|last=Byun|first=Sookeun|last2=Ruffini|first2=Celestino|last3=Mills|first3=Juline E.|last4=Douglas|first4=Alecia C.|last5=Niang|first5=Mamadou|last6=Stepchenkova|first6=Svetlana|last7=Lee|first7=Seul Ki|last8=Loutfi|first8=Jihad|last9=Lee|first9=Jung-Kook|date=2008-12-10|title=Internet Addiction: Metasynthesis of 1996–2006 Quantitative Research|url=http://online.liebertpub.com/doi/abs/10.1089/cpb.2008.0102|journal=CyberPsychology & Behavior|volume=12|issue=2|pages=203–207|doi=10.1089/cpb.2008.0102|issn=1094-9313}}</ref> Below are some of the commonly used definitions.
-In 1998, Dr. Jonathan J. Kandell defined Internet addiction as "a psychological dependence on the Internet, regardless of the type of activity once logged on."
+In 1998, Dr. Jonathan J. Kandell defined Internet addiction as "a psychological dependence on the Internet, regardless of the type of activity once logged on."<ref>{{Cite journal|last=Kandell|first=Jonathan J.|date=1998-01-01|title=Internet Addiction on Campus: The Vulnerability of College Students|url=http://online.liebertpub.com/doi/abs/10.1089/cpb.1998.1.11|journal=CyberPsychology & Behavior|volume=1|issue=1|pages=11–17|doi=10.1089/cpb.1998.1.11|issn=1094-9313}}</ref>
-English psychologist Mark D. Griffiths (1998) conceived Internet addiction as a subtype of broader '''technology addiction''', and also a subtype of '''[[Behavioral addiction|behavioral addictions]]'''.
+English psychologist Mark D. Griffiths (1998) conceived Internet addiction as a subtype of broader [[Technology addiction|'''technology addiction''']], and also a subtype of '''[[Behavioral addiction|behavioral addictions]]'''.<ref>{{Cite web|url=http://psycnet.apa.org/record/1998-06638-003|title=PsycNET|website=psycnet.apa.org|language=en|access-date=2018-02-21}}</ref>
-Dr. Keith W. Beard (2005) articulate 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]".
+Dr. Keith W. Beard (2005) articulate 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]".<ref>{{Cite journal|last=Beard|first=Keith W.|date=2005-02-01|title=Internet Addiction: A Review of Current Assessment Techniques and Potential Assessment Questions|url=http://online.liebertpub.com/doi/abs/10.1089/cpb.2005.8.7|journal=CyberPsychology & Behavior|volume=8|issue=1|pages=7–14|doi=10.1089/cpb.2005.8.7|issn=1094-9313}}</ref>
-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. 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'''.
+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.<ref name=":212" /> 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'''.
 == Diagnosis ==
 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.
+=== Difficulties ===
+Given the newness of Internet and the inconsistent definition of Internet addiction disorder, practical diagnosis is far from clearcut. With the first research initiated by Kimberly S. Young in 1996, the scientific study of Internet addiction has merely existed for 20 years.<ref>{{Cite book|url=https://link.springer.com/chapter/10.1007/978-3-319-46276-9_2|title=Internet Addiction|last=Brand|first=Matthias|date=2017|publisher=Springer, Cham|isbn=9783319462752|series=Studies in Neuroscience, Psychology and Behavioral Economics|pages=19–34|language=en|doi=10.1007/978-3-319-46276-9_2}}</ref> A few obstacles are present in creating an applicable diagnostic method of 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 be an integral or necessary part of human lives. The addictive or problematic use of internet is thus easily masked or justified.