Internet addiction

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Classification according to ICD-11
6C51.0 Gaming Disorder, predominantly online
6C51.1 Gaming disorder, predominantly offline
6C51.Z Gaming disorder, unspecified
ICD-11 ( WHO version 2019)

As Internet addiction , even Internet or online addiction , the phenomenon called, Internet excessively, that is harmful to use. In the English-speaking world, the terms internet addiction (disorder) , pathological internet use and compulsive internet use can be found , i.e. pathological or compulsive use of the internet , which better describe the problem area. In 2018, online gambling addiction was included as a disease in the WHO's new diagnostic catalog , the ICD-11 . The term excessive online behavior (EOV) is synonymous with terms such as Internet addiction , Internet addiction or online addiction used.

The lack of standardization of the concept of internet addiction is a major obstacle to further development of this research area. The researchers argue about whether internet addiction is an independent disease or whether it is just a symptom of another underlying disease. There is debate over whether it is an impulse control disorder or an  obsessive-compulsive disorder rather than an addiction.

Spread / epidemiology

Various studies in recent years report internet addiction prevalences between 0.8% and 26.7%. This variance within the prevalence is sometimes due to the heterogeneity of the instruments used to record Internet addiction, diagnostic criteria, cut-off scores and, last but not least, to cultural differences. Because of these methodological difficulties, the interpretation of prevalences is still possible to a limited extent and makes comparisons between different countries more difficult. It is estimated that in Germany between 560,000 and 1.5 million people (1–3% of the German population) show tendencies towards the development and maintenance of Internet addiction. In 4.6% of the population, compulsive online use for at least 4 hours a day would be “problematic internet use”. This number roughly corresponds to the proportion of cannabis users in Germany. The proportion of gambling addicts is around 0.3 to 0.5%, i.e. around 250,000 people. The proportion of Internet addicts is higher among young people than among older people. According to the study, 2.4% of 14 to 24 year olds are said to be internet addicts. 13% are considered "problematic in their internet use". In the 14 to 16 age group, girls are at 4.9% more at risk than boys, 3.1% of whom are dependent on online use. In the group of up to 24 year olds the ratio is roughly the same. Overall, men are said to be more likely to suffer from internet addiction than women. With 77% female users concentrate more on social networks such as Facebook, young men on computer games. Further results show that the prevalence in European samples between 1.0 and 9.0%, in samples from the Middle East between 1.0 and 12.0% and in Asian samples slightly higher between 2.0 and 18.0% lie. The government of South Korea estimates that around 210,000 Korean children and adolescents are affected by internet addiction (2.1% between the ages of 6 and 19). No precise estimates are available for the USA. Only two epidemiological studies have so far examined the prevalence over the entire population. In Norway the prevalence was 0.7% and in the USA 1.0%.

Manifestations

Different areas are described in which pathological internet use can occur:

Internet addiction, like other behavioral disorders, causes neglect of common habits, social contacts, personal care and personal hygiene , as a large part of the available time is spent on the Internet. In extreme cases, the virtual world can become a supposedly complete replacement for other real social contacts and thus lead to social isolation . The addiction is hidden from the outside world, or if you don't want to admit it, your behavior is played down. Common withdrawal symptoms are bad mood, nervousness , irritability , trouble sleeping, or sweating .

Depressed and lonely people are considered to be particularly at risk . When the pressure of everyday life becomes very high, the virtual world can offer an escape route, whereby everyday tasks and social demands are neglected. The driving force is the pursuit of certain tasks, escape from reality and experimentation with identity as well as the combination of satisfying the so-called play instinct and the need for communication. The simulation of social advancement can play a role as well as the feeling of omnipresence . Depressed people find virtual relief, narcissistic personalities satisfy their claim to power, young people have new opportunities to explore their limits and the supposed opportunity to develop their personality. Participants in frequent player role-playing games (so-called " MMORPGs ") and " browser games " may take their game successes with them into reality in order to assert themselves against other people. Often game successes are the substitute for successes in real life and are seen by those affected as more important than devoting themselves to their own reality.

Terminology

Colloquially, internet addiction is referred to as an " addiction ". It is a substance-independent dependency , which is recorded in the classification of the ICD-10 :

  • F63 Abnormal habits and impulse control disorders
  • F63.0 Pathological gambling
  • F63.8 Other abnormal habits and impulse control disorders
  • F63.9 Abnormal habit and impulse control disorder, unspecified

In science, one often makes do with the classification as a disorder of impulse control (F63.8 or F63.9). Internet addiction, however, together with pathological gambling, is considered to be exotic among impulse control disorders, because both cannot be described by the compulsive ending of unpleasant states of tension, but by the loss of control over behavior that was originally experienced primarily as a pleasure. Two competing disorder models dominate in Germany: the behavioral addiction model and the model of a relationship and behavioral disorder .

