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Researchers say that people with certain mental health conditions, like ADHD, depression, social phobia and others are at greater risk to develop a co-occurring addiction to the internet. Learn more about what types of disorders put a person at increased risk of internet addiction and about what can be done to prevent it for those most at risk.

Researchers in Taiwan followed 2293 junior high school students over a 2 year period to observe which of these students would develop internet addictions and to determine what risk factors increase a person’s susceptibility for the addiction.

Each student was tested by self report questionnaire to measure:

• Internet addiction
• Hostility
• Depression
• ADHD
• Social phobia

The research team then revisited with each student at 6, 12, 18 and 24 months into the experiment to retest for the conditions listed above.

The Results

Students who scored high on measures of ADHD and hostility were most likely to develop internet addiction over the course of the 2 year study – this was true for both male and female study subjects.

Depression and social phobia were also found to predict an increased likelihood of internet addiction.

Prevention

The researchers say that it’s important that parents identify and treat conditions like ADHD, hostility, depression and social phobia as early as possible to prevent an increased likelihood co-occurring internet addiction.¹

Additional Factors that Can Increase a Person’s Susceptibility to Internet Addiction

In addition to mental health disorders, other life factors that can increase your risk of an internet addiction disorder include:

• You are lonely – having difficulty forming real-life relationships can increase the appeal of easy to engage in online interactions
• You Have mobility issues (not being able to easily leave the home to socialize)
• You are stuck at home – caregivers of very young or the elderly sometimes feel stuck in the house and escape to the internet to socialize
• You suffer from anxiety
• You suffer from excessive stress – you may use the internet for escapism
• You are addicted to alcohol, drugs or gambling – having any other form of addiction increases your risks of an internet addiction²

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As a relatively new and evolving condition, Internet Addiction Disorder (IAD) does not yet have a codified set of diagnostic criteria. Here are the latest recommendations (from 2010) to help doctors and other mental health workers make a diagnosis. Easy to understand, these new diagnostic criteria may help you diagnosis a problem that you or a loved one deals with.

Published in the journal Addiction in Feb 2010; here are the proposed diagnostic criteria for Internet Addiction Disorder (IAD).

Based on the recommended criteria, to meet a diagnosis of IAD a person must display both of the following symptoms:

1. A preoccupation with the internet (thinking a lot about time spent in the past online or anticipating and planning a coming online session)

2. Withdrawal symptoms – after a few days without access to the internet IAD sufferers will experience symptoms such as dysphoria, boredom, anxiety and irritability.

And at least one of the following symptoms:

1. Tolerance – needing to spend increasing amounts of time online achieve the same level of satisfaction that was previously achieved after briefer sessions
2. Wanting to reduce time spent online – Either a persistent desire to reduce time spent online or previous attempts and failures in limiting time spent online
3. Continuing to use the internet despite knowing the harms it does you – you continue to excessively use the internet even though you know that your use of the internet causes you physical or psychiatric harms (Or worsens existing problems)
4. Losing interest in things that were previously enjoyed – you no longer participate at the same level in hobbies or activities that you used to enjoy or find meaningful because of your excessive use of the internet
5. Using the internet to feel better – to relieve negative emotions, such as dysphoria, anxiety, guilt and others

Additionally:

1. Your behaviors cannot be better explained by another mental health disorder
2. Your internet usage must cause you significant life impairment, such as the loss of a job or important relationship or reduced capacity to perform at work or school
3. Your excessive internet usage must be ongoing for longer than 3 continuous months and you must spend more than 6 hours online per day (not including time spent online at work or for school)¹

Sex addicts used to be mostly male, and they often came from a background that included some form of sexual abuse.

Cybersex addicts are equally male and female, the numbers are rising, and anyone seems vulnerable to the easy access and temptation of online explicit content.

Men tend to spend more time viewing pornography, and women tend to prefer more interactive and relationship oriented cyber sex, but beyond that, there is little understanding of who is most at risk for a cybersex addiction. We do know that the numbers affected are rising - sexual addiction therapists are reporting a dramatic increase in the numbers of people seeking treatment.

What is Cybersex Addiction?

Internet sex addicts will spend increasing time online engaged in sexual activity. They will take increasingly greater risks as they progress in their addiction, and they will continue to engage in online sex, even when this pastime causes them real world harms.

