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Psychiatry and Clinical Neurosciences 2014; 68: 197–205 doi:10.1111/pcn.

12124

Regular Article

Internet abusers associate with a depressive state but not a


depressive trait
Andrew Chih Wei Huang, PhD,1* Huai-En Chen, BS,1 Ying-Chou Wang, PhD2 and
Le-Min Wang, PhD3
1
Department of Psychology, Fo Guang University, Yi-Lan, 2Department of Clinical Psychology, Fu Jen Catholic University,
New Taipei City, and 3Women and Children Protection Brigade of Tainan City Police Department, Tainan, Taiwan

Aim: The present study investigated three issues: (i) not show a depressive trait in the Minnesota Multi-
whether Internet abusers display a depressive state phasic Personality Inventory-2 compared to low-risk
without a depressive trait; (ii) which symptoms are Internet abusers. Therefore, high-risk Internet abuse
shared between Internet abuse and depression; and participants exhibited a depressive state without a
(iii) which personality characteristics were shown in depressive trait.
Internet abusers.
Conclusions: In a comparison of the symptoms of
Methods: Ninety-nine male and 58 female partici- depression and Internet abuse, it was found that
pants aged 18–24 years were screened with the Chen high-risk Internet abuse participants shared some
Internet Addiction Scale. After screening, subjects common behavioral mechanisms with depression,
were separated into the high- (n = 73) and low-risk including the psychiatric symptoms of loss of inter-
(n = 84) Internet abuser groups. Participants were est, aggressive behavior, depressive mood, and guilty
respectively administered the Chinese version of the feelings. High-risk Internet abuse participants may be
Beck Depression Inventory-II to assess a depressive more susceptible to a temporal depressive state but
state and the Minnesota Multiphasic Personality not a permanent depressive trait. The present findings
Inventory-2 to assess a depressive trait. have clinical implications for the prevention and
treatment of Internet abuse.
Results: The present results showed that high-risk
Internet abusers exhibited a stronger depressive state
Key words: depressive state, depressive trait, Internet
than low-risk Internet abusers in the Beck Depression
abuse.
Inventory-II. However, high-risk Internet abusers did

NTERNET MISUSE HAS spread throughout many mood, and guilty feelings.4 Recent data demonstrated
I countries and across different cultures for more than
the past decade.1 Past studies of Internet abuse have
that numerous psychiatric disorders could be associ-
ated with Internet abuse, including major depressive
shown that abusers can elicit various symptoms disorder,5 aggressive behavior,6 attention-deficit/
similar to those observed with substance misuse, such hyperactivity disorder, social phobia, and substance
as impulsive behaviors,2 withdrawal symptoms, toler- use.7 Interestingly, most Internet abuse individuals
ance,3 aggressive behavior, loss of interest in social, indicate that they have experienced some negative
occupational, and recreational activities, depressed emotional responses after ‘surfing the net’.8,9 There-
fore, a depressive state might be an important compo-
nent of Internet abuse’s psychiatric symptoms.
*Correspondence: Andrew Chih Wei Huang, PhD, Department of
Growing studies reported that Internet abuse
Psychology, Fo Guang University, No. 160, Linwei Rd, Jiaosi Shiang,
Yilan County 26247, Taiwan. Email: chweihuang@mail.fgu.edu.tw correlated with the pathologic symptoms of
Received 17 July 2012; revised 3 September 2013; accepted 9 depression.7,10–18 For example, some studies have
September 2013. shown that Internet abuse subjects could be classified

