CyberPsychology & Behavior

Volume 1, Number 3, 1998

Mary Ann Liebert, Inc.

Internet Addiction:
The Emergence of a New Clinical Disorder

KIMBERLY S. YOUNG, Psy.D.

ABSTRACT

Anecdotal reports indicated that some on-line users were becoming addicted to the Internet
in much the same way that others became addicted to drugs or alcohol, which resulted in aca-
demic, social, and occupational impairment. However, research among sociologists, psychol-
ogists, or psychiatrists has not formally identified addictive use of the Internet as a prob-
lematic behavior. This study investigated the existence of Internet addiction and the extent
of problems caused by such potential misuse. Of all the diagnoses referenced in the Diag-
nostic and Statistical Manual of Mental Disorders—Fourth Edition (DSM-IV; American Psy-
chiatric Association, 1995), Pathological Gambling was viewed as most akin to the patholog-
ical nature of Internet use. By using Pathological Gambling as a model, addictive Internet use
can be defined as an impulse-control disorder that does not involve an intoxicant. Therefore,
this study developed a brief eight-item questionnaire referred to as a Diagnostic Question-
naire (DQ), which modified criteria for pathological gambling to provide a screening instru-
ment for classification of participants. On the basis of this criteria, case studies of 396 de-
pendent Internet users (Dependents) and 100 nondependent Internet users (Nondependents)
were classified. Qualitative analyses suggest significant behavioral and functional usage dif-
ferences between the two groups such as the types of applications utilized, the degree of dif-
ficulty controlling weekly usage, and the severity of problems noted. Clinical and social im-
plications of pathological Internet use and future directions for research are discussed.

INTRODUCTION Similar addiction models have been

that some on-line
Recent reports indicated
users were becoming addicted to the Inter-
net in much the same way that others became
addicted to drugs, alcohol, or gambling, which
resulted in academic failure,1'2 reduced work
performance,3 and even marital discord and
separation.4 Clinical research on behavioral ad-
dictions has focused on compulsive gambling,5
overeating,6 and compulsive sexual behavior.7
Department of Psychology, University of
Bradford, PA 16701.
applied to
technological overuse,8 computer depen-
dency,9 and obsessive video game playing.10
However, research among sociologists, psy-
chologists, or psychiatrists has not formally
identified addictive use of the Internet as a
problematic behavior. Therefore, the purpose
of this exploratory study was to investigate if
Internet usage could be considered addictive,
and to identify the extent of problems created
by such misuse.
With the popularity and wide-spread pro-
motion of the Internet, this study first sought
to determine a set of criteria that would define
Pittsburgh,
addictive from normal Internet usage. If a

237
238 YOUNG

workable set of criteria could be effective in di-
agnosis, then such criteria could be used in clin-
ical treatment settings and facilitate future re-
search on addictive Internet use. However,
proper diagnosis is often complicated by the
fact that the term addiction is not listed in the
of this study. The cutoff score of five or more
criteria is consistent with the number used to
diagnose Pathological Gambling. Furthermore,
the DSM-IV outlines 10 criteria for Pathologi-
cal Gambling, although two items were viewed
as nonapplicable to Internet usage and omitted

