Internet addiction disorder

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

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 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.

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.

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."

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.

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."

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

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]".

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.

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. 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. 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.
• High comorbidity: Internet addiction is often accompanied by other psychiatric disorders such as personality disorder and mental retardation. It is found that Internet addiction is accompanied by other DSM-IV diagnosis 86% of the time. 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). Another study in South Korea found an average of 1.5 other diagnoses among adolescent internet addicts. 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. 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. 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, neither DSM-IV (1995) nor DSM-V (2013) consider Internet addiction as a mental disorder. 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. The WHO's draft 11th Revision of the International Classification of Diseases (ICD-11) scheduled for publication in 2018 also include gaming disorder. There is still considerable controversy over whether IAD should be included in the DSM-V and recognized as a mental disease in general.

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.

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.” 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:

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

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

Young further extended her 8-question YDQ assessment to the now most widely used Internet Addiction Test (IAT), 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), the Internet-Related Addictive Behavior Inventory (IRABI), the Chinese Internet Addiction Inventory (CIAI), the Korean Internet Addiction Self-Assessment Scale (KS Scale), the Compulsive Internet Use Scale (CIUS), the Generalized Problematic Internet Use Scale (GPIUS), the Internet Consequences Scale (ICONS), and the Problematic Internet Use Scale (PIUS). 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.

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

• 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. Based on Young's Internet Addiction Test (IAT), 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. The Internet Process Addiction Test (IPAT) 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. 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.

Single-question instruments

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

Classification and related disorders

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

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

• Cybersexual addiction: compulsive use of adult websites for cybersex and cyberporn;
  • Main article: Internet sex addiction.
• 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.
  • Main article: Video game addiction.

Prevalence

Research-based Prevalence Rate of Internet Addiction
Country or Region	Rate or Population	Sample	Year	Instrument
Global	6%	A meta-analysis-based estimate	1994 - 2012	YDQ & IAT
Asia
Asia	20%
China	10.4%	10158 adolescents	2016	IAT
Hong Kong	17 - 26.7%	Over 3000 high school students	2009 - 2015	IAT
Taiwan	13.8%	1708 high school students	n.a.	YDQ
South Korea	2.1%	An estimate based on Korean population aged 6-19 years	2006
Japan	2.0%	853 adolescents aged 12-15 years	2014	IAT
Europe
Europe	4.4%	11956 adolescents in 11 European countries	2009 - 2010	YDQ
Germany	1.5 million	An estimate based on German population	n.a.
Spain	16.3%	40955 school adolescents aged 12-17 years	2016	PIUS-a
Norway	0.7%	3399 individuals aged 16-74 years	2007	YDQ
UK	18.3%	371 college students	n.a.	PIUS
North America
USA	0.3-0.7%	2513 Adults	2004	Non-standard

Different samples, methodologies, and screening instruments are employed across studies and therefore one should take caution interpreting and comparing the above-listed figures.

Causes and effects

Kimberly S. Young 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.

Young 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 also discusses the findings of Maressa Hecht-Orzack of McLean Hospital who set up a service for computer and Internet addiction 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.

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.

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. This occurrence of compulsions may be attributed to an automatic defense mechanism in which the individual avoids anxiety.

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.

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". 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". 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 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 and later included in Greenfield's 1999 book Virtual Addiction.

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. The Internet Addiction Test, the Chen Internet Addiction Scale, the Compulsive Internet Use Scale, the Problematic And Risky Internet Use Screening Scale, and Generalized Problematic Internet Use Scale are later measures of usage levels.

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. Some individuals prefer online interaction to face-to-face encounters.

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. 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. 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. 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, 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. 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." 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 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) 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.

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).

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.

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

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

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. 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.

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.

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.

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. It offers a 7- to 12-week intensive program for adolescents and adults intended to help people set device limits, and address digital distractions.

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.

Epidemiology

Over the past decade, the concept of Internet addiction has grown in terms of acceptance as a legitimate clinical disorder often requiring treatment. 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.

While the existence of Internet addiction is debated, self-proclaimed sufferers are resorting to the courts for redress. 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). 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).

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.

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).

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

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.

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.