Some scientists, such as the psychiatrist Bert te Wildt, do not see internet addiction as an independent disease, but rather as a shift of non-substance-related addictions to the internet. The discussions between the different scientific positions continue.

Internet addiction is partly as a generic term for other disorders such as online shopping addiction , computer addiction Internet Sex Addiction , computer game addiction and online gambling addiction used. Already established mental disorders are transferred to online activities , which also leads to contrary positions within the scientific discussions.

In order to promote research and to be able to develop better prevention and therapy options, the requirements for recognition of “online / new media addiction” at the World Health Organization are to be examined.

Symptoms

As early as 1998, the Center for On-Line Addiction identified five specific types of Internet addiction :

  • Cybersexual addiction describes the dependence on pornographic material and sexual interaction on the Internet.
  • Cyberrelationship addiction is the dependency on virtual friendships, which suppress or replace real relationships with friends and family.
  • Net-compulsion encompasses all obsessive Internet activities including gambling, shopping and auctions.
  • Information overload is obsessive research and surfing for no apparent reason.
  • Computer addiction (computer game playing) means excessive computer gaming.

Hahn and Jerusalem define internet addiction or internet addiction as a non-substance-related addiction that is considered to be present when:

  • The largest part of the daily time budget is spent on internet use over longer periods of time, including behavioral activities such as optimization work on the computer ( narrowing the behavioral space ),
  • the person has largely lost control of their Internet use or attempts to reduce the extent of use or to interrupt use, remain unsuccessful or not even made - although there is awareness of personal or social problems caused by them (loss of control ),
  • In the course of time, a development of tolerance can be observed, i.e. the behavioral dose had to be increased to achieve the targeted positive mood,
  • withdrawal symptoms occur as a result of temporary, prolonged interruption of Internet use as impairments of psychological well-being such as restlessness, nervousness, dissatisfaction, irritability and aggressiveness,
  • there is a psychological desire to use the Internet ( craving ),
  • Internet activities have negative social consequences in the areas of work and performance as well as social relationships, such as anger with family, friends or the employer.

Many forms of social interaction are now taking place online that were previously assigned to areas that appeared to be excluded from internet addiction, such as: B. appointments made online or doing homework together on Facebook - this circumstance also makes it difficult to distinguish it from “normal” behavior, as this assumed normality is subject to constant change. Experts describe more than 35 hours of private Internet use per week as problematic.

therapy

Since there is no agreement in medicine on the name and diagnosis, the German health insurance companies and pension providers do not recognize the diagnoses of computer addiction or internet addiction. In order to be able to help those affected, the diagnoses in ICD-10 F63.8 ( other abnormal habits and impulse control disorders ) or F63.9 ( abnormal habits and impulse control disorders, unspecified ) are used, for which the costs the therapeutic measures are taken over. In Germany, in the context of reintegration, it is also possible for the social welfare office to cover part or all of the costs if the costs of the measure exceed one's own possibilities and no other cost bearer exists.

Therapies are now possible in almost every facility that deals with addiction and dependence. The therapy can be carried out as an inpatient , partial inpatient or outpatient . Various therapeutic measures are available:

  • inpatient therapy
  • Adaptation
  • semi-stationary accommodation
  • day clinic
  • One-on-one interviews
  • indicative groups
  • Support groups

The special problem of therapy against Internet addiction is that the usual therapy goal of material dependence , namely the most complete abstinence possible , cannot be achieved. Computers and other electronic media are part of everyday life. As part of therapy, however, those affected can learn to use the computer medium and the Internet in a more conscious, socially tolerated and adapted manner.

Subsequent problems often have to be addressed. As with other behavioral therapies, a therapy contains incentives to arouse the interest of those affected in sport and other leisure activities . In addition, in the case of young people affected, the respective parents must generally be involved, since the trust between children and parents may be disturbed and must be rebuilt.

In the case of (spouses) partners, marriage counseling may be indicated in order to jointly find strategies to cope with addiction as well as to save the relationship.

The importance of self-help groups for therapy is generally recognized . Many therapists are now convinced that lasting therapeutic success is only possible by attending self-help groups. Attending a self-help group is not tied to participation in inpatient or outpatient therapy. Since there is not (yet) a high need for self-help groups in the area of ​​computer, online and media addiction and because of the numerous parallels to gambling addiction , computer and gambling addicts usually come together to form joint self-help groups.

