The Dawning of a New DisorderA blog entry dated April 28, 2008, on Online Journalism Blog looks at the “seven psychological complaints of bloggers and social media addicts” and begins, “In my capacity as amateur psychotherapist to the blogerati, I have discovered a new raft of complaints as social media addicts adapt to the demands of new technologies and fluctuating social structures.” The entry goes on to elaborate on the seven complaints: Comment Guilt, RSS Reader Sisyphus Complex, Twitter Rage, Twitterhoeia, Six Degrees of Separation Syndrome, Plug-in/Update Cofusion and FOOcamp Anxiety, and on May 13, 2008, expanded to include Meme Orphanism, Wit Anxiety Gloom Syndrome (WAGS), Community Disconnection Attack, User Account Phantasm and Social Network Exclusion Anxiety. This entry serves to illustrate how much new media have come to pervade our everyday lives, and although quite humorous, only begins to touch on a deeper problem. For some, it is not just a matter of annoyance and frustration or recognition of one’s lack of rank in a complex social hierarchy. It can be a profound problem that grips like any other addiction; causes shame like any other addiction, and may result in isolation and problems with finances and relationships. A disorder in its infancy, internet addition and its relation to impulse and compulsion disorders is a growing body of work within psychology.
What is Internet Addiction? Based on the research of Dr. Kimberly Young, who began work on internet addiction in 1996, internet addiction is an impulse control disorder most similarly characterized with the diagnosis of substance abuse or gambling compulsion in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). It is generally categorized along the lines of compulsive online gaming and gambling, sexual addictions, which include cybersex and cyber porn, shopping, web surfing and internet affairs. Subjects have reported that their inability to control internet usage has impaired their academic, personal, financial, occupational and physical lives. These subjects also reported going to extreme lengths in order to obtain access to the internet, experiencing a sense of euphoria or a “high” when finally able to accomplish their task. These same subjects have also had to go to extreme measures in order to curb their addiction, sometimes cancelling service or discarding their modems and computers. Based on a case studyby Dr. Young of 496 participants classified as 396 dependents and 100 non-dependents, striking patterns occurred. The average dependent had been using the internet one year or less and generally deems hm or herself to be computer illiterate. The type of application frequented also varied between the groups with dependents frequenting “highly interactive” sites such as chat rooms and Multi-User Dungeon (MUD) – an application that could be considered the precursor to massively multiplayer online role-playing game (MMORPG) and Second Life. While one may think this is a purely western-centric phenomenon, an article published in the Guardian on November 11, 2008, indicating China’s push to recognize internet addiction, says otherwise. The Chinese equivalent of the DSM, not yet approved, but expected to be by the Chinese ministry of health, indicates that 6 hours of online activity not related to study or work is considered an addiction. In March 2008, Dr. Jerry Block published an editorial in The American Journal of Psychiatry detailing how internet addiction has become an issue in South Korea citing that South Korea considers internet addiction one of its most serious public health issues. A further interesting note is that health authorities may be able to recognize the problem more readily in Korea since the majority of internet usage takes place in public, i.e., internet cafes where data can more easily be accessed, as opposed to North America where internet access takes place mainly in the home. One of the greatest challenges to the recognition of internet addiction as a disorder comes from the issue of co-morbidity in which several disorders occur simultaneously with a primary disorder. In her analysis of 259 addicted users and applying a Beck Depression Inventory (BDI) to measure depression, Dr. Kimberly Young found mild to moderate levels of depression in her sample. The main issue, however, (and those that challenge internet addiction as a separate disorder will articulate this point vociferously) is whether or not compulsive internet use is a symptom of depression - or other recognized disorders, such as obsessive compulsive disorder - or a completely separate disorder. Which Comes First, Addiction or Depression?Research to date has involved the analysis of a cocktail of variables all in an effort to try and determine whether internet addiction or “overindulgence in the internet is the cause or the consequence of mental problems.” Studies from around the world are trying to determine the complex interconnection between addiction and the prevalence of other disorders such as depression, alcohol dependence, obsessive compulsive disorder, attention deficit and hyperactivity disorder and even measures of hostility and social phobias. Most research agrees that there is an association been these types of disorders and internet addiction. What has not been established is causality in either direction. So, while someone deemed an internet addict is more likely to be associated with one of these disorders, whether the disorders cause internet addiction or internet addiction causes the disorder, has not yet been established.
