A study on Internet addiction and its relation to psychopathology and self-esteem among college students (2018)

Manish Kumar¹, Anwesha Mondal^2
1 Department of Psychiatry, Calcutta Medical College, Kolkata, West Bengal, India
² Department of Clinical Psychology, Institute of Psychiatry- A Center of Excellence, Kolkata, West Bengal, IndiaMiss. Anwesha Mondal
P-29, Jadu Colony, Flat No-1, First Floor Behala, Kolkata – 700 034, West Bengal
India

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ipj.ipj_61_17

Background: Internet use is one of the most important tools of our present-day society whose impact is felt on college students such as increased use of Internet. It brings change in mood, an inability to control the amount of time spent with the Internet, withdrawal symptoms when not engaged, a diminishing social life, and adverse work or academic consequences, and it also affects self-esteem of the students.

Objective: The main objective of this study is to explore the Internet use and its relation to psychopathology and self-esteem among college students.

Methodology: A total of 200 college students were selected from different colleges of Kolkata through random sampling. After selection of the sample, Young’s Internet Addiction Scale, Symptom Checklist-90-Revised, and Rosenberg Self-Esteem Scale were used to assess the Internet usage, psychopathology, and self-esteem of the college students.

Results: Depression, anxiety, and interpersonal sensitivity were found to be correlated with Internet addiction. Along with that, low self-esteem has been found in students to be associated with possible users of Internet.

Conclusion: Internet usage has been found to have a very strong impact on college students, especially in the areas of anxiety and depression, and at times it affected their social life and their relationship with their family.

Keywords: Internet addiction, psychopathology, self-esteem

Internet is being integrated as a part of day-to-day life because the usage of the Internet has been growing explosively worldwide. It has dramatically changed the current communication scenario, and there has been a considerable increase in the number of Internet users worldwide in the last decade. With the advancement in media and technologies, Internet has emerged as an effective tool in eliminating human geographical barriers. With the availability and mobility of new media, Internet addiction (IA) has emerged as a potential problem in young people which refers to excessive computer use that interferes with their daily life. The Internet is used to facilitate research and to seek information for interpersonal communication and for business transactions. On the other hand, it can be used by some to indulge in pornography, excessive gaming, chatting for long hours, and even gambling. There have been growing concerns worldwide for what has been labeled as “Internet Addiction,” which was originally proposed as a disorder by Goldberg ^[1] Griffith considered it a subset of behavioral addiction that meets the six “core components” of addiction, i.e., salience, mood modification, tolerance, withdrawal, conflict, and relapse. Increasing research has been conducted on IA.^[2],[3] With regard to IA, it has been questioned whether people become addicted to the platform or to the content of the Internet.^[4] A study suggested that Internet addicts become addicted to different aspects of online use where it is differentiated between three subtypes of Internet addicts: excessive gaming, online sexual preoccupation, and e-mailing/texting.^[5],[6] According to the study, various types of IA are cyber-sexual addiction, cyber-relationship addiction, net compulsions, information overload, and computer addiction.

Based on a growing research base, the American Psychiatric Association vision is to include Internet use disorder in the appendix of the fifth edition of the Diagnostic and Statistical Manual for Mental Disorders ^[7] for the first time, acknowledging the problems arising from this type of addictive disorder. There has been an explosive growth in the use of Internet not only in India but also worldwide. Reports reveal that there were about 137 million Internet users in India in 2013 and further suggest India as the world’s second largest in Internet use after China in the near future. According to the Internet and Mobile Association of India and Indian Market Research Bureau, out of 80 million active Internet users in urban India, 72% (58 million individuals) have accessed some form of social networking in 2013,^[8] which is to touch around 420 million by June 2017.

The warning signs of IA include the following:

• Preoccupation with the Internet (thoughts about previous online activity or anticipation of the next online session)
• Use of the Internet in increasing amounts of time in order to achieve satisfaction
• Repeated, unsuccessful efforts to control, cut back, or stop Internet use
• Feelings of restlessness, moodiness, depression, or irritability when attempting to cut down the use of the Internet
• Online longer than originally intended
• Jeopardized or risked loss of significant relationships, job, educational, or career opportunities because of Internet use
• Lies to family members, therapists, or others to conceal the extent of involvement with the Internet
• Use of the Internet is a way to escape from problems or to relieve a dysphoric mood (e.g., feelings of hopelessness, guilt, anxiety, and depression)
• Feeling guilty and defensive about Internet use
• Feeling of euphoria while performing Internet-based activities
• Physical symptoms of IA.

