The Association between Pathological Internet Use and Comorbid Psychopathology: A Systematic Review
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Background: Pathological Internet use (PIU) has been conceptualized as an impulse-control disorder that shares characteristics with behavioral addiction. Research has indicated a potential link between PIU and psychopathology; however, the significance of the correlation remains ambiguous. The primary objective of this systematic review was to identify and evaluate studies performed on the correlation between PIU and comorbid psychopathology; the secondary aims were to map the geographical distribution of studies, present a current synthesis of the evidence, and assess the quality of available research. Sampling and Methods: An electronic literature search was conducted using the following databases: MEDLINE, PsycARTICLES, PsychINFO, Global Health, and Web of Science. PIU and known synonyms were included in the search. Data were extracted based on PIU and psychopathology, including depression, anxiety, symptoms of attention deficit and hyperactivity disorder (ADHD), obsessive-compulsive symptoms, social phobia and hostility/aggression. Effect sizes for the correlations observed were identified from either the respective publication or calculated using Cohen’s d or R2. The potential effect of publication bias was assessed using a funnel plot model and evaluated by Egger’s test based on a linear regression. Results: The majority of research was conducted in Asia and comprised cross-sectional designs. Only one prospective study was identified. Twenty articles met the preset inclusion and exclusion criteria; 75% reported significant correlations of PIU with depression, 57% with anxiety, 100% with symptoms of ADHD, 60% with obsessive-compulsive symptoms, and 66% with hostility/aggression. No study reported associations between PIU and social phobia. The majority of studies reported a higher rate of PIU among males than females. The relative risks ranged from an OR of 1.02 to an OR of 11.66. The strongest correlations were observed between PIU and depression; the weakest was hostility/aggression. Conclusions: Depression and symptoms of ADHD appeared to have the most significant and consistent correlation with PIU. Associations were reported to be higher among males in all age groups. Limitations included heterogeneity in the definition and diagnosis of PIU. More studies with prospective designs in Western countries are critically needed.
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The social participation instrument had good test-retest reliability with a kappa of 0.70 based on dichotomous results.
“Good test-retest reliability was found with a κ of 0.70 based on dichotomous results [22]”
From Occurence of Internet addiction in a general population sample: A Latent Class Analysis (2014) · cites this paper as [22]
Social participation was assessed with a standardized instrument asking about participation in 13 activity domains during the previous 12 months.
“It was assessed with a standardized instrument by asking if respondents had taken part in activities in 13 domains during the last 12 months [22]”
From Occurence of Internet addiction in a general population sample: A Latent Class Analysis (2014) · cites this paper as [22]
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- Authors
- Carli, V., Durkee, T., Wasserman, D., Hadlaczky, G., Despalins, R., Kramarz, E., Wasserman, C., Sarchiapone, M., Hoven, C. W., Brunner, R., & Kaess, M.
- Affiliations
- Karolinska Institutet (SE)
- University of Molise (IT)
- Columbia University (US)
- Heidelberg University (DE)
- Venue
- Psychopathology
- Publisher
- S. Karger AG
- Published
- 2012-07-31
- Volume
- 46
- Issue
- 1
- Pages
- 1-13
- ISSN
- 0254-4962 (ISSN-L)
- 1423-033X
- OpenAlex
- W2036230720
- Cited by
- 639
- References
- 91
- Citations by year
- 2026: 27 · 2025: 33 · 2024: 31 · 2023: 46 · 2022: 71 · 2021: 59 · 2020: 96 · 2019: 52 · 2018: 58 · 2017: 45 · 2016: 40 · 2015: 28 · 2014: 39 · 2013: 14
- FWCI
- 13.88
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Psychopathology (publishedVersion)
- PubMed (publishedVersion)
- Archivio Istituzionale della Ricerca - Università degli Studi del Molise (submittedVersion)
- INFM-OAR (INFN Catania) (submittedVersion, other-oa)
- Zenodo (CERN European Organization for Nuclear Research) (submittedVersion, other-oa)
- Funders
- European Commission (223091)
- Universität Heidelberg
- Karolinska Institutet
- Universidad de Oviedo
- Topics
- Social Sciences › Sociology and Political Science › Impact of Technology on Adolescents
- Social Sciences › Psychology › Clinical Psychology › Sexuality, Behavior, and Technology
- Social Sciences › Psychology › Clinical Psychology › Gambling Behavior and Treatments
- Keywords
- internet addiction, comorbid psychopathology, depression, anxiety, ADHD symptoms, obsessive-compulsive symptoms, social anxiety disorder, behavioral addiction, impulse control disorders, sex differences
- MeSH terms
- Aggression, Anxiety Disorders, Attention Deficit Disorder with Hyperactivity, Female, Hostility, Humans, Disruptive, Impulse Control, and Conduct Disorders, Male, Comorbidity, Behavior, Addictive, Internet
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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