Epidemiology

Internet addiction in Germany

According to a study carried out on behalf of the Federal Ministry of Health and presented in Berlin on September 25, 2011, according to new estimates, there are more internet addicts in Germany than gambling addicts. According to this, around 560,000 people in Germany are dependent on the Internet. For example, 1% of 14 to 64-year-olds are likely to be dependent on the Internet, while 4.6% have “problematic Internet use” after at least 4 hours online. This number roughly corresponds to the proportion of cannabis users in Germany. The proportion of gambling addicts is around 0.3 to 0.5%, i.e. around 250,000 people. The proportion of Internet addicts is higher among young people than among older people. According to the study, 2.4% of 14 to 24 year olds are said to be internet addicts. 13% are considered "problematic in their internet use". In the 14 to 16 age group, girls are at 4.9% more at risk than boys, 3.1% of whom are dependent on online use. In the group of up to 24 year olds the ratio is roughly the same. Overall, men are said to be more likely to suffer from internet addiction than women. With 77% female users concentrate more on social networks such as Facebook, young men on computer games.

In April 2008, the Committee for Culture and Media of the German Bundestag took the lead in organizing a public hearing of experts on the subject of online addiction . The drug report of the Federal Government 2009 dedicates a separate chapter to online addiction for the first time and comes to the result: “From a health point of view, the addiction-like use of the Internet has gained in importance. Above all, male adolescents and young adults show a losing, slipping and, in extreme cases, psychopathologically conspicuous online usage behavior, especially with regard to online game worlds ”.

The Committee for Education, Research and Technology Assessment of the German Bundestag held a public meeting on June 9, 2016 on the topic of new electronic media and addictive behavior - risks, coping strategies and prevention options . In this context, the Office for Technology Assessment at the German Bundestag presented the TAB work report on new electronic media and addictive behavior . The public event was organized by the consortium partner IZT - Institute for Future Studies and Technology Assessment .

Internet addiction and other mental illnesses

Adolescents who already have another mental illness are statistically more susceptible to internet addiction than young people who are not receiving psychiatric treatment. In addition, studies show a connection between pathological Internet use and the risk of suicide , as well as problems in identifying young people.