Internet or computer addiction can also cause physical discomforts such as:

• Carpal tunnel syndrome (pain and numbness in hands and wrists)
• Dry eyes or strained vision
• Backaches and neck aches; severe headaches
• Sleep disturbances
• Pronounced weight gain or weight loss.

IA results in personal, family, academic, financial, and occupational problems that are characteristic of other addictions. Impairments of real-life relationships are disrupted as a result of excessive use of the Internet. IA leads to different social, psychological, and physical disorders. The worst effects of IA are anxiety, stress, and depression. Excessive use of Internet also affects the academic achievements of students. Students addicted to Internet are more involved in it than their studies, and hence they have poor academic performance.^[9] This hypothesis has been confirmed by a number of studies. Many studies examined the association between psychiatric symptoms and IA in adolescents. They found that IA is associated with psychological and psychiatric symptoms such as depression, anxiety, and low self-esteem. In addition, several studies have shown links between Internet use and personality traits. They have found loneliness, shyness, loss of control, and low self-esteem to be associated with IA.

In a study ^[10] on young adolescents, it was found that about 74.5% were moderate (average) users and 0.7% were found to be addicts. Those with excessive use of Internet had high scores on anxiety, depression, and anxiety depression. In another study,^[11] the prevalence of IA among Greek students was 4.5% and at-risk population was 66.1%. There were significant differences between the means of psychiatric symptoms in Symptom Checklist-90-Revised (SCL-90-R) subscales among addicted and nonaddicted students. Depression and anxiety appeared to have the most consistent correlation with IA. In addition, obsessive-compulsive symptoms, hostility/aggression, time in the Internet, and quarrel with parents are associated with IA. In another study by Paul et al., 2015, on 596 students, 246 (41.3%) were mild addicts, 91 (15.2%) were moderate addicts, and 259 (43.5%) were not addicted to Internet use. There was no pattern of severe IA among the study group. Males, students of arts and engineering stream, those staying at home, no extracurricular activity involvement, time spent on Internet per day, and mode of accessing Internet were some of the factors significantly associated with IA pattern. In another study,^[12] the prevalence of IA among 1100 respondents was 10.6%. People with higher scores were characterized as male, single, students, high neuroticism, life impairment due to Internet use, time for Internet use, online gaming, presence of psychiatric morbidity, recent suicidal ideation, and past suicidal attempts. Logistic regression showed that neuroticism, life impairment, and Internet use time were the three main predictors for IA. Compared to those without IA, the Internet addicts had higher rates of psychiatric morbidity (65.0%), suicidal ideation in a week (47.0%), lifetime suicidal attempts (23.1%), and suicidal attempt in a year (5.1%). In another study,^[13] a significant relationship was found between IA and general psychopathology and self-esteem. The addiction status was assessed as risk of low level in 59 (31.89%) participants, high level in 27 (14.59%) participants, and none in 99 (53.51%) participants. A high positive correlation was found between Internet Addiction Scale (IAS) and SCL-90 subscales and Rosenberg Self-Esteem Scale (RSES). In three different IA groups, it was found that all SCL-90 subscale averages increase and RSES subscale averages decrease as IA severity increases.

Aim of the study

In India, use of Internet is enormous, especially in the young population. Hence, it was found necessary to study the pattern of Internet usage in young adults in Indian setting and its relationship with their mental and physical health and self-esteem. With this aim in mind, the present study has been undertaken to take a close look on this issue.