© 2013 The Authors 197


Psychiatry and Clinical Neurosciences © 2013 Japanese Society of Psychiatry and Neurology
198 A. C. W. Huang et al. Psychiatry and Clinical Neurosciences 2014; 68: 197–205

as moderately-to-severely depressed, but non-Internet


abuse subjects could be classified as non-depressed14 METHODS
when undergoing Young’s Internet Abuse and the
Beck Depression Inventory (BDI) tests. Furthermore,
Participants
it was reported that Internet addicts had higher scores A sample of 157 students (99 men and 58 women),
of depression and anxiety.15 A recent study indicated aged 18–24 years, were recruited from Fo Guang Uni-
that Internet abuse subjects displayed higher depres- versity, National Yi-Lan University, and Lan Yang
sion, anxiety, obsessive–compulsive behavior, and Institute of Technology in Taiwan. All participants
hostility than subjects without Internet abuse, based were administered the Chen Internet Abuse Scale
on self-report. Moreover, this pattern of psychiatric (CIAS),24 the BDI-II, and the MMPI-2. All participants
symptoms was similar to substance abusers.7 Some were screened by the criteria of MMPI-2 Validity
psychiatric comorbidity studies of Internet abuse and scales, so the valid samples were 157 (99 male and 58
psychiatry have shown that depression,11 attention- female) university students. The CIAS screened the
deficit/hyperactivity disorder,10,12 social phobia, and 157 participants. A cut-off score of 58 (not including
hostility could predict the occurrence of Internet 58, ≧59) produced 84 low-risk and 73 high-risk
abuse.13,18 Internet abusers. A score of more than 58 was a
However, other studies have demonstrated some highly efficacious cut-off score for dissociating
opposing evidence to suggest that Internet abuse was Internet abusers from non-Internet abusers.25 All of
not related to depression.19–21 A recent Chinese Inter- the participants provided informed written consent
net abuse report has shown that being male, alcohol before participating in the study. This study complied
consumption, family dissatisfaction, and the experi- with the Ethical Principles of Psychologists and the
ence of a recent stressful event, but not depression Code of Conduct 2002.
levels, affected the susceptibility to Internet abuse.21
Additionally, an Internet abuse study with samplings
from Korean high school students has demonstrated Instruments
that Internet abuse scores were not significantly cor- The CIAS score served as a screening tool to separate
related with depression scores, but Internet abuse the low- and high-risk Internet abuse groups.25 The
scores were associated with suicidal ideation scores.20 BDI-II22 and MMPI-223 scores served as dependent
Another study showed that the time spent online in variables to reveal the magnitude of depression (i.e.,
subjects with Internet abuse did not correlate with depressive states) and personality characteristics (i.e.,
depression, anxiety, or social fearfulness.19 depressive trait), respectively. Depressive states and
The issues of whether Internet addicts were associ- traits were analyzed with Pearson correlations to test
ated with depression and whether clinical personality their relations for all participants. The high and low
characteristics occurred in Internet abusers were depressive trait groups were separated by the mean
explored further in the present study. Furthermore, value of depression index D and DEP of MMPI-2,
no study of which we are aware has examined respectively. BDI scores greater than 20 served as the
whether Internet abusers not only have a temporal high-depressive state group.26
depressive state associated with Internet use, but
also a permanent depressive personality trait. There-
fore, the present study used the BDI-II to assess a
CIAS
depressive state22 and the Minnesota Multiphasic Per- We followed our previous report (2010) and used the
sonality Inventory-2 (MMPI-2) to assess a depressive CIAS scale to measure participants’ Internet abuse.27
trait.23 The present study used a cut-off of 58 points (not
Altogether, the present study investigated three including 58, ≧59) to screen participants into high-
specific items. The study was concerned with whether and low-risk Internet abuse groups.25 The partici-
Internet abusers exhibited a higher depressive state pants’ responses on the CIAS are based on a 4-point
but not a depressive trait in personality. Second, the Likert scale for each item. The CIAS may be viewed
present study compared the possible shared charac- as a reliable test because of its test–retest reliability
teristics of depression and Internet abuse. Finally, and internal consistency (between 0.79 and 0.93;
the study examined which personality characteristics P < 0.05). The Cronbach’s α value for the CIAS is
Internet abusers exhibited. 0.93.24

