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Teens With ADHD, Depression Risk Internet Addiction

In a wired world, obsessive use is likely to increase, experts say

TUESDAY, Oct. 6 (HealthDay News) -- Teenagers with psychosocial disorders such as ADHD, depression and social phobia are more likely to be addicted to the Internet than other teens, new research suggests.

Because computer use is a way of life in the United States, the potential exists for childhood computer addiction to become a major public health problem, the Taiwanese study authors say.

They asked 2,293 seventh graders, whose average age was 12, to fill out questionnaires that assessed whether they had ADHD (attention-deficit hyperactivity disorder), depression, social phobia or abnormal feelings of hostility. Six to 24 months later, they were asked about their Internet usage, including how many hours they spent on the Internet and what sorts of sites they visited.

After two years, nearly 11 percent of students were addicted to the Internet. Common activities included online gaming and chatting.

Boys and girls who had ADHD or hostility were more likely to be addicted to the Internet than teens without those conditions. Having social phobia or depression also predicted Internet addiction in girls, though not in boys.

"It makes a great deal of sense to me why children with these kinds of issues would find the Internet utterly compelling," said Michael Gilbert, senior fellow at the Center for the Digital Future at University of Southern California's Annenberg School for Communication.

"If you have a child that is hyperactive, the Internet can move at their pace," he said. "If you have a child that is depressed or has social phobia, they can get in touch with other kids dealing with the same kinds of issues. They can go into artificial worlds, like 'Second Life,' where they can live out fantasies or take on different personas. For kids who have anger or hostility, the Internet gives them a chance to play out their aggression there."

The study appears in the October issue of Archives of Pediatrics & Adolescent Medicine.

As yet, no agreed-upon definition of Internet addiction exists among mental health professionals, nor is the disorder included in the Diagnostic and Statistical Manual of Mental Disorders, although it is being considered for the latest edition.

Most often, Internet addiction is considered to be excessive use of the Internet that negatively impacts grades, family relationships or emotional state. Symptoms include a preoccupation with the Internet, greater use of the Internet than anticipated or desired, an inability to stop, and using the Internet so much that it crowds out other activities.

In the study, being male, spending more than 20 hours a week on the Internet and playing online games were risk factors for Internet obsession.

Experts say they are seeing more of it.

"We see children and teens spending a tremendous amount of time on the Internet. Activities can range from chatting and using Facebook to participating in online gaming, shopping, pornography or 'Second Life,'" said Dr. Harold Koplewicz, director of the Child Study Center at New York University Langone Medical Center. "Like anything else, when it's done too much and it starts causing dysfunction in other parts of our lives, it qualifies as an addiction, obsession or compulsion."

Parents of teenagers should monitor the time their children spend on the Internet and the sites they visit. This is especially important for parents of children with ADHD, social phobia or another mental health condition, Koplewicz said.

Children with ADHD have difficulty focusing, which leads to problems in school. Their impulsivity makes them more likely to be in car accidents. They are also more likely to use alcohol or marijuana daily. Because children with ADHD crave novelty, it makes sense that the Internet would appeal to them, Koplewicz said.

"Parents of children who have these disorders, most specifically ADHD, should be most vigilant and cautious about the added risk the Internet holds for their children compared to the rest of the population," Koplewicz said.

Also, pediatricians and mental health professionals should ask their teenage patients about their Internet usage, Koplewicz added.

Even with those steps, in a society in which the Internet is increasingly used for schoolwork, employment, socializing and communicating, curtailing computer use is difficult.

"Everyday, the Internet becomes more integral to life," Gilbert said. "It's a tough new problem for psychologists and parents because they can't get away from it. The Internet will be at every table, in every bar, classroom and maybe on their wrist."

Gilbert advised parents to focus on helping their child deal with their depression, hostility or social phobia.

"It has to be dealt with at the source. It's not about taking their Internet away," Gilbert said. "They are going to be confronted with that media wherever they go."

More information

The National Institute on Media and the Family has more on Internet addiction.

SOURCES: Michael Gilbert, senior fellow, Center for the Digital Future, University of Southern California's Annenberg School for Communication, and author, "The Disposable Male"; Harold Koplewicz, M.D., director, New York University Child Study Center and chair, department of child and adolescent psychiatry, New York University Langone Medical Center; October 2009 Archives of Pediatrics & Adolescent Medicine

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