Internet addiction: How big a problem is it?

Yesterday, a study was reported in the British media that Chinese scientists had observed differences in the brains of people who obsessively use the internet similar to those found in people who have substance addiction. This led to the question of whether this was “proof that internet addiction exists”. I was asked for my comments by both the Guardian and the Daily Telegraph and I thought I would use my blog to put forward my own view on the topic.

There is currently a debate among psychologists and psychiatrists as to whether ‘Internet addiction’ constitutes a true addiction and should therefore be recognized as a psychiatric disorder in the American Psychiatric Association’s fifth edition of the forthcoming Diagnostic and Statistical Manual. The past 15 years have produced many empirical studies demonstrating that a significant number of individuals appear to report psychological problems associated with excessive Internet use. The extent and severity of these problems may be somewhat overestimated because of the relatively low methodological quality of many studies in this area. Most studies have utilized inconsistent criteria to identify Internet addicts and/or have applied recruitment methods that may have caused serious sampling bias. More specifically in relation to Internet addiction criteria used in most studies, I have asserted in a number of my publications that the main problems with the measures used is that they tend to (i) have no measure of severity, (ii) have no temporal dimension, (iii) overestimate the prevalence of problems, and (iv) take no account of the context of Internet use.

In a number of published literature reviews, I have also argued that those working in the Internet addiction field need to distinguish between addictions on the Internet, and addictions to the Internet. My view is that most ‘Internet addicts’ are not addicted to the Internet itself, but use it as a medium to fuel other addictions. I have also used case study evidence to argue that some very excessive Internet users may not have any negative detrimental effects as a consequence of their behavior and therefore cannot even be classed as addicted. In short, a gambling addict who uses the Internet to gamble is a gambling addict not an Internet addict. The Internet is just the place where they conduct their chosen (addictive) behavior. However, I am the first to concede that I have also observed that some behaviors engaged on the Internet (e.g., cybersex, cyberstalking etc.) may be behaviors that the person would only carry out on the Internet because the medium is anonymous, non face-to-face, and disinhibiting.

For these reasons, it is often argued that problematic Internet behaviors may be more appropriately conceptualised within existing known psychopathologies such as depression or anxiety. Nevertheless, a number of researchers (including myself) have argued that Internet addictions do exist and can arise from unhealthy involvement in a range of online activities. These activities may include browsing websites, online information gathering, downloading or trading files online, online social networking, online video gaming, online shopping, online gambling, and various online sexual activities such as viewing pornography or engaging in simulated sexual acts.

While there is no consensus regarding the clinical status of Internet addiction, there appears to be significant demand for treatment for Internet-related problems, particularly in China, Taiwan and South Korea, where the estimated prevalence of Internet addiction problems among adolescents ranges from 1.6% to 11.3%. The South Korean government has reportedly established a network of over 140 counselling centres for treatment of Internet addiction, and have introduced treatment programs at almost 100 hospitals. In addition, numerous ‘boot camp’-style programs for Internet-addicted adolescents have emerged in both China and Korea. In Western countries, clinics specializing in the psychological treatment of computer-based addictions have also emerged, including: the Center for Online and Internet Addiction located in Bradford, Pennsylvania, United States; the Computer Addiction Study Center, McLean Hospital, Belmont, Massachusetts, United States; the Broadway Lodge residential rehabilitation unit located in Somerset, England; and the Smith & Jones 12-step (Minnesota Model) clinic located in Amsterdam, Holland. Additionally, there are some online providers of treatment services for Internet addiction (e.g., www.netaddiction.com; www.netaddictionrecovery.com; www.onlineaddiction.com.au), many of which are modelled on 12-step self-help treatment philosophies including specific types of groups such as Online Gamers Anonymous.

Available evidence suggests that, internationally, a large number of individuals with Internet-related problems have received some form of treatment from a mental health or medical service provider. However, very few studies have examined the effectiveness of any such treatments, including counselling, psychotherapy, or pharmacological interventions. The number of studies in this area is not as large as the number of studies examining the general features and correlates of Internet addiction, or as the number of studies of psychological treatment for other behavioral addictions, such as pathological gambling.