© 2013 The Authors


Psychiatry and Clinical Neurosciences © 2013 Japanese Society of Psychiatry and Neurology
Psychiatry and Clinical Neurosciences 2014; 68: 197–205 Internet abuse and depression 199

oneself in the best way), and L values (i.e., the ‘lie


BDI-II scale’). The test–retest reliability of the Chinese
Like the CIAS, each item was scored on a 4-point MMPI-2 for the clinical and content scales ranges
Likert scale, which reflected the degree of participant from 0.74 to 0.94 and 0.70 to 0.95, respectively.29
agreement with each of the statements. Each item on The average Cronbach’s α coefficient for the clinical
the questionnaire had possible scores between 0 and scales is 0.63 for men and 0.64 for women. The
3. The BDI-II is a reliable test, reflected by its internal average Cronbach’s α coefficient for the content
consistency and test–retest reliability between 0.92 scales is 0.76 and 0.77 for men and women,
and 0.93 (P < 0.01).28 The Cronbach’s α value of respectively.29
the BDI-II is 0.92 and 0.93, respectively, for clinical
patients and college students.28
Procedure
All of the participants were asked to complete the
MMPI-2 CIAS instrument and were then separated into low-
The Traditional Chinese MMPI-2 in the ‘Hong Kong’ and high-risk Internet abuse groups. They were
version has clinical scales and content scales. The administered the BDI-II to assess the depression state
clinical scales assessed 10 clinical personality charac- and the MMPI-2 to assess various personality charac-
teristics, including hypochondriasis (Hs), depression teristics, including the depressive trait.
(D), conversion hysteria (Hy), psychopathic deviate
(Pd), masculinity–femininity (MF), paranoia (Pa),
Statistical analysis
psychasthenia (Pt), schizophrenia (Sc), hypomania
(Ma), and social introversion (Si). The content scales All raw data were analyzed using the t-independent
measured 15 personality characteristics, including test. Values of P < 0.05 were considered statistically
anxiety (ANX), fears (FRS), obsessiveness (OBS), significant. The effect size was calculated by Hedge’s g
depression (DEP), health concerns (HEA), bizarre statistic, which was modified by Cohen’s d statistic:
mentation (BIZ), anger (ANG), cynicism (CYN), anti- the g-value is equal to 0.20 for a small effect, to 0.50
social practices (ASP), type A personality (TPA), low for a medium effect, and equal to and above 0.80 for
self-esteem (LSE), social discomfort (SOD), family a large effect.30
problems (FAM), work interference (WRK), and
negative treatment indicators (TRT). The assessments
of validity scales included Q (i.e., the ‘cannot say’
RESULTS
scale, which is the number of items left unanswered), Table 1 shows that 49 of the male participants could
F (i.e., ‘faking good’ or ‘faking bad’), K (i.e., the be classified with low-risk Internet abuse and 50 of
‘defensiveness scale’, which is a more effective and the male participants could be classified with high-
less obvious way of detecting attempts to reveal risk Internet abuse, using 58 as the cut-off score.

Table 1. Comparisons of demographic characteristics, Internet addiction, and a depressive state between low- and high-risk
Internet abuse groups

Internet abuse
Characteristics Low-risk Internet abusers (n = 84) High-risk Internet abusers (n = 73) t(155) P
Sex
Male participants 49 50 – –
Female participants 35 23 – –
Internet addiction, mean (SE) 49.76 (0.75) 68.42 (0.98) −15.14 0.00*
Depressive state (BDI), mean (SE) 10.43 (1.09) 15.29 (1.54) 2.58 0.01*
*P < 0.05, compared with low-risk Internet abusers.
BDI, Beck Depression Inventory.

© 2013 The Authors


Psychiatry and Clinical Neurosciences © 2013 Japanese Society of Psychiatry and Neurology
200 A. C. W. Huang et al. Psychiatry and Clinical Neurosciences 2014; 68: 197–205

Table 2. Comparisons of personality characteristics between low- and high-risk Internet abuse groups

