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Navigating the Mental Health Internet |
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Internet addiction has been been the subject of increasing clinical interest, although it remains a controversial topic. While some argue that the Internet is merely a communications medium and cannot be compared to addictive stimuli like drugs and alcohol, others point to the growing number of individual cases related to overuse of the Internet seen in psychotherapy practices. Similar problems have been reported with overuse of video and computer gaming before the arrival of the Internet, so it not the Internet per se that created this type of problem. One of the first articles documenting excessive dysfunctional Internet usage that merited clinical attention is case study of a 43 year old woman preoccupied with chat rooms which eventually destroyed her 17 year marriage. Internet addiction includes not only excessive chat room participation, but several ways that people spend too much time online to the detriment of their social and financial well-being. Below are some examples where cases of problems related to Internet use have been documented:
cartoon about cyberaffairs
Cases of people who get into deep financial trouble in online auctions have been reported.
Dysfunctional use of the Internet by children as well as adults can result in diminished participation in the family.
The results, presented at the American Psychological Association Meeting in 1999, showed that
The Internet appears to be a growing problem in the workplace. Psychologist Michael Fenichel,PhD described some clinical observations about persons who present for treatment with computer-related issues:
There is no official psychological or psychiatric diagnosis called Internet addiction. The most recent edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) does not include such a category. To become an official diagnosis, "Internet Addiction Disorder" must be shown by research that it can be reliably diagnosed, and that the diagnosis correlates with outcome, treatment results, histories, and prognosis (to establish external validity). Many have argued that it is closer to pathological gambling which is an Impulse Disorder rather than a type of substance related disorder. Already studies are establishing a connection between problematic Internet use and DSM-IV Axis I Impulse Disorder. For example, a study of 20 individuals with problematic Internet use was conducted where problematic Internet use was defined as (1) uncontrollable, (2) markedly distressing, time-consuming or resulting in social, occupational or financial difficulties and (3) not solely present during hypomanic or manic symptoms. The researchers found:
Researchers have worked to establish the first criterion--the constellation of symptoms that constitutes Internet addiction. Psychologist Kimberly S. Young conducted a three-year study of Internet abuse reported in Internet Addiction: The Emergence Of A New Clinical Disorder, which was presented at an APA Meeting. Based on her findings and her extensive clinical experience with this problem, she has proposed a definition which involves having four or more of the symptoms listed below during the past year.
Dr. Young has created an interactive online test for Internet Addiction based on the above criteria , although reliability and validity data are not reported. Dr. Young also has tests on her site for other Internet-releated problems including:
John Suler,PhD has proposed a treatment approach that is based on the observation that,
Internet addiction, like all others types, entails isolation from others and prioritizing of the compulsive activity over all other aspects of life. Dr. Suler goes on to propose some interventions that integrate online and off-line worlds.
Dr. Young, who founded the Center for Online Addiction, leads an online self-help group for Internet Addictions. Although some would compare this to holding an AA meeting in a bar, she has been able to engage people in re-evaluating and altering their patterns of Internet usage using this approach. She believes that, as with other addictions, it is first necessary for the person to break through their denial. However, she reports that Internet addiction does not require abstinence for a healthy and life-enhancing recovery. The Internet can be a personal and professional resource when used appropriately. Her treatment approach focuses on
Dr. Young's book, Caught in the Net, describes therapeutic interventions and provides practical self-help tools.
There are no accepted guidelines as to how to distinguish "normal" enthusiasm from "pathological" preoccupation. Storm King asked a crucial question: We don't know whether the Internet can actually make someone addicted or alternatively if those who are overusing the Internet already have a vulnerability to such behavior. Stanton Peele,PhD has also raised questions about the validity of the concept of addiction. He argues that the disease model does not explain the dysfunctional aspects of such behaviors and is not scientifically based, even when applied to substances such as alcohol and cocaine. Why aren't people who spend a lot of time reading called "book addicts" instead of people affectionately calling them bookworms?
As mentioned previously, not all researchers and clinicians support the idea of Internet addiction. They question the necessity for a unique diagnosis, pointing to the lack of such diagnoses for television addiction, telephone addiction, etc. One such researcher is John Grohol,PsyD who has been a vocal skeptic of Internet addiction as a distinct disorder. But is clear that people have lost their jobs, flunked out of school, and gotten divorced because their Internet use consumed all their time. Such extreme cases demonstrate the need for therapists to pay attention to Internet use in their assessment.
John Suler, Ph.D.'s site on the Psychology of Cyberspace contains a good overview and links to other websites on Internet addiction The APA Monitor recently published a special issue on Psychology and the Internet Reformulating the Internet Paradox: Social Cognitive Explanations of Internet Use and Depression by Robert LaRose, Matthew Eastin, and Jennifer Gregg. Journal of Online Behavior
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online gambling
Case of Online Auction Addiciton
on time with children
The Nature of Internet Addiction: Psychological Factors in Compulsive Internet Use
QUIZ EXERCISE 29: 
online support group for Internet addicts
Cartoon about family life and the Internet
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