In Germany, roughly 560,000 people are affected by internet addictions. This often involves problematic immersion in online computer game worlds or in internet pornography and cybersex.

Escape into Virtual Worlds

Essay. The increasing occurrence of internet-related addictions must not be addressed in medicine alone but should be discussed broadly in society and politics - and in the educational sector.

11.10.2018

Since the early 1990s, people have been able to use the internet freely all over the world. But what should be done when the internet becomes addictive?

Due to rapid and impressive technical development, new and impressive internet offers, online games and digital services are constantly being created, which continue to revolutionize our everyday life, the professional world and leisure time.

Where does problematic, excessive or even pathological media consumption begin?

Social networks are changing the way we communicate and interact. Computer games and virtual realities immerse us in other, strange and exciting worlds. Online shops invite us to shop anytime and smartphones give us a new feeling of “security” – always with us, always available, never alone.

There is no doubt that the digital revolution of recent decades has triggered a wave of social change, the complexity and effects of which are still difficult to grasp for individuals and society.

What would be a “sensible” or “unproblematic” approach to media? And where does problematic, excessive or even pathological media consumption begin?

A widespread problem – but what is it?

In Germany, roughly 560,000 people are affected by internet addictions. This often involves problematic immersion in online computer game worlds or in internet pornography and cybersex. The people affected often also get caught up in their social networks, or they cannot live without streamed TV series.

In layperson’s terms, internet addiction can be recognised by the fact that those affected completely lose control over their internet use, they are permanently trapped in their virtual worlds and they use the internet to escape their reality.

But why does this happen and who gets addicted?

Game manufacturers and internet giants are developing ever more sophisticated mechanisms and applications to permanently captivate users in the virtual world.

The causes of internet addiction or computer game dependency are very different in each individual case. Often individual characteristics and social burdens both play an important role.

In an individual level, for example, anxiety and accompanying psychological disorders might increase the risk of internet addiction, while divorce, workplace bullying, unemployment, lack of perspective and loneliness could be classed as social burdens.

In addition, major game manufacturers and internet giants are developing ever more sophisticated mechanisms and applications to permanently captivate users in the virtual world and to continue to increase the gigantic growth of the online (games) market.

Due to the dramatic consequences and increasing prevalence of the problem, “Internet Gaming Disorder” was included in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) for the first time in 2013.

Symptoms and consequences may be serious

In medical-psychotherapeutic treatment and associated research, however, a distinction is usually made between five sub-types of internet addiction, which are increasingly overlapping or merging into one another.

These sub-types include dependency on 1.) internet pornography and cybersex, 2.) online relationships (social network, Facebook etc.), 3.) monetary online offers (online gambling, online shopping), 4.) random surfing and research, 5.) playing (online) computer games.

In addition, internet addiction always leads to serious problems in the social environment, i.e. family, education, at work or among friends. Due to excessive internet consumption, those affected often neglect their diet, health and personal hygiene. There might also be other consequences such as job loss, unemployment, social isolation, etc.

People addicted to the internet often suffer from depression, social anxiety or disorders in their attention and activity. Relatives also often suffer from the excessive media consumption of their children or partners.

Recognition could help sufferers

For many years now, affected individuals have been approaching specialist outpatient clinics and addiction counselling centres in search of therapeutic help to escape the virtual world and develop a controlled approach to their media.

Now, due to the dramatic consequences and increasing prevalence of the problem, “Internet Gaming Disorder” was included in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) for the first time in 2013 as a research diagnosis and clear addiction criteria were defined.

In the meantime, the World Health Organization (WHO) published the inclusion of the diagnosis “(Internet-) Gaming Disorder” in the chapter “Disorders based on addictive behaviour” in its advance notice of the 11th version of the International Statistical Classification of Diseases and Related Health Problems (ICD-11).

The legitimation of this new internet-related behavioural addiction will hopefully lead to increased possibilities for researching causes, effects and accompanying phenomena and for developing specific forms of treatment.

Education and public debate also needed

However, the increasing occurrence of internet-related addictions must not be addressed in medicine alone but should be discussed broadly in society and politics.

Educational projects and prevention measures should try to explain to children and young people what opportunities and risks there might be in media use.

What is “different”, “sick” or perhaps simply “new” in terms of media use?

Questions, however, remain:

To what extent are concepts of media education established and desired within families and society? What should be regulated or controlled? Which single freedoms of individuals may be thereby curtailed? To whom should or shouldn’t the rules and recommendations apply?

It will take strong and strenuous discussion to bridge the gap between the generations of “digital immigrants” (born before the widespread adoption of digital technology) and “digital natives” (born in a world of the internet).

Finally, a broad social orientation is needed to answer the question of what is “different”, “sick” or perhaps simply “new” in terms of media use.

In layperson’s terms, internet addiction can be recognised by the fact that those affected completely lose control over their internet use.

References:

Rumpf, J. H. et al. (2011): Prävalenz der Internetabhängigkeit PINTA. Bericht an das Bundesministerium für Gesundheit, https://www.bundesgesundheitsministerium.de

Young K.; Pistner M.; O’Mara J.; Buchanan J.; (1999): Cyber Disorders. The Menthal Health Concern for the New Millenium. CyberPsychology and Behavior, 2 (5), S. 475−479

Bundesministerium für Gesundheit (BMG), Drogenbeauftragte der Bundesrepublik Deutschland (2017): Drogen und Suchtbericht 2017 der Bundesregierung

American Psychiatric Association APA (2013): Diagnostic and Statistical manual of mental disorder (5th ed.), DSM-5. Washington DC: APA

World Health Organisation WHO (2018): The ICD-11 classification of mental and behavioural disorders. ICD 11 Beta Draft online, https://icd.who.int/dev11/l-m/en

Further information can be found at www.onlinesucht-ambulanz.de and www.psychosomatik.lwl-uk-bochum.de.