Very recently, I – along with colleagues from the University of Adelaide (Dr Daniel King and Professor Paul Delfabbro) – published a systematic review of the Internet addiction treatment literature. Our review investigated the reporting quality of treatment studies according to the 2010 Consolidating Standards of Reporting Trials (CONSORT) statement. Our evaluation of the studies we reviewed highlighted several key limitations, including (a) inconsistencies in the definition and diagnosis of Internet addiction, (b) a lack of randomization and blinding techniques, (c) a lack of adequate controls or other comparison groups, and (d) insufficient information concerning recruitment dates, sample characteristics, and treatment effect sizes.

There were also wider issues as to whether the people being treated in the studies evaluated were actually bona fide ‘Internet addicts’ as some of the people treated may have been addicted to a specific application or activity on the Internet (e.g., gaming, gambling, social networking) rather than being addicted to the Internet itself. We also stressed that research is also needed into whether addicts who use a particular medium to engage in their activity require different types of intervention and/or treatment. For instance, do Internet gambling addicts need or require different treatment interventions than gambling addicts who do not use the Internet to gamble?

Finally, there appears to be a significant need for consensus concerning the clinical definition of Internet addiction and possible sub-forms relating to particular Internet applications and/or activities. This theoretical obstacle, which has existed for over 15 years, has hindered progress in all areas of this field, including the development and validation of a recognised diagnostic tool. Our evaluation of the literature using the CONSORT criteria identified many areas of study design and reporting in need of improvement. In particular, there is a need for more randomized, controlled trials, in both the pharmacological and non-pharmacological intervention literature.

Dr Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK

I would also like to thank Dr Daniel King and Professor Paul Delfabbro (University of Adelaide) for their additional input

Further reading

Griffiths, M.D. (1995). Technological addictions. Clinical Psychology Forum, 76, 14-19.

Griffiths, M.D. (1998). Internet addiction: Does it really exist? In J. Gackenbach (Ed.), Psychology and the Internet: Intrapersonal, Interpersonal and Transpersonal Applications. pp. 61-75. New York: Academic Press.

Griffiths, M.D. (2000). Internet addiction – Time to be taken seriously? Addiction Research, 8, 413-418.

Griffiths, M.D. (2010). Internet abuse and internet addiction in the workplace. Journal of Worplace Learning, 7, 463-472.

King, D.L., Delfabbro, P.H., Griffiths, M.D. & Gradisar, M. (2011). Assessing clinical trials of Internet addiction treatment: A systematic review and CONSORT evaluation. Clinical Psychology Review, 31, 1110-1116.

Widyanto, L. & Griffiths, M.D. (2006). Internet addiction: A critical review. International Journal of Mental Health and Addiction, 4, 31-51.

Widyanto, L. & Griffiths, M.D. (2006). Internet addiction: Does it really exist? (Revisited). In J. Gackenbach (Ed.), Psychology and the Internet: Intrapersonal, Interpersonal and Transpersonal Applications (2nd Edition), pp.141-163. New York: Academic Press.

Widyanto, L. & Griffiths, M.D. (2009). Unravelling the Web: Adolescents and Internet Addiction. In R. Zheng, J. Burrow-Sanchez & C. Drew (Eds.), Adolescent Online Social Communication and Behavior: Relationship Formation on the Internet. pp. 29-49. Hershey, Pennsylvania: Idea Publishing.

Widyanto, L., Griffiths, M.D. & Brunsden, V. (2011). A psychometric comparison of the Internet Addiction Test, the Internet Related Problem Scale, and Self-Diagnosis. Cyberpsychology, Behavior, and Social Networking, 14, 141-149.

