1. U N I V E R S I T Y O F B E R G E N
INTERNET ADDICTION
Os, February 9 2015
Ståle Pallesen
Professor, PhD
University of Bergen

2. WHAT CHARACTERIZES ADDICTION?
 Salience (the drug/behavior dominates the persons mind)
 Tolerance (increase intensity of drug use or behavior in order to achieve
desired effect)
 Mood modification (using drug or initiating behavior gives pleasure
and alleviates mood)
 Relapse (after period of abstinence, the use or behavior is reinstated
with the same intensity as before)
 Withdrawal (when not using drug or engaging in behavior for some time
negative physical or psychological symptoms arise)
 Conflict (interpersonal and/or intra-personal)
 Problems (health problems, problems functioning in some settings)

3. CHEMICAL AND NON-CHEMICAL ADDICTIONS?
 Urges to engage in counterproductive behavior
 Tension until satisfaction from the addiction
 Rapid, but temporarily, reduction in tension when using the
addictive stimuli
 Gradually build-up of urge
 Unique external cues for specific addictions
 Secondary conditioning (irrelevant stimuli becoming
associated with the addictive stimuli)
 Similar strategies for relapse prevention (cue-exposure and
response prevention)
 Triggering of brain reward centers

4. DIFFERENT NON-CHEMICAL ADDICTIONS
TO BE
ACKNOWLEDGED
 Internet Gaming
Disorder
ACKNOWLEDGED
 Gambling
disorder
OTHERS
 Internet
Addiction
 Exercise
addiction
 Workaholism
 Mobile phone
addiction
 Compulsive
buying

5.  Griffiths argues (1999) that it is the content and
not internet in itself one becomes addicted to
 Internet addiction typologies (Young, 2009)
 Excessive gaming
 Online sexual pre-occupation
 E-mailing/texting
Griffiths. Psychologist 1999; 12: 246-250
Young. Journal of Contemporary Psychotherapy 2009; 39:241-246
CRITICISM OF INTERNET ADDICTION

6. INTERNET ADDICTION DIAGNOSTIC QUESTIONNAIRE
1. Do you feel preoccupied with the Internet (think about previous on-line
activity or anticipate next on-line session)?
2. Do you feel the need to use the Internet with increasing amounts of time in
order to achieve satisfaction?
3. Have you repeatedly made unsuccessful efforts to control, cut back, or stop
Internet use?
4. Do you feel restless, moody, depressed, or irritable when attempting to cut
down or stop Internet use?
5. Do you stay on-line longer than originally intended?
6. Have you jeopardized or risked the loss of significant relationship, job,
educational or career opportunity because of the Internet?
7. Have you lied to family members, therapist, or others to conceal the extent
of involvement with the Internet?
8. Do you use the Internet as a way of escaping from problems or of relieving
a dysphoric mood (e.g., feelings of helplessness, guilt, anxiety,
depression)?

7. PREVALENCE OF INTERNET ADDICTION
Large differences between studies
 1.7% in boys and 1.4% of girls in a Finish representative study of 7 292
adolescents 12-18 years old (Kaltiala-Heino et al., 2004)
vs.
 15.3% prevalence in a nationally representative sample of 3616 college
students in Taiwan (Lin et al. 2011).
Lin et al. Cyberpsychology, Behavior and Social Networking, 2011; 14: 741-746
Kaltiala-Heino et al. Addiction Research & Therory 2004 12: 89-96

8. FACTORS RELATED TO INTERNET ADDICTION
Kuss et al. Current Pharmaceutical Design, 2014; 20: 4026-4052
Lam. Current Psychiatry Report 2014; 16: article no. 508
INTERNET ADDICTION
SOSIODEMOGRAPHICS
Higher family income
Male gender
INTERNET USE
Online gaming
Social applications
PSYCHOSOCIAL
Loneliness
Low life satisfaction
Low school performance
Neuroticism
Low agreeableness
Poor relations at school
Friends drinking alcohol
Family conflict
Low parental monitoring
Not living with mother
COMORBIDITY
Alcohol / substance use
Depression
ADHD
Social phobia/anxiety
Antisocial behavior

9. LONELINESS / SOCIAL ISOLATION AND INTERNET
ADDICTION

10.  384 students at 2 universities in Turkey.
 Completed questionnaires about loneliness, self-esteem,
life-satisfaction and internet addiction
Bozoglan et al. Scandinavian Journal of Psychology 2013; 54: 313-319

