Internet addiction is one of addictive disorders it considered as psychological addiction which needs intervention by psychiatrists

1. INTERNET ADDICTION
BY
ABEER MAHMOUD
Prof. Of psychiatry, faculty of medicine
Ain Shams University

3. OUTLINE
Introduction
What is Addiction?
What is Internet Addiction?
Types of Internet Addiction
What makes internet use addictive?
Symptoms
Consequences

4. INTRODUCTION
With the growing importance of the
internet in everyday life, more and more
people are using various on-line
resources each day. The world wide web
is informative, convenient, resourceful ,
fun, but also potentially way for internet
addiction.

5. WHAT IS
ADDICTION?

6.  The term "addiction" is used in many contexts
to describe an obsession, compulsion, or
excessive psychological dependence, such as:
drug addiction (e.g. alcoholism, nicotine
addiction), problem gambling, crime, money,
work addiction, compulsive overeating,
Oniomania (compulsive shopping), computer
addiction, video game addiction, pornography
addiction, television addiction, etc.
http://en.wikipedia.org/wiki/Addiction

7.  So, the term addiction is also sometimes applied to
compulsions that are not substance-related, such
as problem gambling and computer addiction. In
these kinds of common usages, the term addiction
is used to describe a recurring compulsion by an
individual to engage in some specific activity,
despite harmful consequences, as deemed by the
user himself to his individual health, mental state, or
social life.
http://en.wikipedia.org/wiki/Addiction

8. WHAT IS INTERNET
ADDICTION?

10.  Studies on Internet addiction originated in the US
by Dr. Kimberly Young, who presented the first
research on Internet addiction in 1996 ,her paper
“Internet Addiction: The Emergence of a New
Disorder”.

11. Internet
Addiction
Internet
Addiction
disorder
Computer
Addiction
Compulsive
Internet
Use
Pathological
Internet Use
Internet
Dependence
Internet
Overuse

12.  A maladaptive pattern of internet use, leading to
clinically significant impairment or distress as
manifested by three (or more) of the following,
occurring at any time in the same 12-month
period:
(I) Tolerance, as defined by either of the following:
 (A) A need for markedly increased amounts of time on Internet
to achieve satisfaction
 (B) Markedly diminished effect with continued use of the same
amount of time on Internet.
INTERNET ADDICTION DISORDER (IAD) - DIAGNOSTIC
CRITERIA
Author: Ivan Goldberg, M.D.

13. CRITERIA – IAD II
(II) Withdrawal, as manifested by either of the
following:
 (A)The characteristic withdrawal syndrome
 (1) Cessation of (or reduction) in Internet use that has been
heavy and prolonged.
 (2) Two (or more) of the following, developing within
several days to a month after Criterion 1: (a) psychomotor
agitation - (b) anxiety - (c) obsessive thinking about what is
happening on Internet - (d) fantasies or dreams about
Internet - (e) voluntary or involuntary typing movements of
the fingers.
 (3) The symptoms cause distress or impairment in social,
occupational or other important area of functioning
 (B) Use of Internet or a similar on-line service is engaged in to
relieve or avoid withdrawal symptoms
 (III) Internet is often accessed more often or for
longer periods of time than was intended.

14. (IV) There is a persistent desire or unsuccessful
efforts to cut down or control Internet use.
(V) A great deal of time is spent in activities
related to Internet use
(e.g. organizing files of downloaded
materials; researching Internet vendors,
trying new browsers.)
(VI) Important social, occupational, or
recreational activities are given up or reduced
because of Internet use.

15. DESTRUCTIVE CONSEQUENCES
(VII) Internet use is continued despite
knowledge of having a persistent or
recurrent physical, social, occupational, or
psychological problem that is likely to been
caused or exacerbated by Internet use
 sleep deprivation, marital difficulties, lateness for
early morning appointments, neglect of
occupational duties.
 Isolation
 Job loss

16. VALUE SHIFT – DESTRUCTIVE EFFECT
 Online addicts realize that they give up values
which have been important to them:
 Respect of the other person.
 Repulsion of violence and coercion.
 Religion values of integrity, purity and self discipline.
 Pathological Cybersex destroys the life of a person
 Internally (distorted fantasies, continuous craving)
 in relationships (partner, family)
 in the workplace (risk of job loss and poverty)

