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The new wave of online technology has seen the Internet take an increasingly large place amongst society throughout the past few decades. The introduction of Internet-capable personal devices such as mobiles phones and tablets have granted users further access, triggering Internet traffic to grow exponentially. Due to this immense social shift towards the online, contemporary issues have appeared on both an intrapersonal and interpersonal scale. Reports during the 1990’s, when the effects of the Internet intensified, suggested that some online users were becoming addicted in much the same way that others may become addicted to drugs, alcohol or gambling. However, as has been seen since this initial prognosis, Internet addiction has shown to be much more challenging and controversial to categorise than alternative substance-based addictions. In general terms, Internet addiction can be described as excessive preoccupations, behaviours or urges regarding computer and Internet use that leads to distress or impairment (Shaw & Black, 2008). This research review will identify major issues in Internet addiction, as well as overview the major controversies, such as the inauguration of Internet addiction as a concept, tests founded to measure it, general verses specific addiction, addiction to gaming and the symptoms of excessive Internet use.
Substantial research in the addiction field had been accomplished throughout the 20th century, however, due to the relative newness of Internet addiction, research that clearly outlines the stages of acquisition and the consequences of this type of addiction are less prominent. First mentions of computer addiction came through anecdotal reports in the late 1970’s, specifically through the media, with colloquial terms such as ‘computer addicts’ and ‘machine-code junkies’ being used to describe heavy computer users. The general public widely accepted that symptoms of computer addiction included the impairment of psychological development and the breakdown of social relationships. A few academics took a partial interest in the field throughout the 1980’s, however serious research was not conducted until Shotton (1991) partook in a study to further analyse this issue. Through a series of interviews and questionnaires, Shotton (1991) found that the effects of computer addiction were much less severe than previous literature and the media had suggested, citing logical reasons that explain why individuals engage in interacting with a machine so extensively. Shotton (1991) believed that introverted people who turned away from human relationships could find companionship through computing. Although revolutionary, Shotton’s research became quickly less pertinent when the Internet rose to fame in the mid-1990’s drastically changing the function and usability of computers.
At the 104th annual meeting of the American Psychological Association in 1996, Young (1998) presented a paper on the emergence of a new clinical disorder known as Internet addiction. Young reformed the prognosis in the DSM-IV (American Psychiatric Association, 1995) for Pathological Gambling into a brief questionnaire referred to as the Internet Addiction Diagnostic Questionnaire (IADQ) used as a screening instrument for addictive Internet use where participants who scored on 5 or more were deemed as dependant Internet users. Young demonstrated that dependant Internet users spent an average of 38.5 hours per week online, compared to 4.9 hours for non-dependant users. Furthermore, the research illustrated that non-dependant users viewed the Internet as a valuable source of information and a medium for personal and business communication. This contrasts with dependant users, who saw the Internet as a significant part of their lives, enabling them to meet and socialise with new people, with many often preferring their online friends to their real life relationships. The study likened the consequences of Internet addiction to that of other addictions, citing academic problems, work complications, distorted sleep patterns relationship difficulties, and denial of use as symptoms of excessive Internet use. Young provides a framework for further research on addictive Internet use, concluding that many individuals demonstrated impulse-control difficulty similar to pathological gambling or alcohol abuse.
The proposal put forth by Young (1998) sparked much debate amongst academics which has continued to this day. Beard and Wolf (2001) contended Young’s claim, arguing that her criteria for Internet addiction were too rigid and subjective for self-reported measures. They proposed that for an individual to exhibit Internet addiction, they must meet five necessary criteria, and one of three optional criteria, both deriving from Young’s original questionnaire. Beard and Wolf go on to question the term ‘Internet addiction’ altogether, explaining that excessive Internet use cannot be defined as an addiction, as it does not result in all of the symptoms and behaviours associated with conventional addictions such as physical withdrawal. The controversy surrounding this term is currently bolder than the times of yesteryear with the Internet’s increasing hold on society. Starcevic and Aboujaoude (2016) firmly stand against the diagnosis ‘Internet addiction’ citing some issues with its use. They argue against the term in a literal sense, citing that there is no evidence that addiction to the Internet as a medium exists, it is merely a facilitator for other behavioural addictions. Furthermore, and progressively so, the Internet is too vague a term as it refers to the limitless variety of behaviours that could be performed online. As such, the term ‘Internet addiction’ should be replaced by more specific behaviours.