Diagnostic and Statistical Manual of Mental Dis- from this adaptation. It was hypothesized that
orders—Fourth Edition (DSM-IV).11 Of all the di- meeting five of eight rather than 10 criteria
agnoses referenced in the DSM-IV, Pathologi- would be a slightly more rigorous cutoff score
cal Gambling was viewed as most akin to the to differentiate normal from addictive Internet
use. It should be noted that while this scale pro-
pathological nature of Internet use. By using
Pathological Gambling as a model, Internet ad- vides a workable measure of pathological In-
diction can be defined as an impulse-control ternet use, further study is needed to determine
disorder that does not involve an intoxicant. its construct validity and clinical utility. It
Therefore, this study developed a brief eight- should also be noted that the term Internet is
item questionnaire referred to as a Diagnostic used to denote all types of on-line activity.
Questionnaire (DQ) that modified criteria for
pathological gambling to provide a screening
instrument for classification of participants: DESIGN
1. Do you feel preoccupied with the Internet Participants
(think about previous on-line activity or an-
ticipate next on-line session)? Participants were volunteers who responded
2. Do you feel the need to use the Internet with to: (a) nationally and internationally dispersed
increasing amounts of time in order to newspaper advertisements, (b) flyers posted
achieve satisfaction? among local college campuses, (c) postings on
3. Have you repeatedly made unsuccessful ef- electronic support groups geared towards In-
forts to control, cut back, or stop Internet ternet addiction for electronic respondents
use? (e.g., the Internet Addiction Support Group,
4. Do you feel restless, moody, depressed, or the Webaholics Support Group), and (d) those
irritable when attempting to cut down or who searched for the keywords "Internet" or
stop Internet use? "addiction" on popular Web search engines
5. Do you stay on-line longer than originally (e.g., Yahoo).
intended?
6. Have you jeopardized or risked the loss of Measurements
a significant relationship, job, educational,
or career opportunity because of the Inter- Anexploratory survey consisting of both
net? open-ended and closed-ended questions was
7. Have you lied to family members, a thera- constructed for this study that could be ad-
pist, or others to conceal the extent of in- ministered by telephone interview or electronic
volvement with the Internet? collection. The survey administered the struc-
8. Do you use the Internet as a way of escap- tured DQ containing the eight-item classifica-
ing from problems or of relieving a dys- tion list. Subjects were then asked: (a) how long
phoric mood (e.g., feelings of helplessness, they have used the Internet, (b) how many
guilt, anxiety, depression)? hours per week they estimated spending on-
line for non-essential use, (c) what types of ap-
who answered "yes" to five or
Participants plications they most utilized, (d) what made
more of the criteria were classified as depen- these particular applications attractive, (e)
dent Internet users (Dependents), and the re- what problems, if any, did their Internet use
mainder were classified as nondependent In- cause in their lives, and finally, (f) to rate any
ternet users (Nondependents) for the purposes noted problems in terms of mild, moderate, or
INTERNET ADDICTION
severe impairment. Lastly, demographic infor-
mation from each subject such as age, gender,
highest educational level achieved, and voca-
tional background were also gathered.
Procedures
Telephone respondents were administered
the survey verbally at an arranged interview
time. The survey was replicated electronically
between Dependents and Nondependents.
and existed as a World-Wide Web (WWW)
Among Dependents, 17% had been on-line for
page implemented on a UNIX-based server more than
that captured the answers into a text file. The
WWW location of the survey was submitted to
several popular search engines and new groups
available to assist on-line users in finding Web
pages of interest. On-line users entering key-
word searches using "Internet" or "addiction"
would find the survey and have the option to
follow the link to the survey to fill it out. An-
swers to the survey were sent to a text file di-
rectly to the principal investigator's electronic
mailbox for analysis.
The results yielded 605 total responses in a
3-month period with 596 valid responses that
were classified from the DQ as 396 Dependents
and 100 Nondependents. Approximately 55%
of the respondents replied via the electronic
survey method, and 45% via the telephone sur-
vey method. The qualitative data gathered
were then subjected to content analysis to iden-
tify the range of characteristics, behaviors, and
attitudes found.
FINDINGS
Demographics
The sample of Dependents included 157
males and 239 females. Mean ages were 29 for
males, and 43 for females. Mean educational
background was 15.5 years. Vocational back-
ground was classified as 42% none (i.e.,
homemaker, disabled, retired, students), 11 %
blue-collar employment, 39% nontech white-
collar employment, and 8% high-tech white-
collar employment. The sample of Nonde-
pendents included 64 males and 36 females.
Mean ages were 25 for males, and 28 for fe-
males. Mean educational background was 14
years.
239
Usage differences
The following will outline the differences be-
tween the two groups, with an emphasis on the
Dependents to observe attitudes, behaviors,
and characteristics unique to this population of
users.
Length of time using Internet. The length of
using the Internet differed substantially
time
1 year, 58% had only been on-line
between 6 months to 1 year, 17% said between
3-6 months, and 8% said less than 3 months.
Among Nondependents, 71 % had been on-line
for more than 1 year, 5% had been on-line be-
tween 6 months to 1 year, 12% between 3-6
months, and 12% for less than 3 months. A to-
tal of 83% of Dependents had been on-line for
less than 1 full year, which might suggest that
addiction to the Internet happens rather
quickly from one's first introduction to on-line
services. In many cases, Dependents had been
computer illiterate, and described how they ini-
tially felt intimidated by using such informa-
tion technology. However, they quickly felt a
sense of competency and exhilaration as their
navigational ability and technical mastery
rapidly improved.
Hours per week. To ascertain how much time
respondents spent on-line, they were asked
to provide a best estimate of the number of
hours per week they currently used the Inter-
net. It is important to note that estimates were
based upon the number of hours spent "surf-
ing the Internet" for non-essential (e.g., per-
sonal e-mail, scanning newsgroups, playing in-
teractive games) rather than for academic or
employment related purposes. Dependents es-
timated a M 38.5, SD 8.04 hours per week
= =
compared to Nondependents who estimated
M 4.9, SD = 4.70 hours per week. These es-
=
timates show that Dependents spent nearly
eight times the number of hours per week as
that of Nondependents in using the Internet.
Dependents gradually developed a daily Inter-
net habit of up to 10 times their initial use as
their familiarity with the Internet increased.
This may be likened to tolerance levels that de-
velop among alcoholics who gradually increase
their consumption of alcohol to achieve the de-
240 YOUNG