17. INTERNET ADDICTION COMPARED
TO SUBSTANCE ABUSE DISORDER
Criteria for substance abuse that applies to
Internet addiction:
 Recurrent substance use resulting in a failure to fulfill major
role obligations at work, school, or home
 Continued substance use despite having persistent or
recurrent social or interpersonal problems caused or
exacerbated by the effects of the substance (DSM-IV-TR, 2000)

18. INTERNET ADDICTION COMPARED TO IMPULSE
CONTROL DISORDER
Criteria for impulse control disorder such as
gambling that applies to Internet addiction:
 Preoccupation with gambling
 Repeated unsuccessful efforts to control, cut back, or
stop gambling
 Gambling as a way of escaping from problems
 The significant loss of a relationship, job, or educational
or career opportunity because of gambling

19. TYPES OF INTERNET
ADDICTION

20.  Web surfer
 Pornography/Cybersexual
 Chat rooms/online dating/social networking
 Gaming (video/computer) and online
gambling

21. FOUR AREAS WITH ADDICTIVE POTENTIAL
Internetpornography
Chat
Online-Games
Internet-Gambling

22. WHAT MAKES
INTERNET USE
ADDICTIVE?

23. Peel (1991) “ It gives you feeling and
gratifying sensations of pain, uncertainty, or
discomfort. It may create powerfully
distracting sensations that focus and absorb
attention. It may enable a person to forget or
feel “OK” about some problems. It may
provide an artificial, temporary feeling of
security or calm, of self-worth or
accomplishment, of power and control,
intimacy or belonging ”
PDF article by Dr. Kimberly S. Young: Internet Addiction: Symptoms, evaluation and treatment

24.  It is accessible 24/7
 It can be anonymous
 It feels secure
 It is easy to use
 It provides the illusion of connection
 It can be inexpensive
 It is fun and very engaging

25. COMPLICATIONS

26. Physical complications
Carpal Tunnel Syndrome
Dry Eyes
Headaches
Back Aches
Eating irregularities (skipping meals)
Sleep disturbances
Physical complications
Carpal Tunnel Syndrome
Dry Eyes
Headaches
Back Aches
Eating irregularities (skipping meals)
Sleep disturbances

27. FAMILIAL PROBLEMS
 Marriages
Dating relationships
Parent-child relationship
Close friendships

28. ACADEMIC PROBLEMS
More time is spent “researching” than actually
completing assignments.
Incomplete or Missing Assignments
Inability to concentrate on real life instruction
Grades begin to decline
Skipping classes to stay in chat room
Absenteeism

29. COMPLICATIONS - COMORBIDITY
 Alcoholism: Alcohol is being used to get calmer but
also to enhance the sexual excitement.
 Substance abuse (from Cocain to Viagra)
 Depressive Episodes: caused by negative
psychosocial consequences of the cyber-addiction
or the break-up of relationships.
 Suicidal thoughts: out of despair and hopelessness.
 Obsessive-Compulsive Behavior: Online addicts
develop complex rituals to conceal their
dependency and to make sure their family,
colleagues or company cannot access their
“hidden area”.
 Paranoid Thinking: Fear of being discovered and
being ashamed lets them associate even marginal
observations with personal threats.

30. DIFFERENCES BETWEEN MEN AND WOMEN
 MEN
 „Kick“ through visual material
 Sexual excitement with masturbation.
 Collecting mania (thousands of pictures etc.)
 Tendency towards violent and abasing content.
 WOMEN:
 „Kick“ through communication (Chat).
 Romantic stories and images (80 %)
 Sexual excitement is secondary.

33. CONSEQUENCES

34. MY THOUGHTS
I believe that everyone has some form
of internet addiction. The severity of
the addiction is what differs.
Technology plays a huge role in today’s
society.
We rely on the internet for information
and other daily activities.
Most jobs require the use of
internet/computer for job-related
functions.