11.  361 students at 2
universities in
Hong Kong
completed
questionnaires
assessing social
contact (face-to-
face and online),
loneliness and
internet addiction.
 The data were
collected twice,
with 4 months
apart.
Yao & Zhong. Computers in Human Berhavior 2014; 30: 164-170

12.  648 students at a
university in Turkey
completed
questionnaires
assessing self-
control, depression,
loneliness and
internet addiction.
Özdemir et al. Computers in Human Behavior 2014; 34: 284-290
Depression
Loneliness
Low self-
control
Internet
Addiction

13. OBESITY AND INTERNET ADDICTION

14.  1150 junior and
senior middle
school students
in Xiangtan,
China
participated.
 Height and
weight were
measured and
obesity was
calculated.
 Questionnaires
about internet
addiction and
health habits
were completed
at the schools.
Li et al. Obesity 2014; 22: 482-487

15.  2029 high school students in Turkey reported their height and
weight and completed questionnaires assessing internet
addiction and eating attitudes.
Canan et al. Cyberpsychology, Behavior and Social Networking, 2014; 17: 40-45

16.  1157 students in
secondary school and
high schools in Pakistan
completed questions
about background,
internet use and internet
addiction, and loneliness
Koyuncu et al. Journal of Pakistan Medical Association, 2014; 64: 998-1002

17. SLEEP AND INTERNET ADDICTION

18.  2029 high school students in Turkey completed questionnaires
assessing internet addiction and sleep habits/problems.
Canan et al. Sleep and Biological Rhythms , 2013; 11: 210-213

19.  3393 Norwegians, aged 16-74 years old, answered questions
about internet addiction and different problems, among others
sleep problems.
Bakken et al. Scandinavian Journal of Psychology 2009; 50: 121-127

20.  719
adolescents
in Hong
Kong
answered
questions
about
internet
addiction,
sleep and
depression
Cheung and Wong. Journal of Sleep Research 2011; 20: 311-317

21. SCHOOL PERFORMANCE AND INTERNET ADDICTION

22.  86
adolescents
suffering from
internet
addiction
compared
with an age
and gender
matched
group of 43
adolescents
without
internet
addiction
Tsitsika et al. TheScentificWorldJOURNAL 2011; 11: 866-874

23.  718 children
and
adolescents
in Hong Kong
interviewed
about internet
addiction,
internet skills,
grades and
academic
performance.
Leung & Lee. Social Science Computer Review 2012; 30: 403-418

24.  5122
adolescents
from various
schools in
Shaghai
completed a
questionnaire
assessing
background
variables,
internet
addiction,
and
academic
achievements
Xu et al. BMC Public Health 2012; 12: article no. 1106

25.  2735
adolescents
12-18 years
from 8
schools in
Singapore.
 They
completed a
questionnaire
about
background,
academic
performance,
social
support, well-
being and
time used
surfing the
internet
Mythily et al. Annals of Academic Medicine Singapore 2008; 37: 9-14

26. DEPRESSION AND INTERNET ADDICTION

27.  2293
adolescents in
grade 7
completed
questionnaires
about internet
addiction and
depression.
 One year later
the
assessment
was repeated.
Ko et al. Comprehensive Psychiatry 2014; 55: 1377-1384
Adolescents without IA
at first investigation
Adolescents with IA
at first investigation

28.  1041
adolescents
aged 13-18
years old from
schools in the
Guangzhou
province of
China.
 Questionnaires
about anxiety
and depression
was completed
at baseline at
follow-up.
Pathological
use of internet
was assessed
at baseline
Lam & Peng. Archives of Pediatric and Adolescent Medicine 201; 164: 901-906.

29.  10988
adolescents
aged 13-23
years old from
9 cities in
China.
 Questionnaires
about
background,
internet
addiction,
depression,
self-esteem,
and life-
satisfaction
were asked.
Wang et al. Addiction Research and Theory 2013; 21: 62-69.

30. TREATMENT EFFECTS OF INTERNET ADDICTION

31. Winkler et al. Clinical Psychology Review, 2013; 33: 317-329.

32. CONCLUSIONS

33.  Many studies show a relationship between internet addiction, loneliness, obesity, poor sleep,
impaired school performance and depression.
 The majority of studies is based on a cross-sectional design (chicken and egg problem)
 Few studies have looked into the content of internet use when investigating internet addiction
 Most studies seem to have been conducted in an Asian context
 The few good longitudinal studies and treatment studies suggest that internet addiction may
be a cause and a consequence of other problems.

34. Faculty of Psychology