Clinical features and axis I comorbidity of Australian adolescent pathological Internet and video game users

May 31, 2013The Australian and New Zealand journal of psychiatry

Mental health symptoms and other disorders linked to problematic Internet and video game use in Australian teenagers

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Abstract

The prevalence rates of pathological Internet use (PIU) and pathological video gaming (PVG) among Australian adolescents are 6.4% and 1.8%, respectively.

A subgroup of adolescents exhibited both PIU and PVG, accounting for 3.3% of participants.
Key clinical features of pathological technology use include withdrawal, tolerance, deception, secrecy, and conflict.
Common symptoms reported by adolescents without PTU, such as preoccupation and escapism, may not serve as reliable clinical indicators.
Adolescents with PIU showed higher rates of depression, panic disorder, and separation anxiety compared to those with PVG alone.
An increase in Internet use among female adolescents is suggested, leading to increased levels of PIU.

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OBJECTIVES: Although there is growing international recognition of pathological technology use (PTU) in adolescence, there has been a paucity of empirical research conducted in Australia. This study was designed to assess the clinical features of pathological video gaming (PVG) and pathological Internet use (PIU) in a normative Australian adolescent population. A secondary objective was to investigate the axis I comorbidities associated with PIU and video gaming.

METHOD: A total of 1287 South Australian secondary school students aged 12-18 years were recruited. Participants were assessed using the PTU checklist, Revised Children's Anxiety and Depression Scale, Social Anxiety Scale for Adolescents, revised UCLA Loneliness Scale, and Teenage Inventory of Social Skills. Adolescents who met the criteria for PVG or PIU or both were compared to normal adolescents in terms of axis I comorbidity.

RESULTS: The prevalence rates of PIU and PVG were 6.4% and 1.8%, respectively. A subgroup with co-occurring PIU and PVG was identified (3.3%). The most distinguishing clinical features of PTU were withdrawal, tolerance, lies and secrecy, and conflict. Symptoms of preoccupation, inability to self-limit, and using technology as an escape were commonly reported by adolescents without PTU, and therefore may be less useful as clinical indicators. Depression, panic disorder, and separation anxiety were most prevalent among adolescents with PIU.

CONCLUSIONS: PTU among Australian adolescents remains an issue warranting clinical concern. These results suggest an emerging trend towards the greater uptake and use of the Internet among female adolescents, with associated PIU. Although there exists an overlap of PTU disorders, adolescents with PIU appear to be at greater risk of axis I comorbidity than adolescents with PVG alone. Further research with an emphasis on validation techniques, such as verified identification of harm, may enable an informed consensus on the definition and diagnosis of PTU.

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Clinical features and axis I comorbidity of Australian adolescent pathological Internet and video game users

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