The easy access, affordability and anonymity of the internet sexual experience has greatly increased the numbers of people experiencing a sexual addiction. Most people start off through normal curiosity, enjoy the excitement that engaging in sexual activity online brings, and gradually increase the time they spend engaging in cybersex. A Stanford University study on internet sex addiction led researchers to speculate that there were 9 million internet sex addicts in America.

The variation and unending size of the internet pornographic landscape feeds the addiction, like nothing before. There is no end to the experience, and a user can spend hours viewing constantly changing images. Over time, internet sex addicts will progress to more extreme forms of pornography, or online sexual activity. Sometimes men will cross an unexpected line, and view illegal images, in the never ending quest for the more extreme images needed to induce an excitement reaction.

Some common traits of cyber sex addicts include:

• Internet users addicted to online sex spend hours a day, trance like, looking at sexually explicit material - or if they are women, likely participating in explicit online chats.
• They experience a tolerance, and find themselves viewing increasingly extreme content - as what was once exciting becomes mundane.
• They continue to spend hours on the internet engaged in sexual activity, even when it harms their real life relationships.
• They become less able to have intimate and satisfying sexual relationships in real life.
• They feel guilty and ashamed after viewing explicit content on the internet
• They are preoccupied about spending time online to engage in sexual activities, and will feel anxious if unable to do so.

The Risks of Cybersex Addiction

Although cybersex addicts do not face the same risks of disease, arrest or violence as more traditional sex addicts do, an addiction to internet sex can cause a great deal of pain.

Marriage therapists report that problems with internet pornography are now a regular cause for divorce between clients. Sex addiction therapists explain that a cybersex addiction can derail normal and necessary intimacy between partners. Cybersex addicts are unable to achieve the same sort of sexual fulfillment through physical interactions as they can online, and most will avoid sexual content with their partners.

Although many cybersex addicts dismiss claims of infidelity, partners feeling competition from online parties often feel differently, and this too can destroy relationships.

Internet sex addiction is progressive, and sex addicts will take ever greater risks to engage in sexual activity online as their addiction progresses. Many will get caught looking at pornography at work or by family, and many will face negative consequences for their inability to control themselves.

Cybersex can lead to increased rates of depression, shame and guilt.

Treatment for Internet Sex Addiction

Sexual compulsions are not easily broken, and most cybersex addicts will require professional or structured support to mend their sexual lives.

Sex addicts need to learn why they feel compelled to engage in inappropriate sexual activities, need to learn how they can control their temptations, and work on fixing the problems in their life that cause them to seek escape or release through inappropriate sexual gratification.

Sexual support groups modeled on the 12 steps of AA are found in all major centers, and sexual addiction therapists are equally common. In most cases it is recommended that the partners of sex addicts get some co-dependency counseling, to learn what role they may be playing in the propagation of the addiction.

Residential treatment stays are increasingly common for the treatment of sexual compulsions, and as the effects of cybersex addiction ripple down, inpatient programs are more readily found.

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Kids that spend more than 2 hours a day in front of a video game, computer or TV set are at increased risk of mental health problems, obesity, poor school performance and a host of other negatives. Read the research highlights that paint a scary picture of what excessive screen time does to a developing mind and learn some easy to implement tips to get your son or daughter away from the TV or video game screen!

The experts haven’t yet decided if excessive or pathological video game play qualifies as a true addiction, but there’s little doubt that for some kids - video games harm quality of life and overall development.

The American Academy of Pediatricians recommends no screen time for children under the age of 2 and only 2 hours a day at maximum for kids older than 2 – a daily limit that’s pretty routinely exceeded in a whole lot of American households!

Want a few compelling reasons why you should limit the amount of video game and other screen time in your household?

Kids that spend too much time in front of a screen each day:

• Are more likely to be obese
• May have reduced creativity (passive screen time reduces the time available to flex creative muscles in free play)
• Are more likely to bully their peers
• Are more likely to have mental health problems, like higher levels of depression or anxiety and have more difficulty sustaining attention
• Do worse in school
• Sleep more poorly¹

And if that isn’t enough to scare any parent – research on kids who play video games to excess (for hours a day) also makes for some pretty frightening reading.

