Review of literature on internet addiction

L of addiction research & the best use of scientific research and information from our 700+ peer reviewed, open access journals that operates with the help of 50,000+ editorial board members and esteemed reviewers and 1000+ scientific associations in medical, clinical, pharmaceutical, engineering, technology and management inspiring speakers and experts at our 3000+ global conferenceseries events with over 600+ conferences, 1200+ symposiums and 1200+ workshops l, pharma, engineering, science, technology and article open et addiction: a o eduardo pezoa-jares, isabel lizarindari espinoza-luna and josue alberto vasquez-medina*. September 13, 2012; accepted november 15, 2012; published november 22, on: pezoa-jares re, espinoza-luna il, vasquez-medina ja (2012) internet addiction: a review. Visit for more related articles at journal of addiction research & et addiction (ia) is an increasingly prevalent clinical entity in adolescents and young adults, but can affect people of all ages. The following review attempts to describe available data on ia, thus hoping to create awareness in health professionals regarding this et addiction; neurobiology; addiction; internet; social network; internet use disorder; internet has profoundly changed our everyday experience. We use the web to find information and perform many activities, although for a great majority of internet users the primary purpose for going online is to connect with others. The internet has become a part of our daily lives, and who we are determines how we use it [2]. Are several activities that can be performed on the internet: surfing, e-mailing, downloading, social networking, blogging, navigating in virtual worlds, gaming, chatting, and others [3]. Despite its inherent benefits, the internet is not without its problems, especially when its use becomes excessive. Over the last decade, in parallel to the flourishing popularity of the internet, the number of research studies addressing the addictive potential of the internet has steadily increased. Regardless of this fact, there is still controversy whether addiction to the internet is a real, unique problem or just a transient social phenomenon that all modern technologies have gone through [4]. Hope of creating awareness on the existence of this emerging phenomenon, this text attempts to give a comprehensive overview of internet addiction (ia) as a clinical entity. Also, recent research concerning neurobiological findings and treatment of subjects with ia will be reviewed. Given the rising popularity of facebook and other social networks, a thought on social network addiction is made. Lastly, we give a reflection on policy and regulatory implications addressing the ia tion of using the internet as an ‘addiction’. Introduction of affordable personal computers, the growth of internet access and its rising popularity have led to concerns over its excessive use [5,6]. If performed in a maladaptive pattern and high frequency, internet use could lead to psychological, family, academic or work dysfunction [7]. However, it was not until the 1990s that the internet was considered as a tool that could lead to addiction. Griffiths [10] included internet use as one of many behaviors that could lead to a ‘technological addiction’, defined as a non-chemical addiction involving human-machine interaction, which could be passive or active, with inducing and reinforcing first to suggest an addiction to the internet, although ironically, was the new york psychiatrist ivan goldberg. In 1995, he elaborated a symptom list for what he called ‘internet addiction disorder’, analogous to the criteria for substance dependence from the diagnostic and statistical manual of mental disorders, fourth edition (dsm-iv) [11]. However, it was kimberly young who was the first person to investigate this phenomenon in a methodical manner, defining a person as internet ‘dependent’ or ‘nondependent’ based on modified criteria for dsm-iv pathological gambling [12]. Her pioneering research has become a point of reference for subsequent investigations addressing the phenomenon of internet addiction around the world [13-15]. Attempts to understand and treat addiction as a purely biological or a purely environmental problem have not been successful [17]. Griffiths postulates a ‘components model’, which defines addiction as the sum of related features: salience, mood modification, tolerance, withdrawal, conflict and relapse [18,19]. These components reflect both biological and psychosocial features of the addictive phenomena, and all of them must be present to consider any behavior as an versies about the term ‘internet addiction’. There is no consensus among the various investigators as to how to call this phenomenon, and different terms have been proposed: internet dependency [11], internet addiction [12] , pathological internet use [20], problematic internet use [21], compulsive computer use [22], virtual addiction [23], internet use disorder [24]. Traditionally, the dependence on exogenous drugs causing neuroadaptation of the brain reward circuitry has served as a primary definition of addiction. Therefore, ia could be viewed as a “behavioral addiction”, which is the result of moving towards a definition of addiction based more on behavior [28]. It is our view that to keep using the term ‘internet addiction’ is still valid, given that there is a great deal of literature using this term, and it has become popular both in academic circles and the media. For these reasons, we will continue to designate the phenomenon as ‘internet addiction’ throughout the rest of this ence data on ia are limited by methodological difficulties concerning diagnosis and heterogeneity of diagnostic instruments. Internet use et use per day; assessment of academic, social or lifestyle onnaire based on dsm-iv substance ’s diagnostic questionnaire (telephone). Internet-related addictive ory, version ii / young's diagnostic -reported internet dependency and related psychological et addiction scale for taiwanese high ed young’s internet addiction scale (online). S internet addiction ’s internet addiction ’s internet addiction ’s diagnostic ’s internet addiction ’s 10-item internet addiction test.

