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Internet Addiction: Escapism or Psychological Disorder?

On September 17, a man died of exhaustion in a cybercafé in Guangzhou, China, after playing online video games for three consecutive days. He's not the first Chinese man to die from what his countrymen call "game fatigue system." Earlier this year a teacher from Jinzhou in Liaoning province collapsed after playing for fifteen days.

China, which has more than 140 million Internet users, is cracking down on abuse with new rules that restrict the opening of new cybercafés and limit young people under 18 years of age to three hours of gaming at a stretch. Several cities now offer Internet addiction counseling centers.

Academics in China, Taiwan and other parts of the world study "Internet Addiction Disorder (IAD)" as a psychological disorder that requires medical intervention. Some foreign doctors are prescribing drugs like Prozac as a treatment for IAD.

The Chinese profile of an Internet addict is similar to the one that American scholars have drawn: he tends to be a young male who goes online at night. He is also more likely to have attention deficit disorder (ADD) and to suffer from personality problems such as hostility, social phobia or shyness, social isolation, dependency, low self-esteem, and loneliness. He may be using the Internet as an escape for his problems and his inability to cope in social situations. Chinese professors link IAD to not having a good sense of time and the inability to value one's time, and to having parents with negative styles, usually overly strict and authoritarian.

Internet Addiction Disorder is common among young people ages 12 to 18 years old. In one study of 1708 Chinese high school students, about 13.8% had IAD; in another among college students, the rate was 12.5% for males and 6.35% for females. The rate in the United States is probably similar. An American study of online gambling among 1356 undergraduates turned up 6.3% who gamble at least once a week, with 61% of those were "pathologically compulsive" gamblers.

American clinicians are split on whether there is such as thing as Internet Addiction Disorder. Those who do not believe IAD is a medical disorder argue that the Internet is just a new modality for escaping the world. For example, although people read or watch television to excess, medical science does not recognize "book addiction" or "TV addiction."

Dr. Kimberly Young, author of a pioneering study in 1996, believes that IAD belongs in medicine's official Diagnostic and Statistical Manual of Mental Disorders (DSM). IAD almost made it into the 2000 edition of this standard physician's reference book in the section of "impulse-control disorders" such as compulsive gambling, kleptomania, pyromania, etc. Psychiatrist Ivan Goldberg actually composed criteria for IAD as an "impulse-control disorder without an intoxicant." Some of them include:

  1. Users have persistent thoughts about stopping their Internet behavior, but cannot stop;

  2. Users develop tolerance to the Internet and begin staying on their computers for longer and longer periods of time;

  3. They experience withdrawal symptoms such as moodiness when they are off the Internet;

  4. They think about or fantasize about what they are missing when they are not on the Internet;

  5. They spend hours reading and searching for new computer accessories;

  6. They give up healthy activities such as sports, socializing and family time;

  7. Their Internet use disrupts relationships with spouses, parents or friends, and they become defensive or secretive about their Internet use. ;

  8. Internet use puts their jobs or academic careers at risk.
"Interactive" use of the Internet is more addictive than surfing or reading Internet articles. The most common IADs are online gaming and gambling. However, some become obsessed with interactive social networks like Facebook and MySpace or interactive spaces like chatrooms and forums. Other common forms of Internet addiction are eBay shopping and pornography.

If you believe your teenager uses the Internet for abnormal amounts of time, you may want to consider moving her computer out of her room and into a family area. You may want to restrict use to school work only. You can refuse to pay for subscriptions for online gaming, especially the more addictive multiplayer video games.

Ultimately, the best "cure" is to encourage your child to join extracurricular activities like sports, music, drama and school clubs, and to socialize in the "real" world.

If your child has developed an excessive obsession with online gaming, you may also consider a temporary ban on use. For some parents this is almost impossible to monitor, however. Wilderness programs report that they sometimes are sent students whose parents have voiced concerns about online gaming obsessions. Because the child is completely removed from the gaming world when in a wilderness program, any therapeutic intervention has a greater chance of success.