life

Editorial
Internet Addiction
Fehér Gergely

Centre for Occupational Medicine, Medical School, University of Pecs, 7624 Pecs, Hungary; [email protected]

This topic was dedicated to the complexity of internet addiction and contains 23 articles
submitted by prestigious workgroups and originally launched as a Special Issue entitled
“Internet Addiction”. Due to the large number of manuscripts and the diversified ap-
proaches, these papers were originally published by four high-quality MDPI journals. I
hope this set of articles can help us in a more accurate understanding of the development
of compulsive internet use.
The extensive availability of the internet has led to the recognition of problematic
internet use (so-called internet addiction, IA). Problematic internet use is usually defined
as a problematic, compulsive use of the internet, resulting in significant impairment in an
individual’s function in various life domains over a prolonged period of time. This disorder
is increasingly prevalent; about 5% of the whole population is considered to suffer from it.
A difficulty in recognizing this disorder is that internet-based technology has improved
many aspects of our lives, and it is now an essential part of our everyday routine, including
work, private life, and social functioning; therefore, many individuals are not aware of the
misuse or problematic use [1].
IA seems to have several risk factors. The most important ones are a younger age
at the start of internet use and being male [2]. An extensive Czech study conducted by
Kopecky et al. including more than 27,000 students aged between 7 and 17 years showed
that they spent a large part of their leisure time at school using their mobile phones linked
to one of the social networks, YouTube, and videogames instead of practicing sports or
social activities [3]. In the absence of their digital devices, they had to face boredom
and loneliness, which underlines the importance of proper control [3]. Furthermore,
the unlimited and exaggerated use of mobiles devices/phones may be associated with
Citation: Gergely, F. Internet a new psychiatric term entitled nomophobia (the acronym means “no-mobile-phobia”),
Addiction. Life 2022, 12, 861. https:// described as experiencing intense fear anxiety, stress, and discomfort due to the idea of
doi.org/10.3390/life12060861 being without a mobile phone or the inability to use it [4]. A systematic review and meta-
Received: 20 May 2022
analysis conducted by Humood and his colleagues showed that the prevalence of severe
Accepted: 7 June 2022
nomophobia can be as high as approximately 21% in the general population and about 9%
Published: 9 June 2022
in high school students [5]. However, in their meta-regression analysis, neither age nor sex
was a significant predictor, so these results merit further investigation, but also underline
Publisher’s Note: MDPI stays neutral
the importance of digital control.
with regard to jurisdictional claims in
Family functioning also has a crucial role in the development of IA [6]. The study
published maps and institutional affil-
published by Li et al. showed that better-functioning families are less likely to be associated
iations.
with problematic internet use [7]. Kapus and his workgroup also showed the negative role
of impaired family relationships such as living without parents was a significant predictor
of IA in their extremely impressive study, which took many co-variates into account [8].
Copyright: © 2022 by the author.
One’s place of stay may have an influence of IA, as problematic use seems to be more
Licensee MDPI, Basel, Switzerland. common in rural areas and among those with low socioeconomic status [9]. In their inter-
This article is an open access article esting research paper, Yasuma et al. retrospectively analyzed the role of urban upbringing
distributed under the terms and on IA and found a positive association even after adjusting for both sociodemographic
conditions of the Creative Commons characteristics and psychopathology (including measuring psychological distress and a
Attribution (CC BY) license (https:// history of mental illnesses in the past 12 months) [10].
creativecommons.org/licenses/by/ Certain individual personality traits appear to be common among adolescents with
4.0/). problematic internet use [2,11]. According to the paper by Li et al., adolescents with high

Life 2022, 12, 861. https://doi.org/10.3390/life12060861 https://www.mdpi.com/journal/life

