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Internet Addiction Linked to ADHD, Depression in Adolescents

A new study suggests that kids who are depressed, hostile, or have ADHD or social phobia are more likely to develop an addiction to the Internet than other adolescents.

Amanda MacMillan wrote in an article on CNN Health that although Internet addiction is not yet included in the Diagnostic and Statistical Manual of Mental Disorders, signs of a potential problem include spending a lot of time on the Internet, an inability to cut back on usage, a preoccupation with online activities, and symptoms of withdrawal such as anxiety, boredom, or irritability after a few days of not going online. (The diagnosis is being considered for the 2012 edition of the Manual.)

Past research suggests that 1.4 percent to 17.9 percent of adolescents are addicted to the Internet, with percentages higher in Eastern nations than in Western nations, according to the study published in the Archives of Pediatrics & Adolescent Medicine.

In the survey of 2,293 seventh-grade students in Taiwan, 10.8 percent developed an Internet addiction, which was determined by a high score on an Internet addiction scale.

The researchers from Kaohsiung Medical University Hospital, in Taiwan, followed the adolescents for two years and found that ADHD and hostility were linked to Internet addiction in children in general. Depression and social phobia also predicted problems in girls, but not boys.

Boys were at a higher risk of Internet addiction than girls, and those who used the Internet for more than 20 hours a week, every day, or for online gaming were also at higher risk.

Michael Gilbert, a senior fellow at the Center for the Digital Future at the University of Southern California's Annenberg School for Communication, said he wasn’t surprised by the findings.

"The study's indication that children who are hyperactive or diagnosed ADHD are finding an outlet on the Web makes such perfect sense," he said, because those children crave the constant stimulation of fast-paced video games and interactive social networks.

Kids with depression, anger issues, or social problems also turn to the Internet as therapy, added Gilbert, who was not involved in the study. "They can take on an avatar or a different identity, and can contact other kids with the same problems and social inadequacies; they don't have to function in conventional social ways."

Gilbert said it’s important that this issue is given the attention it deserves.

"I don't get the feeling when I talk to therapists that they really understand the concept of addiction to the Internet," he said. "They think more in terms of pornography sites or gambling sites specifically, but Internet addiction itself is not fully understood yet by the therapeutic community."

Internet addiction may be not as widespread in the U.S.—or at least not as well recognized—as it is in Asian countries. In 2008, for example, a Chinese survey showed that more than four million teenagers spend more than six hours a day online.

But if at-risk children—such as those identified in the Taiwanese study—are given sufficient time and exposure without careful monitoring, Internet addiction could easily become one of the most chronic childhood diseases in America, said Dr. Dimitri A. Christakis of the Center for Child Health, Behavior, and Development in Seattle.

Our culture practically mandates time online, he said, with Wi-Fi connections in coffee shops and BlackBerries and iPhones that allow Internet access almost anywhere. "It would be as if we mandated that everyone drink two beers every day or everyone gamble for an hour every day," Christakis said.

Internet addiction among younger generations may often go unnoticed, however, because parents and pediatricians themselves are using the Web more than they'd like.

Since adolescents cannot easily avoid computers, treatment for addiction cannot simply involve abstaining from the Internet, said Christakis. Parents, educators, and medical professionals need to identify high-risk children early on and monitor their Internet usage to prevent problem behavior from forming.

Time on the Internet needs to be monitored as well, especially for children who may be at high risk for addiction because of depression, ADHD, or social problems, he added.

"You can't tell a kid never to use the Internet the way you'd tell an alcoholic never to have a drink again," Christakis said. "But parents need to be thinking about what types of Internet or online gaming are particularly addictive. Ones that allow for continuous, real-time feedback are particularly risky."

Gilbert said that families should strive to make the Internet a healthy part of their home life. "Putting the computer in a very public place, like the hallway, can integrate the Internet into normal life, rather than it becoming something you go off and do in secret.”

Teachers and health-care professionals should also take the potential for Internet addiction seriously, according to Christakis, who co-wrote an editorial published with the study.

"Our intention in raising this concern is not to be alarmist but rather to alert pediatricians to what might become a major public health problem for the United States in the 21st century," he wrote.

Posted on October 19th, 2009

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