<ref name=":3">{{Cite book|url=https://link.springer.com/chapter/10.1007/978-3-319-46276-9_1|title=Internet Addiction|last=Young|first=Kimberly|date=2017|publisher=Springer, Cham|isbn=9783319462752|series=Studies in Neuroscience, Psychology and Behavioral Economics|pages=3–18|language=en|doi=10.1007/978-3-319-46276-9_1}}</ref> 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, anti-social behavior that has very little social redeeming value. Many so-called Internet addicts do not suffer from the same damage to health and relationships that are common to established addictions.<ref>{{Cite news|url=https://www.nytimes.com/2005/12/01/fashion/thursdaystyles/hooked-on-the-web-help-is-on-the-way.html|title=Hooked on the Web: Help Is on the Way|last=Kershaw|first=Sarah|date=2005-12-01|work=The New York Times|access-date=2018-02-28|language=en-US|issn=0362-4331}}</ref>
+* ''High comorbidity:'' Internet addiction is often accompanied by other psychiatric disorders such as personality disorder and mental retardation.<ref name=":3" /><ref>{{Cite journal|last=Ko|first=Chih-Hung|last2=Yen|first2=Ju-Yu|last3=Chen|first3=Cheng-Sheng|last4=Chen|first4=Cheng-Chung|last5=Yen|first5=Cheng-Fang|date=2008/02|title=Psychiatric Comorbidity of Internet Addiction in College Students: An Interview Study|url=https://www.cambridge.org/core/journals/cns-spectrums/article/psychiatric-comorbidity-of-internet-addiction-in-college-students-an-interview-study/6AD97FFDD455521E14DA8A12DE578454|journal=CNS Spectrums|language=en|volume=13|issue=2|pages=147–153|doi=10.1017/S1092852900016308|issn=1092-8529}}</ref><ref>{{Cite journal|last=Floros|first=Georgios|last2=Siomos|first2=Konstantinos|last3=Stogiannidou|first3=Ariadni|last4=Giouzepas|first4=Ioannis|last5=Garyfallos|first5=Georgios|title=Comorbidity of psychiatric disorders with Internet addiction in a clinical sample: The effect of personality, defense style and psychopathology|url=http://linkinghub.elsevier.com/retrieve/pii/S0306460314002627|journal=Addictive Behaviors|volume=39|issue=12|pages=1839–1845|doi=10.1016/j.addbeh.2014.07.031}}</ref><ref>{{Cite journal|last=Shapira|first=Nathan A.|last2=Goldsmith|first2=Toby D.|last3=Keck|first3=Paul E.|last4=Khosla|first4=Uday M.|last5=McElroy|first5=Susan L.|title=Psychiatric features of individuals with problematic internet use|url=https://doi.org/10.1016/S0165-0327(99)00107-X|journal=Journal of Affective Disorders|volume=57|issue=1-3|pages=267–272|doi=10.1016/s0165-0327(99)00107-x}}</ref><ref>{{Cite journal|last=Black|first=D. W.|last2=Belsare|first2=G.|last3=Schlosser|first3=S.|date=December 1999|title=Clinical features, psychiatric comorbidity, and health-related quality of life in persons reporting compulsive computer use behavior|url=https://www.ncbi.nlm.nih.gov/pubmed/10665630|journal=The Journal of Clinical Psychiatry|volume=60|issue=12|pages=839–844|issn=0160-6689|pmid=10665630}}</ref> It is found that Internet addiction is accompanied by other DSM-IV diagnosis 86% of the time.<ref name=":4">{{Cite journal|last=Block|first=Jerald J.|date=2008-03-01|title=Issues for DSM-V: Internet Addiction|url=https://ajp.psychiatryonline.org/doi/abs/10.1176/appi.ajp.2007.07101556|journal=American Journal of Psychiatry|volume=165|issue=3|pages=306–307|doi=10.1176/appi.ajp.2007.07101556|issn=0002-953X}}</ref> 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|attention deficit hyperactivity disorder (ADHD)]].