According to the Center for Internet Addiction Recovery (whose director is Kimberly S. Young, 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." More than half are also addicted to alcohol, drugs, tobacco, or sex.

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.

Scientists have found that compulsive Internet use can produce morphological changes in the structure of the brain. 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. 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.

Patricia Wallace PhD, Senior Director, Information Technology and CTY Online, at the Johns Hopkins University Center for Talented Youth argues 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

People using their smartphones.

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)

Main article: Video game addiction

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. 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.

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.

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. 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. 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.

Communication addiction disorder (compulsive talking)

Main article: Communication addiction disorder

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. 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. 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. 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. Sometimes teenagers use social networks to show their idealized image to the others. 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. However, other studies claim that people are using social networks to communicate their real personality and not to promote their idealized identity.

Virtual reality addiction

Main article: 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, 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.

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.

See also

• Addictive personality
• Cyberslacking
• Digital addict
• Digital detox
• List of repetitive strain injury software (i.e. break reminders)
• Media multitasking
• Pornography addiction
• Procrastination
• Psychological effects of Internet use
• Soft addiction
• Underearners Anonymous
• Workaholic

Further reading

• Young, Kimberly S. "Internet Addiction: Symptoms, Evaluation, And Treatment" (PDF).
• Dowling, Nicki A.; Quirk, Kelly L. (2009). "Screening for Internet Dependence: Do the Proposed Diagnostic Criteria Differentiate Normal from Dependent Internet Use?". CyberPsychology & Behavior. 12: 21. doi:10.1089/cpb.2008.0162.
• "The development of adaptive and maladaptive patterns of Internet use among European adolescents at risk for internet addictive behaviours: A Grounded theory inquiry" (PDF). Eu Net Adb. Athens: National and Kapodistrian University of Athens. 2012. {{cite journal}}: Cite uses deprecated parameter |authors= (help)
• "Psychological Research and a Sociological Perspective on Problematic and Addictive Computer Game Use in Adolescents". Internet Addiction. A Public Health Concern in Adolescence. New York: Nova Science Publishers. 2013. pp. 87–110. {{cite book}}: Cite uses deprecated parameter |authors= (help)
• Dreier, M.; Wölfling, K.; Beutel, M.E. (2014). "Internetsucht bei Jugendlichen". Monatsschrift Kinderheilkunde. 162 (6): 496. doi:10.1007/s00112-013-3069-2.
• Grassani, E. (2014). L'assuefazione tecnologica. Metamorfosi del sistema uomo-macchina. Milan, Italy. {{cite book}}: |work= ignored (help)CS1 maint: location missing publisher (link)
• Grohol, J. M. (1999). "Internet Addiction Guide". Psych Central.
• Hansen, S. (2002). "Excessive Internet usage or 'Internet Addiction'? The implications of diagnostic categories for student users". Journal of Computer Assisted Learning. 18 (2): 235. doi:10.1046/j.1365-2729.2002.t01-2-00230.x.
• Padilla-Walker, Laura M.; Nelson, Larry J.; Carroll, Jason S.; Jensen, Alexander C. (2009). "More Than a Just a Game: Video Game and Internet Use During Emerging Adulthood". Journal of Youth and Adolescence. 39 (2): 103. doi:10.1007/s10964-008-9390-8. PMID 20084557.
• Potera C (Mar–Apr 1998). "Trapped in the Web?". Psychology Today. 31 (2): 66–70.
• Surratt, Carla G (1999). Netaholics?: The creation of a pathology. Commack, NY: Nova Science Publishers.
• Turel, Ofir; Serenko, Alexander; Bontis, Nick (2011). "Family and work-related consequences of addiction to organizational pervasive technologies". Information & Management. 48 (2–3): 88–95. doi:10.1016/j.im.2011.01.004. INIST 24090862.
• Tel Aviv University (August 18, 2007). "What exactly is internet addiction, and what is the treatment?". Science Daily.
• "On Digital Immigrants & Digital Natives". Zur Institute. 2009. {{cite web}}: Cite uses deprecated parameter |authors= (help)

External links

• A list of self-control software
• A subreddit for those struggling with Internet overuse