1. Internet Addiction: A growing worldwide epidemic Thomas J. Killian Jr
TPSY
Dr. Mark Cartiglia, Ph.D
March 13, 2016

2. Introduction to Internet Addiction
Epidemic that is seen worldwide.
Early onset was considered an impulse behavioral addiction.
New research shows Internet Addiction not cause, but now result of certain mental health issues.
Different psychosocial aspects identified correlating to Internet Addiction.
Some research shows there may be different types of online applications correlating to Internet Addiction.
Introduction
In the world today, there is a growing epidemic that has its control over the population. The epidemic is Internet Addiction, which is seen throughout the world. This amplified epidemic gets its power from the need for the Internet use from work to personal life. Internet Addiction has caused many individual socioeconomic problems, psychosocial problems, and physical problems. Some of the things about this addiction are still being evaluated by researchers. The Internet Addiction has been listed as an impulse behavioral addiction early on, like that of gambling addiction, and now is starting to manifest to a whole new state. Research shows now that Internet Addiction is not mainly the cause for problems, but is the result of the problems of individuals. These problems associated with Internet Addiction shown as the result are individuals who have some form of mental health issue. Mental health issues that are identified are depression, low self-esteem, and/or feelings of loneliness/hopelessness. Other issues identified relate to an individual’s abilities to handle or not handle social interactions. One thing that makes the Internet Addiction phenomenon difficult to define with specific details is the many complexities associated with its existence. Research shows there are many different online applications that favor those with specific deficits of mental health issues or lack of social interaction skills (Blachnio & Przepiorka, 2016; Douglas, Mills, Niang, Stepchenkova, Byun, Ruffini, and Blanton, 2008; Lu and Yeo, 2015; Kuss, Shorter, van Rooij, Griffiths, & Schoenmakers, 2014; Tao, Huang, Wang, Zhang, Zhang, & Li, 2010)

3. What is Internet Addiction?
APA (2013) DSM-5 definition of how addiction works within the human body.
Early criteria for Internet Addiction (Computer Programmers).
Young’s Diagnostic Questionnaire (YDQ).
Criteria explained by the research of TAO et al (2010).
Contraindicating research by Lu and Yeo (2015) on criteria.
Internet Addiction Defined
The American Psychiatric Association (2013) Diagnostic and Statistical Manual fifth edition (DSM-5) defines addiction as the use of any
substance or behavior that activates the brain’s reward system, which then causes the use of the substance or behavior habitually used again and again to achieve the activation of the brain’s reward system. Many of the earlier research had a very simplistic definition of criteria that identified Internet Addiction. The criteria looked at only individuals that worked in the computer industry, building and maintaining computers. These individuals were identified because research showed they had a great insatiable need for knowledge on a more frequent basis (Lee, Choi, Shin, Lee, Hung, & Kwon, 2012). As research continued there were changes to the criteria seen to correlate with Internet Addiction. The authors Kaess, Durkee, Brunner, Carli, Parzer, Wasserman, and Kahn (2014) use a diagnostic assessment tool named the Young’s Diagnostic Questionnaire (YDQ) to help identify criteria to help evaluate if an impulse behavioral addiction was present with an individual. As demonstrated by the research of Tao et al. (2010), some criteria commonly used to help detect impulse behavioral addiction are tolerance, withdraw, using the substance more than first intentioned, salience or thinking about using the substance when the substance is not present, and poor psychosocial abilities. Lu and Yeo (2015) provided research that showed there were two schools of thought for Internet Addiction one being the earlier view that Internet Addiction fits the category of an impulse behavioral addiction. On the contrary these authors also showed that Internet Addiction also fit into a second school of thought where this phenomenon was seen as a result of an individual feeling depressed or lonely.

4. Different views of Internet Addiction: Result of maladaptive behaviors
Lu and Yeo (2013) state Internet Addiction shows criteria to be related to an impulse behavioral addiction.
Ex. Gambling addiction.
Preoccupation
Mood modification
Tolerance
Withdrawal
Functional impairment
Impulsivity trait predictor evident in Internet Addiction and those with other impulse control addictions.
CAO, Su, Liu, and Gao (2007) also seen this trait predictor present in Internet Addiction and also other impulse control addictions.
Also seen was the decrease in psychosocial, economical, and socioeconomically.
Lu and Yeo (2015) state in their research that Internet Addiction is an impulse control Addiction. This type of Addiction has some common criteria displayed by the individual. These criteria seen are preoccupation, mood modification, tolerance, withdrawal, and functional impairment. These traits are also seen in an individual diagnosed with gambling addiction. Their research looked at certain trait characteristics of the individuals being tested. The authors seen a high correlation with the impulsivity trait and those who are diagnosed with a type of impulse behavioral addiction like that of gambling addiction. The authors Cao, Su, Liu, and Gao (2007) state that Internet Addiction is defined as the individual’s inability to control his or her Internet use. This inability to control Internet use leads to many other psychosocial, economic, and socioeconomic difficulties for the individual. As the authors hypothesized, they did find a correlation between the impulse trait identifier and those more at risk for Internet Addiction. From this research it is also seen that individuals have some hardships in specific areas of their lives. There was a decrease in school functioning, work functioning, and face to face social interactions. Another factor seen was the increase of the individuals suffering from depression and anxiety at a higher rate than those individuals without the impulsivity trait predictor.

