Internet Addiction Disorder: a Review (Part 1)

What is Internet Addiction Disorder (IAD)?

The World Wide Web is informative, convenient, and fun. There are varying opinions on the subject of Internet addiction. Recent reports indicate that some on-line users are becoming addicted to the Internet in the similar way that others became addicted to drugs, alcohol, or gambling, which resulted in academic failure (1,2), reduced work performance (3) and even marital discord and separation (4). As the Internet increasingly becomes part of our lives, Internet addiction disorder has received much attention. The term Internet Addiction Disorder was coined by psychiatrist Ivan Goldberg. Those who are addicted to Internet may withdraw from social and interpersonal interactions other than those on the Internet. Their family relationships and academic or occupational functioning may deteriorate.

Internet Addiction Disorder: Myth or Reality?

Do some people have problems with spending too much time online? Sure they do. Some people also spend too much time reading, watching television, and working, and ignore family, friendships, and social activities. But do we have TV addiction disorder, book addiction, and work addiction being suggested as legitimate mental disorders in the same category as schizophrenia and depression? While many believe the term addiction should only be applied to cases involving chemical substance (5,6); similar diagnostic criteria have been applied to a number of problem behaviors such as pathological gambling (7,8,9) eating disorders (10, 11), sexual addictions (12), generic technological addictions (13), and video game addiction (14,15,16,17).

Like all other addictions, Internet addiction is a psychophysiological disorder involving tolerance (the same amount of usage elicits less response; increased amounts become necessary to evoke the same amount of pleasure), withdrawal symptoms (especially, tremors, anxiety, and moodiness), affective disturbances (depression, irritability), and interruption of social relationships (a decline or loss, either in quality or quantity). Due to the nature of Internet Addiction Disorder, of all other addictions, it is said to be closest to pathological gambling.

Diagnostic Criteria

A maladaptive pattern of Internet use, leading to clinically significant impairment or distress as manifested by three (or more) of the following, occurring at any time in the same 12-month period, is all that is required to diagnose a person as having Internet Addiction Disorder:
(I) tolerance, as defined by either of the following:

(A) A need for markedly increased amounts of time on Internet to achieve satisfaction

(B) Markedly diminished effect with continued use of the same amount of time on Internet

(II) Withdrawal, as manifested by either of the following
(A) The characteristic withdrawal syndrome

(1) Cessation of (or reduction) in Internet use that has been heavy and prolonged.

(2) Two (or more) of the following, developing within several days to a month after Criterion 1:

(a) Psychomotor agitation

(b) Anxiety

(c) Obsessive thinking about what is happening on Internet

(d) Fantasies or dreams about Internet

(e) Voluntary or involuntary typing movements of the fingers

(3) The symptoms in Criterion B cause distress or impairment in social, occupational or other important other area of functioning

(B) Use of Internet or a similar on-line service is engaged in to relieve or avoid withdrawal symptoms

(III) Internet is often accessed more often or for longer periods of time than was intended

(IV) There is a persistent desire or unsuccessful efforts to cut down or control Internet use

(V) A great deal of time is spent in activities related to Internet use (e.g., buying Internet books, trying out new browsers, researching Internet vendors, organizing files of downloaded materials

(VI) Important social, occupational, or recreational activities are given up or reduced because of Internet use.

(VII) Internet use is continued despite knowledge of having a persistent or recurrent physical, social, occupational, or psychological problem that is likely to be caused or exacerbated by Internet use (18) (sleep deprivation, marital difficulties, lateness for early morning appointments, neglect of occupational duties, or feelings of abandonment in significant others).

What Makes the Internet So Addictive?

Given the recent surge in access to information technologies (19), we have a new generation of diverse computer users. Internet itself is not addictive, but, perhaps specific applications play a significant role in the development of Internet abuse. Secondly, internet users report a sense of excitement while using the Internet, which can be paralleled to the "high" experienced when people become addicted to video games (16) or gambling (7). This implies that the level of excitement experienced by the on-line users while engaged in the Internet may be associated with addictive use of the Internet.

Since the aspects of the Internet where people are spending the greatest amount of time online have to do with social interactions, it would appear that socialization is also one of the factors what makes the Internet so "addicting." Whether it's via e-mail, a discussion forum, chat, or a game online, people are spending time in exchanging information, support, and chit-chat with other people like themselves (20). On the other hand, the type of application utilized by the on-line user may also be associated with the development of Internet abuse.

Who Are Internet Addicts?

In the first concentrated study of the social and psychological effects of Internet use at home, researchers have found that people who spend even a few hours a week online experience higher levels of depression and loneliness than they would have if they used the computer network less frequently (21). On the other hand if we analyze Internet addiction in terms of behaviour, it is found that most people who think they are addicted are probably suffering from the desire to not to deal with other problems in their lives. Those problems may be a mental disorder (depression, anxiety, etc.), a serious health problem or disability or a relationship problem. It is no different than turning on the TV so you won't have to talk to your spouse, or going "out with the boys" for a few drinks so you don't have to spend time at home. Nothing is different except the modality.

An alternative hypothesis has been given by Dr. John M. Grohol (20). It mentions that the behaviors we are observing are phasic. Most people with "Internet addiction," are likely newcomers to the Internet. They are going through the first stage of acclimating themselves to a new environment -- by fully immersing themselves in it. Since this environment is so much larger than anything they have ever seen before, some people get "stuck" in the acclimation (or enchantment) stage for a longer period of time than is typical for acclimating to new technologies, products, or services.

(References are included in part 2 of the article)

About the Author

Ms. Aditi Singh, M.A. (Psychology), M. Phil. (Medical & Social Psychology) is a Ph. D. Scholar at Central Institute of Psychiatry, Ranchi, India. She is an editor of www.mind.in and a contributor to www.psyplexus.com .