Pauline Anderson

May 05, 2014

NEW YORK ― Mounting research points to the potentially devastating effects of Internet addiction, especially in adolescents.

A new literature review of 13 published articles showed that people with Internet addiction disorder (IAD), especially those addicted to Internet gaming, tend to have certain brain abnormalities.

The results were presented here at the American Psychiatric Association's 2014 Annual Meeting.

Changes in Brain Blood Flow

Internet addiction is also associated with changes in blood flow.

"Increased blood flow is actually seen in the areas of the brain involving reward and pleasure centers, and decreased blood flow is observed in areas involved in hearing and visual processing," Sree Jadapalle, MD, a second-year psychiatry resident at Morehouse School of Medicine in Atlanta, Georgia, told reporters attending a press briefing.

Dr. Sree Jadapalle

The prevalence of IAD among American youth is about 26.3%, "which is huge," said Dr. Jadapalle. "That's actually more than alcohol and illicit drug use disorders."

IAD is not currently an established mental disorder. However, proposed criteria for this condition include the loss of control over Internet use, resulting in marked distress, preoccupation, mood changes, tolerance, withdrawal, and functional impairments of social, occupational, and academic performance. Another proposed criterion is spending more than 6 hours a day on nonacademic, nonbusiness Internet use for more than 6 months.

The research shows a significant correlation between IAD and mental health problems, including depression, suicidal behavior, obsessive-compulsive disorder, eating disorders, attention deficit/hyperactivity disorder, as well as alcohol and illicit drug use disorders, said Dr. Jadapalle. Some studies show that IAD may increase suicide attempts in the presence of depression, she added.

Dopamine Changes

Internet addiction is also linked to dopamine changes. Studies indicate that prolonged Internet use leads to a reduction in dopamine transporters, the effects of which are stagnation of dopamine in the synaptic cleft, said Dr. Jadapalle. She added that the resulting excess dopamine causes stimulation of adjacent neurons, which may result in a euphoric effect.

A state of reduced levels of dopamine transporters is seen in substance use disorders and other addictive behaviors, she noted.

The duration and degree of Internet addiction appear to be correlated with activation of the "out of body" or disembodiment-related areas of brain, noted Dr. Jadapalle. Internet addicts also have enhanced reward sensitivity and decreased sensitivity to monetary loss. This may make them indifferent to the consequences of their behavior, which can include psychological, social, and work difficulties.

Despite the increased prevalence, the basic epidemiology and pathophysiology of IAD is unclear, said Dr. Jadapalle.

"To date, very few neuroimaging studies have been performed to investigate the brain structural and functional changes with Internet addiction among the at-risk population of adolescent." This, she said, is unfortunate, because youth represent "our future generation."

Screening for IAD among adolescents with mental health problems is important, given the increasing prevalence of suicidal behavior in this age group, said Dr. Jadapalle. Physicians can use various Internet addiction scales to screen for IAD.

There are not yet any guidelines for treating this condition. However, considering its significant correlation with depression, selective serotonin reuptake inhibitors may alleviate symptoms, according to some studies.

"South Asian countries have some detox centers for Internet addiction that use some psychotherapeutic interventions," said Dr. Jadapalle.

Internet Is Here to Stay

Moderator of the press briefing Jeffrey Borenstein, MD, president and CEO, Brain and Behavior Research Foundation, New York City, said that this study was "very interesting" and that Internet addiction needs "a lot more research."

"The Internet is here to stay," said Dr. Borenstein.

He noted that although just a few years ago, studies on Internet use encompassed only PC (personal computer) use, with the explosion of iphones, instant messaging, and other new technologies, the Net affects almost every aspect of daily life.

"It's important for us to study the effects of the connectedness that we experience, especially the effects on younger people," said Dr. Borenstein, who admitted to checking his messages himself during the press briefing.

He added that although Internet addiction is not good, not all effects of Internet use are negative. "There may be positive effects of the connectedness, and we want to study that, too."

American Psychiatric Association's 2014 Annual Meeting. Abstract NR7-33. Presented May 4, 2014.

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