Internet 'Addiction' Linked to Druglike Withdrawal

So-called "Internet addiction" is associated with increased depression and even druglike withdrawal symptoms, new research suggests.

A study of 60 adults in the United Kingdom showed that those who were classified as high Internet users had a significantly greater decrease in positive mood after logging off their computers than the participants classified as low Internet users.

"Internet addiction was [also] associated with long-standing depression, impulsive nonconformity, and autism traits," report the investigators, adding that the latter is "a novel finding."

"We were actually expecting that people who used the net a lot would display enhanced moods after use — reflecting the positive reinforcing properties of the net," coinvestigator Phil Reed, DPhil, professor and chair in the Department of Psychology at Swansea University in the United Kingdom, told Medscape Medical News.

"So the key finding of an immediate increased negative mood, the withdrawal effect, was something of a surprise. But the more we looked into the literature, the more it seemed to fit the notion of an addictive disorder," added Dr. Reed.

He noted that the main takeaway message for clinicians is that some people may experience disruptions to their lives from excessive Internet use — and that this can affect both their psychological and physical health.

In addition, patients "may need help exploring the reasons for this excessive use and what functions it serves in their lives."

The study was published online February 7 in PLoS One.

Novel Psychopathology

"Over the past decade, since the term became widely debated in the medical literature, 'internet addiction' has become regarded as a novel psychopathology that may well impact on a large number of individuals," write the investigators.

As reported last year by Medscape Medical News, the upcoming fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) will include Internet use gaming disorder in its Section 3, which is for conditions deemed to require further research.

In fact, excessive Internet use has become a cause of concern in countries all over the world.

China recently announced plans to develop criteria for Internet addiction diagnosis. The country is also implementing stricter regulations on Internet cafes.

"Internet addiction has become a serious problem in China," said Li Jianwei, an official with the Ministry of Culture, in a recent article published in China Daily.

Downside of Technology

"We have had a long-standing interest in uses of computer technology to help children and young people with autism spectrum disorder and special educational needs. These uses have always been very positive," said Dr. Reed.

"However, the emergence of literature suggesting that this helpful tool might also produce problems for some people seemed to warrant some attention. In fact, the flagging of [this] disorder as a potential problem in the new DSM-5 also means that we need to know more about this issue," he added.

For this study, 60 adult volunteers (mean age, 24 years; 55% women) underwent the following tests:

the 20-item Internet Addiction Test,
the Positive and Negative Affect Schedule (PANAS) questionnaire to measure moods,
the Spielberger Trait-State Anxiety Inventory total score (STAI-T/S),
Beck's Depression Inventory (BDI),
the Oxford Liverpool Inventory of Feelings and Experiences (O-LIFE), and
the Autistic Spectrum Quotient Questionnaire (AQ).

All participants were then allowed to use the Internet for 15 minutes. Immediately after this exposure, they again completed the PANAS and STAI questionnaires.

Subgroups were created for those deemed problematic and/or high Internet users (n = 32) and those found to be low Internet users (n = 28).

Druglike Withdrawal

Results showed strong associations between Internet addiction and depression on the BDI, autism traits on the AQ, and schizotypal impulsive nonconformity on the O-LIFE — and weaker associations between this type of addiction and long-standing anxiety, as measured by the STAI-T/S.

Compared with baseline, the high-Internet-use group showed a significantly greater drop in positive mood than did the lower-use group (P < .001).

"The immediate negative impact of exposure to the internet on the mood of internet addicts may contribute to increased usage by those individuals attempting to reduce their low mood by re-engaging rapidly in internet use," write the investigators.

"It is also worth suggesting that this negative impact on mood could be considered as akin to a withdrawal effect," they add.

Dr. Reed noted in a release that for these people, the feeling is similar to "coming off illegal drugs like ecstasy."

"These initial results, and related studies of brain function, suggest that there are some nasty surprises lurking on the net for people's well-being," he said.

The researchers note that key reasons why many of these individuals use the Internet so much is to access pornography and gambling Web sites — which have been shown in the past to potentially lead to addictive states.

"It may be that any results relating to 'internet addiction' are actually manifestations of other forms of addiction," they write.

The study authors have reported no relevant financial relationships.

PLoS One. Published online February 7, 2013. Full article