Excessive and pathological Internet use – Risk-behavior or psychopathology?

Michael Kaess,Danuta Wasserman,Romuald Brunner,Jochen Kindler,Alan Apter,Helen Keeley,Julio Bobes,Franz Resch,George J Musa,Christina W Hoven,Shira Barzilay,Marco Sarchiapone,Merike Sisask,Johanna Klar,Peter Parzer,Vanja Gomboc,Doina Cozman,Vladimir Carli,Gergely Mészáros ,Judit Balázs ,Vita Poštuvan ,Peeter Värnik ,Christian Häring ,Pilar A Sáiz ,Jean‐Pierre Kahn

doi:10.1016/j.addbeh.2021.107045

Abstract

Pathological Internet use (but only with respect to gaming) is classified as mental disorder in the ICD-11. However, there is a large group of adolescents showing excessive Internet use, which may rather be considered adolescent risk-behavior. The aim was to test whether pathological and excessive Internet use should be considered as “psychopathology” or “risk-behavior”.A representative, cross-sectional sample of 11.110 students from 10 European Union countries was analyzed. Structural equation models, including the factors “risk-behavior” and “psychopathology” and the variables excessive and pathological Internet use, were tested against each other.“Risk-behavior” was operationalized by several risk-behaviors (e.g. drug abuse, truancy, etc). “Psychopathology” included measures of several mental disorders (e.g. depression, hyperactivity, etc). Excessive Internet use was assessed as the duration and frequency of Internet use. Pathological Internet use was assessed with the Young Diagnostic Questionnaire (i.e., presence of addiction criteria).Excessive Internet use loaded on “risk-behavior” (λ = 0.484, p < .001) and on “psychopathology” (λ = 0.071, p < .007). Pathological Internet use loaded on “risk-behavior” (λ = 0.333, p < .001) and on “psychopathology” (λ = 0.852, p < .001). Chi-square tests determined that the loadings of excessive Internet use (χ2 (1) = 81.98, p < .001) were significantly stronger on “risk-behavior” than “psychopathology”. Vice versa, pathological Internet use loaded significantly stronger on “psychopathology” (χ2 (1) = 107.10, p < .001).The results indicate that pathological Internet use should rather be considered as psychopathology. Excessive Internet use on the other hand, should be classified as adolescent risk-behavior.

Highlights

The accessibility of the Internet in European Union countries has expanded enormously during the last decade
The results indicate that pathological Internet use should rather be considered as psychopathology
Adaptive Internet use was reported by 83.2%, maladaptive Internet use by 13.1% and pathological Internet use was reported by 3.8%

Summary

Introduction

The accessibility of the Internet in European Union countries has expanded enormously during the last decade (according to the Eurostat – the households’ level of Internet access from 68% in 2010 to 90% in 2019). Psychological and emotional, and the social and physical quality of life can be negatively influenced by pathological Internet use (Machimbarrena et al, 2019). Five online behaviors have been labelled as potentially addictive: Online games, social media, Internet pornography, gambling and online search. For the diagnosis of Internet Gaming Dis order, nine criteria based on those for substance-use disorder and gambling disorder were developed: preoccupation, withdrawal, toler ance, unsuccessful control, loss of interest, continuation despite prob lems, deception, escape negative mood and risk opportunities. 5 of 9 criteria must be fulfilled within the past 12 months Those criteria have been applied for other Internet-specific addictions, such as social media addiction, as well. In the ICD-11, Gaming Disorder (6C51) is included in the section of behavioral addictions (WHO, 2018)

Methods

Results

Conclusion