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Internet Addiction - Truth or Spin?

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Chez Claudia

Internet Addiction - Truth or Spin?

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DevilYouKnow: indulging_breck
My attention was caught today by a BBC News article titled "US shows signs of net addiction" that reported on a study published this month in CNS Spectrums. The phrase that made me stop and wonder was this one:

"A typical addict is a single, white college-educated male in his 30s, who spends more than 30 hours a week on "non-essential" computer use, it found."

The first part seemed pretty logical. Single, college educated people are more likely to have the time and money to be spending long hours on the Internet in multiple locations, and while I think the gender balance is about even on Net use now, men might still use it more often. However it was the "non-essential" part that I found particularly curious. What did the researchers count as "non-essential"? So I went looking for the original study and found a whole host of problems with what they did (and didn't) report and what they were fishing for in the first place.

The cited study raises some rather different issues from the BBC article. To begin with they laid out what they considered addiction to be:

"The least restrictive set required the respondent to report an unsuccessful effort to reduce Internet use or a history of remaining online longer than intended, Internet use interfering with relationships, and a preoccupation with Internet use when 'offline'."

Fair enough. It seems to me if the user is considering Net time to be a problem, then it's a problem.

"The least restrictive proposed diagnostic criteria set yielded a prevalence of problematic Internet use of 0.7%" out of 2513 respondents. The most restrictive criteria set took that down to .3% Not a huge number, and only 56.3% of targeted people actually answered the survey (which is actually a pretty good response rate) which was conducted in early 2004 even if it's only being reported now. The survey took an average of 11 whopping minutes. Not a lot of time to discuss definitions or how people are interpreting the questions. Yet the conclusion is

"Conclusion: Potential markers of problematic Internet use seem present in a sizeable proportion of adults." (emphasis mine)

Sizable? From .3 to .7%? Seems a little hyperbolic. The authors also cite two other studies indicating Internet addiction exists, and here's where we get a clue as to what "non-essential" use might be:

"Preliminary phenomenological studies of this problem have described the typical affected individual as a college-educated single white male in his fourth decade, with substantial psychiatric comorbidity, who spends ~30 hours/week on computer use that is not essential to his work or well being, resulting in significant subjective distress and functional impairment."

Two interesting points here. The first is that this sentence is almost exactly what was quoted by the BBC in its news report. Only that wasn't the authors' conclusion, that was their summary of earlier study results. Second, "not essential" seems to mean not for work or his/her "well being," presumably use that was bad for you in some way. What counts as bad for you? Presumably:

"E-mail, chat rooms, auction houses, gambling casinos, the “blogosphere,” and pornography sites are only a few of the Internet venues that have been associated with problematic use."

It seems to me that gambling and pornography excesses might be facilitated by Internet access but that should hardly qualify as an Internet addiction. And how is e-mail, chatting or discussing issues on blogs an addiction versus hanging around the local pub discussing these issues? Is excess talking an addiction? Is it only considered an addiction if someone else wishes you would shut up? Or perhaps they just want you to get back to work:

"We are unaware of any large-scale random-sample, epidemiological study of this putative disorder. However, a telephone survey of 1,500 companies, which produced responses from 224, reported that 60% of these companies had disciplined, and >30% had terminated, employees for inappropriate Internet use. A study of 18,000 individuals who logged onto the ABC News Web site reported that 5.7% met criteria for “compulsive Internet use."

I'd think ABC News would be pretty happy about those compulsive news readers since only a small number of people under 60 are even watching broadcast news anymore.