Literature review on internet addiction

Calculated from data reported on the 1: epidemiologic data on the prevalence of internet al and technological differences between countries play a major role in the prevalence of ia. Brenner presented results from a survey of 563 internet users who admitted problematic use, in which older users reported experiencing fewer problems than younger users [52]. It has been suggested that this gender distribution may be explained by the fact that males, especially adolescents and young adults, use the internet more than females and are more likely to express interest in games, pornography and gambling, activities that have all been associated with ia [20]. The popularity of the internet, detecting and diagnosing ia is often difficult, as its legitimate business and personal use often mask addictive behavior [53]. Problematic internet use has been described as more impulsive and ego-syntonic in nature, and individuals with this problem have described an increasing sense of tension or arousal before successfully logging onto the internet, which was difficult or impossible to resist, and a relief of that tension that was often pleasurable as they logged on [54]. These data support the inclusion of ia as an impulse control the other hand, several impulse-control disorders, such as pathological gambling and kleptomania, have similarities to substance addictions on its behavioral and biological components [63,64]. Diagnostic criteria for impulse control disorders overlap with those for substance dependence, [64] and there is growing evidence indicating that behavioral addictions resemble substance addictions in natural history, phenomenology, tolerance, comorbidity, genetics, neurobiological mechanisms and response to treatment [26]. Furthermore, recent neuroimaging findings have associated internet overuse with neurobiological changes, [65] similar to those observed in addictions. Internet addicts develop urges to use the internet when offline and computer usage significantly preoccupies their time and thoughts. A sense of tension or arousal may develop before logging on to the internet, with a sense of relief obtained once successfully logged on. More important, the excessive internet usage leads to significant impairment in work, school, family or social domains. Information on biological, psychological and social factors should be reviewed to allow the mental health professional to understand how the internet has impacted these domains. According to the 8-item diagnostic questionnaire developed by young, [12] an individual would be internet dependent by fulfilling five or more criteria. 68] elaborated on criteria modeled after dsm-iv impulse control disorder, and emphasized that excessive internet use does not occur during periods of hypomania or mania, based on their findings on elevated comorbidity with bipolar disorder or schizoaffective disorder and ia [54]. 61] proposed seven items of symptom criteria, plus three additional criteria: 1) exclusion, by not accounting for psychotic disorders or bipolar i disorder; 2) clinically significant impairment; and 3) course, with duration of ia in excess of 3 months, with at least 6 hours of non-essential internet usage per day. The dsm-5 substance-related disorders work group have proposed criteria which take into account withdrawal and tolerance, although they consider internet gaming as the only activity with addictive potential [24]. It was designed to assess which areas of an individual’s life might be affected by their excessive internet use [69]. Since the conception of the iat, other assessment instruments have been developed, such as the chen internet addiction scale, [70] compulsive internet use scale, [71] problematic internet use questionnaire, [72] generalized problematic internet use scale, [73] internet-related addictive behavior inventory [52] and pathological internet use scale, [20] among is not clear whether ia represents a manifestation of an underlying disorder, or is a discrete disease entity [63]. A biopsychosocial perspective, addiction is the result of an interaction between many factors including biological and/or genetic predisposition, psychological constitution (i. The integration of all these factors results in behaviors, which, if maladaptive and repetitive, have the potential to become an addiction (figure 1). Also, there are studies evaluating electrophysiological parameters and different modalities of magnetic resonance imaging, such as voxel-based morphometry, diffusion tensor imaging and functional gh no twin studies have investigated the heritability of ia to date, it has been shown that another behavioral addiction, pathological gambling, presents heritability estimates close to 50% [83]. If ia is considered a behavioral addiction, it is possible to imply a genetic susceptibility for the et al. This study found the excessive internet use group to have higher levels of harm avoidance and ss-5httlpr 1:biopsychosocial model of a biopsychosocial perspective, addiction is the result of ors which originate from an interaction between various biological,Psychological and environmental r study assessed genetic polymorphisms of the dopaminergic system and temperament in adolescents with excessive internet videogame play. In this study, the taq1a1 allele, low activity comt alleles and higher reward-dependence scores were significantly more prevalent in patients with excessive internet videogame play, relative to a control et al. Results showed an association between subjects with occasional and frequent problems with the internet and having the cc variant of the rs1044396 -related potentials are a valuable measure for studying brain-behavior relationships. Right orbitofrontal cortex, right nucleus accumbens, bilateral anterior cingulate, medial frontal cortex, right dorsolateral prefrontal cortex, and right caudate nucleus have been found to be activated in subjects with internet gaming addiction [90]. While performing a reality-simulated guessing task, internet addicts show increased activation in orbitofrontal cortex in ‘gain’ trials and decreased anterior cingulate activation in ‘loss’ trials. Using voxel-based morphometry (vbm) have shown that internet addicts have decreased gray matter volume in the bilateral dorsolateral prefrontal cortex, supplementary motor area, orbitofrontal cortex, cerebellum, left anterior cingulate cortex, left posterior cingulate cortex, left insula, left lingual gyrus, both inferior temporal gyri, right middle occipital gyrus, and left inferior occipital gyrus, whereas an increase in volume has been observed in left thalamus gray matter [92,95,96]. 98] assessed d2 dopamine receptor availability in internet addicts using positron emission tomography (pet) and a radioligand, [11c] raclopride. Are reports evaluating the efficacy of escitalopram [99], naltrexone [57] or the combination of citalopram/quetiapine [100] in treating internet addicts. At the end of the 10th week of open-label escitalopram, primary measures of internet use showed a statistically significant decrease, compared with baseline. However, at the end of the 9-weeks placebo-controlled phase, there were not differences in outcomes between the escitalopram or placebo r trial evaluated treatment with bupropion to decrease craving for internet game play [102].