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About drmarkgriffiths

Professor MARK GRIFFITHS, BSc, PhD, CPsychol, PGDipHE, FBPsS, FRSA, AcSS. Dr. Mark Griffiths is a Chartered Psychologist and Professor of Gambling Studies at the Nottingham Trent University, and Director of the International Gaming Research Unit. He is internationally known for his work into gambling and gaming addictions and has won many awards including the American 1994 John Rosecrance Research Prize for “outstanding scholarly contributions to the field of gambling research”, the 1998 European CELEJ Prize for best paper on gambling, the 2003 Canadian International Excellence Award for “outstanding contributions to the prevention of problem gambling and the practice of responsible gambling” and a North American 2006 Lifetime Achievement Award For Contributions To The Field Of Youth Gambling “in recognition of his dedication, leadership, and pioneering contributions to the field of youth gambling”. His most recent award is the 2013 Lifetime Research Award from the US National Council on Problem Gambling. He has published over 430 research papers, three books, over 120 book chapters, and over 1000 other articles. He has served on numerous national and international committees (e.g. BPS Council, BPS Social Psychology Section, Society for the Study of Gambling, Gamblers Anonymous General Services Board, National Council on Gambling etc.) and is a former National Chair of Gamcare. He also does a lot of freelance journalism and has appeared on over 2000 radio and television programmes since 1988. In 2004 he was awarded the Joseph Lister Prize for Social Sciences by the British Association for the Advancement of Science for being one of the UK’s “outstanding scientific communicators”. His awards also include the 2006 Excellence in the Teaching of Psychology Award by the British Psychological Society and the British Psychological Society Fellowship Award for “exceptional contributions to psychology”.

Posted on January 13, 2012, in Addiction, Cyberpsychology, I.T., Internet addiction, Online addictions, Online gambling, Online gaming, Psychology and tagged , , , , . Bookmark the permalink. 5 Comments.

  1. Some people manifest problems in their lives through the media of the Internet. I am not sure what the purpose of developing a label ‘Internet Addict’ serves? Focusing on the activity draws attention away from the individuals personal problems and creates moral panics. The focus is frequently on what is it about the Internet that is addictive (e,g, Triple AAA model, Internet addiction scales etc.) and how can that be controlled? Any activity that is rewarding and has the capacity to distract people from their everyday lives, is likely to be undertaken excessively by some people. Where do we draw the line with inventing these new addictions? No doubt, as new technologies evolve there will be ‘discoveries’ of more and more ‘addictions.’ Instead, I believe we should be looking at what drives people to undertake excessive behaviours, and how can we help prevent those excesses. Attempting to change activities for everyone is futile, understanding how to help people is not. Lets concentrate on understanding the cause rather than the manifest symptoms.

  2. I think that internet addiction does exist, and it’s important that we both study it and try to understand the implications of it. I actually found some great advice on the following site, which has advice for identifying an internet addiction and overcoming it. Hope this may help someone, as it helped me.

  3. ‘Yesterday, a study was reported in the British media that Chinese scientists had observed differences in the brains of people who obsessively use the internet similar to those found in people who have substance addiction. ‘

    This could mean that both ‘addictions’ had the same underlying cause. In other words, the behaviour might just be a symptom.

  4. Found this write up on the web. Really valid information that you shared. Thank you.

  5. I have missed real time with my children by “playing” on the internet – checking emails, responding (can take hours), facebooking, texting, etc…. I see people everywhere I go – playgrounds, airports, restaurants..no longer communicating with their children, loved ones. I ask myself every day, what kind of example am I setting for my children? I unintentionally ignore them while responding to the machine…it has become socially acceptable to do so and this is the most frightening aspect of the world today in re: to technological advances. WE are becoming desensitized to all the information overload. I read that same article above and DO think our brains get rewired by staring at screens all day long. We lose track of time, become distracted, forgetful, anxious, even depressed. I am not an internet addict – I am just like the rest of the “Average” world who owns a lap top and a smart phone….but where does it stop? I feel the pull every hour to check my phone for new messages…perhaps I am addicted…but aren’t we all? The average teen receives 3,700 texts in a month – tell me that’s not an addiction? and where does it stop? I want my children to know how to communicate with others – to feel and understand the human emotions that are connected to real life language/talking/laughing…and not just the words on a screen (lol).
    The next time you are waiting for a flight at the airport – look around… I challenge you to find 3 people at your gate who are not staring into a screen. I think we are all becoming “addicted” – the only reason not to label is as such is because people would lose permission to live the majority of their daylight hours (and evening) on screen time. It is what it is… but again, where does it stop and if it doesn’t, how does one self impose limits when everything you do these days is done online/electronically. I’m beginning to feel like a robot…and I’m not even a “gamer”….
    Newsweek’s iCrazy cover story – worth checking out.

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