In terms of who was interviewed, only those 18 or over participated, which is interesting because that means teen use of the Internet (which I'd expect to be high) was not included, and that the youngest respondents would be 20 by now. In other words most of what one might call the "Internet generation", those born after 1990, were not included in this survey. Of course, such participants weren't likely to be married or working either which seemed to be an issue of interest for the researchers. The actual questions were:

"The survey attempted to measure prevalence rates for compulsive buying, body dysmorphic disorder, and problematic Internet use. The survey’s eight Internet-related questions were created by extrapolating from diagnostic criteria for other impulse control disorders, obsessive-compulsive disorder, substance abuse scales, and from suggested criteria for problematic Internet use. Interviewers asked whether the respondent: (Q 1) uses the Internet regularly; (Q 2) feels that personal relationships have suffered as a result of excessive Internet use; (Q 3) conceals non-essential Internet use; (Q 4) feels preoccupied by the Internet when offline; (Q 5) finds it difficult to stay away from the Internet for several days at a time; (Q 6) goes online to escape problems or relieve negative mood; (Q 7) has tried to cut back on Internet use, and, if so, (Q 7A) whether the attempt was successful; and (Q 8) how often respondent stays online longer than intended (very often, often, sometimes, rarely, or never)."

That's a rather interesting set of combined issues -- compulsive purchasing (which, given that "auction houses" are problematic Internet sites could conflate those two topics) feeling bad about your body and your Internet use? What surprises me in the study results is that the answers to the first two issues are NOT REPORTED. Might that not be an important factor in how people answer the third set of questions? Let's look at the demographic data:

"Compared with the US adult population, the respondents include a substantially higher percentage of women and to a lesser extent, a higher percentage of people >55 years of age. A little over half (56.7%) of the respondents were married compared with 52.5% in the general US population (χ2 17.33, df=1, P<.001) (Table 1). The respondents’ ethnic distribution closely resembles that of the US population but includes a smaller proportion of Hispanic individuals (Table 1). The mean age of respondents was 48.5 years. The mean number of people per household was 2.8. Most respondents (50.8%) fell in the middle class socioeconomic stratum reporting an annual household income between $50,000 and $150,000." (emphasis mine)

Wow, this is an older group of people. And very different from the "30 year old male" that the BBC cites in its news story. And only 16.8% of the group have never been married. I'm guessing this telephone poll managed to get a lot of older people at home. How many of these people are even employed outside the home? Well, either they didn't gather or didn't report this data. They also decided that the gender imbalance in the responses was a problem:

"We adjusted the response data to the gender distribution of the US adult population. In this gender-adjusted response set, 68.9% were regular Internet users; 5.9% felt their relationships suffered as a result of excessive Internet use; 8.7% attempted to conceal non-essential Internet use; 3.7% felt preoccupied by the Internet when offline; 13.7% found it hard to stay away from the Internet for several days at a time; 8.2% utilized the Internet as a way to escape problems or relieve negative mood; 12.3% had tried to cut back on Internet use, of whom 93.8% were successful; and, 12.4% stayed online longer than intended very often or often."

No gender breakdown on who thought their relationships suffered, who was attempting to conceal use and for what purpose, or why they found it difficult to stay away. And apparently only 4.3% of those who wanted to cut back on use actually had a problem with doing so. The gender breakdown would seem to be an important issue when they later mention:

"Small studies have also suggested that individuals with problematic Internet use are highly likely to suffer from mood and anxiety disorders." (Not to mention compulsive shopping and body issues?)

I was curious about this so I looked up this study which was "Psychiatric features of individuals with problematic internet use" (Journal of Affective Disorders Volume 57, Issues 1-3 , January-March 2000, Pages 267-272). There I also found the "non-essential" phrase used only here it was marked very clearly what this meant:

"the nature of internet use, including time spent on ‘essential’ (required job/school functions) versus ‘nonessential’ (pleasure/recreational or personal) use" and "‘Nonessential’ use occurred in the following domains: chat forums (17.7%), e-mail (15.1%), WWW ‘surfing’ (14.0%), multi-user domains (12.7%), miscellaneous uses including games and designing web pages (9.2%), pornography (8.1%), news/current events (6.8%), newsgroups (6.1%), file transfers (3.7%), music (3.2%), shopping/buying (2.5%), card catalogs (0.6%) and political uses (0.3%)."