<ref name=":10">{{Cite journal|last=Stone|first=Richard|date=2009-06-26|title=China Reins in Wilder Impulses in Treatment of ‘Internet Addiction’|url=http://science.sciencemag.org/content/324/5935/1630|journal=Science|language=en|volume=324|issue=5935|pages=1630–1631|doi=10.1126/science.324_1630|issn=0036-8075|pmid=19556477}}</ref> Another study in South Korea found an average of 1.5 other diagnoses among adolescent internet addicts.<ref name=":4" /> Further, it is noted in the United States that many patients only resort to medical help when he/she is in trouble with other disorders.<ref name=":3" /><ref name=":4" /> For many individuals, overuse or inappropriate use of the Internet is a manifestation of their [[Depression (mood)|depression]], [[Social anxiety disorder|social anxiety disorders]], [[Impulse control disorder|impulse control disorders]], or [[pathological gambling]].<ref>{{Cite journal|last=Hawi|first=Nazir S.|title=Internet addiction among adolescents in Lebanon|url=https://doi.org/10.1016/j.chb.2012.01.007|journal=Computers in Human Behavior|volume=28|issue=3|pages=1044–1053|doi=10.1016/j.chb.2012.01.007}}</ref> 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,<ref name=":4" /><ref>{{Cite journal|last=Bai|first=Ya-Mei|last2=Lin|first2=Chao-Cheng|last3=Chen|first3=Jen-Yeu|date=2001-10-01|title=Internet Addiction Disorder Among Clients of a Virtual Clinic|url=https://ps.psychiatryonline.org/doi/abs/10.1176/appi.ps.52.10.1397|journal=Psychiatric Services|volume=52|issue=10|pages=1397–1397|doi=10.1176/appi.ps.52.10.1397|issn=1075-2730}}</ref> neither [[DSM-IV codes|DSM-IV]] (1995) nor [[DSM-5|DSM-V]] (2013) consider Internet addiction as a mental disorder.<ref name=":5">{{Cite web|url=https://www.psychiatry.org/psychiatrists/practice/dsm|title=DSM-5|website=www.psychiatry.org|access-date=2018-02-19}}</ref> It is worth noting, though, a subcategory of IAD, [[Video game addiction|Internet gaming disorder]] is listed in [[DSM-5|DSM-V]] as a condition that requires more research in order to be considered as a full disorder in May 2013.<ref name=":35">{{Cite journal|last=Campanella|first=M.|last2=Mucci|first2=F.|last3=Baroni|first3=S.|last4=Nardi|first4=L.|last5=Marazziti|first5=D.|date=2015|title=Prevalence of Internet Addiction: A Pilot Study in a Group of Italian Students|script-title=|url=https://pdfs.semanticscholar.org/723c/c63367664ab92115bfa4f6ba02b71346f4bb.pdf|journal=Clinical Neuropsychiatry|volume=4|pages=90-93|citeseerx=|via=}}</ref><ref name=":5" /><ref>{{Cite journal|last=Lopez-Fernandez|first=Olatz|date=2015-09-01|title=How Has Internet Addiction Research Evolved Since the Advent of Internet Gaming Disorder? An Overview of Cyberaddictions from a Psychological Perspective|url=https://link.springer.com/article/10.1007/s40429-015-0067-6|journal=Current Addiction Reports|language=en|volume=2|issue=3|pages=263–271|doi=10.1007/s40429-015-0067-6|issn=2196-2952}}</ref> The [[World Health Organization|WHO]]'s draft 11th Revision of the [[International Classification of Diseases (ICD-10)|International Classification of Diseases (ICD-11)]] scheduled for publication in 2018 also include [[Video game addiction|gaming disorder]].<ref>{{Cite web|url=http://www.who.int/features/qa/gaming-disorder/en/|title=Gaming disorder|website=World Health Organization|language=en-GB|access-date=2018-03-02}}</ref> There is still considerable controversy over whether IAD should be included in the [[DSM-5|DSM-V]] and recognized as a mental disease in general.<ref name=":23">{{Cite journal|last=Weinstein|first=Aviv|last2=Lejoyeux|first2=Michel|date=2010|title=Internet Addiction or Excessive Internet Use|url=https://pdfs.semanticscholar.org/bfc4/b9bdf9a61dbb326fe5f14daf13a159fe93e3.pdf|journal=The American Journal of Drug and Alcohol Abuse|volume=36|pages=277-283|via=}}</ref>