sired effect. In contrast, Nondependents re-
ported that they spent a small percentage of
their time on-line with no progressive increase
in use. Centralized use of the Internet, coupled
with the lack of desire to control routine usage,
appears to be a distinguishable characteristic
among Dependents.
Applications used. The Internet itself is a term
that represents different types of functions that
are accessible on-line. Table 1 displays the var-
ious applications rated as "most utilized"
among Dependents and Nondependents. Re-
sults suggest that clear differences existed
among the specific Internet applications uti-
lized between the two groups. Nondependents
predominantly used those aspects of the Inter-
net that allowed them to gather information
(i.e., Information Protocols and the World Wide
Web) and electronic mail (e-mail). Nondepen-
dents viewed the Internet as a useful resource
tool and a medium for personal and business
communication.
sage sent. It should be noted that MUDs differ
from chat rooms, as these are an electronic spin-
off of the old Dungeon and Dragons games
where players take on character roles. There are
literally hundreds of MUDs, ranging in themes
from space battles to medieval duels. To log
into a MUD, a user creates a character name,
for example, Hercules, who fights battles, du-
els other players, kills monsters, saves maid-
ens, or buys weapons in a make-believe role-
playing game. MUDs can be social in a similar
fashion as in the chat room, but typically all di-
alogue is communicated while "in character."
Newsgroups, or virtual bulletin-board mes-
sage systems, were the third most utilized ap-
plication among Dependents. Newsgroups can
range on a variety of topics from organic chem-
istry to favorite television programs to the best
tasting cookie dough. Literally, there are thou-
sands of specialized newsgroups that an indi-
vidual user can subscribe to and post and read
new electronic messages. The World-Wide

Comparatively, Dependents predominately Web and Information Protocols, or data base