There were only 20 people in the study and they were self-selected to participate due to their computer use problems. From the list of problems they had it seems to me that recreational computer use was the least important issue of all. They were diagnosed to be (A) Bipolar (12 of the 20) or depressed (2 of 20), suffered alcohol abuse (2), panic disorders including social phobia (8) with 5 having PTSD, among a dozen other problems. Interestingly 2 of those 20 also had "Body disomorphic disorder" and 4 had compulsive buying "Impulse control disorder" making me wonder even more about the unreported results of the CNS study. In short:

"Nineteen (95.0%) of 20 individuals had histories of psychiatric disorders in family members. Thirteen (65.0%) had at least one first- or second-degree relative with a depressive disorder, ten (50.0%) with a bipolar disorder and 12 (60%) with a substance use disorder."

And yet the result they gathered from this study was that they were surprised to find so many bipolar people as opposed to depressed people as reported in a previous study of Internet use. The "previous study" was actually a Human-Computer Interaction study (Kraut, R., Patterson, M., 1998. Internet paradox...) which I read some years back that did not diagnose individuals but simply reported that increased Internet use was associated with loneliness and depression but did not conclude the relationship was causal. In fact a later study to Kraut et al's refuted that association as deriving largely from individuals struggling with their own lack of technological knowledge and computer support and that the symptoms eased as they became more acclimated to Net use and better able to use it effectively.

This was a really long post but I've seen the issue of "Internet addiction" come up repeatedly in the popular press (and to some degree academic articles) and yet I've never found discussions of it very convincing as arising from anything but other longstanding issues in the person's life. The lack of detail in the academic articles is often very frustrating as well and the articles cited often provide less support for the study's conclusions than one might expect. Another source cited by the CNS paper which used the above Bipolar study as a jumping off point found Internet use to be associated with impulse-control disorders and reported that the respondents to their online questionaire:

"Most of the visitors were males (74 persons), only 12 females answered. 44 visitors were under the age of 20, 32 visitors were between 20 and 30 years, and 10 visitors were above the age of 30. Most of them described themselves as a student (68 persons).

The following group of questions represented a high prevalence of features of impulse control disorders among Internet users: (1) 82% reported a great urge to be ‘online’ if they are disconnected; (2) 92% thought that without Internet the world is an empty and dull space; (3) 77% of the visitors have daytime fantasies about Internet use; (4) 81% became very nervous if the Internet connection was slow; (5) 43% reported depressive mood and of feeling guilty after a longer use of the web; (6) 71% of the visitors reported agressive behaviour if they were interrupted by others using the Internet."

I had to wonder what percentage the respondents were out of how many people visited the site and didn't feel the questions applied to them? And only 81% felt "nervous" about slow connections? As opposed to 100% of people who feel annoyed? And how many impulse-control people feel annoyed with their cell phones or bored at work?

I'm wondering if on a future survey I should ask about how people feel about their own Internet use.
  • That is one sloppy piece of data collection and reporting. Sheesh.
    • Heh, well news reports often do a poor job of reporting on studies because they want to catch people's attention, not report on whetever it is being studied. However as someone who's trying to do their own study I can sympathize with researchers who sometimes have conflicting things being told to them about how to present a report or what to include or even what to cite. Given that the issue of Internet addiction is one that's been raised to me about what I'm writing I thought I'd take a look at some studies out there and I have to say I don't find them that informative about what even constitutes "addiction."
  • "E-mail, chat rooms, auction houses, gambling casinos, the “blogosphere,” and pornography sites are only a few of the Internet venues that have been associated with problematic use."

    So the downfall of Western Civilization is a result of email (which help us all keep in touch in this frantically paced world), chat rooms (which connect us to interesting people we would otherwise have never met), the blogsosphere (which is allowing everyone to write and think creatively, not just the academics) and auction houses (which allow us to sell stuff we don't want anymore to someone who has been searching for just that item.)

    Give humans ANYTHING and we will find a way to abuse it, overuse it and become addicted to it!
    • Hey -- what happened to Hank's icon?

      Yes, with all the focus on Internet addiction I see much less reported in the press about the incredible frustration people feel with myriad technological devices that fail to work as expected. Mike and I spent the better part of an afternoon trying to get some new software installed on the computers, talking to customer service, rebooting numerous times (which meant constant interruptions to anything else we were using the computers for) and so on. The latest installation actually interrupted my first attempted reply to you because the computer just spontaneously did a reboot. Now that's "non-essential" computer time!
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