The concluding argument by Starcevic and Aboujaoude (2016) in the previous paragraph feeds into one of the major controversies surrounding Internet addiction, where two schools of thought have emerged. The generalised view believes that Internet addiction merits its own classification as a new psychiatric disorder, whereas the specialised view breaks down an individual’s Internet usage and defines their addiction in regards to specific online activities. After many years of debate, a modern study by Montag et al. (2015) set out to examine whether it is appropriate to differentiate between generalised and specialised Internet addiction. Participants from Europe and Asia completed two generalised scales (IAT and GPIUS-2) and a specialised scale developed to measure four domains of internet use; video gaming, shopping, social networks and pornography. The results of the study demonstrated that there are indeed specific forms of Internet addiction and that large parts of both generalised and specific addiction do not overlap. However, this is not true in the case of social network addiction as there was a considerable overlap between it and generalised Internet addiction. The authors argue that this may be because Facebook does not exist without the internet, unlike the other specified domains. Laconi, Tricard and Chabrol (2015) also took a keen interest in the relationship between generalised Internet addiction and specialised internet addiction. This study had participants complete an array of scales relating to specific Internet uses (gambling, sex, video watching, communication, information seeking, gaming, work, shopping) and generalised Internet use. The study determined that out of 378 participants just 29 showed symptoms of generalised Internet addiction, in contrast to 170 showing specific Internet addiction, prompting the authors to call for the distinction between the two.
One of the biggest revelations for Internet addiction as a diagnosis came recently when the DSM-5 (2013) introduced a non-substance addiction for the first time in its history. Internet gaming disorder was added in Section 3 of the DSM-5 after careful review of over 250 publications in this area due to the significant amount of research in recent years and the consequences of the condition. Prior to the DSM-5, a substantial number of tests were used to examine Internet addiction, generating no clear diagnostic criteria. One of the more popular tests was proposed by Young (1998) in her original paper and known as the Internet Addiction Test (IAT). This scale added to the IADQ as it contained 20 items measured on a Likert scale. Its internal consistency has been examined amongst a variety of settings, most of which have proven to be positive (Widyanto & McMurran, 2004). However, its factor structure has been inconsistently reported in different contexts challenging its original unidimensional design (Lai et al., 2013). Through a systematic review of 68 epidemiological studies on Internet addiction, Kuss et al. (2014) reported that as many as twenty-one different scales were developed between the IAT in 1998 to the DSM-5 in 2013 in an attempt to examine an individual’s addiction to the Internet, each test with their own issues.
Petry et al. (2014) discuss the inclusion of Internet gaming disorder in the DSM-5 by assembling international experts to achieve consensus about assessing this disorder in an array of contexts as defined by the nine criteria in the DSM-5. Pre-occupation refers to the individual thinking about gaming not only while playing but also while they are not playing. Withdrawal refers to particular symptoms that emerge when one is unable to initiate gaming, or when one is trying to withhold from gaming. Tolerance denotes that an individual feels the need to game for extended periods of time to feel sufficient excitement. The fourth criterion is unsuccessful attempts to stop or reduce gaming. A person with Internet gaming disorder may also protrude a loss of interest in other hobbies or activities. The individual may also continue to game excessively even though they are aware of the negative consequences that arise from this behaviour. Deception refers to lying about the extent of their time gaming to others. The penultimate criteria the authors discussed is using gaming as an escape or relief from a negative mood, such as feelings of anxiety, sadness or depression. A person with Internet gaming disorder may also jeopardise or lose valuable relationships, work opportunities or educational opportunities due to their attraction to gaming. For the DSM-5 to deem an individual with this disorder, they must meet five or more of the criteria discussed within the past year. However, as Internet gaming disorder is situated in Section 3 of the DSM, which contains emerging measures and models, and due to the relative newness of the field, much more research must be conducted to produce a definitive set of criteria.