+=== Screening instruments ===
+'''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|''Diagnostic and Statistical Manual of Mental Disorders'' ''(DSM)'']] handbook.<ref name=":21">{{Cite journal|last=Byun|first=Sookeun|last2=Ruffini|first2=Celestino|last3=Mills|first3=Juline E.|last4=Douglas|first4=Alecia C.|last5=Niang|first5=Mamadou|last6=Stepchenkova|first6=Svetlana|last7=Lee|first7=Seul Ki|last8=Loutfi|first8=Jihad|last9=Lee|first9=Jung-Kook|date=2008-12-10|title=Internet Addiction: Metasynthesis of 1996–2006 Quantitative Research|url=http://online.liebertpub.com/doi/abs/10.1089/cpb.2008.0102|journal=CyberPsychology & Behavior|volume=12|issue=2|pages=203–207|doi=10.1089/cpb.2008.0102|issn=1094-9313}}</ref>
+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.”<ref name=":21" />  By adapting the [[DSM-IV codes|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:<ref name=":02">{{Cite book|url=https://www.worldcat.org/oclc/38130573|title=Caught in the net : how to recognize the signs of Internet addiction--and a winning strategy for recovery|last=S.|first=Young, Kimberly|date=1998|publisher=J. Wiley|isbn=9780471191599|location=New York|oclc=38130573}}</ref><ref>{{Cite journal|last=Young|first=Kimberly S.|date=1998-01-01|title=Internet Addiction: The Emergence of a New Clinical Disorder|url=http://online.liebertpub.com/doi/abs/10.1089/cpb.1998.1.237|journal=CyberPsychology & Behavior|volume=1|issue=3|pages=237–244|doi=10.1089/cpb.1998.1.237|issn=1094-9313}}</ref><ref>{{Cite journal|last=Yellowlees|first=Peter M.|last2=Marks|first2=Shayna|title=Problematic Internet use or Internet addiction?|url=https://doi.org/10.1016/j.chb.2005.05.004|journal=Computers in Human Behavior|volume=23|issue=3|pages=1447–1453|doi=10.1016/j.chb.2005.05.004}}</ref>
+# Preoccupation with the Internet;
+# A need for increased time spent online to achieve the same amount of satisfaction;
+# Repeated efforts to curtail Internet use;
+# Irritability, depression, or mood lability when Internet use is limited;
+# Staying online longer than anticipated;
+# Putting a job or relationship in jeopardy to use Internet;
+# Lying to others about how much time is spent online; and
+# 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.<ref>{{Cite journal|last=Beard|first=Keith W.|last2=Wolf|first2=Eve M.|date=2001-06-01|title=Modification in the Proposed Diagnostic Criteria for Internet Addiction|url=http://online.liebertpub.com/doi/abs/10.1089/109493101300210286|journal=CyberPsychology & Behavior|volume=4|issue=3|pages=377–383|doi=10.1089/109493101300210286|issn=1094-9313}}</ref>
+Young further extended her 8-question YDQ assessment to the now most widely used Internet Addiction Test (IAT),<ref name=":02" /><ref name=":24">{{Cite journal|last=Cheng|first=Cecilia|last2=Li|first2=Angel Yee-lam|date=2014-12-01|title=Internet Addiction Prevalence and Quality of (Real) Life: A Meta-Analysis of 31 Nations Across Seven World Regions|url=http://online.liebertpub.com/doi/abs/10.1089/cyber.2014.0317|journal=Cyberpsychology, Behavior, and Social Networking|volume=17|issue=12|pages=755–760|doi=10.1089/cyber.2014.0317|issn=2152-2715}}</ref><ref>{{Cite journal|last=Widyanto|first=Laura|last2=McMurran|first2=Mary|title=The Psychometric Properties of the Internet Addiction Test|url=http://online.liebertpub.com/doi/pdf/10.1089/cpb.2004.7.443|journal=CyberPsychology & Behavior|volume=7|issue=4|pages=443–450|doi=10.1089/cpb.2004.7.443}}</ref> which consists of 20 items with each on a 5-point [[Likert scale]]. Questions included on the IAT expand upon Young's earlier 8-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 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),<ref name=":02" /> the Internet-Related Addictive Behavior Inventory (IRABI),<ref>{{Cite journal|last=Brenner|first=V.