Two research articles were recently published that shed more light on the so-called “Internet addiction”, a concept we’ve long lampooned here due to its continuing lack …
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I get that the instruments used do not really differentiate between problematic internet use and internet use that is not problematic. And I understand that internet addiction is not a diagnosis- it is not in the DSM (a similar debate continues about Battered Women’s Syndrome and has raged on for years now).
I think most people use the term colloquially- specifically those who find themselves “addicted” and reach out for help.
So what DO we call this phenomenon that occurs when people’s lives are adversely effected by thier own internet use?
I am open to suggestions.
DeeAnna
Does every behavior needs its own unique label? What do you call it when people watch too much TV/read/talk on the phone and ignore their significant other/chores/social engagements? What do you call it when a person spends all of his free time following his favorite sports team or has to watch every episode of American Idol no matter what? What do you call someone who goes to college and spends all of their free time studying instead of finding a balance between socializing and studying? What do you call a mother who insists on taking 30 pictures anytime their child does anything of interest?
I could go on. There are virtually limitless examples of people doing something in their life and taking it to an unhealthy extreme. I’m not certain we need to differentiate this type of behavior based upon the focus of the interaction. If it were me, I might put it into a type of obsessive disorder, or a new compulsive behavior disorder that recognizes that compulsions can include gratification (and not just anxiety relief). But it is in no way Internet-specific and can be applied to virtually any behavior a person takes to an unhealthy extreme.
It is not what I, the clinician calls it, it is how the client identifies. From the client’s point of view, many tell me they are “addicted” to the internet. Do I invalidate their experience? Do I intercede with. “Now, your behavior does not need to be labeled…” Or do I meet my client where he or she is at?
Addictive behaviors are not necessarily just about substances. That is fairly well accepted in our culture, no?
I suspect that internet addiction is where people don’t feel strongly motivated to do anything other than surf the net, and so end up spending hours and hours on the internet by default, simply because it holds some appeal for them and little else does.
If this is the case and can be shown to be the case (I’m not saying it is for sure but I’d like to put it forward as a proposition or hypothesis) then I think we would have to consider ‘internet addiction’ to be qualitatively different from other forms of addiction where the addiction supercedes activities and interests which would otherwise hold a strong appeal, as is often the case with drug or alcohol addiction.
I think that if I was in your position, DeeAnna, I would ask the client whether there were any other activities they would care to engage in, and if not why not.
Having said that I don’t rule it out entirely. People can develop serious addictions to computer games.
I think Dr John is right to try to get us to think about this issue and question assumptions. Hopefully a reflective consideration of these issues will help us to gain a clearer understanding of what we’re talking about.
@DeeAnna… Researchers need clear, theoretically-consistent and reliable criteria in order to study a cluster of symptoms and then organize them into a distinct “disorder.” So while the popular media might talk about these concepts (which then trickle down into people’s minds as a legitimate disorder), professionals often will need a more critical eye so that we aren’t pointing the finger at the wrong thing (one’s interactions with the Internet versus one’s own procrastination, major depression, social anxiety, time management issues, or something else altogether).
Disorders aren’t a matter of “belief” (that would be what constitutes a religion) in what a client tells you. There has to be a solid and strong empirical research basis to validate a disorder in order for the profession to continue to be taken seriously. What the newest research shows is that, unfortunately, much of the research done on this phenomenon to-date has relied on a very weak and insensitive measure.
As you well know, I have weighed in on this topic here based on personal experience and what I have seen with patients and other’s revelations. Addiction, or dependency moreso, is defined by the consequences of the behaviors/actions/substances, and I hope most of clinicians in the field would not argue in general terms there can be dependency on this medium that impairs function.
As of 2009, with DSM5 getting more tainted by it’s pending overinclusion of diagnoses, I am not going to split hairs about a term “internet addiction”, but refocus on addiction/dependency with the process that causes impairment/dysfunction.
