Internet Addiction Disorder: Causes, Symptoms,and Consequences

东方阳

Jennifer R. FerrisPsychologyVirginia Tech

INTRODUCTION

        The growing body of research in the area of addiction suggests that Internet Addiction Disorder,  a psychophysiological disorder involving tolerance; withdrawal symptoms; affective disturbances; and interruption of social relationships, is a presenting problem that is becoming more common in society as on-line usage increases by the day.  

With the growing importance of the Internet in everyday life, more and more people are accessing various on-line resources each day.  The World Wide Web is informative, convenient, resourceful, and fun.  For some people though--the addicted--these benefits are becoming detriments.  There are varying opinions on the subject, especially among those who utilize the Internet.  Some say that the Internet can be addicting, to the point that it disturbs one's life and the lives of those around him.  Others say that there is no such thing as Internet Addiction Disorder-- getting pleasure out of a computer is not the same as getting pleasure from cocaine or any other drug.  Whether there is or is not a bona fide disorder, the Internet is disrupting many people's lives.   Who is to blame for this disorder?  

Is it the WWW companies or is it the individual?  Whichever (if either), the solution is not to outlaw the Internet, as with psychoactive drugs.  Simple methods of prevention do exist that can reduce the negative effects of Internet use.   

DEFINING INTERNET ADDICTION DISORDER

        To be diagnosed as having Internet Addiction Disorder, a person must meet certain criteria as prescribed by the American Psychiatric Association.   Three or more of these criteria must be present at any time during a twelve month period:

  1. Tolerance:  This refers to the need for increasing amounts of time on the Internet to achieve satisfaction and/or significantly diminished effect with continued use of the same amount of time on the Internet.

2.  Two or more withdrawal symptoms developing within days to one month after  reduction of Internet use or cessation of Internet use (i.e., quitting cold turkey) , and these must cause distress or impair social, personal or occupational functioning. These include: psychomotor agitation, i.e. trembling, tremors; anxiety; obsessive thinking about what is happening on the Internet;  fantasies or dreams about the Internet;  voluntary or involuntary typing movements of the fingers.

3.  Use of the Internet is engaged in to relieve or avoid withdrawal symptoms.

4.  The Internet is often accessed more often, or for longer periods of time than was intended.  

5.  A significant amount of time is spent in activities related to Internet use ( e.g., Internet books, trying out new World Wide Web browsers, researching Internet vendors, etc.).

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

7. The individual risks the loss of a significant relationship, job, educational or career opportunity  because of excessive use of the  Internet.