|date=1997|title=Psychology of computer use: XLVII. Parameters of Internet use, abuse and addiction: the first 90 days of the Internet Usage Survey|url=http://journals.sagepub.com/doi/abs/10.2466/pr0.1997.80.3.879|journal=Psychological reports|volume=80(3)|pages=879-882|via=}}</ref> the Chinese Internet Addiction Inventory (CIAI),<ref name=":22">{{Cite journal|last=Huang|first=Zheng|last2=Wang|first2=Mo|last3=Qian|first3=Mingyi|last4=Zhong|first4=Jie|last5=Tao|first5=Ran|date=2007-12-01|title=Chinese Internet Addiction Inventory: Developing a Measure of Problematic Internet Use for Chinese College Students|url=http://online.liebertpub.com/doi/abs/10.1089/cpb.2007.9950|journal=CyberPsychology & Behavior|volume=10|issue=6|pages=805–812|doi=10.1089/cpb.2007.9950|issn=1094-9313}}</ref> the Korean Internet Addiction Self-Assessment Scale (KS Scale),<ref>{{Cite journal|last=Heo|first=Jongho|last2=Oh|first2=Juhwan|last3=Subramanian|first3=S. V.|last4=Kim|first4=Yoon|last5=Kawachi|first5=Ichiro|date=2014-02-05|title=Addictive Internet Use among Korean Adolescents: A National Survey|url=http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0087819|journal=PLOS ONE|language=en|volume=9|issue=2|pages=e87819|doi=10.1371/journal.pone.0087819|issn=1932-6203}}</ref> the Compulsive Internet Use Scale (CIUS),<ref>{{Cite journal|last=Meerkerk|first=G.-J.|last2=Van Den Eijnden|first2=R. J. J. M.|last3=Vermulst|first3=A. A.|last4=Garretsen|first4=H. F. L.|date=2008-12-10|title=The Compulsive Internet Use Scale (CIUS): Some Psychometric Properties|url=http://online.liebertpub.com/doi/abs/10.1089/cpb.2008.0181|journal=CyberPsychology & Behavior|volume=12|issue=1|pages=1–6|doi=10.1089/cpb.2008.0181|issn=1094-9313}}</ref> the Generalized Problematic Internet Use Scale (GPIUS),<ref>{{Cite journal|last=Caplan|first=Scott E.|title=Theory and measurement of generalized problematic Internet use: A two-step approach|url=https://doi.org/10.1016/j.chb.2010.03.012|journal=Computers in Human Behavior|volume=26|issue=5|pages=1089–1097|doi=10.1016/j.chb.2010.03.012}}</ref> the Internet Consequences Scale (ICONS),<ref>{{Cite journal|last=Clark|first=Deborah J.|last2=Frith|first2=Karen H.|date=September 2005|title=The Development and Initial Testing of the Internet Consequences Scales (ICONS)|url=https://journals.lww.com/cinjournal/Abstract/2005/09000/The_Development_and_Initial_Testing_of_the.13.aspx|journal=CIN: Computers, Informatics, Nursing|language=en-US|volume=23|issue=5|pages=285|issn=1538-2931}}</ref> and the Problematic Internet Use Scale (PIUS).<ref>{{Cite journal|last=Demetrovics|first=Zsolt|last2=Szeredi|first2=Beatrix|last3=Rózsa|first3=Sándor|date=2008-05-01|title=The three-factor model of Internet addiction: The development of the Problematic Internet Use Questionnaire|url=https://link.springer.com/article/10.3758/BRM.40.2.563|journal=Behavior Research Methods|language=en|volume=40|issue=2|pages=563–574|doi=10.3758/BRM.40.2.563|issn=1554-351X}}</ref> 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.<ref name=":2">{{Cite journal|last=Chang|first=Man Kit|last2=Law|first2=Sally Pui Man|title=Factor structure for Young’s Internet Addiction Test: A confirmatory study|url=https://doi.org/10.1016/j.chb.2008.03.001|journal=Computers in Human Behavior|volume=24|issue=6|pages=2597–2619|doi=10.1016/j.chb.2008.03.001}}</ref><ref>{{Cite journal|last=Widyanto|first=Laura|last2=Griffiths|first2=Mark D.