Internet addiction disorder
Encyclopedia
Internet addiction disorder (IAD), or, more broadly, Internet overuse, problematic computer use or pathological computer use, is excessive computer use that interferes with daily life. These terms avoid the distracting and divisive term addiction
Behavioral addiction
Behavioral addiction is a form of addiction which does not rely on drugs or alcohol. Increasingly referred to as process addiction or non-substance-related addiction ) behavioral addiction includes a compulsion to repeatedly engage in an action until said action causes serious negative consequences...

and are not limited to any single cause.

IAD was originally proposed as a disorder in a satirical
Satire
Satire is primarily a literary genre or form, although in practice it can also be found in the graphic and performing arts. In satire, vices, follies, abuses, and shortcomings are held up to ridicule, ideally with the intent of shaming individuals, and society itself, into improvement...

 hoax
Hoax
A hoax is a deliberately fabricated falsehood made to masquerade as truth. It is distinguishable from errors in observation or judgment, or rumors, urban legends, pseudosciences or April Fools' Day events that are passed along in good faith by believers or as jokes.-Definition:The British...

 by Ivan Goldberg, M.D., in 1995.
He took pathological gambling as diagnosed by the Diagnostic and Statistical Manual of Mental Disorders
Diagnostic and Statistical Manual of Mental Disorders
The Diagnostic and Statistical Manual of Mental Disorders is published by the American Psychiatric Association and provides a common language and standard criteria for the classification of mental disorders...

 (DSM-IV) as his model for the description of IAD. It is not, however, included in the current DSM as of 2009. IAD receives coverage in the press, and possible future classification as a psychological disorder continues to be debated and researched.

Online activities which, if done in person, would normally be considered troublesome, such as compulsive gambling or shopping, are sometimes called net compulsions.
Others, such as reading or playing computer games, are troubling only to the extent that these activities interfere with normal life.
Supporters of disorder classification often divide IAD into subtypes by activity, such as excessive, overwhelming, or inappropriate pornography
Pornography
Pornography or porn is the explicit portrayal of sexual subject matter for the purposes of sexual arousal and erotic satisfaction.Pornography may use any of a variety of media, ranging from books, magazines, postcards, photos, sculpture, drawing, painting, animation, sound recording, film, video,...

 use,
gaming
Online game
An online game is a game played over some form of computer network. This almost always means the Internet or equivalent technology, but games have always used whatever technology was current: modems before the Internet, and hard wired terminals before modems...

,
online social networking
Social network service
A social networking service is an online service, platform, or site that focuses on building and reflecting of social networks or social relations among people, who, for example, share interests and/or activities. A social network service consists of a representation of each user , his/her social...

, blogging, email, or Internet shopping. Opponents note that compulsive behaviors may not themselves be addictive.

Possible disorder

There is debate over whether to include "Internet Addiction" as a diagnosis in DSM-V, the next (May 2013) edition of the DSM.
Some argue that Internet addiction disorder exists and should be included, and some that it is neither an addiction nor a specific disorder and should not be included in DSM-V.

In 2006, the American Medical Association
American Medical Association
The American Medical Association , founded in 1847 and incorporated in 1897, is the largest association of medical doctors and medical students in the United States.-Scope and operations:...

 declined to recommend to the American Psychiatric Association
American Psychiatric Association
The American Psychiatric Association is the main professional organization of psychiatrists and trainee psychiatrists in the United States, and the most influential worldwide. Its some 38,000 members are mainly American but some are international...

 that they include IAD as a formal diagnosis in DSM-V, and recommended further study of "video game overuse."
Some members of the American Society of Addiction Medicine
American Society of Addiction Medicine
The American Society of Addiction Medicine is a physician society with a focus on addiction and its treatment.- History :ASAM has its roots in research and clinical traditions that pre-date its founding in the early 1950s, when Ruth Fox, M.D. began regular meetings with other physicians interested...

 opposed identifying Internet overuse and video game overuse as disorders. Among the research identified as necessary is to find ways to define "overuse" and to differentiate an "Internet addiction" from obsession
Fixation (psychology)
Fixation: 'concept originated by Sigmund Freud to denote the persistence of anachronistic sexual traits'. Subsequently '"Fixation" acquired a broader connotation...

