A Synthesis of Three
Articles about Internet Addiction
Laura Ann Collins
Northcentral
University
Abstract
The purpose of this paper is to provide a synthesis of three
articles on the topic of Internet Addiction (IA). Each article will be briefly described. Then, common themes between the three
articles such as definition of IA, structure of IA, and the assessment of IA
will be explored. Finally, utilizing
information from the three articles, avenues for future research will be
suggested. Critique of the accuracy and
validity of the articles will not be completed within this paper as a full
literature review is beyond the scope of this paper.
A
Synthesis of Three Articles about Internet Addiction
Kuss, Shorter, van Rooij,
Griffiths, and Schoenmakers (2014) cite statistics from
the International Telecommunication Union showing usage of the internet in
developing countries has more than doubled between 2002 and 2012. From the end of 2013 to May 2015, the number
of internet users increased from 2.7 billion to 3.2 billion (International Telecommunication Union, 2015) . With the rapid increase in global internet use,
questions arise about how to quantify the degree to which internet use impacts
the lives of individuals, what is driving internet use, and how to determine
when internet use is excessive. These
questions then give rise to questions about how to define, assess, and conceptualize
internet addiction. Each of these latter
questions is addressed in one of the three articles synthesized in this report. Lee et al. (2012) attempt to define IA. Kuss et al. (2014) attempt to link IA to a
comprehensive model of addiction. Lortie
and Guitton (2013) review 14 different IA assessment tools (questionnaires) in
order to determine which tools best fit current models of IA.
Brief Description of Each Article
Lortie and
Guitton (2013) completed a search of available internet addiction
questionnaires from January 1993 to October 2011. After several limiting choices (ex. requiring
articles to be peer-reviewed, language of article being English, specific
components in questionnaire, etc.), the final sample was comprised of 14
questionnaires. Lortie and Guitton express
concern IA is neither well-defined at this point nor necessarily fundamentally
similar to other forms of addiction such as substance or behavioral addictions.
Additional concerns are the lack of predictive ability of the assessments,
differentiating between excessive use and abuse, and lack of adequate cut-off
points for most of the questionnaires.
Lortie and Guitton conducted various statistical methods with respect to
the questionnaires and report the summary of results. This article has been cited by over 50 other
articles as of December 2015 (Researchgate.net, 2015) .
Lee et al.
(2012) discuss how IA is related to other addictions through the trait of
impulsivity. They also suggest
neurocognitive implications of addiction, such as inhibited stop-signals, which
exist in people who experience pathological gambling may also exist in people
experiencing IA. Finally, they
hypothesize that the higher the degree of impulsivity, the more severe the
symptoms of IA. The number of
participants of this study is fairly small (27 subjects per 3 different
groups). The pool of participants was
comprised of Korean men who were seeking treatment, possibly complicating
ability to apply results of this study across genders or nationality. Lee et al. include brief statistical data and
descriptions, but focus more on discussing the implications of their research
and areas for future research. The
article has been cited at least 33 times as of December 2015 (Researchgate.net 2, 2015) .
Kuss et al.
(2014) hypothesize that IA fits within Griffiths addiction components model and
align with the syndrome model of addictions.
Griffiths is one of the authors of this study, as well as the developers
of the Griffiths addiction component model.
The background information provided on development of the concept of IA
is extensive. This article, like that of
Lee et al. (2012), compares IA to pathological gambling and other
addictions. Like the article by Lortie
and Guitton (2013), Kuss et al. discuss concern about pathologizing behavior
without significantly more data. The
study uses large sample sizes (3,105 and 2,257), although differences between
the samples in age and nationality may be confounding. Two assessment tools are also used, although
the study suggests possible limitations of the differences in how the tools are
administered. This article is quite
expansive in description and detail of statistical methods utilized. This article has been cited in at least 10
articles as of December 2015 (Researchgate.net 3, 2015) .
The
difference between how many times the articles have been cited in other
articles may be a result of the date of publication or a result of the impact
factor of the journal in which they have been published. “Impact Factor” is a term to describe the
Journal Citation Reports produced by Thomson Reuters. “It is a measure of the frequency with which
the ‘average article’ in a journal has been cited in a particular year or
period” (Garfield, 2015 [original 1994]) . Addiction
has an impact factor of 4.74 (Researchgate.net, 2015) . Cyberpsychology,
Behavior, and Social Networking has an impact factor of 2.18 (Researchgate.net 2, 2015) . International
Journal of Mental Health and Addiction has an impact factor of 0.99 (Researchgate.net 3, 2015) . However, it is also possible that the
difference may be related to the statistical description density of the
articles and the proportion of statistical jargon to verbal discussion of
methods and impact of the research contained within the article. A person who is not fluent in statistical
methods may have difficulty comprehending much of the article by Kuss et al. (2014).