used the two-way communication functions search engines that access libraries or electronic
available on the Internet (i.e., chat rooms, means to download files or new software pro-
MUDs, newsgroups, or e-mail). Chat rooms grams, were the least utilized among Depen-
and Multiuser Dungeons, more commonly dents. This may suggest that database searches,
known as MUDs, were the two most utilized while interesting and perhaps time consuming,
mediums by Dependents. Both applications al- are not the actual reasons Dependents become
low multiple on-line users to simultaneously hooked on the Internet.
communicate in real time; similar to having a Dependents enjoyed those aspects of the In-
telephone conversation except in the form of ternet, which allowed them to meet, socialize,
typed messages. The number of users present and exchange ideas with new people through
in these forms of virtual space can range from these highly interactive mediums. Dependents
two to over thousands of occupants. Text commented that the formation of on-line rela-
scrolls quickly up the screen with answers, tionships increased their immediate circle of
questions, or comments to one another. Send- friends among a culturally diverse set of world-
ing a "private message" is another available op- wide users. On-line relationships were often
tion that allows only a single user to read a mes- seen as highly intimate, confidential, and less
threatening than real-life friendships, and re-
Table 1. Internet Applications Most Utilized duced the perceived loneliness in the Depen-
by Dependents and Nondependents dent's life. Additional probing revealed that
Fype of computer user
Dependents mainly used e-mail to arrange
"dates" to meet on-line or to keep in touch be-
Application Dependents Nondependent tween real-time interactions with new-found
on-line friends. Dependents often preferred
Chat rooms 35% 7%
MUDs 28% 5%
their on-line friends over their real-life rela-
Newsgroups 15% 10% tionships, due to the ease of anonymous com-
E-mail 13% 30% munication and the extent of control in reveal-
WWW 7% 25%
Information Protocols 2% 24% ing personal information among other on-line
users.
INTERNET ADDICTION 241

Extent of problems. One major component of Table 2. Comparison of Type of Impairment

toSeverity Level Indicated
this study was to examine the extent of prob-
lems caused by excessive Internet use. Again, Impairment level
significant differences were noted between Mild Moderate Severe
Nondependents and Dependents. Nondepen- Impairment None
dents reported that time distortion was the ma- Academic 0% 2% 40% 58%
jor consequence of Internet use, however, not Relationship 0% 2% 45% 53%
to the extent that real-life responsibilities were Financial 0% 10% 38% 52%
Occupational 0% 15% 34% 51%
neglected. However, Dependents reported that Physical 75% 15% 10% 0%
excessive use of the Internet resulted in per-
sonal, family, and occupational problems sim-
ilar to those documented in other established
addictions such as pathological gambling,12 fun, leave me alone," might be
an addict's re-

eating disorders,13 and alcoholism.14'15 Prob-
lems reported were classified into five cate-
gories: academic, relationship, financial, occu-
pational, and physical. Table 2 shows a
breakdown of the problems rated in terms of
none, mild, moderate, and severe impair-
ment.
Although the merits of the Internet make it
an ideal research tool, students experienced
significant academic problems when they
surfed irrelevant web sites, engaged in chat-
room gossip, conversed with Internet pen pals,
and played interactive games at the cost of pro-
ductive activity. Students had difficulty com-
pleting homework assignments, studying, or
getting enough sleep to be alert for class the
next morning due to such Internet misuse. Of-
tentimes, they were unable to control their In-
ternet use, which eventually resulted in poor
grades, academic probation, and even expul-
sion from the university.
Marriages, dating relationships, parent-
child relationships, and close friendships were
also disrupted by excessive use of the Internet.
Dependents gradually spent less time with
friends and family in exchange for solitary time
in front of a computer. Loved ones first ratio-
nalized the obsessed Internet user's behavior as
"a phase," in hopes that the attraction would
soon dissipate. However, when addictive be-
havior continued, arguments about the in-
creased volume of time and energy spent on-
line soon ensued. Such complaints were often
deflected as part of the denial exhibited by De-
pendents. They became angry and resentful at
others who questionned or tried to take away
their time from using the Internet. For exam-
ple, "I don't have a problem," or "I am having
sponse. Finally, similar to alcoholics who will
try to hide their addiction, Dependents en-
gaged in the same efforts to lie or hide how
long they spent on-line. These behaviors cre-
ated distrust that over time hurt the quality of
once-stable relationships.
Marriages and dating relationships were the
most disrupted when Dependents formed new
relationships with "on-line friends." On-line
friends were viewed as exciting, and in many
cases lead to romantic interactions and Cyber-
sex (i.e., on-line sexual fantasy role-playing).
Cybersex and romantic conversations were
perceived by Dependents as harmless interac-
tions as these sexual on-line affairs did not in-
volve touching and electronic lovers lived
thousands of miles away. However, Depen-
dents neglected their spouses in place of con-
tinual electronic rendezvous with on-line
lovers, leaving no quality time for their mar-
riages. Finally, Dependents continued to emo-
tionally and socially withdraw from their mar-
riages, exerting more effort to maintain
recently discovered on-line relationships.
Financial problems were another problem
that arose for Dependents who paid for their
on-line service. For example, one woman spent
nearly $800.00 in one month for on-line service
fees. Instead of reducing the amount of time
she spent on-line to avoid such charges, she re-
peated this process until her credit cards were
overextended. Today, financial impairment is
less of an issue as flat rate fees are now being
offered. However, the movement towards flat
rate fees raises another concern that users are
able to stay on-line longer without suffering fi-
nancial burdens, that may encourage addictive
use.
242 YOUNG