, self-medicating for depression or other disorders, and compulsion
Compulsive behavior
Compulsive behavior is behavior which a person does compulsively—in other words, not because they want to behave that way, but because they feel they have to do so....

.

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
Vietnam War
The Vietnam War was a Cold War-era military conflict that occurred in Vietnam, Laos, and Cambodia from 1 November 1955 to the fall of Saigon on 30 April 1975. This war followed the First Indochina War and was fought between North Vietnam, supported by its communist allies, and the government of...

-related Post-Traumatic Stress Disorder
Post-traumatic stress disorder
Posttraumaticstress disorder is a severe anxiety disorder that can develop after exposure to any event that results in psychological trauma. This event may involve the threat of death to oneself or to someone else, or to one's own or someone else's physical, sexual, or psychological integrity,...

.
The case is pending before the court in the Southern District of New York (case summarized in Glaser & Carroll, 2007).

Support

According to Maressa Orzack
Maressa Orzack
Dr. Maressa Hecht Orzack is Clinical Associate in Psychology at McLean Hospital; Coordinator of Behavior Therapy Affective Disease Program, also at McLean Hospital and Assistant Clinical Professor of Psychology, Department of Psychiatry at Harvard Medical School. She also holds private practice at...

, director of the Computer Addiction Study Center at Harvard University
Harvard University
Harvard University is a private Ivy League university located in Cambridge, Massachusetts, United States, established in 1636 by the Massachusetts legislature. Harvard is the oldest institution of higher learning in the United States and the first corporation chartered in the country...

's McLean Hospital
McLean Hospital
McLean Hospital is a psychiatric hospital in Belmont, Massachusetts.It is noted for its clinical staff expertise and ground-breaking neuroscience research...

, between 5% and 10% of Web surfers suffer some form of Web dependency.

Another supporter, Jeremy Greenfield, Ph.D. of the Center for Internet Behavior conducted a study with ABC News
ABC News
ABC News is the news gathering and broadcasting division of American broadcast television network ABC, a subsidiary of The Walt Disney Company...

.com in 1999 and is author of Virtual Addiction. He believes that some services available over the Internet
Internet
The Internet is a global system of interconnected computer networks that use the standard Internet protocol suite to serve billions of users worldwide...

 have unique psychological properties which induce dissociation, time distortion, and instant gratification, with about 6% of individuals experiencing some significant impact on their lives. However, he says it may not best be seen as an addiction but rather as a compulsion
Compulsive behavior
Compulsive behavior is behavior which a person does compulsively—in other words, not because they want to behave that way, but because they feel they have to do so....

. Greenfield claims that sex, gaming, gambling, and shopping online can produce a mood-altering effect.

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." Over 60% of people seeking treatment for IAD claim involvement with sexual activities online which they consider inappropriate, such as excessive attention to pornography or involvement in explicit sexual conversations online. More than half are also addicted to alcohol, drugs, tobacco, or sex.

In 2008 Jerald J. Block, M.D., Hilarie Cash, PhD, Kim McDaniel MA, argued that Internet addiction should be included as a disorder in the DSM-V. Block observed that diagnosis was complicated because 86% of study subjects showing IA symptoms also exhibited other diagnosable mental health disorders. 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.

In his essay Internet Addiction: Does it Really Exist? 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 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 as high as 10-20%. On the other hand, increases in the density of the right parahippocampal gyrus and a spot called the left posterior limb of the internal capsule were also found. 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.

Opposition

Psychiatrist Dr. Goldberg states 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
Depression (mood)
Depression is a state of low mood and aversion to activity that can affect a person's thoughts, behaviour, feelings and physical well-being. Depressed people may feel sad, anxious, empty, hopeless, helpless, worthless, guilty, irritable, or restless...