Common Themes
All three articles provide some
form of definition of internet use and pathological internet use. Kuss et al. (2014) suggest IA and other
addictions develop through the same or similar biological, social, and
psychological pathways. This may
indicate IA can be defined with other substance and behavioral addictions
through a single model focusing on the components of salience, mood
modification, tolerance, withdrawal, physiological symptoms, conflict, and
relapse. Kuss et al. further posit a
component model meshes with the syndrome model of addiction stating IA,
substance use addiction, and behavioral addictions have a common base of
domains (ex. Neurobiological changes, response to treatment approaches,
etc.).
Lortie and Guitton (2013) consider
“dysfunctional internet use” as use which shows tolerance and results in
negative impact to social and functional life.
They express concerns that without specific cut-off points, the
assessments do not adequately differentiate normal, excessive, and addictive
internet use.
Lee at al. (2012, p 373) define IA
as “inability to control internet use… [which] can lead to serious impairment
in psychological and social functioning.”
Lee et al. (2012) suggest IA can be considered as an addiction similar
to substance addiction or pathological gambling, as a behavioral problem, and
as an impulse control disorder. They
further suggest people experiencing IA may also have decreased ability to
regulate stop responses as do people experiencing other forms of
addiction. Lee et al. correlate level of
evidenced impulsivity with severity of experienced internet addiction.
Future Research
Each of the three articles bases at
least part of the definition of IA on the extant definitions for substance use
disorder and for pathological gambling as listed within the Diagnostic and
Statistical Manual 5th Edition (DSM-5). However, as previously described, Lortie and
Guitton express concerns with “superimposing” the extant addiction models on IA
without evidence showing that to do so is appropriate.
Each article explicitly states
there is no uniform, comprehensive definition of IA. Each article suggests that for the body of
research to evolve, a definition of IA which is standard must be
developed. Until there is an accepted
definition of IA, comparison across research articles will remain
difficult. Additionally, normal use of
internet, excessive use of internet, and distinction between purpose of
internet use (ex. social, gaming, work, etc.) must be defined in order to
ensure that over-pathologizing internet use does not occur. Lortie and Guitton (2013, p. 1212) conclude
“existing questionnaires do not emphasize the need to distinguish between
‘normal’ everyday uses and ‘pathological’ heavy users of the internet.” Differentiating between normal and
pathological internet use will be an important area for future research for
development of accurate conceptualization of IA.
Lortie and Guitton (2013)
specifically note that because the definition for and the structure of IA are both
disputed, there are no baselines by which to distinguish normal, excessive, and
pathological internet use. Lortie and
Guitton also discuss concerns that none of the 14 questionnaire included within
their research attempted to predict future excessive behavior. Kuss et al. (2014) note if IA is to be
considered a disease (addiction) there should be clear patterns of
transmission, course, and prognosis. Further,
Kuss et al. note concerns other researchers have had with what to include or
exclude from the definition of IA. For
example, Kuss et al. cited Defabbro’s 2013 statement that internet use disorder
should be a separate entity from video game disorder. Lee et al. (2012) suggest impulsivity might
be considered a marker for risk to develop addictions and hypothesize excessive
or addictive internet use can be conceptualized as an impulse disorder.
Future research needs to finalize a
comprehensive definition of pathological internet use, create cut-off points to
separate normal, excessive, and pathological internet use, and create a model
which neither under- nor over- pathologizes internet use. Once a definition of pathological internet
use is created, the question of whether or not that type of use is an addiction
will need to be settled. If pathological
internet use is considered to be an addiction, then the disorder will need to
be integrated into the current understanding of addiction as a chronic brain
disease (Volkow, 2014) . Once all these tasks have been accomplished,
science will be able to direct its attention to seeking effective treatment for
IA.
References
Garfield, E. (2015 [original 1994], December). The
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http://wokinfo.com/essays/impact-factor/
International Telecommunication Union. (2015, May). ICT
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https://www.itu.int/en/ITU-D/Statistics/Documents/facts/ICTFactsFigures2015.pdf
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addiction using the parsimonious internet addiction components model - a
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