U N I V E R S I T Y O F B E R G E N

INTERNET ADDICTION

Os, February 9 2015

Ståle Pallesen

Professor, PhD

University of Bergen

WHAT CHARACTERIZES ADDICTION?

Salience (the drug/behavior dominates the persons mind)

Tolerance (increase intensity of drug use or behavior in order to achieve

desired effect)

Mood modification (using drug or initiating behavior gives pleasure

and alleviates mood)

Relapse (after period of abstinence, the use or behavior is reinstated

with the same intensity as before)

Withdrawal (when not using drug or engaging in behavior for some time

negative physical or psychological symptoms arise)

Conflict (interpersonal and/or intra-personal)

Problems (health problems, problems functioning in some settings)

CHEMICAL AND NON-CHEMICAL ADDICTIONS?

Urges to engage in counterproductive behavior

Tension until satisfaction from the addiction

Rapid, but temporarily, reduction in tension when using the

addictive stimuli

Gradually build-up of urge

Unique external cues for specific addictions

Secondary conditioning (irrelevant stimuli becoming

associated with the addictive stimuli)

Similar strategies for relapse prevention (cue-exposure and

response prevention)

Triggering of brain reward centers

DIFFERENT NON-CHEMICAL ADDICTIONS

TO BE

ACKNOWLEDGED

Internet Gaming

Disorder

ACKNOWLEDGED

Gambling

disorder

OTHERS

Internet

Addiction

Exercise

addiction

Workaholism

Mobile phone

addiction

Compulsive

buying

Griffiths argues (1999) that it is the content and

not internet in itself one becomes addicted to

Internet addiction typologies (Young, 2009) Excessive gaming

Online sexual pre-occupation

E-mailing/texting

Griffiths. Psychologist 1999; 12: 246-250

Young. Journal of Contemporary Psychotherapy 2009; 39:241-246

CRITICISM OF INTERNET ADDICTION

INTERNET ADDICTION DIAGNOSTIC QUESTIONNAIRE

1. Do you feel preoccupied with the Internet (think about previous on-line

activity or anticipate next on-line session)?

2. Do you feel the need to use the Internet with increasing amounts of time in

order to achieve satisfaction?

3. Have you repeatedly made unsuccessful efforts to control, cut back, or stop

Internet use?

4. Do you feel restless, moody, depressed, or irritable when attempting to cut

down or stop Internet use?

5. Do you stay on-line longer than originally intended?

6. Have you jeopardized or risked the loss of significant relationship, job,

educational or career opportunity because of the Internet?

7. Have you lied to family members, therapist, or others to conceal the extent

of involvement with the Internet?

8. Do you use the Internet as a way of escaping from problems or of relieving

a dysphoric mood (e.g., feelings of helplessness, guilt, anxiety,

depression)?

PREVALENCE OF INTERNET ADDICTION

Large differences between studies

1.7% in boys and 1.4% of girls in a Finish representative study of 7 292

adolescents 12-18 years old (Kaltiala-Heino et al., 2004)

vs.

15.3% prevalence in a nationally representative sample of 3616 college

students in Taiwan (Lin et al. 2011).

Lin et al. Cyberpsychology, Behavior and Social Networking, 2011; 14: 741-746

Kaltiala-Heino et al. Addiction Research & Therory 2004 12: 89-96

FACTORS RELATED TO INTERNET ADDICTION

Kuss et al. Current Pharmaceutical Design, 2014; 20: 4026-4052

Lam. Current Psychiatry Report 2014; 16: article no. 508

INTERNET ADDICTION

SOSIODEMOGRAPHICS

Higher family income

Male gender

INTERNET USE

Online gaming

Social applications

PSYCHOSOCIAL

Loneliness

Low life satisfaction

Low school performance

Neuroticism

Low agreeableness

Poor relations at school

Friends drinking alcohol

Family conflict

Low parental monitoring

Not living with mother

COMORBIDITY

Alcohol / substance use

Depression

ADHD

Social phobia/anxiety

Antisocial behavior

LONELINESS / SOCIAL ISOLATION AND INTERNET

ADDICTION

384 students at 2 universities in Turkey.

Completed questionnaires about loneliness, self-esteem,

life-satisfaction and internet addiction

Bozoglan et al. Scandinavian Journal of Psychology 2013; 54: 313-319

361 students at 2

universities in

Hong Kong

completed

questionnaires

assessing social

contact (face-to-

face and online),

loneliness and

internet addiction.