Subjects with internet videogame addiction were recruited, and were compared with healthy controls who had experience with, but were not addicted to, videogames. After a 6 week period of bupropion sustained-release treatment, craving for internet video game play and total game play time were decreased in the addiction studies have evaluated treatment in subjects with ia and a comorbid psychiatric disorder. Bupropion 150-300 mg/day was evaluated in a prospective, randomized, double-blind clinical trial, in a male sample with comorbid online game addiction and major depressive disorder [103]. All participants were randomly assigned to bupropion+education for internet use, or placebo+education for internet use. Results showed improvements in severity of online game addiction that was associated with parallel changes in depressive symptoms during bupropion trial examined the role of methylphenidate treatment in individuals with comorbid adhd and internet videogame addiction [104]. Children diagnosed with adhd who were internet videogame players were treated with methylphenidate 18–54 mg/day for 8 weeks. Cbt helps internet addicts recognize maladaptive cognitions, modify and reconstruct adaptive cognitions, and return to reality. Currently there is an ongoing study evaluating the efficacy of a manualized short-term treatment program for internet and computer game addiction; it is based on cbt, combining group with individual therapy [107]. Therefore, multimodal psychotherapy includes various psychotherapeutic approaches, and it has been studied in different trials for the treatment of ia, showing improvement on internet use measures, psychosomatic symptoms, quality of life, depressive symptoms, as well as increased functionality in family and social domains [110]. Its inception, the internet has worked as a channel for communication in connected social networks. Enthusiasts, who describe a paradigm shift that has resulted in the ‘social web’, the internet has always been social. However, in the last years, certain internet portals have emerged that are specifically designed to support and develop friendship, and whose overt purpose is to provide a context and appropriate tools for doing so [112]. It has been suggested that “facebook addiction” or preferably “‘social networking site addiction” could be another subcategory of the spectrum of internet addiction disorders [115,116]. This scale contains 18 items, three for each of the six core features of addiction: salience, mood modification, tolerance, withdrawal, conflict, and relapse. Syndrome model of addiction’, [119] addictive phenomena should be understood as a syndrome with multiple expressions, that are the result of interacting biopsychosocial antecedents, different manifestations, and diverse consequences. As such, ia -and sns addiction- could be viewed as different manifestation of the same underlying syndrome, with shared psychological and biological features. Although extraversion has been negatively correlated with measures of ia [123] and less consistently related to substance use and abuse, [124] low conscientiousness has been reported with diverse substance addictions [125]. The current literature on sns addiction is scarce, and for the time being, we need to draw assumptions from indirect evidence. The last years, a point has been made for regulating the internet in order to prevent people from becoming addicted to it. In asian countries, two kinds of approaches have been proposed to address this problem (particularly excessive internet gaming): a shutdown system or a fatigue system [128]. Although government should not refrain from regulating the internet at all, we believe that intervention on internet freedom could create more problems than it tries to resolve. Furthermore, as already stated, any addiction is the result of an interaction between biological, psychological and environmental factors. Instead, ia might be a manifestation in people who, given their biopsychosocial antecedents, are addiction-prone individuals. Whichever effective policy to reduce rates of addiction cannot be focused on environmental issues only (either controlling internet access/content or penalizing possession of drugs), but take an integral approach at the magnitude of the though, it should be noted that any attempt at regulation cannot be generalized to every nation or culture. Appropriate internet regulatory policy will depend on the societal structure and prevailing technology of each study of ia is still in its beginnings; however, the last decade has seen an increased interest in the subject, with research pouring in data from different parts of the world. Mental health professionals should be aware of the spectrum of ia, and work towards implementation of preventive, diagnostic and treatment ak j (1998) history, structure, and function of the internet. Computers in human behavior 26: rooij aj, schoenmakers tm, van de eijnden rj, van de mheen d (2010) compulsive internet use: the role of online gaming and other internet applications. Psychiatr danub 23: i, larose r, eastin ms, lin ca (2004) internet gratifications and internet addiction: on the uses and abuses of new media. Cns drugs 22: o diaz l, matos retamozo l,kendall folmer r (2006) adicción a internet: perfil clínico y epidemiológico de pacientes hospitalizados en un instituto nacional de salud mental. Cyberpsychology & behavior 1: son a, götestam kg (2004) internet addiction: characteristics of a questionnaire and prevalence in norwegian youth (12-18 years). 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