Studies

References and comments

  1. ↑ WHO makes online gambling addiction an official disease . mdr.de, June 18, 2018, accessed June 19, 2018
  2. ↑ ICD-11 - 6C51 Gaming disorder. icd.who.int, accessed on June 19, 2018. The DSM-5 classification from 2013, which is more used for research, only mentions internet addiction in the appendix. ( Electronically tied up , süddeutsche.de from November 22, 2013)
  3. ↑ Sebastian Wachs, Karsten D. Wolf: Connections between deviant and high-risk online behavior of 12 to 13 year old children from three countries . In: Jahrbuch Medienpädagogik , 12. Springer Fachmedien, Wiesbaden 2015, pp. 71–97.
  4. ↑ MA Moreno, L Jelenchick, E Cox, H Young, DA Christakis: Problematic internet use among us youth: A systematic review . In: Archives of Pediatrics & Adolescent Medicine . tape 165 , no. 9 , September 1, 2011, p. 797-805 , doi : 10.1001 / archpediatrics.2011.58 , PMC 3215336 (free full text).
  5. ↑ Alexander Winkler, Beate Dörsing, Winfried Rief, Yuhui Shen, Julia A. Glombiewski: Treatment of internet addiction: A meta-analysis . In: Clinical Psychology Review . tape 33 , no. 2 , March 1, 2013, p. 317-329 , doi : 10.1016 / j.cpr.2012.12.005 .
  6. ↑ D. Kuss, M. Griffiths, L. Karila, J. Billieux: Internet Addiction: A Systematic Review of Epidemiological Research for the Last Decade . In: Current Pharmaceutical Design . tape 20 , no. 25 , 2014, p. 4026-4052 , doi : 10.2174 / 13816128113199990617 ( full text [PDF]).
  7. ↑ a b Prevalence of Internet Addiction, Report to the Federal Ministry of Health, 2011 ( Memento of the original from September 29, 2011 in the Internet Archive ) Info: The archive link was automatically inserted and not yet checked. Please check the original and archive link according to the instructions and then remove this notice. (PDF; 298 kB) @1@ 2Template: Webachiv / IABot / www.drogenbeauftragte.de
  8. ↑ K. Wölfling, M. Bühler, T. Leménager, C. Mörsen, K. Mann: Gambling and Internet Addiction . In: The neurologist . tape 80 , no. 9 , August 22, 2009, p. 1030-1039 , doi : 10.1007 / s00115-009-2741-1 .
  9. ↑ Internet addiction at the level of cannabis use. In: Berliner Morgenpost September 26, 2011. See also more addicts to the Internet than to gambling. In: MDR September 26, 2011. ( Memento from October 1, 2011 in the Internet Archive )
  10. ↑ Marcantonio M. Spada: An overview of problematic Internet use . In: Addictive Behaviors . tape 39 , no. 1 , p. 3–6 , doi : 10.1016 / j.addbeh.2013.09.007 .
  11. ↑ The American Journal Of Psychiatry Editorial on Epidemiological Cultural Differences in Internet Addiction
  12. Jump up ↑ Inger Johanne Bakken, Hanne Gro Wenzel, K. Gunnar Götestam, Agneta Johansson, Anita Øren: Internet addiction among Norwegian adults: A stratified probability sample study . In: Scandinavian Journal of Psychology . tape 50 , no. 2 , April 1, 2009, p. 121-127 , doi : 10.1111 / j.1467-9450.2008.00685.x .
  13. ↑ Lorrin M. Koran, Ronald J. Faber, Elias Aboujaoude, Michael D. Large, Richard T. Serpe: Estimated Prevalence of Compulsive Buying Behavior in the United States . In: American Journal of Psychiatry . tape 163 , no. 10 , October 1, 2006, p. 1806–1812 , doi : 10.1176 / ajp.2006.163.10.1806 .
  14. ^ Jerald J. Block: Issues for DSM-V: Internet Addiction. American Journal of Psychiatry, 2008, 165 (3), pp. 306-307, doi: 10.1176 / appi.ajp.2007.07101556 .
  15. ↑ Oliver Bilke-Hentsch, Klaus Wölfling, Anil Batra (eds.): Praxisbuch Behavioral Addiction: Symptoms, Diagnosis and Therapy in Children, Adolescents and Adults. Georg Thieme Verlag, Stuttgart 2014, p. 110
  16. ↑ Oliver Bilke-Hentsch, Klaus Wölfling, Anil Batra (eds.): Praxisbuch Behavioral Addiction: Symptoms, Diagnosis and Therapy in Children, Adolescents and Adults. Georg Thieme Verlag, Stuttgart 2014, pp. 111–112
  17. ↑ Bert te Wildt: Digital Junkies. Internet addiction and its consequences for us and our children. Droemer eBook, Munich 2015, chap. 2.4
  18. ↑ German Bundestag Printed Matter 16/13382 - application (PDF) on June 17, 2009. (PDF, 48 kB)
  19. ↑ See the research overview by Ulrike Braun: Excessive Internet use of young people in a family context. Analyzes of social class, family climate and parental employment status. Springer Fachmedien Wiesbaden 2014, p. 15
  20. ^ Hahn, André and Jerusalem, Matthias (2001): Internet addiction. Youngsters caught in the net. In: Raithel, Jürgen (Ed.): Risk behavior of young people. VS Verlag für Sozialwissenschaften, 2001, pp. 279–293
  21. ↑ The web has arrived in everyday life. Spiegel Online, August 11, 2010
  22. ↑ Internet addiction at the level of cannabis use . In: Berliner Morgenpost , September 26, 2011. See also more addicts to the Internet than to gambling. ( Memento from October 1, 2011 in the Internet Archive ) MDR, September 26, 2011.
  23. ↑ Drugs and Addiction Report . ( Memento of the original from December 13, 2015 in the Internet Archive ; PDF; 1.5 MB) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. Federal Ministry of Health, May 2009; Retrieved July 13, 2010 @1@ 2Template: Webachiv / IABot / www.drogenbeauftragte.de
  24. ↑ Drug and Addiction Report published in 2009 , Federal Ministry of Health, press release, May 4, 2009
  25. ↑ Internet and computer games - when does addiction begin? Annual meeting of the drug commissioners of the federal government, July 3, 2009
  26. ↑ Study on the addiction potential of digital media explained . German Bundestag. June 9, 2016. Retrieved May 16, 2019.
  27. ↑ New electronic media and addictive behavior (PDF) Office for Technology Assessment at the German Bundestag. Retrieved May 16, 2019.
  28. ↑ Martin Fuchs, David Riedl, Astrid Bock, Gerhard Rumpold & Kathrin Sevecke: Pathological Internet Use — An Important Comorbidity in Child and Adolescent Psychiatry: Prevalence and Correlation Patterns in a Naturalistic Sample of Adolescent Inpatients. In: BioMed Research International. No. 2018, p. 8.