Want a few good reasons to get your son or daughter away from the computer screen or video game console?

According to research:

• Teens in Singapore who were classified as addicted to gaming (playing an average of 31 hours per week and experiencing problems in other areas of life due to their game play) were more likely to be impulsive and to do worse in school and more likely to have impaired social functioning and emotional health problems like depression and anxiety. The research showed that those teens who continued to play video games excessively over the course of the 2 year study experienced a worsening in emotional health and social functioning; those that managed to reduce their play improved in these areas.²
  
• UK researchers found that children who spent the more time in front of a screen had the highest levels of psychological difficulties. Interestingly, they found that high levels of screen time were not offset by high levels of activity time. Kids who spent a lot of time playing computer games or watching TV and a lot time engaged in active play were just as affected as kids who did not also get the active play. The research suggests that screen time is not offset by other types of activities.³
• Iowa State University researchers found that middle school students who exceeded the 2 hours recommended screen time per day were twice as likely to have attention problems (as reported by their teachers) as kids who watched spent less than 2 hours a day in front of a screen.⁴
  

Preventing Excessive Screen Time

Whatever your thoughts on the validity of terms like, gaming addiction, there seems little doubt that excessive time spent in front of any kind of TV or computer screen during the childhood and teen years does a lot more developmental harm than good – so how can you get your son or daughter to turn off the game and get engaged in something a little more beneficial?

According to the experts, effective strategies for reducing your child’s screen time include:

• Remove TVs and video game players from the bedroom into family areas
• Help your child find alternative activities to game play or TV watching
• Turn the TV off at meal times and when no one is actively watching a program
• Set rules limiting the amount of time per day that your child can turn on the TV or play video games
• Do not set a bad example – make sure to minimize your own screen time to acceptable levels⁵

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The 2 hallmarks of an email addiction are an obsession with thoughts of checking for email and an inability to resist the urge to check. Email addicts might check for mail hundreds of times per day - and eventually think of little else.

With each passing month technological advances increase our ability to stay connected. We can now check emails and message between friends, family and work peers, anywhere and at any time - and although technology for most means freedom, for some, it becomes an anchor of compulsion.

A significant number of people check email, either on the computer or through PDA's often enough to cause real harm to their quality of life. No one is quite sure how many people suffer an "email addiction" but researchers speculate that as many as 6% of internet users would meet the criteria for an impulsive-compulsive disorder, through their online and emailing behaviors.

For these people, thoughts of email communication become a pervasive obsession, and it can be very difficult to resist the urge to check for messages, again and again and again – hundreds of times per day.

These email addicts suffer a legitimate mental health disorder, which is treatable, but rarely goes away on its own.

An Impulsive-Compulsive Disorder

Psychiatrists classify email addiction as a form of impulsive-compulsive disorder. It is compulsive in the way that sufferers are rarely free from thoughts of checking messages (often even in the middle of the night) and impulsive in that email addicts are unable to resist their impulses to check their email with incredible frequency, even though they know it to be a harmful habit.

Although it seems far less serious than comparative impulsive disorders, such as impulsive hair pulling or fire starting, the negative effects of an email addiction can be profound.

Family members describe living with loved ones, who although present in body, are always absent in spirit – forever lost to email messaging. Parents with email addictions can't spend quality time focused on their children, and spouses of email addicts almost never get quality time with their partner.

Email addiction is progressive. Patients complaining of email addiction will find that they eventually become anxious and depressed unless they are checking their messages, and the only way to alleviate this dysphoric mood is to again check their messages.

Email addiction can lead to social isolation. Social isolation within the family – as loved one's lose interest in attempting meaningful communication, and literal social isolation, as loved ones eventually get so discouraged as to leave.

What Causes Email Addiction?

Impulsive disorders often emerge out of once pleasurable acts. The act of checking email, and sporadically finding enjoyable communication therein, is pleasurable, and reinforcing in itself. It feels good to get an email, so we check for emails more often.

Eventually, email addicts don’t check their emails as a way to feel pleasure, but as a way to alleviate the negative feelings associated with not checking email.

Scientists speculate that there are neurological underpinnings to the disorder, in the cortex and limbic systems in the brain (the areas that regulate impulse control and pleasure) and suspect that email addicts will show altered brains from their pathology.