The data were

collected twice,

with 4 months

apart.

Yao & Zhong. Computers in Human Berhavior 2014; 30: 164-170

648 students at a

university in Turkey

completed

questionnaires

assessing self-

control, depression,

loneliness and

internet addiction.

Özdemir et al. Computers in Human Behavior 2014; 34: 284-290

Depression

Loneliness

Low self-

control

Internet

Addiction

OBESITY AND INTERNET ADDICTION

1150 junior and

senior middle

school students

in Xiangtan,

China

participated.

Height and

weight were

measured and

obesity was

calculated.

Questionnaires

about internet

addiction and

health habits

were completed

at the schools. Li et al. Obesity 2014; 22: 482-487

2029 high school students in Turkey reported their height and

weight and completed questionnaires assessing internet

addiction and eating attitudes.

Canan et al. Cyberpsychology, Behavior and Social Networking, 2014; 17: 40-45

1157 students in

secondary school and

high schools in Pakistan

completed questions

about background,

internet use and internet

addiction, and loneliness

Koyuncu et al. Journal of Pakistan Medical Association, 2014; 64: 998-1002

SLEEP AND INTERNET ADDICTION

2029 high school students in Turkey completed questionnaires

assessing internet addiction and sleep habits/problems.

Canan et al. Sleep and Biological Rhythms , 2013; 11: 210-213

3393 Norwegians, aged 16-74 years old, answered questions

about internet addiction and different problems, among others

sleep problems.

Bakken et al. Scandinavian Journal of Psychology 2009; 50: 121-127

719

adolescents

in Hong

Kong

answered

questions

about

internet

addiction,

sleep and

depression

Cheung and Wong. Journal of Sleep Research 2011; 20: 311-317

SCHOOL PERFORMANCE AND INTERNET ADDICTION

86

adolescents

suffering from

internet

addiction

compared

with an age

and gender

matched

group of 43

adolescents

without

internet

addiction

Tsitsika et al. TheScentificWorldJOURNAL 2011; 11: 866-874

718 children

and

adolescents

in Hong Kong

interviewed

about internet

addiction,

internet skills,

grades and

academic

performance.

Leung & Lee. Social Science Computer Review 2012; 30: 403-418

5122

adolescents

from various

schools in

Shaghai

completed a

questionnaire

assessing

background

variables,

internet

addiction,

and

academic

achievements

Xu et al. BMC Public Health 2012; 12: article no. 1106

2735

adolescents

12-18 years

from 8

schools in

Singapore.

They

completed a

questionnaire

about

background,

academic

performance,

social

support, well-

being and

time used

surfing the

internetMythily et al. Annals of Academic Medicine Singapore 2008; 37: 9-14

DEPRESSION AND INTERNET ADDICTION

2293

adolescents in

grade 7

completed

questionnaires

about internet

addiction and

depression.

One year later

the

assessment

was repeated.

Ko et al. Comprehensive Psychiatry 2014; 55: 1377-1384

Adolescents without IA

at first investigation

Adolescents with IA

at first investigation

1041

adolescents

aged 13-18

years old from

schools in the

Guangzhou

province of

China.

Questionnaires

about anxiety

and depression

was completed

at baseline at

follow-up.

Pathological

use of internet

was assessed

at baseline

Lam & Peng. Archives of Pediatric and Adolescent Medicine 201; 164: 901-906.

10988

adolescents

aged 13-23

years old from

9 cities in

China.

Questionnaires

about

background,

internet

addiction,

depression,

self-esteem,

and life-

satisfaction

were asked.

Wang et al. Addiction Research and Theory 2013; 21: 62-69.

TREATMENT EFFECTS OF INTERNET ADDICTION

Winkler et al. Clinical Psychology Review, 2013; 33: 317-329.

CONCLUSIONS

Many studies show a relationship between internet addiction, loneliness, obesity, poor sleep,

impaired school performance and depression.

The majority of studies is based on a cross-sectional design (chicken and egg problem)

Few studies have looked into the content of internet use when investigating internet addiction

Most studies seem to have been conducted in an Asian context

The few good longitudinal studies and treatment studies suggest that internet addiction may

be a cause and a consequence of other problems.

Faculty of Psychology