5. Different Views of Internet Addiction: The cause of impulsive behaviors
Lu and Yeo (2015) hypothesized two factors
1. There is a correlation between cognitive distortions and motivation to lead to Internet Addiction.
2.There is a cycle that leads one from cognitive distortions to depression to Internet Addiction and back again.
Yao and Zhong (2014) saw similar results as the previous study
1.Depression directly affected Internet Addiction.
2. There is a never ending cycle from depression to Internet Addiction to loneliness to Depression and back to Internet Addiction.
Kuss et. al (2014) states Internet Addiction is caused by maladaptive behaviors.
The authors Lu and Yeo (2015) hypothesized that Internet Addiction is a result of the individual having a cognitive distortion. They also hypothesized that there is a correlation between cognitive distortion and motivation that would lead to the individual having a high risk of Internet Addiction. After looking at these factors their research showed that individuals with cognitive distortions had a higher risk to have an Internet Addiction. A correlation between cognitive distortions and motivation showed if an individual showed cognitive distortions and had high motivation that individual was at a really high risk for Internet addiction. The research also showed that Internet Addiction did not cause depression or loneliness. Rather, Internet Addiction was the cause by cognitive distortions that lead to depression and/or loneliness and this in turn caused the individual to have Internet Addiction. This way of viewing Internet Addiction is different from previous studies. Previous studies hypothesized that Internet Addiction was the cause of these psychosocial disabilities such as depression and loneliness. The pattern showed that these events can cause a never ending loop of psychosocial inabilities with the individual. Even looking at the study done by Yao and Zhong (2014) showed in their findings that depression directly affected the individual to be at a higher risk of Internet Addiction. They also seen in their research that higher Internet use would also cause less face to face social interactions leading to the feelings of depression and loneliness causing a cycle of psychosocial inconsistencies as seen in the previous study. Kuss et al. (2014) also showed similar results that maladaptive behaviors also caused an increase in Internet Addiction.

6. Ages, Gender, and Ethnicities affected by Internet Addiction
Characteristics more susceptible for Internet Addiction
Single young males and those who are gay
College population
Middle aged
Less educated
Age range
19-24
No specific ethnicity
Two final criteria seen
Instrumentalist- use Internet for self-gratifying activities
Ritualist- use Internet when bored or lonely.
Douglas et al. (2008) showed in their research there has not been an indication showing one specific attribute to what individuals would put an individual at a higher risk for Internet Addiction. Many studies have been done all over the globe and a specific conclusion has yet to be developed a specific area that has a more centrally affected by Internet Addiction. There findings show there are certain characteristics for those who may be more at risk for Internet Addiction. The research showed a more defined picture of singles, young males to more specific. Another portion of their findings related a higher risk for Internet Addiction among the college population. They also seen a correlation of those individuals who are gay, middle aged, and those are less educated to be at a higher risk for Internet Addiction. Their research presented findings of individuals in the age range of are more at risk than others in the population outside of that age range. With all these criteria their research gave a better view of two types of characteristics for those more at risk. The two categories were those who were instrumentalists, and those who were ritualists. Instrumentalists showed they used the Internet for more self-gratifying activities. As for the ritualist who use the Internet when they are bored or lonely. These two categories showed a high correlation of their types of Internet use and Internet Addiction.

7. Internet Applications
Blanchnio and Przepiorka (2016) states Internet has risen fast and is used all over the world
Social Networking Sites (SNS) - Facebook.
Facebook has 829 million daily users
Facebook Addiction is a subclass of Internet Addiction
Similarities seen in this study compared to others are:
Low level of self-esteem
Low level of optimism
Low life satisfaction
Loneliness
As the 20th Century began, a new form of media was introduced to the world. The new form of media was the dawning of the Internet and soon this new media became a large part of our everyday society. The ability to access the Internet has no limits and shows no limits in the future. One of the newest forms of communities that has formed is the “Facebook” community that is run by a Social Networking Site (SNS) online application. SNS has given a rise to new ways that individuals communicate to one another not just for personal but also business and educational lives. This SNS community has reach over 829 million daily active users. It permits unlimited and endless ways of expression. It also allows users new ways of expressing their opinions to a mass of individuals quickly. SNS is not all positive there is a dark side that comes at a price for using this platform. Addiction of users to the SNS is relatively new as is the idea of Internet Addiction (Blachnio & Przepiorka, 2016). The research of authors Blachnio and Przepiorka (2016) showed that Facebook addiction is one subclass under Internet Addiction and that is very debilitating for many. Their research showed there is a presence of maladaptive behaviors associated with these addictions. Many of the addicts showed low levels of self-esteem, low level of optimism, low level of satisfaction in life, and loneliness. These same results have been shown over and over again to correlate with Internet Addiction.