Anyone seems at risk for the disorder, but we do know that those with a co-occurring mental health condition are more susceptible to technological compulsions, as are people with other addictions.

Email Addiction Treatment

Some email addicts are able to self regulate their behavior through a determined and structured program of access. Most people will need some professional therapy.

Cognitive behavioral therapy seems most beneficial to technology and internet communication addicts. Cognitive behavioral therapy teaches clients to recognize the erroneous thought patterns and beliefs they have associated with their problematic behavior, and to change how they think about it – thereby changing how they act.

Family therapy can help to educate the whole family on the underpinnings of the disorder, and help to create a family support system against relapse.

In many cases, where there is a co-occurring mental health condition, medication management can lead to significant symptoms relief. For those clients with a single diagnosis of impulsive-compulsive internet addiction, SSRI's may be helpful.

Getting Help for an Email Addiction

Email addiction is a real and recognized subset of impulsive compulsive disorder. Although we have a tendency to belittle the seriousness of addictions to technology and to the internet, these addictions can be very harmful, do reduce quality of life, and are quite responsive to therapies.

Admitting to the problem and getting help can be difficult, but life is better free from compulsion.

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EverCrack - the name says it all, and it's not funny anymore for the hundreds of thousands that are so addicted to their virtual worlds that they can't stop playing.

Evercrack, heroinware…these joking references to the addictive lure of online video games have become more real and ominous as the numbers of video game addicts rise, and as stories of neglect and despair mount.

Massively multi player role playing games, or MMPRPG's, such as EverQuest, WarCraft or Diablo II, attract millions of players daily. Most players enjoy their pastime, many acknowledge spending countless hours in play, and some even admit to serious addictions compelling them to play. Many more have addictions that they deny.

Gaming addicts report that video games have cost them marriages, lost them jobs and lost them custody of children. The real world repercussions of a virtual fantasy addiction can be extreme.

A relatively new phenomenon, the incidence rates of gaming addiction are not known. Experts speculate that 5% of gamers are addicted, and admit that the numbers could be higher. Anecdotally, therapists say that more people are seeking help for their addictions (or more commonly - loved ones are seeking help for an addicted person) each year.

When Does Game Play Become an Addiction?

Answering yes to any of the following questions may indicate that you have a problem with video games.

• Do you find that you consistently play for far longer than you had intended to?
• Do you continue to play, even though your game-play causes you significant problems in your real life?
• Do you feel anxious or irritable when you are unable to play for any lengthy period of time?
• Do you ever lie about your game play, or the amount of time you spend playing?
• Do you ever lose track of time while playing?

Why Are MMPRPG's So Addictive?

Doctors studying video game addiction say that the reason that people get hooked – is that the games are designed purposefully to demand ever increasing amounts of game play. They are addictive by design.

Chasing Goals That Never End

Players spend a great deal of time and energy into creating a character, their virtual persona, and the games are set up so that they must invest a great deal of time and effort to expand their character's powers and abilities.

Players get focused on a goal of acquiring a new weapon or spell, and are very reluctant to stop playing before they have met their target. Of course, as soon as they do achieve their goal, there is always the next great thing, and the next. Addiction professionals liken this to a gambling addict chasing a win, and then continuing to play even after they do win. There is no end.

Playing With Friends

Also, the games are by nature very interactive and players work together collaboratively to achieve certain tasks. Players feel that they cannot leave the game prior to fulfilling their obligations to their team.

The social aspect of the games is a large part of the attraction for many players. In their virtual world they can be whoever they want to be, and it is relatively easy to improve their character. People who might find real world interactions difficult are particularly at risk for gaming addiction, drawn in by virtual friendships, often the only friendships they know.

Developmentally, therapists say they see a lot of developmentally stunted people, people that have never learned how to socialize appropriately outside of a gaming environment.

Virtual Escapism

Finally, there is a real sense of escapism to entering a virtual world. Gamers describe leaving their problems behind as they get immersed in their virtual kingdoms, and periods of gaming can be used as a break from the responsibilities of real life. This can become a negative spiral, as more time is spent playing, the problems of life intensify, and the response is through ever more gaming and escape.

