Internet Addiction and Psychiatric Disorders

DT2019103-Hotma Uli O.T.

The use of the Internet has changed the world. Many benefits can be obtained from using the Internet
such as education, health, communication, agriculture, to the economy. But there is also a negative
effect. As the governments of South Korea and China, as well as Taiwan, are looking for policies and
strategies to prevent health risks and negative outcomes from overuse of the Internet in their countries.
Also, many studies were conducted to look at the effect of technology on symptoms such as attention
deficit, hyperactivity disorder (ADHD), anxiety, inattention, and hyperactivity-impulsivity. In this article, I
will examine Internet Addiction and its relationship with psychiatric disorders.

1. Introduction
Internet Addiction disorder is not currently registered as a clinical entity in the Diagnostic and
Statistical Manual of Mental Disorders (DSM). There has been much philosophical controversy over
fundamental concepts such as the boundary between "irregular" and "normal" mental states. Or the
narrowest question is what is meant by "addiction" and "addiction disorder". This condition which
affects “Internet Addiction” (IA) is difficult to be included as a nuisance term.
According to some experts, IA is defined as "... the inability of individuals to control their
internet use, which results in marked disruption and/or functional impairment in daily life." (JH, HJ, IH, &
al, 2006). In addition, some write the meaning of IA as “Internet addiction seems to be a common
disorder that deserves to be included in the DSM-V. Conceptually, the diagnosis is an impulsive-
compulsive spectrum disorder involving online and/or offline computer use and consists of at least three
subtypes: excessive gaming, sexual preoccupation, and email/text messages. ”(JJ., 2008; 165 :)
Internet Addiction shows descriptions of overuse, tolerance, withdrawal phenomena, and
negative effects - these images have characteristics such as substance use such as drug abuse. In addition,
when patients with internet addiction try to leave, several cases claim they experience tremors,
trembling, anger, fatigue, sweating, nausea, and irritability (R., 2009).
When Internet Addiction occurs in the youth community, it is found that they spend more time
on the internet compared to adults. Adolescents also tend to be more prone to developing depressive
disorders, anxiety disorders, low self-esteem, social anxiety, impulsivity, shame, attention deficit
hyperactivity disorder (ADHD), and suicidal tendencies. (Piplani, Bhushan, & Tekkalaki, 2019)
2. Causes of Internet Addiction
Conceptually, the study identified three subtypes related to compulsive-impulsive spectrum
disorders involving online and/or indirect computer use, namely: excessive play, sexual preoccupation
(cybersex), and email/text messages. Then there are four components associated with this subtype,
namely:
• Unconscious or excessive use of time
• Feelings of anger, depression, tension, or withdrawal when unable to access the device
• Tolerances include more software, more usage time, the need for better computer
equipment
• There are adverse consequences such as lying, poor performance, fatigue, social isolation, or
arguments. (Weinstein & Lejoyeux, 2010)

Many factors predispose a person to Internet addiction:

a) Neuro-anatomical factors. People who experience internet addiction have brain changes
similar to those of addiction to drugs and gambling. Especially the attention, planning, and
priority setting.
b) Biological factors. Internet addicts have an imbalance of the chemicals the brain uses to
communicate (neurotransmitters). Internet addicts' dopamine and serotonin transmitters
are lower than the general population.
c) Individual factors. People who have social problems and are shy tend to become addicted
to the internet. Because the use of the internet makes it easier for someone to interact
without having to meet in person.
d) Factors associated with the Internet. The internet offers a wide variety of awards that are
straightforward and unpredictable. As stated by Tristan Harris, how the design of the web
is made so that users always visit or even cannot be separated from the internet itself.

Based on studies it is also known that internet addiction is more prevalent: men, adolescents,
people with social difficulties, people with drug addiction problems, and people with psychiatric
disorders such as anxiety, depression, or attention deficit hyperactivity disorder (Varela, 2019).
Apart from the above factors, other factors affect internet addiction, namely self-concept. A
study conducted showed a significant deficit of self-concept in addicted internet users. This is related to
the development of the adolescent phase where they form a self-concept at the stage of their
development. An individual must explore and select the values, roles, and goals that are relevant and
adequate to them. If unsuccessful, this leads to confusion of identity and community roles and the risk of
mental disorders such as depression, personality disorders, or addiction. The teenagers then look for
social interactions and the internet to provide tempting opportunities because they can provide negative
compensation and deficit self-concept. These experiences are repeated and finding multiple accesses to
self-discovery can increase the risk of addiction. They have minimal real experience, thus increasing self-
concept deficits and psychiatric disorders. This also causes high levels of depression, anxiety, and other
personality disorders among internet-addicted users. (Leménager, et al., 2020)