8. Second type of Internet Application
Kirby, Jones, and Copello (2014) research shows similar symptomology of addiction with Massively Multiplayer Online Role Playing Games (MMPROG).
Tolerance, withdrawal, salience, and psychosocial inabilities.
Problematic vs. Engaged Use
Problematic Use- the inability to set appropriate boundaries between game use and real life responsibilities.
Engaged Use- a sense that the individual can set appropriate boundaries between game play and real life responsibilities.
Maladaptive behaviors
Depression, anxiety, social phobias, and low self-esteem.
Similarities found between Gambling Addiction and MMPROGs subcategory of Internet Addiction.
Immersion loss experienced only allowing focus on the game use and not the real life responsivities the individual encounters.
Seen by the authors Kirby, Jones, and Copello (2014) with the rise of the Internet of the past decade, research has seen a growing number of Massively Multiplayer Online Role Playing Games (MMPORG) grow in use across the global population. This use of the MMPORGs has shown to interfere with other areas of life causing negative impacts to the user in various ways especially psychologically. There is a common theme in their research showed between Internet Addicts, and also those being diagnosed addicted to MMPROGs. There are a few elements that are recognized as the core attributes of addiction. These elements are tolerance, withdrawal, salience, and psychosocial inabilities. Many psychological issues are present alongside the overuse of MMPORGs and linked to issues as: depression, anxiety, social phobias, low self-esteem, and level performance in many area of life. Individuals that have shown problematic use are the ones that are considered to be more likely to have an addiction. This problematic use does not allow the individual to put boundaries on when it is time for the game and when it is time for real life responsibilities. Engaged play is coined as the ability for online players to have firm boundaries between play and real life responsivities and can make appropriate judgments of when it is time to take care of the responsibilities in life and stop playing the game. Evidence from this study showed there is a link between the problematic use of MMPORGs as there is with gambling, which correlates the problematic use of MMPORGs to and addiction. With both gambling addiction and problematic use of MMPORGs, the individual loses the ability of redirecting their attention to be immersed so that there is an escape from the real world and its responsibilities.

9. Future Research Paths A need for a better assessment tool
Young’s Diagnostic Questionnaire
Need for a new tool
Sample population size
There is a need for a non self-scoring tool to help increase population size.
Stigma reduction
Theoretical Models
Continuing to work on development of a better theoretical model of Internet Addiction.
As seen by the authors van Van Rooij and Prause (2014) there are additional models popular in use to help identify and describe the findings and define Internet Addiction. The research showed a lot remains to be known about Internet Addiction and finding the best way to start to treat this addiction. Their research explained there is a need for a better assessment tool to use to help with the identification of the symptomologies of the addiction. The most commonly used assessment tool is the Young’s Diagnostic Questionnaire (YDQ). Although, this assessment tool has some basic assessment ability its use provides a high face validity. The YDQ is the only assessment tool that has this high face validity among the other assessment tools available. The authors also state there is a need for a different way to use the questionnaire other than the self-scored type used more recently. The authors state one factor avoiding an accurate diagnosis from this type of assessment tool is the feeling from the individual of having a stigma place on him or her. This factor also limits the population size of the studies causing more inaccurate results from the millions of online users. The last future recommendation is to build a better theoretical modeling of Internet Addiction.

10. Conclusion Epidemic world wide
Need for a more efficient assessment for earlier treatment intervention.
Wider range of participants being used to gather more information.
Starting to build a better recovery model for Internet Addiction.
Conclusion
Today’s world is seeing a rise of a new epidemic that is debilitating and causing a serious breakout from all four corners of the globe. No one person could ever think that in today’s society with the knowledge of healthy versus non-healthy habits. Individuals would still have the accessibility to a strong new drug to cause such an overwhelming addiction as Internet Addiction. There are many free and easily accessible points in which an individual can gain complete access to the substance. Everywhere one goes they can easily connect to the Internet using a “hotspot” from grocery stores to educational institutions. Even in medical institutions, with electronic patient information, public “hotspots” are available for connection to the Internet. As the world changes and becomes more electronic-based, the need and demand for Internet connectivity will continue to increase. More now than ever research needs to help build a better understanding of Internet Addiction. Also the different criteria that leads to its onset, and the different types of online applications that contribute to building of Internet Addiction. This is needed because there will be a need to help create a better recovery model to help identified addicts to get the treatment needed to recover from this disorder. Further research can start to identify more online applications that lead to Internet Addiction, and to use a wider range of a participant pool to gather results.

11. Reference
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