Internet Addiction in Adolescents

In our increasingly digital age, addiction to internet use is growing in prevalence, and has recently received more and more attention from medical and scientific researchers. Nowhere is the problem more alarming than with adolescents, who have the greatest access to internet-based technologies, and also have the most at stake developmentally.
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Some rather sensationalized news sources have even referred to the rise of internet addiction as a new “electric heroin,” citing the research demonstrating how internet use and serious substance abuse demonstrate similarities in their symptomologies and in the way that they stimulate the reward pathways of the brain.

While the danger and addictive potential of heroin use makes the comparison a little strained, excessive internet use is nonetheless a condition that merits serious attention.

The History Of Internet Addiction

The possibility for addictive behavior related to internet use was first proposed in 1995. The term was initially used in jest, because at the time the rarity of personal computers and the unlikelihood of any individual developing an addiction to internet use made the idea ridiculous.
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In the ensuing years, however, the explosion of internet technologies rapidly made internet addiction a reality. By 1998 a diagnostic tool known as the Internet Addiction Tool (IAT) was developed by Dr. Kimberly Young in order to assess whether an individual’s internet use was pathological.
 
The assessment was based on the criteria for pathological gambling listed in the DSM-IV (the American Psychological Association’s diagnostic manual for mental disorders). This was based on the logic that despite the fact that internet addiction had not yet been recognized by the psychological establishment as a real disorder, the symptoms it presented were similar enough to gambling addiction that the two could be diagnosed in a comparable fashion. When the DSM-V was released in 2013, pathological gambling was updated to a condition now called “gambling disorder,” but problem internet use was once again left out.

Notwithstanding, psychological and medical researchers across the world have begun devoting major resources towards studying the effects of internet use, especially on school age populations ranging from ages 5-22. This field of research has been especially active in Asian countries such as China, Japan, Korea, and Taiwan; countries in which the vast majority of the population have access to the internet and incidence of internet addiction is especially high. Recent studies have found that an estimated 19.8% of adolescents in Taiwan and 20% of adolescents in Korea screened positive for either internet addiction or excessive internet use.

The Diverse Manifestations of Excessive Internet Use

Internet Addiction has been grossly understudied, and additional research is required to establish prevalence rates in European and North American countries. The various diagnostic tools currently available are often times outdated, and assess patterns of internet use that are no longer relevant. Future research is needed to validate measuring tools that more accurately reflect the actual patterns of internet use in today’s adolescents. 
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In the 1990s, the internet functions available to the average user were so limited that one of the only possible types of pathological use was compulsively checking websites, in a pattern that closely mirrored compulsive gambling. However, today’s adolescents use the internet for so many different things that, depending on their pattern of use, the internet can either enable or catalyze a host of different disordered patterns of thinking.

For example, online gaming can be associated with the impulsivity often marked in cases of Attention Deficit Hyperactivity Disorder (ADHD). Adolescents with a bent towards narcissistic personality disorder might gravitate towards excessive self-promotion on networking outlets like Twitter, Facebook, or Instagram. The constant stream of world news and cultural information present on social media websites can enable a crippling fear of missing out (or “FOMO”) that might co-occur with an anxiety disorder. And the internet also provides opportunities for the destructive cyber-bullying perpetuated by over-aggressive adolescents.

Of course it is impossible to determine if the disordered or problematic patterns of thinking listed above are caused by internet use or if the internet use simply enables preexisting pathological tendencies to manifest. It is also possible that there is a reciprocal relationship, with excessive internet use both fostering and enabling the expression of negative behavior patterns.

Diagnosis and Understanding

While this diversity of the symptomology of internet addiction makes it difficult to issue blanket statements, the important thing is to have the discernment to distinguish between frequent internet use and the excessive patterns of use that can lead to addiction.
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Internet use should not be judged to be excessive until several of the following criteria are met (among others): impaired psychological well-being; worsened academic performance; physical abnormalities including back pain, eye strain or carpal tunnel syndrome; severely decreased family and peer interactions; and finally the traditional markers of addiction, including increased tolerance, signs of withdrawal after lack of use, disregard for consequences, and difficulty controlling behavior.

While discussions of internet addiction can often alarm parents who may believe that their child spends too much time online, it’s important not to jump to conclusions nor to inhibit overall internet use wholesale. Internet use is not per se harmful or inhibiting; in fact, there is a mountain of evidence that adolescents with regular internet access generally have higher test scores, a greater motivation to learn, greater access to health information, and a general feeling of empowerment compared to adolescents without internet access.

As was noted above, there are many diverse uses for internet technologies, and each has the potential to enable various different disordered patterns of thinking. What is required in such a complex situation is a sensitivity to the overall developmental context of an adolescent’s physical, emotional, and social situation. 

While internet addiction has recently been given increasing attention by mental health professionals and should be taken seriously, parents of adolescents should not jump to conclusions. Using the criteria listed above, in addition to outside research and, if necessary, consultation with a certified health professional, parents of adolescents can be more secure in their ability to discern between the excessive internet use that marks internet addiction and the frequent internet use that marks 21st century adolescence.

By Dr. Syras Derksen,
Registered Psychologist

References
Guan, S. S. A., & Subrahmanyam, K. (2009). Youth Internet Use: Risks and opportunities. Current Opinion in Psychiatry, 22(4), 351-356.
Ong, S. H., & Tan, Y. R. (2014). Internet Addiction in Young People. Annals of Academy of Medicine, Singapore, 43(7), 378-382.
Tao, R., Huang, X., Wang, J., Zhang, H., Zhang, Y., & Li, M. (2010). Proposed Diagnostic Criteria for Internet Addiction. Addiction, 105(3), 556-564.
Wallace, P. (2014). Internet Addiction Disorder and Youth. EMBO Reports, 15(1), 12-16.