Internet addiction nonsense hits the AJP

While we’ve got used to ‘internet addiction’ popping up in the media from time to time, it has inexplicably been the subject of an editorial in this month’s American Journal of Psychiatry arguing it should be included in the DSM-IV – the next version of the diagnostic manual for psychiatry.

The editorial suggests that we should make ‘internet addiction’ a serious public health issue despite the fact that no-one yet has suggested anything that uniquely distinguishes it from its use as a tool or a source of entertainment.

For example, here are the components that the author, psychiatrist Jerald Block, cites as evidence that someone can become addicted to the internet:

1) excessive use, often associated with a loss of sense of time or a neglect of basic drives, 2) withdrawal, including feelings of anger, tension, and/or depression when the computer is inaccessible, 3) tolerance, including the need for better computer equipment, more software, or more hours of use, and 4) negative repercussions, including arguments, lying, poor achievement, social isolation, and fatigue

Apart from the fact that these and most other supposed criteria make no distinction between using the internet and what the person is using the internet for, it’s easy to see that they don’t describe anything unique to the net.

For example, here are my criteria for ‘sports team addiction':

1) excessive time following games, often associated with a loss of sense of time or a neglect of basic drives, 2) withdrawal, including feelings of anger, tension, and/or depression when team news or matches are inaccessible, 3) tolerance, including the need for better match viewing equipment, more news, or more hours of team-related activity, and 4) negative repercussions, including arguments, lying, poor achievement, social isolation, and fatigue

As more people in the world follow sports teams than have access to the internet, surely this is the more serious problem, especially considering the high levels of violence and alcohol abuse associated with this tragic affliction.

You may, of course, substitute whatever interest you want into the criteria to capture people who are the most motivated to pursue their favourite interest, or who are workaholics who rely on the technology (if you want a retro version, substitute the ‘postal system’ for the internet for a 1908 style communication addiction).

Rather curiously, the editorial mentions the figure that 86% of people with ‘internet addiction’ have another mental illness. What this suggests is that heavy use of the internet is not the major problem that brings people into treatment.

In fact, ‘internet addiction’, however it is defined, is associated with depression and anxiety but no-one has ever found this to be a causal connection.

Recent research shows that shy or depressed people use the internet excessively to (surprise, surprise) meet people and manage their shyness.

And in fact, as I mentioned in an earlier article, one of the only longitudinal studies [pdf] on the general population found that internet use is generally associated with positive effects on communication, social involvement, and well-being, although interestingly, those who were already introverts show increased withdrawal.

In other words, the internet is a communication tool and people use it manage their emotional states, like they do with any other technology.

Of course there are some people who are depressed and anxious who use the internet (or follow sports teams, or read books, or watch TV…) to excess, but why we have to describe this as an addiction still completely baffles me.

Link to AJP editorial. Don’t click! You’re feeding your addiction!
Link to previous post ‘Why there is no such thing as internet addiction’.

3 Comments

  1. Stupete_gentes
    Posted March 20, 2008 at 1:33 pm | Permalink

    Am I delusionnal when I think that Addiction is not per se in the substance but in the capacity of the brain to get soothed by elected activities that are repeated over and over again. Like placebo effect wich effects derive from the belief that a substance will act on a certain way. Even people drinking water in presence of drunk persons will act act as if they were drunk and believe they are, I won’t teach you that. The best exemple may be pathological gambling wich consequences may be traumendous and wich shows the similar dialectic between tension and relief. From a neurological perspective, I don’t understand your opposition to the idea that some activities may be addictive without involving drugs. I’m not refering here to the political stacnce made by some of the proponent of an internet addiction. Just the fact. But maybe I miss some important knowledge.
    Thanks

  2. Vaughan
    Posted March 20, 2008 at 2:25 pm | Permalink

    You need to define what you mean by an ‘addiction’. It is not simply being “soothed by elected activities that are repeated over and over again”. Otherwise, we’d have to diagnose everyone who has a hobby as an addict.
    Addiction assumes that there is a causal link between the activity and the negative consequences. There is no evidence for this for the internet.
    Furthermore, the internet is not an activity, it is a medium of communication. So you need to specify what activities people are doing to say what someone is addicted to. As far as I have read, none of the ‘diagnostic criteria’ specify activities.
    So a person putting in loads of hours to launch a business, a compulsive online sexual predator, a manager of a busy fansite, an avid gamer, a shy person who only feels able to meet people in chat rooms, or a person wanting to keep in touch with their friends across the world could all be diagnosed with ‘internet addiction’.
    I hope you can see that classifying these people together tells us nothing and, in some cases, it pathologises perfectly functional and healthy people as having a major mental illness.
    Of course all rewarding things will share some neurological similarities, but you need to start with a coherent concept to compare it with something else otherwise your comparison is meaningless.

  3. Acleron
    Posted March 23, 2008 at 12:15 am | Permalink

    More woo woo doctors wanting work


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