Internet Addiction Among Youth: Physical and Mental Health

Introduction and Definitional Framework

Addictive use of the internet is not necessarily a new phenomenon; however, practitioners are often unaware of the actual negative implications — both physical and mental — that come with internet addiction. Takeshi Sato's extensive research into internet addiction among Japanese youth has illuminated many physical and mental problems associated with prolonged addiction. He argues that Internet Addiction Disorder (IAD) among youth is underestimated because there has been little formal definitional work on what IAD actually is. A comparison of internet addiction with traditional methods of addiction diagnosis helps map out the relative complexity of IAD. The DSM-IV model shows that prior research defined internet addiction as an "impulse control disorder that does not entail an intoxicant." Using models based on gambling addiction, Sato formulated criteria for dissecting internet addiction through the DSM-IV model, which has significantly shaped how we can view internet addiction.

In his landmark work Caught in the Net, Young set about creating a definitive diagnostic instrument using the DSM-IV, which resulted in the Internet Addiction Test (IAT). This test, along with patient feedback, has painted an alarming picture of IAD — especially among youth. Using the IAT among youth worldwide, internet addiction, particularly within college populations, has risen over 200% in the past five years. In Korea, 39.6% of college-age teenagers were found to have mild to severe IAD, with detrimental effects on both their physical and psychological health.

With regard to the characteristics of internet addiction among youth, Greenberg reported that there are specific gender patterns associated with addictive tendencies. Analysis of individual behaviors within substantive studies shows that men have much higher levels of addiction to cigarettes, alcohol, video games, and internet use. His research further identifies a strong connection between low self-esteem and internet addiction, finding that self-esteem was the strongest predictor of IAD and of the amount of time spent online per week. Among Korean youth, depression and suicidal ideation were highest among the IAD group.

Research into physical health afflictions as a direct result of IAD among youth is less than encouraging. IAD as diagnosed through the DSM-IV method displays similar characteristics and physical symptoms to other addictions. Wieland explains that traditional physical manifestations of IAD include "cyber shakes," which occur when addiction withdrawal becomes internalized. For youth, this is an especially serious concern because physical addiction at an early age results in intensified behavior. At the first sign of physical addiction symptoms such as "cyber shakes," youth tend to significantly prolong their internet use and thus neglect themselves physically. Severe cases of starvation and malnutrition have been observed in those who display physical symptoms of addiction. Dry eyes and carpal tunnel syndrome are also observable physical problems associated with such addiction.

Physical and Mental Health Consequences of IAD

Wieland has further found that a disturbing trend is the lack of attention that results from consistent internet use and IAD among youth. Internet addiction has been shown to cause a detachment from the physical environment, and as a result, young people develop a notable lack of attention and focus with respect to their daily reality. This is indicative of poor judgment and results in "lower grades in school, job loss, and indebtedness." Another strongly associated physical symptom is the persistence of migraines. Wieland observes that 40% of severe IAD youth take medication for migraines — a condition that can develop into lifelong problems that are often difficult or impossible to cure.

The physical health of young internet addicts is difficult to assess, partly because physical health problems often result from psychological addiction and are therefore attributed to general addictive behavior rather than internet use specifically. The negligence of addicts with respect to their health causes indirect health problems that may not be directly linked to IAD, yet internet use lies at the heart of how such problems arise and must be understood.

Although emotional withdrawal has been identified as the principal mental dysfunction associated with internet addiction, such emotional distress tends to be a predictor of deeper psychological problems. Katherine Chak's recent research shows that individuals drawn to internet addiction tend to already exhibit behavioral tendencies toward shyness. The less "faith a person has, the firmer belief the person holds in the irresistible powers of others and the higher trust the person places on chance in determining his or her own course of life." Social withdrawal among youth with IAD can have severe effects on their future success in both personal and professional life.