Internet abuse
Personality characteristics Low-risk Internet abusers (n = 84) High-risk Internet abusers (n = 73) t(155) P
Clinical scale, mean (SE)
HS 22.59 (0.60) 21.54 (0.62) 1.21 0.23
D 23.10 (0.49) 23.05 (0.54) 0.06 0.96
Hy 27.70 (0.61) 26.30 (0.63) 1.58 0.11
Pd 26.22 (0.64) 25.40 (0.67) 0.88 0.38
Mff 28.96 (0.48) 27.37 (0.43) 2.46 0.02*
Mfm 25.69 (0.37) 26.14 (0.37) −0.85 0.40
Pa 17.75 (0.53) 17.11 (0.61) 0.80 0.43
Pt 34.08 (0.58) 35.78 (0.86) −1.63 0.11
Sc 44.24 (1.07) 45.95 (1.20) −1.06 0.29
Ma 23.18 (0.46) 23.12 (0.61) 0.08 0.93
Si 34.82 (0.59) 35.11 (0.84) −0.29 0.78
Content scale, mean (SE)
ANX 10.82 (0.55) 12.00 (0.56) −1.49 0.14
FRS 9.93 (0.59) 10.12 (0.57) −0.24 0.82
OBS 6.52 (0.29) 7.21 (0.32) −1.57 0.12
DEP 14.79 (0.55) 15.64 (0.57) −1.08 0.28
HEA 14.94 (0.63) 15.07 (0.69) −0.14 0.89
BIZ 8.79 (0.44) 8.16 (0.47) 0.96 0.34
ANG 6.92 (0.30) 7.71 (0.34) −1.75 0.08
CYN 11.62 (0.43) 11.88 (0.44) −0.42 0.68
ASP 9.42 (0.41) 9.84 (0.49) −0.66 0.51
TPA 8.07 (0.35) 9.22 (0.35) −2.30 0.02*
LSE 10.33 (0.34) 10.48 (0.44) −0.27 0.79
SOD 11.13 (0.45) 10.62 (0.51) 0.76 0.45
FAM 9.82 (0.45) 9.48 (0.43) 0.54 0.59
WRK 14.13 (0.58) 16.62 (0.68) −2.80 0.01*
TRT 10.72 (0.43) 11.90 (0.42) −1.94 0.05**
*P < 0.05, **P < 0.10 compared with low-risk Internet abusers.
ANG, anger; ANX, anxiety; ASP, antisocial practices; BIZ, bizarre mentation; CYN, cynicism; D, depression; DEP,
depression; FAM, family problems; FRS, fears; HEA, health concerns; HS, hypochondriasis; Hy, conversion hysteria;
LSE, low self-esteem; Ma, hypomania; MF, masculinity–femininity; OBS, obsessiveness; Pa, paranoia; Pd, psychopathic
deviate; Pt, psychasthenia; Sc, schizophrenia; Si, social introversion; SOD, social discomfort; TPA, type A personality;
TRT, negative treatment indicators; WRK, work interference.

Thirty-five of the female participants could be classi- Pd, MF, Pa, Pt, Sc, Ma, and Si. However, with the
fied with low-risk Internet abuse and 23 of the female exception of Mff, none of the subscales were signifi-
participants could be classified with high-risk Inter- cantly different between the low- and high-risk Inter-
net abuse. Internet addiction was significantly stron- net abuse groups. The present results indicated that
ger in the high-risk Internet abuse group than in the high-risk Internet abusers may have less female atti-
low-risk Internet abuse group. The BDI-II scores for tude in clinical personality characteristics.
low- and high-risk Internet groups were shown to Additionally, Table 2 shows the MMPI-2 scores for
be the medium effect size (Hedge’s g = 0.42). The the content scale personality characteristics, includ-
t-independent test indicated that the high-risk Inter- ing ANX, FRS, OBS, DEP, HEA, BIZ, ANG, CYN, ASP,
net abusers had a stronger depressive state than the TPA, LSE, SOD, FAM, WRK, and TRT. The present
low-risk Internet abusers (see Table 1). results indicated significant differences in TPA and
Table 2 shows the MMPI-2 scores for the clinical WRK, and there was a tendency for a significant dif-
scale personality characteristics, including HS, D, Hy, ference between the low- and high-risk Internet abuse

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Psychiatry and Clinical Neurosciences © 2013 Japanese Society of Psychiatry and Neurology
Psychiatry and Clinical Neurosciences 2014; 68: 197–205 Internet abuse and depression 201