|last3=Brunsden|first3=Vivienne|date=2010-11-10|title=A Psychometric Comparison of the Internet Addiction Test, the Internet-Related Problem Scale, and Self-Diagnosis|url=http://online.liebertpub.com/doi/abs/10.1089/cyber.2010.0151|journal=Cyberpsychology, Behavior, and Social Networking|volume=14|issue=3|pages=141–149|doi=10.1089/cyber.2010.0151|issn=2152-2715}}</ref><ref>{{Cite journal|last=Widyanto|first=Laura|last2=McMurran|first2=Mary|date=2004-08-01|title=The Psychometric Properties of the Internet Addiction Test|url=http://online.liebertpub.com/doi/abs/10.1089/cpb.2004.7.443|journal=CyberPsychology & Behavior|volume=7|issue=4|pages=443–450|doi=10.1089/cpb.2004.7.443|issn=1094-9313}}</ref>
+Although the various screening methods are developed from diverse contexts, four dimensions manifest themselves across all instruments:<ref name=":4" /><ref name=":12">{{Cite journal|last=Northrup|first=Jason C.|last2=Lapierre|first2=Coady|last3=Kirk|first3=Jeffrey|last4=Rae|first4=Cosette|date=2015-07-28|title=The Internet Process Addiction Test: Screening for Addictions to Processes Facilitated by the Internet|url=http://www.mdpi.com/2076-328X/5/3/341|journal=Behavioral Sciences|language=en|volume=5|issue=3|pages=341–352|doi=10.3390/bs5030341}}</ref>
+* ''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 equipments, increased internet use, and more applications/softwares;
+* ''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.<ref name=":12" /><ref name=":34">{{Cite journal|last=Griffiths|first=M.|date=2000|title=Internet addiction-time to be taken seriously?|url=|journal=Addiction research|volume=8(5)|pages=413-418|via=}}</ref> Based on Young's Internet Addiction Test (IAT),<ref name=":02" /> 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.<ref name=":12" /> The Internet Process Addiction Test (IPAT)<ref name=":12" /> is created to measure the processes to which individuals are addicted.
+Screening methods that heavily rely on DSM criteria has 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.<ref>{{Cite journal|last=Chou|first=Chien|last2=Hsiao|first2=Ming-Chun|title=Internet addiction, usage, gratification, and pleasure experience: the Taiwan college students’ case|url=https://doi.org/10.1016/S0360-1315(00)00019-1|journal=Computers & Education|volume=35|issue=1|pages=65–80|doi=10.1016/s0360-1315(00)00019-1}}</ref> As a consequence of studies being conducted in divergent contexts, studies constantly modify scales for their own purposes, thereby imposing further challenge to the standardization in assessing Internet addiction disorder.<ref name=":21" />
+'''Single-question instruments'''
+Some scholars and practitioners also attempt to define Internet addiction by a single question, typically the time-use of Internet.<ref name=":10" /><ref>{{Cite journal|last=Soule|first=L. C.|last2=Shell|first2=L. W.|last3=Kleen|first3=B. A.|date=2003|title=Exploring Internet addiction: Demographic characteristics and stereotypes of heavy Internet users|url=http://www.tandfonline.com/doi/abs/10.1080/08874417.2003.11647553|journal=Journal of Computer Information Systems|volume=44(1)|pages=64-73|eissn=|via=}}</ref> The extent to which Internet use can cause negative health consequences is, however, not clear from such a measure.<ref name=":21" /> The latter of which is critical to whether IAD should be defined as a mental disorder.