Dependents reported a significant amount of scribed time limits. When time limits failed, De-
work-related problems when they used their pendents canceled their Internet service, threw
employee access on-line for personal use. New out their modems, or completely dismantled
monitoring devices allow bosses to track Inter- their computers to stop themselves from using
net usage, and one major company tracked all the Internet. Yet, they felt unable to live with-
traffic going across its Internet connection and out the Internet for such an extended period of
discovered that only 23% of the usage was busi- time. They reported developing a preoccupa-
ness related.16 The benefits of the Internet such tion with being on-line again, which they com-
as assisting employees with anything from pared to "cravings" that smokers feel when
market research to business communication they have gone a length of time without a cig-
outweigh the negatives for any company, yet arette. Dependents explained that these crav-
there is a definitive concern that it is a distrac- ings felt so intense that they resumed their In-
tion to many employees. Any misuse of time ternet service, bought a new modem, or set up
in the workplace creates a problem for man- their computer again to obtain their "Internet
agers, especially as corporations are providing fix."
employees with a tool that can easily be
abused.17
Finally, mild to moderate physical com-
plaints were noted among Dependents. De- CONCLUSIONS
pendents estimated a M =
38.5 per week, for
non-essential use, with a range of 20-100 hours There are several limitations involved in this
per week. To accommodate such excessive use, study which must be addressed. Initially, the
sleep patterns were typically disrupted due to sample size of 396 Dependents is relatively
late night log-ins. Dependents typically stayed small compared to the estimated 56 million cur-
up past normal bedtime hours and reported be- rent Internet users.18 In addition, the Nonde-
ing on-line until 2, 3, or 4 in the morning, with pendent group was not demographically
the reality of having to wake for work or school matched, which weakens the comparative re-
at 6 a.m. In extreme cases, caffeine pills were sults. Therefore, generalizability of results
used to facilitate longer Internet sessions. Such must be interrupted with caution, and contin-
sleep deprivation caused excessive fatigue, of- ued research should include larger sample
ten making academic or occupational func- sizes and a well-balanced control group to
tioning impaired, and decreased one's immune draw more accurate conclusions.
system leaving Dependents' vulnerable to dis- Furthermore, this study has inherent biases
ease. Additionally, the sedentary act of pro- present in its methodology by utilizing an ex-