3. The relationship between Internet Addiction and psychiatric disorders

Over the last decade, many studies have tried to look at the effects and affects of internet
addiction which is increasing rapidly. Studies show a strong association between addiction to technology
use and comorbid psychiatric disorders.
Research conducted by Andreassen on 23,533 adults, saw that internet addiction was positively
correlated with symptoms of mental disorders such as attention-deficit / hyperactivity disorder
(ADHD), obsessive-compulsive disorder (OCD), anxiety, and depression. In addition, men were
significantly addicted to online games, while women were significantly associated with social media
addiction. (Andreassen, et al., 2016)
Another study by Wang and et al showed a positive relationship between internet addiction and
ADHD. In this study, the symptoms of ADHD in the internet addiction group were more severe than
those who did not experience Internet Addiction. However, age patterns are not positively related to
Internet Addiction. The study further also states that ADHD patients have poor self-control abilities, so
they are more prone to addiction including the internet. ADHD patients are compensated better in
virtual than in real life. They get rewarded, respond to, and make interpersonal relationships easier
online. (Wang, et al., 2017)
There is another study conducted by Dong which shows the score of students who experience
addiction is lower than other normal students. However, they also saw that students who experienced
internet addiction had significantly more Obsessive-compulsive disorder than normal students. These
results are consistent with that Internet Addiction manifests compulsive behavior. (Dong, Lu, Zhou, &
Zhao, 2011)
Not many studies have definitively stated what factors are associated with internet addiction. A
study evaluating incidence and remission rates for internet addiction and predictive factors found that
the 1-year remission rate for internet addiction was 49.5%. This research was conducted on Taiwanese
adolescents. Low reward dependence, high exploratory stimuli, low family functioning, low self-esteem,
and online gaming were all associated with the severity of internet addiction. These factors increase
severity. However, low hostility and low interpersonal sensitivity are factors in reducing / remitting
internet addiction. (Weinstein & Lejoyeux, 2010).

4. Conclusion
Until now, Internet Addiction is still not categorized as a mental disorder. However, several
countries such as South Korea, Taiwan, and China identified it as an emerging public health problem.
Many factors influence internet addiction, such as the search for self-concept, Neuro-anatomical factors,
biological factors, individual factors, to the factors associated with the Internet. Currently, many studies
have looked at significant associations with psychiatric disorders such as ADHD, anxiety, or depression,
but it is not clear whether these psychiatric disorders are risk factors or comorbidities.

References
Andreassen, C. S., J, B., MD, G., DJ, K., Z, D., E, M., & S., P. (2016). The relationship between addictive
use of social media and video games and symptoms of psychiatric disorders: A large-scale cross-
sectional study. Psychol Addict Behav. 2016 Mar;30(2):252-62. doi: 10.1037/adb0000160. PMID:
26999354., 252-262.
Association., A. P. (2013). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. 2013.
Dong, G., Lu, Q., Zhou, H., & Zhao, X. (2011). Precursor or Sequela: Pathological Disorders in People
with Internet Addiction Disorder. . PLOS ONE 6(2): e14703.
https://doi.org/10.1371/journal.pone.0014703.
Enagandula, R., Singh, S., Adgaonkar, G. W., Subramanyam, A. A., & Kamath, R. M. (2018). Study of
Internet addiction in children with attention-deficit hyperactivity disorder and normal control.
Industrial psychiatry journal, 27(1),, 110–114.
JH, H., HJ, Y., IH, C., & al, e. (2006). Psychiatric comorbidity assessed in Korean children and adolescents
who screen positive for internet addiction. J Clin Psychiatry. 2006;67, :821–826.
JJ., B. (2008;165:). Issues for DSM-V: internet addiction. Am J Psychiatry. , 306–307.
Leménager, T., Hoffmann, S., Dieter, J., Reinhard, I., Mann, K., & & Kiefer, F. (2020). The links between
healthy, problematic, and addicted Internet use regarding comorbidities and self-concept-related
characteristics,. Journal of Behavioral Addictions J Behav Addict, 7(1), , 31-43. Retrieved Nov 24,
2020, from https://akjournals.com/view/journals/2006/7/1/article-p31.xml.
Piplani, S., Bhushan, S., & Tekkalaki, B. V. (2019). Internet addiction and ADHD, are they significantly
related? International Journal of Community Medicine and Public Health Piplani S et al. Int J Community
Med Public Health. 2019 Feb;6(2), :615-618.
R., P. (2009). Should DSM-V Designate "Internet Addiction" a Mental Disorder?. . Psychiatry (Edgmont (Pa.
: Township)), 6(2), 31-37.
Varela, E. (2019, October 16). Addiction to the Internet. Retrieved from Clinic Barcelona:
https://www.clinicbarcelona.org/en/assistance/be-healthy/addiction-to-the-internet/causes-and-
risk-factors
Wang, B. Q., Yao, N., Zhou, Q., X, L., J, L., & T, Z. (2017). The association between attention
deficit/hyperactivity disorder and internet addiction: a systematic review and meta-analysis. BMC
psychiatry, 17(1), 260. , https://doi.org/10.1186/s12888-017-.
Weinstein, A., & Lejoyeux, M. (2010). Internet addiction or excessive internet use. Am J Drug Alcohol
Abuse, 36(5):277-83. doi: 10.3109/00952990.2010.491880. PMID: 20545603.