Tools used

1. Sociodemographic data sheet: A self-made, semistructured, sociodemographic data sheet was prepared to collect the participant’s details, details of any previous history of psychopathology, substance abuse, and details of the Internet use
2. Internet Addiction Scale: The IAS ^[14] is a 20-item scale that measures the presence and severity of Internet dependency. This questionnaire is scored on a 5-point scale ranging from 1 to 5. The marking for this questionnaire ranges from 20 to 100, the higher the marks, the greater the dependence on the Internet
3. Symptom Checklist-90-Revised: It is a multidimensional self-report symptom inventory ^[15] designed to measure psychopathology by quantifying nine dimensions as follows: somatization, obsession-compulsion, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, and psychotism. In addition, there are three global indices of distress, the General Severity Index, representing the extent or depth of the present psychiatric disturbance; the Positive Symptom Total, representing the number of questions rated above 1 point; and the Positive Symptom Distress Index, representing the intensity of the symptoms. Higher scores on the SCL-90 indicate greater psychological distress. The SCL-90 was proven to hold excellent test–retest reliability, internal consistency, and concurrent validity
4. Rosenberg Self-Esteem Scale: This scale was developed by sociologist Rosenberg ^[16] to measure self-esteem, which is widely used in social science research. It is a 10-item scale with items answered on a 4-point scale – from strongly agree to strongly disagree. Five of the items have positively worded statements and five have negatively worded ones. The scale measures state self-esteem by asking the respondents to reflect on their current feelings. The RSES is considered a reliable and valid quantitative tool for self-esteem assessment.

Sample

A sample of 200 students studying in various disciplines such as science, arts, and commerce were selected through random sampling from five different colleges of Kolkata.

Procedure

In the initial phase of the study, a total of five colleges were selected according to the convenience of the researchers. After receiving permission from the administrative departments of respective colleges for data collection, researchers approached the participants directly during their college hours, explained the purpose and method of using the questionnaires, and also ensured the confidentiality of the data. Verbal consent was taken from the participants. Only the day scholars were included in the study. The colleges selected for collecting the data did not have free Wi-Fi services. Responses were collected from the participants having Internet connection on their android phones. First, the sociodemographic data sheet was filled up by the participants. Participants having a previous history of psychopathology and substance abuse were excluded from the study. After exclusion of the participants, the questionnaires were distributed to the included participants and after completion, they were scored and interpreted according to the tool. Confidentiality of the data has been maintained.

Sociodemographic and Internet user’s characteristics

Two hundred students participated in the study. The mean age of the students was found to be 21.68 years (±2.82). Students were unmarried and were undergraduates. Majority of the students reported that they use Internet for pleasure and mainly get involved in activities of social networks and online gaming. Focusing on users’ characteristics and Internet activities, it was found that the concerning age of computer use initiation was 15 years, frequency of Internet use per day in hours was 3–4 h, and frequency of Internet use per week in days was every day.

[Table 1] suggests the frequency of IA on the IAS. The frequency of mild users (IAS score: 20–49) was 58 and the percentile was 29. The highest frequency and percentile found in the severe users (80–100) were 79 and 39.5, respectively. The next higher frequency found in moderate users (50–79) was 63 and the percentile was 31.5.

[Table 2] reflects t-test results between SCL-90 and IA. The comparison of scores in all dimensions and the three global indices on SCL-90 between moderate users and severe users of Internet demonstrated that severe users of Internet had higher scores in all dimensions. Symptoms such as obsession-compulsion, interpersonal sensitivity, depression, and anxiety were associated with IA.

[Table 3] reflects t-test results between self-esteem and IA. The comparison of scores on self-esteem between moderate users and severe users of Internet demonstrated that no significant difference was found between them.

[Table 4] describes the regression analysis results of the association between Internet users, the ten dimensions of the SCL-90. The results indicated that students with high usage of Internet had higher level of obsession-compulsion, interpersonal sensitivity, and anxiety.

A number of studies have been conducted across the world among adults with respect to IA. This study is a preliminary step toward understanding the extent of IA among college students in India.

The random sampling method gave the opportunity to gather information from five different colleges in Kolkata. The procedure for selecting the sample has allowed the generalization of the results to the entirety of the college population.

The Internet Addiction Test has been found to be the only validated instrument which identifies the high, low, and average users of Internet. It is found from this study that 39.5% of the students were severe users of Internet. Nearly 31.5% of the students were moderate users. A number of studies reported a higher percentage of Internet-addicted youths.^[17],[18] It is of note that 29% of the students were average users of Internet. Whether these students will actually develop an addiction is difficult to be predicted. Nevertheless, the continuous exposure to Internet and a possible susceptibility to addictive behaviors may represent a possible danger. Previous studies have found similar results concerning moderate IA.^[19],[20] Students who are found to be severe users of Internet use a maximum of 3–4 h per day and they are not able to perform their responsibilities properly such as concentration on academics and developing social isolation owing to excessive use of the Internet. Users who spend a significant amount of time online experience academic, relational, economic, and occupational problems, as well as physical disorders.