东方阳

In recent research, other characteristics have been identified.  The first is feelings of restlessness or irritability when attempting to cut down or stop Internet use. The second is that the Internet is used as a way of escaping problems or relieving feelings of helplessness, guilt, anxiety or depression. The third characteristic is that the user lies to family members or friends to conceal the extent of involvement with the Internet. And, finally, the user returns repeatedly despite excessive fees (Egger & Rauterberg, 1996).
"ADDICTION" AND INTERNET ADDICTION DISORDER
        Bratter and Forest (1985; in Freeman, 1992) define addiction as "a behavior pattern of compulsive drug use characterized by overwhelming involvement...with the use of a drug and the securing  of the supply, as well as the tendency to relapse after completion of withdrawal." 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 (failed impulse control without involving an intoxicant), of all other addictions, IAD is said to be closest to pathological gambling.  However, the effects that the addiction can have on every aspect of the person's life are just as devastating as those of alcoholism. Kimberly S. Young, Psy.D., conducted a study involving nearly 500 heavy Internet users.  Their behavior was compared to the clinical criteria used to classify pathological gambling as defined by the Diagnostic and  
Statistical Manual of Mental Disorders-IV, published by the American Psychiatric Association.  Using this criteria, eighty percent of the participants in the Young's study were classified as dependent Internet users. They "exhibited significant addictive behavior patterns."  She concludes that, "the use of the internet can definitely disrupt one's academic, social, financial, and occupational life the same way other well-documented addictions like pathological gambling, eating disorders, and alcoholism can" (Young, 1996).
        There have been many attempts by medical doctors and psychologists to explain addiction disorders.  These theories include psychodynamic and personality explanations, sociocultural explanations, behavioral explanations, and biomedical explanations.  Not all explain any addiction perfectly, and some are better than others at explaining Internet addiction.
Psychodynamics and Personality
        Psychodynamic and personality views account for addiction through early childhood traumas, correlations with other certain personality traits or other disorders, and inherited psychological dispositions (Sue, 1994).  A dispositional model or diathesis-stress model of addiction might help in understanding IAD.  Certain people, due to a variety of factors, may be predisposed (diathesis) to developing an addiction to something, be it alcohol, heroin, gambling, sex, shopping, or on-line computer services. They could go through their entire lives never developing any kind of addiction.  On the other hand, if the right stressor, or combination of stressors, affects the person at a critical time, the person may be more inclined to develop an addiction.  If the person begins drinking alcohol even occasionally, but continues to increase consumption, he may develop a dependency on alcohol.  The same premise holds for Internet addiction.  If it is the right combination of time, person, and event, then addiction may take place.  The idea is that it is not the activity or subject that is important.  It is the person that is most crucial to the equation.  
Sociocultutral explanations       
        Addictions vary according to sex, age, socioeconomic status, ethnicity, religion, and country.  Some addictions are more common among persons of different categories.
For example, alcoholism is most common in the middle socioeconomic classes, in Native and Irish Americans, and in Catholics.  Whites are more likely to use PCP and hallucinogens, but less likely than Blacks or Latinos to use heroin(Sue, 1994).  Not enough data is available yet about those persons addicted to the Internet to determine if a particular class is most predominant.  In addition, at this point there is not enough diversity among Internet users to make any definitive statements.  As the diversity among users increases, and as the amount of research on the problem increases, hopefully we will know more about this interesting aspect of addiction with regard to the Internet.

