Excessive and pathological Internet use - Risk-behavior or psychopathology?

Michael Kaess; Johanna Klar; Jochen Kindler; Peter Parzer; Romuald Brunner; Vladimir Carli; Marco Sarchiapone; Christina W Hoven; Alan Apter; Judit Balazs; Shira Barzilay; Julio Bobes; Doina Cozman; Vanja Gomboc; Christian Haring; Jean-Pierre Kahn; Helen Keeley; Gergely Meszaros; George J Musa; Vita Postuvan; Pilar Saiz; Merike Sisask; Peeter Varnik; Franz Resch; Danuta Wasserman

doi:10.1016/j.addbeh.2021.107045

Excessive and pathological Internet use - Risk-behavior or psychopathology?

Addict Behav. 2021 Dec:123:107045. doi: 10.1016/j.addbeh.2021.107045. Epub 2021 Jul 9.

Authors

Michael Kaess¹, Johanna Klar², Jochen Kindler², Peter Parzer³, Romuald Brunner⁴, Vladimir Carli⁵, Marco Sarchiapone⁶, Christina W Hoven⁷, Alan Apter⁸, Judit Balazs⁹, Shira Barzilay⁸, Julio Bobes¹⁰, Doina Cozman¹¹, Vanja Gomboc¹², Christian Haring¹³, Jean-Pierre Kahn¹⁴, Helen Keeley¹⁵, Gergely Meszaros¹⁶, George J Musa⁷, Vita Postuvan¹², Pilar Saiz¹⁰, Merike Sisask¹⁷, Peeter Varnik¹⁷, Franz Resch³, Danuta Wasserman⁵

Affiliations

¹ University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland; Clinic of Child and Adolescent Psychiatry, Centre of Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany. Electronic address: michael.kaess@upd.ch.
² University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.
³ Clinic of Child and Adolescent Psychiatry, Centre of Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany.
⁴ Clinic of Child and Adolescent Psychiatry, Centre of Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany; Clinic for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Regensburg, Regensburg, Germany.
⁵ National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institutet, Stockholm, Sweden.
⁶ Department of Medicine and Health Science, University of Molise, Campobasso, Italy; National Institute for Health, Migration and Poverty, Rome, Italy.
⁷ Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, Columbia University, New York, NY, USA; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.
⁸ Feinberg Child Study Centre, Schneider Children's Medical Centre, Tel Aviv University, Tel Aviv, Israel.
⁹ Institute of Psychology, Eötvös Loránd University, Budapest, Hungary; Bjørknes University College, Oslo, Norway.
¹⁰ Department of Psychiatry, University of Oviedo, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Investigación Sanitaria del principado de Asturias (ISPA), Servicio de Salud del Principado de Asturias (SESPA), Oviedo, Spain.
¹¹ Clinical Psychology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
¹² Slovene Centre for Suicide Research, Andrej Marusic Institute, University of Primorska, Koper, Slovenia.
¹³ Tyrol Clinics Holding, Tyrol, Austria.
¹⁴ Department of Psychiatry, Université de Lorraine, Nancy and Fondation Santé des Etudiants de France (FSEF), Paris, France.
¹⁵ North Cork Child and Adolescent Mental Health Service, HSE South, Mallow Primary Healthcare Centre, Gooldshill, Mallow, Co Cork, Ireland.
¹⁶ Semmelweis University, Mental Health Sciences School of Ph.D., Budapest, Hungary; Semmelweis University, Department of Psychiatry and Psychotherapy, Budapest, Hungary.
¹⁷ Estonian-Swedish Mental Health and Suicidology Institute, Tallinn, Estonia; Tallinn University, School of Governance, Law and Society (SOGOLAS), Tallinn, Estonia.

PMID: 34332272
DOI: 10.1016/j.addbeh.2021.107045

Abstract

Pathological Internet use (but only with respect to gaming) is classified as mental disorder in the ICD-11. However, there is a large group of adolescents showing excessive Internet use, which may rather be considered adolescent risk-behavior. The aim was to test whether pathological and excessive Internet use should be considered as "psychopathology" or "risk-behavior". A representative, cross-sectional sample of 11.110 students from 10 European Union countries was analyzed. Structural equation models, including the factors "risk-behavior" and "psychopathology" and the variables excessive and pathological Internet use, were tested against each other. "Risk-behavior" was operationalized by several risk-behaviors (e.g. drug abuse, truancy, etc). "Psychopathology" included measures of several mental disorders (e.g. depression, hyperactivity, etc). Excessive Internet use was assessed as the duration and frequency of Internet use. Pathological Internet use was assessed with the Young Diagnostic Questionnaire (i.e., presence of addiction criteria). Excessive Internet use loaded on "risk-behavior" (λ = 0.484, p < .001) and on "psychopathology" (λ = 0.071, p < .007). Pathological Internet use loaded on "risk-behavior" (λ = 0.333, p < .001) and on "psychopathology" (λ = 0.852, p < .001). Chi-square tests determined that the loadings of excessive Internet use (χ² (1) = 81.98, p < .001) were significantly stronger on "risk-behavior" than "psychopathology". Vice versa, pathological Internet use loaded significantly stronger on "psychopathology" (χ² (1) = 107.10, p < .001). The results indicate that pathological Internet use should rather be considered as psychopathology. Excessive Internet use on the other hand, should be classified as adolescent risk-behavior.

Keywords: Adolescents; Excessive Internet use; Internet addiction; Pathological Internet use; Psychopathology; Risk-behavior; SEYLE.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Behavior, Addictive* / epidemiology
Cross-Sectional Studies
Humans
Internet
Internet Use
Psychopathology
Substance-Related Disorders*
Surveys and Questionnaires
Video Games*