The results of the present study show that severe users of Internet have shown higher psychopathological symptoms in four dimensions such as obsessive-compulsive, interpersonal sensitivity and depression, anxiety, and global severity index than those with moderate users of Internet. This finding has been supported by other studies ^[21] where the association between psychiatric symptoms and IA using the SCL-90 scale had been examined and was found that there was a strong association between psychiatric symptoms and IA. Students with excessive use of Internet reported the presence of psychopathological problems such as obsessive-compulsive and depression. Anxiety and problems such as interpersonal sensitivity were supported by many studies.^{[10],[19],[20]} In another study,^[22] it was found that psychiatric features are associated with IA.

In the present study, no significant relationship has been found between moderate users and severe users of Internet and self-esteem. This is consistent with the result of a previous study.^[10] It may be attributed to the fact which states that the participants’ use of the Internet is not associated as a coping style or as a way of compensating some deficiencies, rather it makes them feel better, as it allows them to assume a different personality and social identity.

Logistic regression analysis showed that obsession -compulsion, interpersonal sensitivity, and anxiety were associated with IA. It reflects that the higher the use of Internet, the individual is more prone to develop obsessive-compulsive symptoms such as difficulty in controlling to use Internet, repetitive thoughts about using Internet, and checking the Internet repetitively. The association between obsessive-compulsive disorder and IA supports previous findings.^[23] Interpersonal sensitivity and anxiety were associated with IA as well. These findings are consistent with that of other studies.^[23],[24] It indicates that individuals with high usage of Internet are prone to become more sensitive in interpersonal relationships and also become more anxious when not using the Internet. In an article, a majority of surveys conveyed the association between pathological Internet use and depression, anxiety, and obsessive-compulsive symptoms.^[19]

High Internet usage leads to psychological difficulties such as anxiety, depression, and loneliness. Severe users were more likely to be anxious and depressed than moderate users and low users. This study showed that severe users of Internet use the Internet more often when they are anxious and depressed. It is clear that the relation between Internet use, anxiety, and depression is affected by many variables. Severe users of Internet have also been associated with increases in impulsivity. Severe and average Internet users displayed significant difference on interpersonal relationships. Individuals with high use of Internet experience have a sense of criticism by others, shyness, and a sense of discomfort when criticized and can be easily hurt, have perceived lower social support, and found it easier to create new social relationships online. The consequence of exploring social support online often worsens their interpersonal problems in reality, accompanied by psychological problems such as anxiety symptoms. Severe users’ Internet group has obsessive-compulsive symptoms more than average users’ Internet group, where severe users’ Internet group was found to be preoccupied with Internet, needs longer amounts of time online, makes repeated attempts to reduce Internet use, feels withdrawal when reducing Internet use, has time management issues, has environmental distress (family, school, work, and friends), and has deception around the time spent online, thus doing mood modification through Internet use.

Students are steered toward more Internet use because of many factors such as different cheap offers of Internet recharge by different telecom companies, blocks of unstructured time, newly experienced freedom from parental intervention, no monitoring of what they express online, facing a peer pressure in showing their identity, and gaining random instant popularity on social media platform. In other words, these users derive great satisfaction from Internet use and perceive it as a way of making up for their shortcomings, which, however, turns into a dependent relationship.

Psychopathologic features increase as the severity of IA increases as found in a study.^[22] A causal relationship between psychiatric and psychological problems and IA needs to be further analyzed in order to determine whether Internet use causes psychiatric problems or exacerbates symptoms that already exist.

In the last one decade, the Internet has become an integral part of our life. In this article, an attempt has been made to study the severity of Internet use and its relation to psychopathology and self-esteem in college students. Individuals having high usage showed depression and anxiety. IA is also associated with obsessive-compulsive symptoms and interpersonal sensitivity. This result highlights the need for more clinical studies focusing on psychiatric or psychological symptoms.

This study has a few limitations too. No specific tool has been used to exclude any previous psychopathology apart from the information gathered through the sociodemographic data sheet. Accurate estimates of the prevalence of IA in college students are lacking. The study did not manage to clarify the causal relationship between IA and psychiatric symptoms. IA may precipitate psychiatric symptoms which may lead to IA. Another limitation of this study is it did not take into account whether psychiatric symptoms may preexist any IA and may create a vulnerability to addiction. The study did not allow us to differentiate the essential use of the Internet from its recreational use. Future studies can be implicated to analyze the results of the students according to different streams of subjects.