35. The Internet Addiction Test (IAT) is the first
validated and reliable measure of addictive
use of the Internet. Developed by Dr.
Kimberly Young, the IAT is a 20-item
questionnaire that measures mild, moderate,
and severe levels of Internet Addiction.
IAT
Activity

36. ANSWER THE FOLLOWING QUESTIONS USING THIS SCALE:
1= RARELY
2= OCCASIONALLY
3= FREQUENTLY
4= OFTEN
5= ALWAYS
1. How often do you find that you stay on-line longer
than you intended?
2. How often do you neglect household chores to
spend more time on-line?
3. How often do you prefer the excitement of the
internet to intimacy with your partner?
4. How often do you form new relationships with
fellow on-line users?
5. How often do others in your life complain about
the amount of time you spend on-line?

37. ANSWER THE FOLLOWING QUESTIONS USING THIS SCALE:
1= RARELY
2= OCCASIONALLY
3= FREQUENTLY
4= OFTEN
5= ALWAYS
6. How often do your grades or school work suffer
because of the amount of time you spend on-
line?
7. How often do you check your e-mail before
something else that you need to do?
8. How often does your job performance or
productivity suffer because of the internet?
9. How often do you become defensive or secretive
when anyone asks you what you do on-line?
10. How often do you block out disturbing thoughts
about your life with soothing thoughts of the
internet?

38. ANSWER THE FOLLOWING QUESTIONS USING THIS SCALE:
1= RARELY
2= OCCASIONALLY
3= FREQUENTLY
4= OFTEN
5= ALWAYS
11. How often do you find yourself anticipating when
you will go on-line again?
12. How often do you fear that life without the internet
would be boring, empty, and joyless?
13. How often do you snap, tell, or act annoyed if
someone bothers you while you are on-line?
14. How often do you lose sleep due to late-night log-
ins?
15. How often do you feel preoccupied with the
internet when off-line, or fantasize about being
on-line?

39. ANSWER THE FOLLOWING QUESTIONS USING THIS SCALE:
1= RARELY
2= OCCASIONALLY
3= FREQUENTLY
4= OFTEN
5= ALWAYS
16. How often do you find yourself saying, “Just a few
more minutes,” when on-line?
17. How often do you try to cut down the amount of
time you spend on-line and fail?
18. How often do you try to hide how long you’ve
been on-line?
19. How often do you choose to spend more time on-
line over going out with others?
20. How often do you feel depressed, moody, or
nervous when you are off-line, which goes away
once you are back on-line?

40. RESULTS
 20-49 points: You are an average on-line user.
You may surf the Web a bit too long at times, but
you have control over your usage.
 50-79 points: You are experiencing occasional or
frequent problems because of the internet. You
should consider their full impact on your life.
 80-100 points: Your internet usage is causing
significant problems in your life. You should
evaluate the impact of the internet on your life and
address the problems directly caused by your
internet usage.
Internet Addiction Test (Young, 1998)

41. Control yourself !
Use The Internet smart !

42. Acknowledge your addiction
1. Acknowledge that your „habit“ is an
addiction, which requires consequent
action.
2. Realize the fact that you support sexual
abuse and slavery of women and children
with your behavior.
INTEGRATION

43. Limit access
3. Filtersoftware – blockade of access
(www.max.com). - Limitations
4. Be accountable to a person you trust. Work at
immature expectations and solution strategies.
Perhaps using special software.
INTEGRATION

44. Transparency
5. Share your addiction with your wife, a friend
or a counselor.
6. Keep your computer in a public room of the
house. Keep certain times to access the
computer to ensure control. Personal
discipline and responsibility.
INTEGRATION

45. Live without the internet!
7. Choose to live without a computer or internet
access for some time („plucking out your eye!“)
8. Attend a self-help group to learn with other addicts
about strategies how to deal with your addiction.
(www.sexhelp.com)
INTEGRATION

46. WHAT ABOUT MEDICATION?
 Serotonin: produced as a side effect of addiction process.
Antidepressants are also elevating serotonin levels.
 Could Serotonin reduce Craving? – possibly reduce feelings of
emptiness and underlying depression.
 Dopamin (increases desire in addiction)
 No proven strategies in this area without severe side effects
(neuroleptics).
 Opiates: central in addiction, creating the feeling of being
„high“.
 Although there are opioid blockers there is no indication that they
reduce non-substance addiction.
 Conclusion:
 Medication (unfortunately) is not a solution; perhaps partially a
support for behavior therapy, where a person is additionally
suffering from depression.
No proven effect!

47. Thank you