Life 2022, 12, 861 2 of 5

self-control showed a high level of consideration of future outcomes, which in turn reduced
internet addiction [12]. Among a sample of Spanish university students, some social skills
variables such as conversation and social ease, empathic and positive feeling skills, and
risk coping predicted problematic internet use in a multivariate analysis, and Romeró-
Lopez and his colleagues also found the increased risk among younger students having
obsessive thoughts about being online and having a higher risk of IA [13]. Zeng et al.’s
research focused on the possible association and pathways among self-esteem, individ-
ual affect, relationship satisfaction, and IA. Mediation analysis of their sample indicated
that negative affect and relationship dissatisfaction mediated the relationship between
self-esteem and IA [14]. A high tendency toward novelty seeking was previously shown to
be associated with IA, and Lane and his workgroup also found that it was associated with
smartphone addiction [2,11,15].
Apart from the time spent online (spending more and more time online is a tentative
indicator of tolerance, the core criterion of dependence), certain online activities are deliber-
ately made to be addictive, such as online gaming [16]. Although internet addiction is not
labelled as a medical condition, gaming disorder was included both in the appendix of the
DSM-V (as a potential warning condition) and in the ICD-11 as a medical condition [17,18].
Despite warning signs, competitive online video gaming (or esports) is extremely preva-
lent in our century and is considered a healthy hobby for the vast majority of people
(also promoted as such by developers) [19]. About 1 out of 5 recreational adult esports
players can be compulsive internet users, which is significantly higher than the estimated
5% prevalence according to the paper by Kósa et al., and this study also draws attention to
the risk factors for IA, such as younger age, family status, and type of employment, and
its possible association with depression and alcohol use (abuse) [20]. Watching videos,
including live streams, can also be additive, as shown by a pilot interview study, but larger
samples are needed to clarify the possible association [21].
Problematic internet use seems to be associated with several mental and medical con-
ditions [22,23]. According to a Russian study conducted by Tereshchenko et al., problematic
internet users struggle with significant disturbances in the quality of nighttime sleep and
excessive daytime sleepiness [24]. Depressive symptoms predicted internet addiction
but not vice versa at a within-person level in a Chinese study [25]. Yi et al. also found
male predominance and suggested effective identification and intervention of depressive
symptoms in the intervention and prevention of internet addiction [25]. Kożybska and his
colleagues showed the possible association of IA and eating disorders [26]. Significant pre-
dictors were the preoccupation with the Internet, neglect of sleep in favor of online activity,
relieving negative feelings while online, and a higher average number of weekends hours
spent online on study/work-related activities, extracurricular activities (working, active
membership in student organizations), lower height, and higher body mass index [26].
Similar to other addictions, the withdrawal from internet use can be associated with
severe symptoms, with a disruption of the brain nerve networks that implement both time
control and autonomic nervous regulation of cardiac activity based on a Russian study
carried out by Krivonogova et al. [27].
The recently recognized coronavirus disease (COVID-19) and pandemic, starting in
2019 with subsequent lockdown, home quarantine, and homework/home education, has
dramatically increased the use of web-based technologies [28]. Frequent and extensive
uses of the internet were shown to be strong predictors of physical health problems by
a Bangladesh study concluded by Abir et al. [29]. The time spent on internet gaming
also significantly increased among adolescents based on a representative survey from
South Korea by Kim et al. [30]. However, a subgroup analysis showed that the majority
of adolescents did not exhibit significant aggravation of addictive internet gaming usage
during the COVID-19 pandemic, except for compulsive gamers [30].
Problematic internet use is extremely well studied among adolescents, but far fewer
research studies are available in adults [1].
Life 2022, 12, 861 3 of 5

Pohl et al. showed that the rate of IA can be as high as 5% among Hungarian teachers,
and it can be associated with burnout, moderate and severe depression, insomnia, and
lower quality of life in all domains [31]. In a multivariate analysis, internet addiction was
shown to be significantly associated with depression and insomnia, which underlines the
importance of this phenomenon [31]. In a large sample of Portuguese workers, IA was also
strongly associated with anxiety and depression, as concluded by Pereira et al. [32]. Apart
from problematic internet use, age (being older), gender (being female), not having enough
economic funds, being unsatisfied with the leadership in the job, being unsatisfied with the
nature of the job, and having higher scores in salience were significant predictors of mental
health issues [32].
IA may be classified as a compulsive-impulsive spectrum disorder based on symp-
tomatology, but it has been undergoing considerable research and is not included in the
most recently published 5th edition of the Diagnostic and Statistical Manual DSM-V [33].
Masters et al. also showed in their systematic literature review that researchers do not
control for academic work activity when measuring medical students’ internet addiction
and that researchers should use more granular tools (as the currently used tools seem to be
far too blunt) and specifically control for work-related activities [34].
Similar to internet addiction (which is not entirely clarified, as proper criteria and
treatment modalities are missing), internet gaming disorder (IGD) has also become an
important health concern in a significant proportion of adolescents, as seen above [1,33].
As randomized studies are missing, we face a lack of guidelines. A recent study raised
the possible efficacy of several treatment modalities, namely psychoeducation, emotion
management, behavior analysis and modification, social skills training, parent participa-
tion, and relapse prevention, which have been described to be effective by participants
and experts [35].
Fear of missing out (FoMO) is a relatively new concept meaning the fear of missing
satisfying experience when the individual is absent from 239 his/her companions and
having a strong desire to always be with others [36]. It is strongly related to mental issues
such as smartphone addiction, compulsive social media use, internet addiction, phubbing
behavior, insomnia, and poorer academic performance [37]. This topic also contains the
Chinese validation of this questionnaire, which may help to explore the psychopathology
leading to internet addiction [37].
However, the widespread use of the internet has not only disadvantages but also
a marked dampening effect. Xie et al. concluded in their extensive scientometric anal-
ysis that new media have almost brought about a new era for maternal health, mainly
characterized by psychological qualities, healthy, and reasonable physical conditions and
advanced technology [38].
Finally, our Special Issue was surrounded by a great deal of interest, which is reflected
in the large number of manuscripts submitted and published. We are pleased to announce
that, in view of the above, the topic will be republished, and details will soon be published
on our website.
I hope you can enjoy this brilliant research.

Funding: This article was funded by NKFI (OTKA)-135316 project.

Conflicts of Interest: The author declare no conflict of interest.

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