, anxiety
Anxiety
Anxiety is a psychological and physiological state characterized by somatic, emotional, cognitive, and behavioral components. The root meaning of the word anxiety is 'to vex or trouble'; in either presence or absence of psychological stress, anxiety can create feelings of fear, worry, uneasiness,...

, 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
Behavioral addiction
Behavioral addiction is a form of addiction which does not rely on drugs or alcohol. Increasingly referred to as process addiction or non-substance-related addiction ) behavioral addiction includes a compulsion to repeatedly engage in an action until said action causes serious negative consequences...

 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
Pornography
Pornography or porn is the explicit portrayal of sexual subject matter for the purposes of sexual arousal and erotic satisfaction.Pornography may use any of a variety of media, ranging from books, magazines, postcards, photos, sculpture, drawing, painting, animation, sound recording, film, video,...

, 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.

A complete review of the Internet addiction research at the end of 2008 (Byun et al., 2008) demonstrated significant, multiple flaws in most studies in this area. The researchers wrote in that article, "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."

Interest

The interest in, and study and public concern over, internet overuse 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.

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.

The Ottawa Sun reports that a 1996 report in the UK "Advances in Psychiatric Treatment" claimed that a "significant minority" suffer from "Internet addiction".

Up to 30% of South Koreans under 18, or about 2.4 million people, are at risk of Internet addiction, said Ahn Dong-hyun, a child psychiatrist at Hanyang University in Seoul who just completed a three-year government-financed survey of the problem.

Data from China Internet Network Information Center (CINIC), as of June 30, 2006, showed that 123 million people had gone online, of which 14.9% were teenagers below 18 years old. Chou and Hsiao reported that the incidence rate of Internet addiction among Taiwan
Taiwan
Taiwan , also known, especially in the past, as Formosa , is the largest island of the same-named island group of East Asia in the western Pacific Ocean and located off the southeastern coast of mainland China. The island forms over 99% of the current territory of the Republic of China following...

 college students was 5.9%. Wu and Zhu identified 10.6% of Chinese college students as Internet addicts.

The China Communist Youth League
Communist Youth League
The Communist Youth League of China also known as the China Youth League is a youth movement of the People's Republic of China for youth between the ages of fourteen and twenty-eight, run by Communist Party of China. The league is organized on the party pattern. Its leader is its First Secretary...

 claimed in 2007 that over 17% of Chinese citizens between 13 and 17 are addicted to the Internet.

Prevention and correction

In many cases, though not all, Internet overuse corrects itself. Sarah Kershaw wrote for the New York Times in 2005: "It was Professor Kiesler who called Internet addiction a fad illness. In her view, she said, television addiction
Television addiction
Television addiction is a disorder studied in television studies where the subject has a compulsion to watch television programming. The compulsion can be extremely difficult to control in many cases. It has many parallels to other forms of behavioral addiction, such as addiction to drugs or...

 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."

Corrective strategies include content-control software
Content-control software
Content-control software, also known as censorware or web filtering software, is a term for software designed and optimized for controlling what content is permitted to a reader, especially when it is used to restrict material delivered over the Web...

, counseling, and cognitive behavioural therapy. One of the major reasons that the Internet is so addicting is the lack of limits and the absence of accountability.

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 August 2009, ReSTART, a residential treatment center
Residential treatment center
A residential treatment center , sometimes called a rehab, is a live-in health care facility providing therapy for substance abuse, mental illness, or other behavioral problems...

 for "pathological computer use", opened near Seattle, Washington, United States. It offers a 45-day program intended to help people wean themselves from pathological computer use, and can handle up to six patients at a time.

In November 2009, the government of the People's Republic of China banned physical punishment to "wean" teens from the Internet. Electro-shock therapy
Electroconvulsive therapy
Electroconvulsive therapy , formerly known as electroshock, is a psychiatric treatment in which seizures are electrically induced in anesthetized patients for therapeutic effect. Its mode of action is unknown...

 had already been banned.