Dr Grohol, would it be fair to ask if you are a bit biased on this issue as you are on the internet as at least part of your income stream? Just curious, and I am not advocating there should not be services in this medium, it is just what are people over-seeking in other avenues here–porn/shopping/chat rooms/others?
therapyfirst
board cert psychMD
There, indeed, can arguably be dependency on any hobby, habit, behavior, or stimulus in the world. My point is that if you’re going to go down that road of reasoning, you shouldn’t limit it to a specific stimulus, behavior, habit or hobby — such behaviors are not stimulus dependent. TV watching, sports, reading, studying, socializing, shopping — these are all common behaviors that people/researchers have both jokingly and seriously suggested as having disordered behavior attached to them. So if we’re going to journey down this road, let’s do it right and whole-hog.
As for being biased, I would think it would do my and my income stream a world lot better if I just gave in said yes to “Internet addiction,” because then I could direct people to a whole slew of resources we could create to offer self-help strategies to people for it (including support groups, psychoeducational information, etc.). Generally most professionals (clinicians and researchers) benefit from the “overinclusion of diagnoses,” and I arguably would too.
In fact, whenever I call a proposed psychiatric label ridiculous, I’m trying to place some common sense limits on our propensity to label any aberrant behavior with a diagnosis. I think that we benefit from keeping the DSM-V closer to the DSM-IV than moving to a tome that’s double the size with double the diagnoses.
Just want to thank whoever selected the photo to go with the article. Fabulous choice.
Just wanted to say I’m incredibly offended by the photograph accompanying the article.
I’ve just taken they Young questionairre before reading this article,
I took sociology and social psych in college and i know about qualitative and quantitative metrics, etc., and I don’t think its accurate at all. To begin with the two answers ‘frequently’ and ‘often’ are near synonyms and probably skew some answers.
My score indicated i was in the ‘normal internet user’ range, despite having scored several questions 4 or 5, and despite that by my own self-assessment I believe myself to be addicted and to display symptoms of internet addiction (interferes w/ life, etc)
for what its worth, the test is squat, honestly hard to believe its the only certifiable one. probably was a good first go but by now its way overdue to be tightened up on.
also, I agree w/ Stephanie. nice job on the softcore photo ;(
one more thing to add. theres a very simple definition for addiction. it means *you cannot stop*. just thought i would cut the gordian knot for some of you.
Caffeine Addiction – Caffeine Effects and Withdrawal part II
Caffeine addiction shows up when a person cannot stop consuming caffeine in high amounts, causing his/her body to demand the substance and react negatively if that no caffeine is intake. Caffeine may not be addictive in the traditional sense, but the body builds up a tolerance over time; some people find it very hard to function well without at least one cup of strong coffee or tea in the morning. The stimulating effects of caffeine are caused by a central nervous reaction, the heart rate increases, blood vessels expand and the brain receives more oxygen. These caffeine effects can last for up to 8 hours, and once they go off then the body feels extremely lazy and slow as a side effect.
Caffeine addiction can even cause death, mainly because the abuse of any stimulant can cause high blood pressure or and heart problems, so if you abuse of it chances are you put yourself at the highest risk of a heart attack.
You need to be careful with caffeine withdrawal because it affects your overall health and therefore, you need to control your consumption of caffeinated products to prevent your body reactions to caffeine withdrawals. If you need more information about caffeine effects and caffeine addiction symptoms or prevention, please investigate a little further on this topics.
You can find more info at: http://yourcaffeineaddiction.com/
We all have our vices.
I don’t see habitual internet use on it’s own as dangerous, but I have seen people that let their lives get out of control because of some of the things made available on it.
If you want to know to who not to go to read:
http://slokas.wordpress.com/
We were extremely with this psychologist.
Today (March 2) at aol’s front page is a little blurb about how the video game “Warcraft” is one of the most addictive games out there, dubbed “Warcrack”.
Just a media article, but seems to echo my concern that the screen is a source for addiction, as the environment to isolate can only add to this dynamic of dependency.
Sadly, it’s a news story based upon an unpublished report by Swedish youth agency based upon people contacting the agency about a concern their child is “addicted” to Warcraft. So a completely biased sample as well.