The Young Ones “Adolescence represents the period when a person’s identity is formed, and is a common period for experiencing confusion and frustration... Schools may provide opportunities for alienation or exclusion from a peer group...” (Kim and Ryu et al. 2006)
Adolescents seem to be at a growing risk for internet addiction. Recognizing that addiction is an impulse control disorder, and that “adolescents are more vulnerable to pathological internet use as they have less ability to control their enthusiasm for something that awakens their interests,” this mix of awkward vulnerability and a desperate need for a sense of belonging make adolescents ripe for finding comfort in online activities. Chang-Kook Yang articulates, how the phenomenon of the internet can appeal to adolescents, “[it] provides a potent mix of immediacy, anonymity and intimacy [and] furthermore... offers a sense of togetherness.”
The Particular Appeal of Gaming To those seemingly isolated, either by choice or by happenstance, from standard social interactions, the world of online gaming is a refuge and none more so than for adolescents. One of the areas where the euphoria of "virtual belonging" is felt most is in the online gaming community. “The cyber game should not simply be considered as a temporary medium for playing games but as a social place where new types of life and human relations are formed," says Leo Sang-Min Whang. While representative multi-player games such as chess and baduk – an Asian board game loosely similar to Connect Four – have a winner and a loser, and are based on a sequence of moves, MMORPGs go on indefinitely and are determined by each player’s moves and not by a programmer.
Whang advises that one’s perspective has a great role to play in determining the value of this “virtual society.” If gaming is seen as gambling or for entertainment, then excessive use will be seen as wasteful, but there is great opportunity for creating “meaningful space” by demanding games with more strategy, wisdom and sophisticated value systems over retaliation.
Chee and Smith bring a fresh perspective to this debate by arguing that the sense of community created by online gaming may be a benefit and that addiction to games such as EverQuest may be no different than one expressing a profound affinity for chocolate. They point to addiction as a “depravation of community.”
Dr. David Greenfield - NBC Today Show. Virtual Addiction This is an example of on online community formed for the purposes of gameplay in EverQuest:
Allakhazam's Magical Realm http://everquest.allakhazam.com/ These are examples of online communities formed to support the significant others of EverQuest addicts. Affectionately termed "EverQuest Widows," these groups are a very serious response to the emotional abandonment felt by spouses.
For more articles regarding online gaming see the digital library of the Digital Games Research Association (DiGRA) http://www.digra.org/dl/order_by_author?publication=Level%20Up%20Conference%20Proceedings Policy Around the Globe In the case of Korea, policy has possibly played a role in the prevalence of intern addiction. As part of an aggressive growth strategy, Korea ensured more widely available access throught the creation of PC cafes or "baangs." In Taiwan, Lin and Tsai indicate that the, “Taiwanese government has strongly advocated internet use island-wide for commercial and educational purposes.” While the internet is sometimes seen as a “flawless superhighway,” Lin and Tsai encourage policy makers, educators and society to start noticing the negative effects and to act.
Chee and Smith discuss the policy implications around the world in the age of internet addiction. In Korea, "The government is funding centers devoted to addressing internet addiction... with a mission to correct the internet misuse and to help internet addicts.”In Thailand, the Ministry of Technology has imposed a gaming curfew blocking all gaming servers between the hours of 22:00 and 06:00. In 2001, China shut down nearly 2000 internet cafes citing widespread parental complaints of absent children. In Germany, where internet addiction is not recognized as a disorder, camps designed to encourage outdoor activities have begun to spring up. Finally, in Greece, law number 3037 prohibits the operation of “electronic games with electronic mechanisms and software."
Doctor Doctor: Treatment
Because internet addiction is not yet a recognized disorder, its treatment is not covered by insurance. Those that are afflicted are left to find their own means to deal with the disruption to their lives. There has been limited success with the use of antipsychotic drugs, but other measures are being taken to help those seeking treatment.
Dr. Jerlad Block, CEO of SMARTguard Software and creator of WallFly: This software allows parents to limit game play for games with violent or sexual content.