longed computer use resulted in a lack of
proper exercise and lead to an increased risk
for carpal tunnel syndrome, back strain, or eye-
strain.
Despite the negative consequences reported
among Dependents, 54% had no desire to cut
down the amount of time they spent on-line. It
was at this point that several participants re-
ported feeling "completely hooked" on the In-
ternet and felt unable to kick their Internet
habit. The remaining 46% of Dependents made
several unsuccessful attempts to cut down the
amount of time they spent on-line in an effort
to avoid such negative consequences. Self-im-
posed time limits were typically initiated to
manage on-line time. However, Dependents
were unable to restrict their usage to the pre-
pedient and convenient self-selected group of
Internet users. Motivational factors among par-
ticipants responding to this study should be
discussed. It is possible that those individuals
classified as Dependent were more likely to re-
spond to advertisements for this study because
they experienced an exaggerated set of nega-
tive consequences related to their Internet use.
If this is the case, the volume of moderate to
severe consequences noted may have elevated
findings making the harmful affects of Internet
overuse greatly overstated. Approximately
20% more women than men responded to this
study, which should also be interpreted with
caution. This result shows a significant dis-
crepancy from the Stereotypie profile of an "In-
ternet addict" as a young, computer-savvy
INTERNET ADDICTION
male,19 and is counter to previous research that Finally, these results also suggested that De-
has suggested males predominantly utilize and pendents were relative beginners on the Inter-
feel comfortable with information technolo-
gies.9'20 Women may be more likely to discuss
an emotional issue or problem more than
men21 and therefore, were more likely than
men to respond to advertisements in this study.
Future research efforts should attempt to ran-
domly select samples to eliminate these
methodological limitations.
Although these limitations are significant,
this exploratory data provides a workable
framework for further exploration of compul-
sive use of the Internet. Individuals were able
to meet a set of diagnostic criteria that show
signs of impulse-control difficulty similar to
symptoms of pathological gambling as defined
by the DSM-IV. In the majority of cases, De-
pendents reported that their Internet use di-
rectly caused moderate to severe problems in
their real lives due to their inability to control
use. Their unsuccessful attempts to gain con-
trol may be paralleled to alcoholics who
are unable to regulate or stop their excessive
drinking despite relationship or occupational
problems caused by drinking; or compared to
compulsive gamblers who are unable to stop
betting despite their excessive financial debts.
The reasons underlying such an impulse con-
trol failure over Internet usage should be fur-
ther examined. One interesting issue raised in
this study is that, in general, the Internet itself
is not addictive. Specific applications appeared
to play a significant role in the development of
pathological Internet use. Dependents were
less likely to control their use of highly inter-
active features than other on-line applications.
These findings suggest that there exists an in-
creased risk for pathological Internet use the
more interactive the application utilized by the
on-line user. It is possible that a unique rein-
forcement exists that on-line relationships have
the ability to provide fulfillment of unmet real-
life social needs. Individuals who feel misun-
derstood and lonely may use virtual relation-
ships to seek out feelings of comfort and
community. However, greater research is
needed to investigate how such interactive ap-
plications are capable of fulfilling such unmet
needs and how this leads to addictive patterns
of behavior.
243
net. Therefore, it may be hypothesized that
new-comers higher
to the Internet may be at a
risk fordeveloping addictive patterns of Inter-
net use. However, it is likely that "hi-tech" or
more advanced users suffer from a greater
amount of denial, because their Internet use has
become an integral part of their daily lives.
Given that, individuals who constantly utilize
the Internet may not recognize compulsive use
as a problem and, therefore, saw no need to
participate in this survey. This may explain
their low representation in this sample. There-
fore, additional research should examine per-
sonality traits that may mediate addictive In-
ternet use, particularly among new users, and
how denial is fostered by its encouraged prac-
tice.
A recent on-line survey22 and two campus-
wide surveys conducted at the University of
Texas at Austin23 and Bryant College24 have
further documented that pathological Internet
use is problematic for academic performance
and relationship functioning. With the rapid
expansion of the Internet into previously re-
mote markets and another estimated 11.7 mil-
lion planning to go on-line in the next year,18
the Internet may pose a potential clinical threat
where little is understood about the treatment
implications for this emergent disorder. Based
upon these findings, future research should de-
velop treatment protocols and conduct out-
come studies for effective management of this
symptom. It may be beneficial to monitor such
cases of addictive Internet use in clinical set-
tings by utilizing the adapted criteria presented
in this study. Finally, future research should fo-
cus on the prevalence, incidence, and the role
of this type of behavior in other established ad-
dictions (e.g., other substance dependencies or
pathological gambling) or psychiatric disor-
ders (e.g., depression, bipolar disorder, obses-
sive-compulsive disorder, attention deficit dis-
order).
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ciation, August 18, 1997, Chicago, IL.
Address reprint requests to:
Dr. Kimberly S. Young
University at Pittsburgh at Bradford
Department of Psychology
300 Campus Drive
Bradford, PA 16701
E-mail: ksy@pih.edu
This article has been cited by:

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