As technology accelerates, and virtual worlds become more expansive and truly interactive, the problem only worsens. Professionals speculate that the hundreds of thousands that now struggle with gaming addictions are just the tip of a coming and much larger iceberg.

Professional Help Is Needed

Addicted players are rarely able to quit playing on their own. Those that attempt to quit describe intense anxiety, cravings to play and irritability - A sense of feeling lost in the real world, and desperately wishing to re-enter their virtual and comfortable world. Some are able to quit on their own, many aren’t, and relapse rates back to gaming are high.

Abstinence and therapy seem necessary to break the cycle of addiction. Few players are able to moderate their play after progressing to addiction. In some cases, pharmacological interventions can help.

Cognitive therapy, in which users are taught to recognize negative thought patterns, and the behavioral repercussions of those thoughts, is seen as the most effective therapeutic intervention.

Gaming addiction is very real, and very devastating, and for those caught in the grips, professional help is very sensible, and often needed

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Who is most at risk for an internet addiction - it's not who you think!

The stereotype of an internet addict is a teenage or young adult male who is socially awkward, often unattractive, yet intelligent.

The reality is completely different.

Internet addiction is considered an impulsive-compulsive disorder and is a recognized mental health disorder. Certain groups are more at risk of developing an addiction to the internet, to video games and to email or text messaging - and they are teens of both sexes and middle aged and older men and women.

Having a present or past addiction to another substance or activity increases the risks of developing an e-addiction dramatically, as does having an additional past or present mental health disorder.

Although teens and the middle aged are statistically the most likely to succumb, anyone seems vulnerable, and as we become increasingly reliant on the internet for communication and entertainment, the numbers who experience problems with their use will likely rise.

Any of us can develop a compulsion, and the internet can create altered states that because they are pleasurable, are reinforcing and addictive. The internet can be used to escape reality, to live an alternate identity or to socialize compulsively. The internet is an amazing medium of information and entertainment, but should be taken, like all things, in moderation.

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A recognized compulsive-impulsive use disorder - understand internet addiction, know how to spot it and learn what can be done.

It can be hard to understand technology addiction – addiction being a concept we are more comfortable associating with the consumption (and intoxication) of drugs or alcohol, but internet addiction is a very real compulsive-impulsive use disorder, similar in some ways to a gambling addiction.

The use of the internet becomes problematic when that use starts causing you problems - and many internet addicts will report negative consequences from their use.

Their drive to be online leads to deteriorating relationships, a reduction in professional or school performance and an increased likelihood of experiencing other mental health disorders.

Internet addicts will feel a need to be online, will experience symptoms of withdrawal when offline for significant periods of time, and will develop a tolerance, needing ever great periods of internet time to feel satisfied.

Although most internet addicts will spend an inordinate amount of time online, the quantity of time spent on the internet is not really relevant. One person may spend a great deal of time online, but not experience an addiction, while another may spend comparatively little, but experience problems due to their use. The way the internet negatively affects quality of life is the most important criteria for the diagnosis of an internet addiction.

The 4 Components of an Internet Addiction

Internet addictions have been segmented into certain distinct subgroups, including, gaming addiction, sexually related internet addiction and email or text messaging addiction. All three share four component features:

1. Negative Consequences – The use of the internet or technology has negatively affected quality of life. Some examples would be - deteriorating social relationships, social isolation, poor work or school performance and arguments about time spent online.
2. Excessive time spent online – Most internet addicts will spend a great deal of time online, will lose track of time while surfing, and will forget to meet basic needs such as for sleep or food, while on the internet.
3. Tolerance – A need to spend more time online to feel satisfied. Also, a preoccupation with acquiring new and better technology or software.
4. Withdrawal – Feeling irritable, depressed or angry when they cannot be online.

How Does an Internet Addiction Happen?

The internet has woven itself into the fabric of our lives, and most of us use it everyday, sometimes for hours a day – and most of us do not become addicted to it.

Scientists don’t yet understand what causes one person to succumb to addiction while another doesn't. Some speculate that people can get addicted to the social aspects of online relationships, relationships that are less threatening and that can be tempting, but are ultimately less fulfilling.

Other clinicians argue that a compulsion to use sprouts out of escapist tendencies, and that the overuse of the internet is a form of self medication from those who cannot or choose not to, face life's problems head-on.