Table 3. Comparisons of validity scales of personality characteristics between low- and high-risk Internet abuse groups

Internet abuse
Personality characteristics Low-risk Internet abusers (n = 84) High-risk Internet abusers (n = 73) t(155) P
Validity scale, mean (SE)
Q 1.21 (0.25) 0.60 (0.18) 1.98 0.05*
F 20.89 (0.88) 21.90 (1.06) −0.74 0.46
K 14.54 (0.42) 13.33 (0.45) 1.95 0.05*
L 6.24 (0.27) 5.71 (0.31) 1.28 0.20
*P < 0.10, compared with low-risk Internet abusers.
F, ‘faking good’ or ‘faking bad’; K, the ‘defensiveness scale’, which is a more effective and less obvious way of detecting
attempts to reveal oneself in the best way; L values, the ‘lie scale’; Q, the ‘cannot say’ scale, which is the number of items
left unanswered.

groups. The results showed that high-risk Internet the dissociation from the D values (t[155] = −3.12,
abusers might have higher scores in Type A person- P < 0.05) (Fig. 1a). The DEP value dissociation also
ality, work interference, and negative treatments than showed a significant increase in BDI scores for the
low-risk Internet abusers. high depressive trait compared with the low depres-
Table 3 shows that the F and L values were non- sive trait (t[155] = −2.30, P < 0.05) (Fig. 1b). There-
significant. The Q and K values tended to increase fore, the depression trait is correlated positively with
significantly in low-risk Internet abusers. the depression state.
Further analysis investigating the interaction In contrast, the BDI scores indicated that the
between state and trait depression appears in Figure 1. depression state separated into low and high depres-
The high depressive trait had significantly higher BDI sive state groups. The results showed that the high
values than those of the low depressive trait for depressive state group significantly increased the

(a) D index (b) DEP index


20 20
*
Mean (±SEM) Beck

*
Mean (±SEM) Beck

Depression Score
Depression Score

15 15

10 10

5 5

0 0
Low depressive High depressive Low depressive High depressive
Figure 1. Assessments of a depression triat (n = 75) triat (n = 82) triat (n = 80) triat (n = 77)
state and a depression trait. Mean
(± SEM) Beck Depression Inventory
(c) (d)
(BDI) scores for low and high depressive
28
trait groups (a) using the mean value of
Mean (±SEM) DEP Score

20
Mean (±SEM) D Score

the D index and (b) using the mean of *


the DEP index of the Minnesota Multi- 18
26 *
phasic Personality Inventory-2 as cut-off 16
scores. Mean (± SEM) (c) D and (d) DEP
scores for low and high depressive 24 14
state groups using the BDI ascending 12
rank cut-off scores. Note: D represents
depression in the clinical scales. DEP 22 10
represents depression in the content Low depressive High depressive Low depressive High depressive
scales. *P < 0.05. state (n = 130) state (n = 27) state (n = 130) state (n = 27)

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202 A. C. W. Huang et al. Psychiatry and Clinical Neurosciences 2014; 68: 197–205

