There’s been a great deal of debate of whether “Internet Addiction” and its close cousin, “Virtual World Addiction”, should be classified as disorders separate from other behavioral addictions. Psychiatrist Ivan Goldberg reputedly borrowed the criteria for substance use and impulse-control disorders from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), and jokingly created the criteria for Internet Addiction Disorder (IAD) way back in 1995. Since then the debate has raged wildly – can these two addictions be meaningfully separated out and classified, or is there little real reason for doing so?

Internet and Virtual World Addiction: what are the specifics?

Internet addiction, and virtual world addiction (by association), seems to revolve around five basic sub-types: gambling, sexual preoccupation, messaging and/or chatting, online gaming and information gathering.

None of these are new concepts. As previously discussed, the Internet and the virtual world are mediums. The problem is with the individual’s pathological need to carry out the activity, not with the medium that provides the means for that activity.  Each of the five sub-types mentioned can be performed using other mediums and indeed have been for some time.

Nonetheless, there is a definite appeal to engaging in these activities online. The internet and virtual worlds provide high levels of convenience. It is much easier and quicker to gamble from home, using electronic funds, than to be physically present or to accomplish the task over the phone. If you are looking to be secretive about your behavior, it’s easiest to hide your actions online – no need to hide physical evidence like books or magazines.

Still, this does not constitute sufficient reason to separate out these addictions from other behavioural issues.

What are the withdrawal symptoms of Internet and Virtual World Addiction?

Symptoms include: loneliness, boredom, anger, irritability, frustration, emotional “vacancy” or numbness, disconnectedness, loss, moodiness, depression and restlessness. Interestingly, these symptoms sound suspiciously like those suffered by people cut off from the rest of society. Internet users asked to give up their internet usage reported that they felt “left out of the loop” – an understandable reaction given how many people interact with each other online rather than face-to-face or over the phone.

Of course, these symptoms are not restricted to folks cut off from society – these apply to other behavioural addictions. Internet and Virtual World addictions do not have symptom lists that specifically separate them from other behavioral addictions.

What are the consequences of being addicted to the Internet and Virtual Worlds?

Having an addiction implies that one relationship or activity has become all-important, other relationship or activities are ignored or given a minimum amount of attention. As with any other addiction, this often includes a reduction in time spent at work (or complete absence), resulting in loss of employment, financial loss and hardship and less time spent maintaining or creating relationships. This leads to existing relationships breaking down, new relationships not created through other mediums, a more secretive approach to relationships (where the true nature of the addiction is hidden from other parties) and reducing relationship quality, Other obligations and chores are neglected, sometimes to the extent that a health risk exists.

For humans as social and physical animals, the most significant of these consequences after health health concrens, is the loss of close relationships with other people, particularly family relationships. Humans require some amount of physical contact to remain healthy – the portion of a relationship that can be experienced online is no less real when experienced over a distance instead of face-to-face. Nonetheless, online relationships will never be able to fully replace relationships where physical contact is possible.

Who gets addicted to the Internet, or to Virtual Worlds?

Intriguingly, those people who suffer from this addiction may have suffered from symptoms very similar to the symptoms for this affliction prior to becoming addicted: depression, guilt, and anxiety. There are often other symptoms (dysphoric mood, feelings of helplessness, interpersonal distress, low self-esteem) and other issues (abandonment, shame, fear) that presage this type of addiction. It’s surprising how common it is for people with these underlying conditions to become addicts; up to 86% of study subjects also exhibit other diagnosable mental health disorders.

Two of the factors that are not necessarily indicators for who will become addicted are age and social capacity, even though stereotypically socially awkward or inept youths are seen as the main sufferers. Daniel Loton of the Victoria University in Australia has shown that what he terms “problem play” (as relates to gaming in virtual worlds) is not restricted to those people who have little capacity for socialization. Low self-esteem is however a good predictor of whether someone will become an addict, according to the study.

Treatment of addiction in behavioural cases?

A diagnosis is most useful where it can be used to treat an affliction. Most behavioral addictions respond well to Cognitive Behavioral Therapy (CBT). Indeed, internet and virtual world addiction cases reportedly respond well to CBT. Thus, there would seem to be little reason to separate out internet and virtual world addiction solely on the basis of needing a treatment specific to the new diagnosis.

In conclusion, there seems to be no need for the distinct and separate classifications of internet and virtual world addiction. These terms merely clump together several different behavioural addictions with the same delivery method. It’s like saying that snorters and injectors of an addictive drug should get a different diagnosis. Even if there are cases where the presentation, withdrawal symptoms or consequences are different, the therapy used to treat the different cases remains the same. Unnecessarily differentiating labels seems to do no more than confuse more than they contribute.

In the third and final article of this series, we will look at behaviour that seems like addictive behavior, but isn’t all that it seems to be on the surface.