东方阳

Behavioral explanations       
        These explanations are based on B.F. Skinner's studies on operant conditioning (Sue, 1994).  The person performs a behavior and gets either rewarded or punished for the behavior.  To illustrate, there might be a child who is painfully shy and fears meeting new people.  Whenever it is time for recess, he goes off on his own, and does not play with the other children.  Thus, he avoids having to talk to anyone new, and consequently avoids the anxiety associated with new encounters.  This avoidance of anxiety is rewarding and reinforces his behavior.  This means that he is likely to engage in this behavior (escaping from the problem)  the next recess, or the next time he must meet new people. This relates to addiction, and specifically Internet addiction in the following way:  Drugs, alcohol, sex,gambling, the Internet, and shopping offer many rewards.  They offer love, excitement, physical, emotional,  and material comfort, and the means to escape from reality.  These can all be rewards.  If an individual wants these rewards and learns that the Internet will allow him to escape, or receive love, or have a lot of fun, he will probably turn to the Internet the next time he feels these needs.  This becomes reinforcing, and the cycle continues.
Biomedical explanations       
        These explanations focus on hereditary and congenital factors, chemical imbalances in the brain and neurotransmitters.  There could be chromosomes, hormones, and surplus or lack of certain necessary chemicals and neurotransmitters that regulate activity in the brain and the rest of the nervous system. According to this perspective, this would cause someone to be susceptible to addiction (Sue, 1994). .  There is definitive research that shows that some drugs act to fill in the synaptic gaps of the neurons in the brain, fooling the brain into sending out faulty information.  This, it is thought, is one reason  for the "high"  one gets from engaging in activities such as running, drug use, and gambling.  This might apply to Internet addiction, since many opportunities on the Internet are fun and exciting.  
IS THIS ALL HYPE?       
        There is debate among users as to whether there really is such an addiction, and as to whether it's a bad thing. Some people feel that the Internet is just a harmless, friendly tool for gathering information, making new friends, and passing time.  Mental Health Net sponsors a discussion room about different topics related to mental health.  There were several responses from people across the United States.  Some of the people agreed that it is indeed possible to become addicted to the Internet.  Others claimed it was all a farce. One of the participants, Charity,  believes there is no such thing as Internet Addiction Disorder.  She says there are many activities in life that she gets pleasure from engaging in, yet she does not believe she is addicted.  She says, "Maybe the computer is just nicely interactive in a world of increasingly isolated people. And it's quiet, which is a very nice thing."  
Scribe, another participant, holds that maybe there is such a disorder, but it may not be all bad.  He says, "...a person may spend a lot of time on the Internet, as I do, because I have finally found the 'bottomless' source of information.  There is no last passage to this reference book, and if I am addicted to anything, it is knowledge... Are we not all addicted to something, which keeps us interested in living?" (Mental Health Net, 1997)
        Others such as Young and other psychologists, feel that used in excess, the Internet can become hazardous to one's mental and physical health.  By definition, an addiction does interfere with normal, adaptive functioning.  So if someone is addicted, his or her functioning is maladaptive.  This may manifest itself in a few of the symptoms classified by the American Psychiatric Association, or it may manifest itself in all of them.       
        The New York Times reported last August about IAD, providing true stories about individuals who think they might be addicted.  The paper tells the story of one woman in the Pacific Northwest who was divorced by her husband because of the enormous amount of time she spent in front of her computer. Her fixation with the Internet apparently caused her to forget to buy food for her children, to take them to their doctor appointments, and to buy enough oil to heat her home. There is also the story of the seventeen year old boy from Texas who was suffering from Internet withdrawal symptoms. When he was brought into the alcohol and drug rehabilitation center, his body convulsed about, and he through tables and chairs around the rooms (Belluck, 1996).
SCAPEGOAT, ANYONE?       
        It seems obvious that Internet Addiction Disorder does indeed exist.  The question arises of who, if anyone, is to blame?   Should it be the individual who chooses to participate in any on-line activity--from research, to chat, to just "surfing" the Net?  A contemporary and pressing issue involving alcohol, drugs, cigarettes and even state-sponsored gambling faces legislatures today.  Is it the suppliers of these addictive substances and products that should take responsibility for the problem? LavaMind, a company that produces computer games, quoted one of their customers in an advertisement on their web page.  "Why is this thing so damned addictive?" is what the customer had written to LavaMind  (LavaMind, 1997).  Should the programmers and on-line services providers, like the drug dealers on the street, or the nicotine fixers at R.J. Reynolds, or the
Commonwealth of Virginia Lottery marketers be held responsible for how and how much people use their products?   Not everyone gets addicted to drugs or the lottery.  In fact, it seems most people who do use the Internet, even in large quantities, never get addicted.  It is hard to say who, if anyone, should take the blame.  Programmers and service providers should be responsible enough to create appropriate products, and provide services in the ways that best serve the public, while maintaining their competitiveness.  Consumers, however, should take responsibility for themselves and "know when to say when".  If not that, then at least "tie one on".  Unfortunately, if there are those that are predisposed to addiction, they might not be the ones to recognize a problem when it is happening.

东方阳

PREVENTION       
        Psychiatrist Ivan Goldberg, MD is the doctor who coined the term Internet Addiction Disorder. Goldberg and Young offer some ways people who believe they are addicted, or may be heading toward addiction, can help themselves.  First, Goldberg says, people must recognize patterns of overuse.   An awareness of the basic symptoms is important.  A key signal to this would be time spent at the computer, but also time spent thinking about the Internet or in activities related to the Internet.  The next step, according to Young, is to identify underlying problems.   Similar to other kinds of addicts, Internet addicts should ask themselves what is causing them to want to escape from everyday life?  
The third step is to devise and act out a plan to work through the problem, rather than escape it.  Escaping from the problem through the Internet, and effectively ignoring it, does not make the problem go away.  It usually only intensifies the problem.  Finally, the addict needs to take steps to resolve the addiction itself.  Young advises a gradually decline in use, until finally a "sensible" amount of time is reached (Murray, 1996).
CONCLUSION               
        The Internet is not the enemy just because people become dependent on it.  It has many important and necessary benefits.  It is fast, ecologically sound, convenient, and informative.  In many ways it makes our lives much simpler.  In many ways it makes our lives more complex. The Internet provides an escape from reality and everyday problems just like alcohol or drugs.         Some argue that the interaction with other people on the Internet fills a social void.  People can assume new identities; others interact with that identity and the person may assume these on-line relationships are the same as the real thing.  It becomes a problem when people become so engrossed and enmeshed in on-line activities, and their "other" lives to the point of neglecting their  health, relationships, jobs, and other responsibilities.  As with many of life's pleasures, moderation is the key.