The stories are numerous, yet extreme, and thus widely covered. You’ve probably heard at least a few.
In South Korea, one couple was so committed to their virtual baby that their actual 3-month-old died in her crib, malnourished, dirty, and all alone while her parents binged on the game Prius. In New Mexico, a woman was sentenced to 25 years when her 3-year-old daughter, who weighed just 23 pounds, starved to death; records show the mother had been on World of Warcraft from noon to 3 a.m. the day she found her daughter’s limp body.
There’s the teenager in Ohio who shot his parents in the back of the head with a 9mm handgun when they told him his gaming had gotten out of hand. And the adolescent in Vietnam who strangled an elderly woman to steal $6 for a video game he wanted. There are also cases of actual physical breakdowns after sitting for so long, such as the 20-year-old in England killed by a blood clot that traveled to his lungs to create a fatal blockage on the day when he played his Xbox for 12 hours straight, or the 32-year-old man in Taiwan who just last week suffered heart failure after gaming at a café for three days straight. There has even been a case of Google Glass addiction reported at a Navy treatment center, where the patient was being seen for alcoholism.
Are these cases of internet addiction, where the problem stems from actual compulsions to immerse oneself in the virtual world? Or did all these people suffer from other psychological problems for which cyber cravings are but a symptom?
Internet addiction – sometimes called “problematic,” “compulsive,” or “pathological” internet use as well as internet “dependency” – has been debated since the mid 1990s, and is now widely considered a real affliction in East Asia. In China, where the internet is sometimes called “electronic heroin,” it was declared an official disorder in 2008 and boot camps to cure adolescents of their dependency have sprung up and now number into the hundreds. (These camps are becoming increasingly controversial, however, due to a lack of professional treatment standards, as well as numerous deaths in the camps.)
In the US, though the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorder V (DSM-V) now includes “Internet gaming disorder” in its “conditions for further study” section, it does not yet recognize “Internet addiction” as a disorder. In 2008, the same year China recognized it as a disorder, an editorial in the American Journal of Psychiatry called for its inclusion in DSM-V, citing literature out of South Korea showing that roughly 80% of those needing treatment may need psychotropic medications, and roughly 20 percent were hospitalized.
Indeed, in just the past two years, researchers around the globe are studying what many call subsets of an umbrella affliction (such as online gaming, shopping, gambling, and pornography), and while it has yet to be recognized by the American Psychiatric Association, internet addiction is now pretty much taken for granted as a disorder among many researchers.
Here’s a sampling of what’s been studied in recent months:
- Prevalence of addiction among youth
- Social anxiety among internet addicts
- Cognitive performance when iPhones are out of reach
- Genes that may be involved in internet addiction
- Depression, hostility, and social anxiety when time online is reduced
- Text neck as a result of chronic slouching over screens
- Suicidal ideation and attempts among adolescent internet addicts
- Impact of early parenting on internet addiction
- Impact of parental depression on a child’s risk factors for Internet addiction
- Insomnia and sleep quality in chronic MMORPG players
- Problem pillaging in cyber games
- Gender differences among adolescents
- Neuroimaging suggestive of behavioral addictions
Of course, not everyone is so sure that problematic, compulsive internet use should be included as a behavioral addiction in DSM-V. Dr. Nicki A. Dowling, a psychologist who focuses on problem gambling, has written in the journal Addiction that at least when it comes to gaming, “criteria are in need of widespread empirical testing and validation,” and “the classification and assessment of internet gaming disorder has resulted in inconsistent evidence relating to its phenomenology, prevalence, cross-cultural application, course, biomarkers and treatment.”
She further clarified in an email to me that “it is probably the activity, rather than the medium, that has the addictive properties.” Instead, she wrote, “I would be more in support of gaming disorder, with subtypes relating to Internet use, rather than Internet addiction, with subtypes relating to specific online activities, because I tend to subscribe to the view that it is the activity, rather than the medium, that promotes the impairment of control.”
In other words, gamers gonna game, just like shoppers are going to shop and gamblers are going to gamble. Still, precisely because it is the job of the developers of games and shopping sites and gambling destinations to lure in as many repeat customers as possible, the online environments for these activities have become particularly “sticky,” as Dr. Patricia Wallace told me. She heads up Johns Hopkins University’s Center for Talented Youth (CTY) online programs and IT, and has written an overview of compulsive online activity that can lead to sharp disruptions of students’ social and educational lives.
“The online environment creates different features that make it even more compelling, that add to it and make it different from what you would have in real life,” she said. “[Developers are] tapping every fundamental psychological discipline to make the game as sticky as they can make it. It’s not that I’m faulting them, it’s their job to build things that will create revenue, but it is a conflict going on here.”
Wallace adds that while compulsive Internet use tends to be most marked in adolescents, it tends to fade to less problematic use in high school and college. She surmises that part of the allure of many online games and activities is the creation of identities at a time when children are still sorting out for themselves who they want to be: “We’re looking at identity formation, where they can craft a persona online that doesn’t have all the drawbacks that their middle school persona may have in real life. They can be a 25-year-old man or an athlete or anything, so they have a little more control over their online reputation, and that’s another motive for people.”
Dr. Kimberly Young, a professor at St. Bonaventure University and the psychologist who founded the first in-patient internet addiction clinic at Bradford Regional Hospital in Pennsylvania, runs a “dual diagnosis clinic” and said that “most addictions are co-occurring with other disorders.”
Right now, their license is only for adults, she said. “But I see a bigger need for internet addiction treatment of adolescents and few places really address this specifically.”