See also

  • Addictive personality
    Addictive personality
    An addictive personality refers to a particular set of personality traits that make an individual predisposed to addictions. People who are substance dependent are characterized by: a physical or psychological dependency that negatively impacts the quality of life...

  • Compulsive gambling
    Compulsive gambling
    Problem gambling is an urge to continuously gamble despite harmful negative consequences or a desire to stop. Problem gambling often is defined by whether harm is experienced by the gambler or others, rather than by the gambler's behavior. Severe problem gambling may be diagnosed as clinical...

  • Pornography addiction
    Pornography addiction
    Pornography addiction, or more broadly overuse of pornography, is excessive pornography use that interferes with daily life.There is no diagnosis of pornography addiction in the current Diagnostic and Statistical Manual of Mental Disorders , and as with the broader proposed diagnosis of sexual...

  • Soft addiction
  • Procrastination
    Procrastination
    In psychology, procrastination refers to the act of replacing high-priority actions with tasks of low-priority, and thus putting off important tasks to a later time...

  • Workaholic
    Workaholic
    A workaholic is a person who is addicted to work.The term generally implies that the person enjoys their work; it can also imply that they simply feel compelled to do it...

  • Online Gamers Anonymous
    Online Gamers Anonymous
    On-Line Gamers Anonymous is a twelve-step program for recovery from video game addiction established as a non-profit organization in the United States. OLGA was founded by Elizabeth Woolley in 2002 after her son, Shawn Woolley, committed suicide while logged in to EverQuest...


Further reading

  • Block, J.J. (2008). "Issues for DSM-V: Internet Addiction". American Journal of Psychiatry. 165:3; March 2008; p. 306-307.
  • Byun, S., et al. (2008). Internet Addiction: Metasynthesis of 1996–2006 Quantitative Research. Cyberpsychology & Behavior, 12, 1-5.available online
  • Caruso, D. (1998). Critics Pick Apart Study on Internet and Depression. available online.
  • Chopra, D. (1997). Overcoming Addictions. New York: Harmony Books.
  • Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. (1994). Washington D.C.: American Psychiatric Association.
  • Dowling, N. A., & Quirk, K. L. (2008). Screening for Internet Dependence: Do the Proposed Diagnostic Criteria Differentiate Normal from Dependent Internet Use? CyberPsychology & Behavior , 12 (1), 1.
  • Garcia Duran, M. (2003, December 14). Internet Addiction Disorder. Allpsych .
  • Grohol, J. M. (1999). Internet Addiction Guide. Psych Central available online.
  • Padilla-Walker, L.M., Nelson, L.J., Carroll, J.S. & Jensen, A.C. (2009). More than just a game: Video game and Internet use during emerging adulthood. Journal of Youth and Adolescence. DOI 10.1007/s10964-008-9390-8.pdf *requires login at BYU*
  • Quinn, M. J. (2009). Ethics for the Information Age (3rd ed.). (M. Hirsch, Ed.) Boston: Pearson.
  • Surratt, Carla G (1999). Netaholics? : the creation of a pathology Commack, NY : Nova Science Publishers.
  • Turel, O., Serenko, A. & Bontis, N. (2011). Family and Work-Related Consequences of Addiction to Organizational Pervasive Technologies. Information & Management, 48(2-3): 88-95. available online
  • University, T. A. (2007, August 18). What exactly is 'Internet Addiction; and What is the Treatment? Science Daily .
  • Welch, E. T. (2001). Addictions: a Banquet in the Grave. Phillipsburg, Pennsylvania: P & R Publishing.
  • Young, Kimberly S. (2001). Caught in the Net: How to Recognize the Signs of Internet Addiction—and a Winning Strategy for Recovery
  • Zur, O. & Zur, A. (2009). On Digital Immigrants & Digital Natives. Zur Institute available online
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