Internet Addiction disorder among Clients of a Virtual Mental Clinic
Ya-Mei
Bai, Chao-Cheng Lin, Jen-Yeu Chen
Psychiatric
Services 2001, Oct 2 (10): 1397
As the Internet increasing becomes part of
our lives, Internet addiction disorder has received much attention.
Internet addicts
may withdrawal from real social and interpersonal interaction other than those
on the Internet. Their
family relationships and
academic or occupational functioning may deteriorate. Several
withdrawal symptoms have
been identified, including
nervousness, agitation and aggression, as well as an addiction syndrome that
included the
presence of withdrawal
symptoms, increasing tolerance and loss of control (1). A high rate of comorbid
mental disorder
has also been reported,
especially depressive
symptoms and social impairment (2,3).
We report the results
of a survey
to determine the the prevalence of Internet addiction disorder among visitors
to
a virtual mental clinic where
100 volunteer mental health professionals provide, at no charge, online answer
to visitors'
questions about mental problems
(4). We hypothesized that visitors who had a comorbid mental health problem
would
have a higher risk of developing
Internet addiction disorder.
The survey was conducted from May to October 2000. During the study
period all visited to the virtual clinic
completed Young’s
Internet addiction disorder questionnaire, a brief seven-item
instrument that adapts DSM-IV criteria
for pathological
gambling (5). A
total of 251 clients completed the questionnaire. The
mean± SD age of the clients
was 25.04± 6.19 years,
with a range of 14 to 44 years. Most
were female
(67percent) and single (84
percent). Most had
an education beyond the
college level (63 percent), and about a third (36 percent) were students. A
majority (56percent)
reported that they had
never visited a real mental clinic .
On the basis of the questions visitors asked, the most
common impending diagnosis was anxiety disorder (29
percent),
followed by mood
disorder (24 percent). The survey
responses indicated that 26 percent
had a impending substance use
disorder. Among the
251 clients, 38 (15 percent)
meet criteria for Internet addiction disorder. Clients who meet the
criteria
did not differ
significantly from those who did not in age, gender, education, marital status,
occupation, or impending
diagnosis. However,
the rate of comorbid substance use disorder was significantly higher among those
who did not
( 58 percent
versus 26 percent; Fisher’s
exact test, two-tailed, p=0.03).
Our survey is the first to document the prevalence of Internet addiction
disorder among visitors to a virtual mental
clinic. The high prevalence
we found needs attention. Few of the
survey respondents raised the issue of Internet addiction
as a problem in
their subsequent interactions with the online mental health professionals,
although some reported many
failed attempts to
cut down on their time spent online, and some reported feeling depressed, nervous,
and agitated when
they were not
online. Either these persons did not recognize the problem or they did not know
how to ask for help. Their
addiction to the
Internet may complicate their existing mental problems (1). They may benefit
from a clinician’s actively
inquiring
about their Internet use and providing them education to help them gain insight
into problematic use.
The high prevalence of comorbid substance use disorders, nearly 60
percent, also needs attention. This finding is
compatible
with those of previous reports. Shapira and colleagues (4) reported that 60
percent of the 20 persons in their
sample who
had Internet addiction disorder also had a substance use disorder.
Young (5)
reported a rate of 52 percent
among 396
subjects.
Activities on the Internet may lead todopamine release in the nucleus accumbens,
which is thought to be important
neurochemical
event in the development of addiction. People who lack self-esteem are more
likely to become Internet
addicts, just
as they are more likely to use drugs or alcohol (1).
It is essential to gain a better understanding of underlying
factors in
the Internet addiction disorder, including how personality traits, family
dynamics, psychosocial factors and
communication
skill influence the way people use the Internet.
Reference
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1017-1031, 1998
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