Still others argue that in some people, internet usage creates a high similar to the high of gambling, and that we can get addicted to this pleasant sensation.

Most clinicians speculate that as research unfolds, we will see a neurological underpinning to the disorder – that the brains of internet addicts will be altered in small ways through their addiction.

What scientists do know is that people prone to other addictions are more likely to suffer an internet addiction, and that people who suffer one or more mental health disorders are far more likely to be susceptible to an internet addiction.

Signs of an Internet Addiction

Certain warning signs may indicate the presence of an internet addiction.

• Excessive thinking about the internet when not online - Thinking about what you will do when next online, and what you have done recently. Normal internet users do not spend much time preoccupied with online activities after logging off. Lying awake in bed thinking about text messages you want to send is a warning sign.
• Lying to others about how much time you spend online. A sign of most addictions, if you need to lie, then you have something to hide.
• Using the internet as a way to escape from problems or negative emotions - Soothing yourself after a hard day with online time, is a dangerous habit.
• Experiencing any significant work or school performance detriments, or relationship harms out of your online habits. If you find yourself staying up very late at night and missing work or class, for example, this could be indicative of a problem.
• Observing the development of a tolerance - If you find that you need ever longer periods of time online to achieve satisfaction, you are developing a tolerance to the internet.
• Cravings to use and withdrawal symptoms are a telltale sign of a problem. If you get anxious or irritable when you cannot get online, when your PDA battery dies or when you get interrupted online, you may be showing withdrawal symptoms.

What are the Risks of an Internet Addiction?

There can be a tendency to discount the seriousness of the disorder, but an internet addiction can create significant problems, can lower quality of life, and in some cases, has even proven fatal.

There have been numerous instances of people ignoring their basic needs during marathon online sessions to such a degree that they eventually died from their neglect.

Less dramatic, but still serious harms include:

• Poor work or school performance
• The erosion of normal social relationships
• A lessening of social abilities to interact offline
• Health deficits from bodily neglect
• Financial difficulties from online activities
• The development of co-occurring mental health disorders, such as depression, or the worsening of existing mental health disorders

What are the Treatments for an Internet Addiction?

The disorder has only gained wide attention and acceptance in the last few years, and there are not yet any comprehensive research findings on the efficacy of treatments for the disorder.

Somewhat problematically, abstinence based models are perhaps not realistic. We cannot expect someone to function in modern society while abstaining from technology.

Most treatments combine individual and group support therapy, cognitive or behavioral modification therapies and pharmacological interventions. Internet addicts are taught to use with control, and learn skills to limit their compulsions for excessive and harmful use.

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Worried about your online habits? Take the following 8 question test, and see if you meet the criteria for internet addiction.

The following 8 questions, adapted from the American Psychiatric Association's diagnostic evaluation for gambling addiction, are used to differentiate between addicted and non addicted internet users.

These questions are not yet endorsed by the APA as a diagnostic evaluation for internet addiction, but are used by many practitioners as a screening tool.

The test was developed by Dr. Kimberly Young.

8 Question Internet Addiction Test

1. Do you feel preoccupied with the Internet (think about previous online activity or anticipate next online session)?
2. Do you feel the need to use the Internet with increasing amounts of time in order to achieve satisfaction?
3. Have you repeatedly made unsuccessful efforts to control, cut back, or stop Internet use?
4. Do you feel restless, moody, depressed, or irritable when attempting to cut down or stop Internet use?
5. Do you stay on-line longer than originally intended?
6. Have you jeopardized or risked the loss of significant relationship, job, educational or career opportunity because of the Internet?
7. Have you lied to family members, therapist, or others to conceal the extent of involvement with the Internet?
8. Do you use the Internet as a way of escaping from problems or of relieving a dysphoric mood (e.g., feelings of helplessness, guilt, anxiety, depression)?

Answering yes to 5 or more of the preceding question indicates an internet addiction.

This test has not been endorsed by the APA, nor has it been proven to be an accurate diagnostic tool.

If you answer yes to any number of the preceding questions, you should consider the possibility of an addiction, and should take steps to get a more formal diagnosis from a licensed doctor or therapist.

Internet addiction is treatable, but it won't go away on its own.