Of all specific Internet addictions, online gaming has arguably garnered the most attention to date from academics and researchers alike. Similar to the studies previously discussed, Rehbein and Mößle (2013) set out to determine whether video game addiction specifically could be distinguished as its own diagnosis in contrast to being attached to Internet addiction as a whole. A range of relevant data was collected from a large sample of 4436 school participants on their video game and Internet usage patterns, along with questions related to their psychological wellbeing. The results determined that video game addiction and Internet addiction can very much be regarded as two distinct nosological entities, and it is important to do so, as there are supreme differences in the sociodemographic characteristics between the two groups. The authors found that males primarily made up the group of video game addicts, whereas females predominately found themselves in the Internet addicted group.
Early in the lifespan of the Internet, Young (1998) found that users were drawn to real-time services such as internet relay chat (IRC) and multi-user domains (MUD). As technology is advanced, these amenities developed further into three-dimensional graphical representations in the form of online games. Massively multiplayer online role-playing games (MMORPGs) took the world by storm in the early 2000s through titles such as “Everquest”, where users were able to play out the life of a character in an online world with other players. Ng and Wiemer-Hastings (2005) investigated the different usages between MMORPG players and Non-MMORPG players by collecting anonymous surveys posted on various gaming forums. Interestingly, MMORPG players were seen to spend significantly more time investing in online gaming. However, the authors emphasise that these players cannot be classified as addicted as they display opposing characteristics to an addict, in that they do not seek self-confidence from the game, would not be irritated if they spent extended periods of time without playing and would find fun elsewhere if MMORPGs did not exist. The authors suggest that MMORPG players have a different perspective on social life, or labelled as introverted by some, and chose to socialise through online gaming rather than in the real world.
Comparable to the term itself, the symptoms of Internet addiction have been hotly debated since its proposal in the mid-1990’s (Valkenburg & Peter, 2009). In the early years of Internet addiction, the predominant belief amongst researchers was that this disorder had a detrimental effect both psychologically and socially. This was demonstrated in a famous study by Kraut et al. (1998) where they analysed this very idea in a longitudinal study. Measures of Internet use were collected over a two-year period, and social and psychological well-being were measured through reliable self-reports by individuals who had never used the Internet prior. Like other studies at the time, Kraut et al. found that excessive use of the Internet was associated with increases in loneliness and depression and declines in social involvement
Due to the increased accessibility of the Internet in a contemporary setting, many academics elude to the convoluted consequences of extreme Internet use in the modern day. Bessiere, Kiesler, Kraut and Boneva (2008) predicted, using previous hypotheses, that the way an individual uses the Internet will produce an increase or decrease in psychological and/or social well-being. A study similar to that of Kraut et al. (1998) was generated to decidedly distant results. Firstly, it was found that using the internet for things other than communication had no apparent consequences on well-being. Additionally, they found that using the Internet to communicate with family and friends actually had declining levels of depression. Whereas using the Internet as a means to interconnect with, and meet new people did induce increased levels of depression. Finally, the authors found that individuals with high levels of social support initially were more prone to negative social consequences in comparison to those with low levels of social support.
All aspects of Internet addiction are still up for debate. With the further protrusion of its presence in the everyday lives of more and more people, many studies have become invalid within a short period, making it problematic to keep up with the ever-changing landscape. Increased accessibility and affordability enable almost everybody the chance to be sucked in by the Internet, whereas in years gone past, especially in its inception, it was a more exclusive group. Perhaps this means that Internet addiction will become more widespread over the coming years, or contrastingly, the concept will die off due the normalisation of its overuse. As has been discussed throughout this review, many scales have been developed in an attempt to diagnose, and it is expected that much more will be established in the future as Internet use becomes increasingly prominent. It is evident that the distinction between generalised and specific Internet addiction needs to be entrenched to improve diagnoses, and this step has been taking with the introduction of the Internet Gaming Disorder in the DSM-5 (American Psychiatric Association, 2013). Much more research needs to be conducted within this field in the coming years to gain decisive conclusions. However researchers may be fighting a losing battle due to the Internet’s perpetual innovations.
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