Internet Addiction: Consensus, Controversies, and the Way Ahead

Objectives: To review the fast-growing literature on Internet addiction. Methods: Descriptive review, using electronic databases as well as hand-search of relevant publications or cross-references from 1970 to 2010. Results: There are no universally accepted definitions for the captioned condition, but investigators seem to agree that it involves problematic computer usage that is time-consuming and causes distress or impairs functioning in important life domains. Several aetiological models have been proposed, from the diverse perspectives of learning theory, cognitive behavioural theory, social learning, reward deficiency, culture, genetics and neurobiology. Controversies abound, ranging from conceptual (whether behavioural addictions are true addictions), technical (which component of Internet use is a person 'addicted' to), and practical (how should Internet addiction be diagnosed, if it exists at all). However, using various instruments and populations, Internet addiction has been suggested as having a prevalence of 0.3 to 38%, with a young male preponderance. Several screening, diagnostic, and severity assessment instruments are now available, but few have been subjected to rigorous psychometric testing. Psychiatric co-morbidity is common. Treatment modalities lack a firm evidence base, but antidepressants, mood stabilisers, and cognitive behavioural therapy and other psychotherapies have been used. Conclusions: Recently, the American Psychiatric Association recommended including Internet addiction in its forthcoming 5th edition of the Diagnostic and Statistical Manual of Mental Disorders, but only as an appendix and not in the main body of the addictive disorders. This appears to be a fairly balanced and cautious approach, which can hopefully give rise to more meaningful research in this important but controversial area. Key words: Behavior, addictive; Internet; Psychotherapy. ...

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