Yip correlates among adolescents in Hong Kong

There has been a rapidly growing public awareness of the potential adverse effects arising from excessive, maladaptive or addictive internet usage 1,2 (hereafter the term internet addiction is used), which is a condition also known by terms such as internet dependence, problematic internet use, compulsive internet use, internet abuse and pathological internet use. Indeed, this condition is currently being considered by the American Psychiatric Association for inclusion in the DSM–V as a psychiatric diagnosis. 3 Asian countries such as South Korea and China have recognised this as a public health problem and thus national-level initiatives involving substantial investment in both countries are underway. 1 An official report in China, which is ranked as the largest internet broadband market in the world, 4 claims that one in every six Chinese internet users may have developed some level of internet addiction. 5 Internet addiction in young people is especially recognised as a social problem. Whereas this generation depends heavily on the internet for learning, social activities and leisure, 6 people of a younger age appear to be less self-regulative and more susceptible to media influences. 7 Previous epidemiological self-report surveys using community samples have indicated that the prevalence rates of internet addiction among adolescents range from 0.9 to 38%. 8 The wide range of results is probably a result of diverse study designs, different assessment methods and sampling from different sub-populations. Many people believe male users are more subject to internet addiction but different research studies show inconsistent results. 9 The conceptualisation and definition of internet addiction are still debated by academics and clinicians. There is a lack of evidence-based standardisation and clear-cut clinical assessment criteria for internet addiction, and there is no aetiological explanation for this condition. 8,10 Some reviews suggest that it is premature to determine the validity of this condition. One of the central criticisms against considering internet addiction as a stand-alone psychiatric disorder is that internet addiction does not seem to exist independently but is highly comorbid with other psychopathological conditions, and therefore a separate set of diagnostic criteria may be unnecessary. For instance, internet addiction has been found to be associated with attention-deficit hyperactivity disorder, 12 depressive symptoms, depressive disorder, 13 anxiety disorder, 14 low self-esteem, 15 impulsivity, 16 social anxiety, 17 shyness 18 and suicidality. 19,20 These findings suggest that a new label of internet addiction may lead to underdiagnosis of primary psychiatric disorders with proven …