I could conduct a completely valid study showing that reading meets all of the same addiction criteria as “Internet addiction,” using the same biased methodology. And while the results would be “valid” in terms of confirming my hypothesis, we still wouldn’t suggest reading is an “addiction.” (Reading, by the way, is also a very isolating behavior that people often do to disconnect from the world around them.)
No, I disagree with your appraisal and your equating reading as synonomous with this issue. Abuse and Dependency infer disruption in function in multiple arenas of life, and while there are possible exceptions to relate reading could be “addictive”, I am nothing less than surprised you dismiss a position there could be a sizeable population, even if only 5% or less that could meet the criteria of internet addiction. Bring in 20 random regular readers and 20 regular internet users, and I would bet a nice lunch there would be a greater likelihood of finding at least 1 or 2 who could meet a criteria of ‘excessive use’ that could be defined as abuse/dependency in the internet group before I would find just 1 in the readers’ group.
By the way, after giving it much thought, you might have some validity to say people read to isolate and disconnect, but how is that equivalent to being on the internet; the latter is interacting and connecting. And in the end, don’t people read to educate and rejuvenate if innundated with too much humanity? Just an opinion.
Thank you for the reply though.
My point wasn’t to single out reading, but to suggest that one could readily and easily identify virtually any behavior — prosocial or not — and claim one could engage in “excessive use” of it. TV. Sex. Video games. Talking to friends. Texting. Reading. Now twittering.
There’s nothing unique or special about the Internet that suggests we should single it out for special treatment and a single diagnosis, when the foundation for such a diagnosis is based upon sand. Might as well single out people’s Blackberries as well.
I can only conclude that if we’re going to go down this path of “excessive use” for any behavior, we not single out a characteristic of that behavior (“Internet use,” “watching TV,” “reading”), but find a solid theoretical foundation that would be inclusive enough for any type of excessive use behavior.
I’m not suggesting this would be a good thing, though, as I believe we already have more than enough diagnoses (although none of them perfect fits) to cover these kinds of behavior in our existing diagnostic system.
There’s this misnomer that if we just had the “right” label to place on something like this, we’d be able to better target treatment. And yet decades worth of research has only produced targeted treatments for broad spectrums of disorders, not Treatment 12890 for Patient XZY.
I concur with your general position we do not want to micromanage/overdiagnose people, but, I have felt you are, at least to some degree, dismissing the general concept that internet use can have an addictive quality per the dynamics behind involvement with this medium. Maybe I should have just said the internet is another example of a culture that is more at risk for addictive tendencies than prior generations had been at risk to develop.
My general point is to just raise the question that, if a person is involved in a behavior which becomes the center of one’s life that is then interfering with what should be appropriate functions/expectations, that others view as unhealthy and worthless when involved in said behavior, it needs to be identified as, at least, possibly “____ abuse or dependency”. And, if truly an addiction, then change is needed.
I believe there is a noteable population that are internet addicts, maybe with other addictions as well, but the internet is one that causes strife with others. And, in the end, if that is a determination a person should be told and advised changed, it should be put out there. I won’t push the issue further here, but we do identify gambling, sex, substances, shopping as unique addictions that now have separate group processes for treatment interventions. The internet is a unique entity, so I do not see it as terrible to offer it as a subset in the general definition of addiction. Again, just an opinion, but one of some experience for me.
Appreciate the brief dialogue, and nice posts the last few weeks by the way. No comment about the Seroquel controversy started by Furious Seasons and furthered by Clin Psych?
Hi, All–You may be interested in reading a psychiatrist’s take on this. I tend to lean more toward Dr. Grohol’s position on this matter, though I think the issues are complex and greatly in need of more research! For what it’s worth, you can see my article at:
http://www.psychiatrymmc.com/should-dsm-v-designate-%E2%80%9Cinternet-addiction%E2%80%9D-a-mental-disorder/
Ronald Pies MD
i believe that a question such as how many hours do you spend on the internet each day wont produce accurate results because some people work using the internet,for example i spend at least 10 hours a day working online and of course these include sometimes little procrastination here and there
I agree with John M. Grohol about labeling. When we label things, they become either black or white, which is totally different from the mostly grey reality.