Factors associated with internet addiction among adolescents : a systematic review

Abstract

Background: Despite its exclusion in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, Internet addiction disorder (IAD) has received attention especially from the psychiatric community. Associated with multiple factors, IAD among adolescents may cause physical, emotional, social, and function impairments that extend to adulthood. Objective: This systematic review explores the prevalence of IAD among adolescents and identifies associated factors. Methods: The databases of Medline and PubMed were searched for related literature through the Boolean Advanced Search using the keywords “Internet” or “cyber,” “addiction” or “dependence,” and “adolescent” or “youth” from 2003 to 2013. A total of 232 articles were retrieved and screened. Only 11 cross-sectional studies from 5 countries were included in this systematic review. The age of adolescent participants in these studies ranged from 13.8 to 17.3 years. Four assessments were employed to explore IAD among adolescents in the 11 reviewed studies. Among these studies, 4 employed the Young’s Internet Addiction (IA) Test, 4 utilized the Chen IA Scale, 2 studies used the Internet-Related Addiction Scale, and one study adhered to the Young’s DRM 52 Scale of Internet use among adolescents. Results: The prevalence of IAD among adolescents range from 1.5% to 18.8%. In this review, factors associated with high prevalence of IAD among adolescents include psychological (e.g., depression, attention deficiency, and hyperactivity disorder), social (e.g., family conflict),and demographic factors (e.g., male gender and older age), as well as use of the Internet (e.g., longer use of the Internet, online chatting, and gaming). Conclusions: With the increasing use of the Internet in managing daily activities, including learning, communication, and entertainment, it has become an essential part of human living in the modern world. The negative effects of IAD among adolescents might result in high healthcare cost, particularly in psychiatric treatment and rehabilitation. Thus, prevention of IAD at the early stage and promotion of healthy use of the Internet are important in safeguarding the mental wellness of people. The result of this review showed the prevalence of IAD among adolescents is associated with psychological, socio-demographic, environmental and living factors. Primary preventive education that focuses on the healthy use of the Internet and guidance could be promoted among adolescents and parents at the school and community levels, respectively. Moreover, secondary prevention programs that concentrate on the early prevention and identification of IAD and specifically designed for the at-risk group could be launched. Extra resources for the employment of counseling personnel should be considered. Future research on the at-risk group population of IAD among adolescents could be conducted. These initiatives could assist in designing a tailor-made intervention, and eventually in preventing the early onset of IAD.