Part of the conflicting data regarding the physical and psychological implications of internet addiction is the discrepancy between research conducted on youth versus adults. Adult internet addiction appears to have much more severe consequences for mental health than recent research conducted on youth. Greenberg argues that this distinction is caused by the demographic differences between adults and youth. Adults with IAD are typically pathologically externalized in other forms, such as severe addiction to gambling, depression, or other addictions identified through DSM-IV methods. In contrast, internet addiction among youth has become a systematic part of teenage culture and is therefore far more socially accepted and functionally integrated. However, Michael A. Weinstein notes in his research that such addiction has caused young internet users to "lose the savvy and skills and patience to conduct social relations in the corporeal world." He further argues that the internet intensifies the negative effects of television addiction up to four times. Overall, many researchers have found evidence to suggest that deteriorating values and social functioning among youth may be among the foundational effects of internet addiction.

The problem of internet addiction within contemporary youth has been the focus of Amanda Lenhart and Mary Madden of the Pew Research Center for several years. Lenhart's study concludes that American teens live in "a world enveloped by communications technologies: the internet and cell phones have become a central force that fuels the rhythm of daily life." This disturbing trend has had many consequences for the physical and psychological wellbeing of youth. The number of teens using the internet has grown over 24% in the past four years, reaching 87% of all teens between the ages of 12 and 17. Compared to data collected four years prior, Lenhart finds the trend of broader and more intensified internet use among teens to be extremely concerning.

Social and Behavioral Dimensions of Youth Internet Addiction

Lenhart argues that such trends are attributable to youth expressing their extensive social and creative impulses through internet use. The proliferation of online games, chat websites, news platforms, shopping sites, and social networks have led teens to create "pseudo" identities online that increasingly resemble their real-life personas. The danger of this trend is significant: a progressive increase in antisocial and predominantly introverted changes within teens has created social ineptitude in the contemporary generation. With a growing variety of technologies supporting teen communication, digital interaction has replaced physical contact. Lenhart believes that the most prominent health damage is psychological. Teens no longer define themselves through physical environments but instead use virtual environments as their primary grounds for social communication and interaction.

Mary Wieland, a sociologist, suggests that computer addiction may lead to severe depression, gambling, substance abuse, and marital infidelity and ultimately divorce among adults. Her research shows that internet addiction causes the limitations of human interaction to broaden beyond the physical environment, implying a regression of personal boundaries and relationships over the long term. For youth, the implicit assumption is that heavy internet use results in the neglect of social networks outside the virtual arena, and the development of strong psychological dependencies on the internet rather than on physical relationships.

The focus of much existing literature has been on the definitional interpretation of IAD and how it has grown to affect youth; however, specific research on the actual physical and mental effects of IAD among teens has been less substantive. Several reasons account for this. Although current research has focused on the impact of IAD on youth health, conflicting data has led to an impasse within the scientific community. From a psychological standpoint, research conducted by Young and Sato suggests that there are both positive and negative consequences of IAD in youth. The integration of technology within teenage culture implies that internet addiction often does not detract from most forms of social engagement or the ability to communicate. For many subjects, internet addiction has not led to a decrease in self-esteem; rather, it has fostered a greater sense of social connectivity through an expanded virtual network.

In direct contradiction, however, Sato shows that internet addiction causes severe reticence among youth — especially those who spend more than five hours per day online. Self-esteem decreases because the lack of physical sociability removes emotional security and the foundations of support. Isolation follows, and teenagers are induced either to seek comfort through even greater internet use or to turn inward through suicidal and severely depressive thinking. Supporting this finding, Chinese, Korean, and Japanese youth with the most severe IAD have expressed strong suicidal and depressive tendencies, with 70% of Korean IAD youth having seriously considered suicide. Some argue that this is an extreme case, since social isolation only occurs in rare instances of internet addiction. Research among American teens suggests that fewer than 10% of teens feel severe isolation as a result of internet addiction — largely because the internet has become a facilitator of actual physical relationships through the creation of virtual identities that parallel their physical personas.