Predictors of the initiation and persistence of Internet addiction among adolescents in Taiwan
Introduction
With the exponential growth of information technology during the past decade, young people now spend more time in the cyber world. In Taiwan, adolescents spend 44 h per week on media, and the Internet is the leading medium that adolescents use (Wu, 2009). The percentage of households with Internet access increased from 54% in 2003 to 81% in 2012 in Taiwan (Taiwan Network Information center, 2012). The cyber world offers information and social networking opportunities, and also cyber risks such as cyberbullying, sexual solicitation, and Internet addiction. Adolescents with Internet addiction are more likely to have various co-morbid psychiatric disorders (i.e., depression, anxiety, attention-deficit hyperactivity disorder, hostility, and social anxiety disorder) (Ko, Yen, Chen, Yeh, & Yen, 2009), interpersonal problems (Kuss et al., 2013, Seo et al., 2009), aggressive behaviors (Ko, Yen, Liu, Huang, & Yen, 2009), self-injury (Lam, Peng, Mai, & Jing, 2009a), suicide ideation (Kim et al., 2006), insomnia (Cheung & Wong, 2011), inappropriate dietary behavior (Tsai et al., 2009), and substance use (Yen, Yen, Chen, Chen, & Ko, 2007).
Internet addiction is an emerging public health problem. The prevalence of youth Internet addiction varies widely across countries, with the prevalence in Asia placed at between 8% and 26% (Ko et al., 2007, Shek and Yu, 2012) and the prevalence in Europe and the United States at between 2% and 8% (Weinstein & Lejoyeux, 2010). Despite wide variations in the instrument that is used for the diagnosis of Internet addiction, it is characterized by preoccupation, uncontrolled impulse, use that is more than intended, tolerance, withdrawal, impairment of control, devotion of excessive time and effort, and impaired decision-making (Karim and Chaudhri, 2012, Shaw and Black, 2008). However, there is consensus neither on a standardized definition nor on the diagnostic criteria for Internet addiction. Internet addiction disorder has not been recognized as a separate disorder by the American Psychiatric Association, while Internet gaming disorder has been included in Section III of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) to urge further investigation. Researchers have used differing terms to describe Internet addiction problems such as problematic Internet use, pathological Internet use, or compulsive Internet use.
Kuss and Griffiths reviewed 68 studies and found that Internet addiction was associated with sociodemographic factors, Internet use, psychosocial factors, and comorbid symptoms and disorders (Kuss et al., 2013). Studies have indicated that the risk factors that are associated with Internet addiction include the following: being male (Jang et al., 2008, Tsai et al., 2009), poor academic performance (Tsitsika et al., 2011), watching online pornography, online gambling (Siomos et al., 2012), online gaming (Ko et al., 2007, Seo et al., 2009), online chatting (Jang et al., 2008), smoking (Lee, Han, Kim, & Renshaw, 2013), alcohol use (Yen, Ko, Yen, Chen and Chen, 2009, Lam et al., 2009b), hostility (Ko, Yen, Chen et al., 2009), poor social skills (Ghassemzadeh, Shahraray, & Moradi, 2008), loneliness (Bozoglan, Demirer, & Sahin, 2013), low self-esteem (Ghassemzadeh et al., 2008, Ko et al., 2007), depression (Jang et al., 2008, Ko, Yen, Chen, Yeh and Yen, 2009), low parental monitoring (Yen, Ko, Yen, Chang and Cheng, 2009, Lin et al., 2009), low school bonding (C.F. Yen et al., 2009), deficient social support (Tsai et al., 2009), experience of stressful events (Lam et al., 2009b), and living in rural areas (C.F. Yen et al., 2009).
Youth and young people are more prone to use Internet excessively to garner social support from friends. A study found that youths being oriented toward having more online friends and preferring online communication were related to an increased risk of Internet addiction (Smahel, Brown, & Blinka, 2012). Other studies have found significant links between low levels of school connectedness (C.F. Yen et al., 2009) and academic performance decrement to Internet addiction by youth (Stavropoulos et al., 2013, Tsitsika et al., 2011). In addition, studies have found that low family function (Ko et al., 2007, Tsitsika et al., 2011) and family dissatisfaction (Lam et al., 2009b) also were associated with Internet addiction among adolescents.
Despite studies that have documented the psychosocial factors associated with Internet addiction, there has been very little longitudinal research examining the risk factors of the initiation and persistence of youth Internet addiction. Taiwan residents tend to adopt information technology very quickly, which is common in Asian societies, particularly among the youth and young adults. The purpose of the present study was to assess the longitudinal predictors of the initiation and persistence of Internet addiction among senior high school students in Taiwan.
Section snippets
Participants
In 2010, a total of 72,327 high school students were enrolled in the 10th grade of 122 high schools (including vocational high schools) in Taipei City and New Taipei City, Taiwan. Based on the sampling frame, which was a list of schools and their 10th grade student enrollments, a probability-proportionate-to-size sampling method was used to systematically draw a random sample of schools. Three to four classes were randomly selected from each sample school. Approval was obtained from the
Demographic characteristics by Internet addiction changed status
Of the 1602 students without Internet addiction in the 10th grade, 253 (15.8%) had initiated Internet addiction by the 11th grade. Of the 605 students with Internet addiction in the 10th grade, 383 (63.3%) continued to have Internet addiction in the 11th grade. Internet addiction initiators and persistent users were mainly male (50.4 and 62.1%, respectively). The rate of average or above-average academic performance in the 10th grade among the no-Internet-addiction group (77.4%) was higher than
Discussion
In the present study, we found that one-sixth of no-Internet-addiction students in grade 10 had initiated Internet addiction in grade 11, while two-thirds of the Internet-addicted students in grade 10 had persistent Internet addiction in grade 11. Our results showed that the incidence rate of Internet addiction among adolescents in Taiwan is high. One study (Zhang, Amos, & McDowell, 2008) in particular found that Chinese students experienced a higher rate of Internet addiction than their U.S.
Role of funding sources
Funding for this study was provided by National Science Council Taiwan Grant NSC 99-2511-S-003-029-MY2. National Science Council Taiwan had no role in the study design, collection, analysis or interpretation of the data, writing the manuscript, or the decision to submit the paper for publication.
Contributors
Fong-ching Chang designed the study, conducted the statistical analysis, and wrote the manuscript. Chiung-hui Chiu designed the study and involved in interpretation of the data. Ching-Mei Lee designed the study and assisted in the development of questionnaire. Ping-hung Chen designed the study and advised on data interpretation. Nae-Fang Miao was involved in the development of questionnaire and data collection. All authors contributed to and have approved the final manuscript.
Conflict of interest
All authors declare that they have no conflicts of interest.
Acknowledgments
The authors wish to thank Professor Jeng-Tung Chiang who assisted in statistics methods. This work was supported by a research grant from National Science Council Taiwan (NSC 99-2511-S-003-029-MY2). Many thanks go to the participant schools and students.
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