D index (t[155] = −2.44, P < 0.05) and DEP index survey design in a sample of Korean adolescents and
(t[155] = −2.28, P < 0.05) compared to the low found that depression significantly correlated with
depressive state group (Fig. 1c,d). It means that the suicidal ideation but not Internet abuse.20 Moreover,
depression state is correlated to the depression trait. a correlation test showed a non-significant relation
Taken together, the depression state is correlated between Internet abuse and depression.21 The present
with the depression trait. data support the hypothesis that Internet abuse and
depression are correlated positively.
However, our data extended this hypothesis
DISCUSSION and further showed that high-risk Internet abusers
High-risk Internet abusers show significantly higher showed seemingly higher depression responses than
rates of the depression state compared to the low-risk low-risk Internet abusers. This depression response
Internet abusers. However, high-risk Internet abuse appears to be like a depression state. The present data
participants did not exhibit any significant depressive further indicated that high-risk Internet abuse partici-
personality characteristics, such as the D index on the pants had a depressive state, but did not show a
clinical scales and the DEP index on the content depressive trait in the personality assessment. There-
scales. High-risk Internet abuse participants may fore, we suggest that Internet games or related events
present a significantly depressive state without dis- can cause Internet addiction and the associated
playing a depressive trait. Internet abusers may natu- depressive state. The concept that depression can be
rally display some personality characteristics, for separated into a state and a trait was consistent with
example, less female attitude, Type A personality, the previous report.32 However, we discuss this
work interference, and negative treatment. Further- concept with Internet addiction.
more, the Q and K values of the validity scales were On the other hand, the present data did not con-
significantly higher in the low-risk Internet abuse flict with the previous investigations of Internet
group when compared with the high-risk Internet addicts and their personality traits. Subjects with
abuse group. It may be due to the social desirability Internet abuse presented a lower level of extraversion
effect resulting in the low-risk Internet abusers to and a higher degree of psychoticism compared with
prevent showing their real mental conditions. controls, suggesting that Internet addicts often show
introversion and psychoticism in their personality
traits.33 A recent personality trait study indicated
Internet abuse and depression: Depressive that online gaming addiction highly correlated with
state versus depression trait personality traits, such as neuroticism, sensation
Previous studies have examined the possible relations seeking, trait anxiety, state anxiety, and aggression.34
between Internet abuse and a depressive state to Therefore, high-risk Internet abusers were not related
show conflicting results. An important claim was that to a high depressive trait.
Internet abuse positively correlated with a depressive
state.11,16,31 For example, a study of Taiwan college
students utilized a self-report questionnaire13 and Clinical implications: Pharmacological and
interview approach12 to show that Internet abuse was
psychosocial interventions
associated with the psychiatric symptoms of The present data indicated that Internet abuse might
attention-deficit/hyperactivity disorder, depression, produce the depressive state but not depressive traits.
and hostility (i.e., aggressive behavior).18 Some The implications of the present study indicate that
studies reported that only men with Internet abuse some typical pharmacological treatments of major
were more susceptible to depressive symptoms com- depressive disorder might be able to treat the depres-
pared with women.12–14 Recent studies reported that sive state of Internet addiction.35–37 First, monoamine
Internet abuse was associated with not only depres- oxidase inhibitor drugs (such as moclobemide) were
sion, but also substance abuse7 and obsessive– shown to block the activation of monoamine oxidase,
compulsive symptoms.11,17 protected active monoamines in the brain, and then
Nevertheless, another line of research did not cor- decrease the depressive state.38 Second, a tricyclic
roborate the connection between Internet abuse and antidepressant drug has been demonstrated to block
depression.20,21 For example, a study regarding Inter- the reuptake of serotonin and norepinephrine to
net addiction and depression used a correlation reduce the depressive state.39 Finally, the selective

© 2013 The Authors


Psychiatry and Clinical Neurosciences © 2013 Japanese Society of Psychiatry and Neurology
Psychiatry and Clinical Neurosciences 2014; 68: 197–205 Internet abuse and depression 203

