Internet Addiction in adolescence: Neurobiological, psychosocial and clinical issues

Highlights

• Adolescents’ mental health is challenged by the risk of Internet Addiction (IA).

• Debate on diagnostic criteria, nosographic labels, assessment tools is necessary.

• Preclinical modeling may contribute to the validation of pathogenetic hypotheses.

Abstract

Despite it has not been formally included in DSM-5 as a disorder, ‘Internet addiction (IA)' has become a worldwide issue. It can be broadly defined as a non-chemical, behavioral addiction, which involves human-machine interaction. We pinpoint it as an “instrumental” form of social interaction (i.e. mediated by machines), a notion that appears useful for the sake of possible preclinical modeling. The features of Internet use reveals as addictive when this comes at the expense of genuine real-life sociability, with an overlap towards the hikikomori phenomenon (i.e., extreme retreat to one’s own room). Due to the specific neuro-developmental plasticity in adolescence, IA poses risks to youths’ mental health, and may likely produce negative consequences in everyday life. The thwarted development of adolescents’ identity, self-image and adaptive social relationships is discussed: the IA adolescents often suffer loss of control, feelings of anger, symptoms of distress, social withdrawal, and familial conflicts. Further, more severe clinical conditions are also associated to IA, such as dysthymic, bipolar, affective, social-anxiety disorders, as well as major depression. This paper overviews the literature on IA, from neuro-biological, psycho-social and clinical standpoints, taking into account recent debates on diagnostic criteria, nosographic label and assessment tools. Neuroimaging data and neurochemical regulations are illustrated with links to pathogenetic hypotheses, which are amenable to validation through innovative preclinical modeling.

Introduction

New technologies and the Internet have undoubtedly changed our lives in the last twenty years. They modified our way of communicating, socializing, entertaining ourselves, working, studying, and even thinking. For those of us who were born in these times, the Internet constitutes an everyday life companion, something that is perfectly integrated in daily experience. Conversely, who among us is a web immigrant (Ferri, 2011), recognizes how different our lives have become, and wonder about how to cope with the many great advantages the web has brought about and the dangers possibly coming from its misuse. This review will focus on one of the many specific aspects connected with the topic, which is Internet Addiction (IA) among adolescents.

While in UK, USA and Asia over 80% of the adolescent population can access to the Internet, lower rates have been found in South America (45–55%). Although with still lower rates, Africa and Middle East young Internet users have grown by ∼3000% in the last ten years (Internet World Stats, 2013). According to international research more than 30% of children under the age of two have used a tablet or smartphone and ∼80% of adolescents owns a similar device (Fox and Duggan, 2013). These impressive numbers have raised understandable concerns among those, in the developmental psychopathology framework, study adolescents and their emotional-behavioral functioning, also because the American Academy of Pediatrics (Christakis, 2014) has suggested that creativity, imagination and the possibility of achieving optimal motor and sensory development might be reduced by the use of such tools (Dalbudak and Evren, 2014).