 ==A multidimensional construct==
-A conceptual model of PIU has been developed based on primary data collected from addiction researchers,<ref>{{cite journal |doi=10.1016/j.chb.2011.07.006 |title=Conceptualizing personal web usage in work contexts: A preliminary framework |journal=Computers in Human Behavior |volume=27 |issue=6 |pages=2271 |year=2011 |last1=Kim |first1=Sunny Jung |last2=Byrne |first2=Sahara }}</ref> psychologists, and health providers as well as older adolescents themselves.<ref name="Moreno MA 1887"/>  That study identified seven concepts, or clusters, that make up PIU using a [[concept mapping]] approach.<ref>{{cite journal |doi=10.1093/intqhc/mzi038 |pmid=15872026 |title=Concept mapping: An introduction to structured conceptualization in health care |journal=International Journal for Quality in Health Care |volume=17 |issue=3 |pages=187–91 |year=2005 |last1=Trochim |first1=W. |last2=Kane |first2=M }}</ref>  These seven clusters are: psychosocial risk factors; physical impairment; emotional impairment; social and functional impairment; risky Internet use; impulsive Internet use; and Internet use dependence. The last three constructs have not been previously identified. Risky Internet use are behaviors that increase risks of adverse consequences. It is not just the amount of time spent on the Internet that puts an adolescent at risk; how the time is spent is also an important consideration.  The impulsive use construct describes an inability to maintain balance or control of internet use in relation to everyday life. Finally, the dependent use construct reflects the more severe symptoms that are typically associated with addictions, such as withdrawal symptoms.  Thus, internet addiction may represent a severe form of PIU.<ref name="Moreno MA 1887"/>
+A conceptual model of PIU has been developed based on primary data collected from addiction researchers,<ref>{{cite journal |doi=10.1016/j.chb.2011.07.006 |title=Conceptualizing personal web usage in work contexts: A preliminary framework |journal=Computers in Human Behavior |volume=27 |issue=6 |pages=2271 |year=2011 |last1=Kim |first1=Sunny Jung |last2=Byrne |first2=Sahara }}</ref> psychologists, and health providers as well as older adolescents themselves.<ref name="Moreno MA 1887">{{cite journal|vauthors=Moreno MA, Jelenchick LA, Christakis DA|year=2013|title=Problematic internet use among older adolescents: A conceptual framework|url=|journal=Computers and Human Behavior|volume=29|issue=4|pages=1879–1887|doi=10.1016/j.chb.2013.01.053}}</ref>  That study identified seven concepts, or clusters, that make up PIU using a [[concept mapping]] approach.<ref>{{cite journal |doi=10.1093/intqhc/mzi038 |pmid=15872026 |title=Concept mapping: An introduction to structured conceptualization in health care |journal=International Journal for Quality in Health Care |volume=17 |issue=3 |pages=187–91 |year=2005 |last1=Trochim |first1=W. |last2=Kane |first2=M }}</ref>  These seven clusters are: psychosocial risk factors; physical impairment; emotional impairment; social and functional impairment; risky Internet use; impulsive Internet use; and Internet use dependence. The last three constructs have not been previously identified. Risky Internet use are behaviors that increase risks of adverse consequences. It is not just the amount of time spent on the Internet that puts an adolescent at risk; how the time is spent is also an important consideration.  The impulsive use construct describes an inability to maintain balance or control of internet use in relation to everyday life. Finally, the dependent use construct reflects the more severe symptoms that are typically associated with addictions, such as withdrawal symptoms.  Thus, internet addiction may represent a severe form of PIU.<ref name="Moreno MA 1887"/>
 Other research also stresses the fact that the Internet addiction disorder is not a unidimensional but a multidimensional construct. Various facets of Internet use must be differentiated because of their differential predictors, mechanisms and consequences.<ref>Pawlikowski, M. et al. (in press, 2013). [http://informahealthcare.com/doi/abs/10.3109/16066359.2013.793313 Pathological internet use: It is a multidimensional and not a unidimensional construct]. Addiction Research & Theory.</ref> Online activities which, if done in person, would normally be considered troublesome, such as compulsive gambling, or shopping, are sometimes called ''net compulsions''.<ref name="netaddiction.com">{{cite web|url=http://netaddiction.com/net-compulsions/ |title=Types of Internet addiction |accessdate=2014-01-30}}</ref>