serotonin reuptake inhibitors (such as fluoxetine40 Interestingly, a similar symptom of Internet abuse is
and escitalopram41) was shown to specifically affiliate the loss of interest in other social, occupational, and
and block the reuptake mechanism of serotonergic recreational activities. Moreover, a similar finding has
neurons, and increased the amount of serotonin been shown by another recent study,47 which sug-
released in the synapse to decrease the depressive gested that the Internet misuse might result from
state. Therefore, Internet addiction can be treated with spending many hours on the Internet, thereby pre-
any of the antidepressant drugs to decrease the depres- venting interpersonal communication, and losing
sive symptoms of Internet addiction. By contrast, interest in interpersonal relationships.47 Second,
these treatments cannot modify the depressive trait for aggressive behavior might emerge in depression such
Internet abusers. that individuals express thoughts of death or suicidal
Psychosocial interventions might be an alternative ideations, plans, or attempts. Depressed patients do
treatment to prevent the suffering of Internet not project their aggressive behavior outward, but
addiction.42–45 For example, a recent investigation has rather place the target on themselves. However, some
proposed that cognitive-behavioral therapy could reports suggest that aggressive behavior may be a
help Internet abusers overcome the maladaptive cog- critical behavioral characteristic when turning off an
nition for Internet misuse to modify their behavior to online game.1,2,6 Third, Internet abuse and depression
re-construct adaptive cognition.42 A similar finding share the symptoms of depressed mood and guilty
was demonstrated in the previous evidence.45 More- feelings. According to the DSM-IV-TR, depressed
over, a previous study with regard to the treatment of patients may feel worthless or guilty. Data from a
compulsive cybersex behavior used some psychoso- website questionnaire indicated that 43% of subjects
cial treatments (e.g., relapse prevention, intimacy reported having depressed mood and guilty feelings
enhancement, lovemap reconstruction, dissociative after a long duration of Internet use.2
states therapy, arousal reconditioning, and coping In summary, the relation between Internet abuse
skills training) to reduce the trauma, intimacy and depression is hypothesized to result from a
dysfunction, depression, and additive behavior.43 common behavioral mechanism, including loss of
Furthermore, the motivational interviewing, reality interest, aggressive behavior, and negative mood.
therapy, Naikan cognitive psychotherapy, group
therapy, family therapy, and multimodal psycho- Discrepancy between Internet abuse and
therapy have been shown to have efficient treatments depression: Psychoticism versus neuroticism
for Internet addiction.42 Recently, some studies have
To elucidate the personality characteristics between
demonstrated that psychological interventions, par-
Internet abuse and depression, a previous study
ticularly cognitive-behavioral therapy, were more
has shown that only the significant effects of
successful than the pharmacological treatment.44
neuroticism, but not psychoticism, occurred in
Therefore, psychosocial interventions might be
patients suffering from depression.48 A recent study
another way to treat Internet abuse.
utilized the Eysenck Personality Questionnaire for
assessing the personality characteristics of Internet
Internet abuse and depression: Some abusers. Their results indicated that Internet abusers
common symptoms showed significant differences in psychoticism and
neuroticism (but not extraversion/introversion and
A critical issue is whether Internet abuse patients
lie) compared to the control group.49 Therefore,
share behavioral symptoms with depressed subjects.
psychoticism was observed only in Internet abusers,
Moreover, the specific reasons why Internet abuse
but not depressed patients. Psychoticism is the dis-
participants present psychiatric symptoms of depres-
crepancy between Internet abusers and depressed
sion may be more important than simply the deter-
patients. The discrepancy between Internet abuse
mination of a positive correlation between Internet
and depression should be investigated in further
abuse and depression. To elucidate this issue, we
studies.
compared the definitions of the symptoms of Inter-
net abuse2–4 and depression.46 Three symptoms are
shared between Internet abuse and depression. First,
Restriction of the present study
depressed patients may have depressed mood or a A possible restriction should be of concern. For
loss of interest or pleasure in nearly all activities. example, although the MMPI-2 personality test is

© 2013 The Authors


Psychiatry and Clinical Neurosciences © 2013 Japanese Society of Psychiatry and Neurology
204 A. C. W. Huang et al. Psychiatry and Clinical Neurosciences 2014; 68: 197–205

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ACKNOWLEDGMENTS of psychiatric symptoms for Internet addiction in adoles-
cents: A 2-year prospective study. Arch. Pediatr. Adolesc.
This research was supported by funding from the Med. 2009; 163: 937–943.
National Research Council of the Republic of China 14. Morrison CM, Gore H. The relationship between excessive
(NSC 98-2410-H-431-005 and NSC 99-2410-H-431- Internet use and depression: A questionnaire-based study
013) to A.C.W. Huang. The authors of this paper do of 1,319 young people and adults. Psychopathology 2010;
not have any commercial associations or financial 43: 121–126.
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addiction in a sample of freshmen university students in
nection with the results or interpretations of this
China. Cyberpsychol. Behav. 2009; 12: 327–330.
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psychosocial situation for a sample of university students.
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