ALTHOUGH THE PSYCHIATRIC recognition of computer or Internet addiction is approximately two decades old (Shotton, 1989), controversy surrounding whether or not it is a mental illness may interfere with recognition and treatment. For some time I was convinced that I suffered from the condition myself, experiencing mild anxiety when I was traveling in countries where there was minimal Internet access. Like any good mental health nurse eager to understand myself and, if necessary, “heal myself” to help others, I decided to learn everything I could about the topic. I was surprised at the attention the issue has received in both the media and the mental health world, both in clinical practice and scientific research.

Several countries in Asia, particularly China, South Korea, and Taiwan, have been reported to have the highest incidence of computer or Internet addiction among young people. Yet Internet users in the United States are not immune. It has recently been estimated that up to as many as 9 million Americans may be at risk for the disorder or at least could be labeled as pathological computer users (Block, 2007). In the debates and discussions (much of which are recorded online for those of us who frequent the Internet), one of the important issues is the naming of the problem. This includes the debate about whether computer addiction, video game addiction, or some variation of the addiction should be included as part of the forthcoming Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) to be published in 2012. These considerations include how excessive computer use is related to addictive and other obsessive-compulsive behaviors.

While the scientific debate continues, we all know individuals who present with mental health problems related to excessive computer use. These may include fear and anxiety related to withdrawal, avoidance of social interaction other than through Internet sources, withdrawal from family and personal relationships, and deviant behavior, such as pornography and illegal gambling (Orzack, 1998). Beard (2005) proposed a comprehensive set of questions that can be used in a screening interview to determine the extent to which Internet addiction affects mental health and functioning. From the treatment perspective, there are a number of interventions that have been evaluated, including withdrawal (such as the boot camps in South Korea), support groups (often online), and a more general approach of inclusion of the symptoms of Internet addiction within the larger context of psychotherapy. One key to intervention is the motivation to change, which can be particularly problematic with the current reliance on the Internet for a large majority of work and leisure activities. Recognizing the societal changes that have occurred in relation to dependence on computer technology for everyday activities, we can anticipate that computer addiction will be a topic that will remain prominent in the immediate and long-term future.

References

Beard, 2005 K.W. Beard, Internet addiction: A review of current assessment techniques and potential assessment questions, Cyberpsychology Behavior 8 (1) (2005), pp. 7–14.

Block, 2007 J. Block, Prevalence underestimated in problematic Internet use study, CNS Spectrums 12 (2007), pp. 14–15.

Orzack, 1998 M.H. Orzack, Computer addiction: What is it?, Psychiatric Times 15 (8) (1998) Retrieved December 1, 2007, from psychiatrictimes.com/p980852.html.

Shotton, 1989 M.A. Shotton, Computer addiction? A study of computer dependency, Taylor & Francis, New York, NY (1989).

Archives of Psychiatric Nursing
Volume 22, Issue 2, April 2008, Pages 59-60

Joyce J. Fitzpatrick