Prevalence of Behavioral Addictions and Their Relationship With Stress and Anxiety Among Medical Students in Saudi Arabia: A Cross-Sectional Study
Open accessAbstract
Behavioral addiction is identified as any compulsive, repeated, and persistent behavior that leads to significant and functionally impairing harm or distress. The aim of this study is to determine the prevalence of internet, video-gaming, and pornography addictions among medical students in Western region. In addition, we intend to investigate the relationship between these behavioral addictions with stress and anxiety. Our study was a cross-sectional study with a sample size of 225. The study participants were medical students in their 3rd, 4th, and 5th academic years from five different medical colleges in Western region. The questionnaire included demographics and adapted five different pre-validated scales: Young's Internet Addiction Test – Short Version (IAT-SV), Internet Gaming Disorder Scale 9 – Short Form (IGDS9-SF), (PPC scale), Perceived Stress Scale (PSS), and Generalized Anxiety Disorder 7-item scale (GAD-7). The IAT-SV scale showed: 71 (31.6%) of the participants had normal internet usage, 51 (22.7%) participants showed problematic usage, and 103 (45.8%) used the internet pathologically. The IGDS9-SF scale had observed the following values: 220 participants (97.8%) were non-disordered, and 5 participants (2.2%) were found to be disordered. Statistical analysis showed a highly significant association between stress and problematic pornography consumption (P < 0.01), and internet addiction (P <0.001). Moreover, there was a significant association between anxiety and internet gaming disorder (P < 0.01). This study showed high prevalence of internet addiction and low prevalence of internet gaming disorder. Also, it gave more understanding to a possible association between these behavioral addictions with stress and anxiety.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Anxiety is a major risk factor for internet addiction.
“Both longitudinal and cross-sectional studies have shown that anxiety is a major risk factor for internet addiction [15,16].”
From Correlations between social media addiction and anxiety, depression, FoMO, loneliness and self-esteem among students: A systematic review and meta-analysis (2025) · cites this paper as [15]
The Discussion (page unavailable) reports a significant association between anxiety and internet addiction in medical students. But this cross-sectional study does not establish that anxiety precedes or causes internet addiction, or that it is a major risk factor; it also provides no longitudinal finding. (LLM, conf=0.88)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
A Global Measure of Perceived Stress
Cohen, S., Kamarck, T., & Mermelstein, R. (1983) · Journal of Health and Social Behavior · doi:10.2307/2136404 · Cited by 32,807 · see citing works
A Brief Measure for Assessing Generalized Anxiety Disorder: The GAD-7
Spitzer, R. L., Kroenke, K., Williams, J. B. W., & Löwe, B. (2006) · Archives of Internal Medicine · doi:10.1001/archinte.166.10.1092 · Cited by 31,765 · see citing works
Development and validation of a Game Addiction Scale for adolescents
Lemmens, J. S., Valkenburg, P. M., & Peter, J. (2009) · Media Psychology · doi:10.1080/15213260802669458 · Cited by 1,428 · see citing works
Introduction to Behavioral Addictions
Grant, J. E., Potenza, M. N., Weinstein, A., & Gorelick, D. A. (2010) · The American Journal of Drug and Alcohol Abuse · doi:10.3109/00952990.2010.491884 · Cited by 1,242 · see citing works
How can we conceptualize behavioural addiction without pathologizing common behaviours?
Kardefelt‐Winther, D., Heeren, A., Schimmenti, A., van Rooij, A., Maurage, P., Carras, M., Edman, J., Blaszczynski, A., Khazaal, Y., & Billieux, J. (2017) · Addiction · doi:10.1111/add.13763 · Cited by 780 · cited 3× · see citing works
“In addition, to consider any behavior as an addiction, it must not be explained by an underlying illness, done willingly or done as a coping method, and it must cause significant functional impairment or distress (2).”
BackgroundYounes, F., Halawi, G., Jabbour, H., El Osta, N., Karam, L., Hajj, A., & Rabbaa Khabbaz, L. (2016) · PLOS ONE · doi:10.1371/journal.pone.0161126 · Cited by 475 · see citing works
Marchant, A., Hawton, K., Stewart, A., Montgomery, P., Singaravelu, V., Lloyd, K., Purdy, N., Daine, K., & John, A. (2017) · PLoS ONE · doi:10.1371/journal.pone.0181722 · Cited by 464 · see citing works
Prevalence of internet gaming disorder in adolescents: A meta‐analysis across three decades
Fam, J. Y. (2018) · Scandinavian Journal of Psychology · doi:10.1111/sjop.12459 · Cited by 409 · see citing works
The development of the Problematic Pornography Consumption Scale (PPCS)
Bőthe, B., Tóth-Király, I., Zsila, Á., Griffiths, M. D., Demetrovics, Z., & Orosz, G. (2018) · The Journal of Sex Research · doi:10.1080/00224499.2017.1291798 · Cited by 317 · see citing works
Prevalence of Internet Addiction in Medical Students: a Meta-analysis
Zhang, M. W., Lim, R. B. C., Lee, C., & Ho, R. (2017) · Academic Psychiatry · doi:10.1007/s40596-017-0794-1 · Cited by 270 · see citing works
Online Porn Addiction: What We Know and What We Don’t—A Systematic Review
de Alarcón, R., de la Iglesia, J., Casado‐Espada, N. M., & Montejo, A. L. (2019) · Journal of Clinical Medicine · doi:10.3390/jcm8010091 · Cited by 267 · see citing works
Neuroscience of Internet Pornography Addiction: A Review and Update
Love, T., Laier, C., Brand, M., Hatch, L., & Hajela, R. (2015) · Behavioral Sciences · doi:10.3390/bs5030388 · Cited by 262 · see citing works
Billieux, J., Flayelle, M., Rumpf, H.-J., & Stein, D. J. (2019) · Current Addiction Reports · doi:10.1007/s40429-019-00259-x · Cited by 242 · cited 1× · see citing works
“Furthermore, it has been associated with low well-being, negative consequences, and other internet addictions (6, 7, 12).”
BackgroundYao, Y.-W., Liu, L., Ma, S.-S., Shi, X.-H., Zhou, N., Zhang, J.-T., & Potenza, M. N. (2017) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2017.10.029 · Cited by 242 · cited 2× · see citing works
“Moreover, neuropathological alterations have been documented with internet gaming disorder and pornography addiction (6, 7).”
BackgroundLeeman, R. F., & Potenza, M. N. (2013) · The Canadian Journal of Psychiatry · doi:10.1177/070674371305800503 · Cited by 235 · see citing works
Wang, B.-Q., Yao, N.-Q., Zhou, X., Liu, J., & Lv, Z. (2017) · BMC Psychiatry · doi:10.1186/s12888-017-1408-x · Cited by 219 · see citing works
Fazeli, S., Zeidi, I. M., Lin, C., Namdar, P., Griffiths, M. D., Ahorsu, D. K., & Pakpour, A. H. (2020) · Addictive Behaviors Reports · doi:10.1016/j.abrep.2020.100307 · Cited by 218 · see citing works
Meng, Y., Deng, W., Wang, H., Guo, W., & Li, T. (2015) · Addiction Biology · doi:10.1111/adb.12154 · Cited by 197 · cited 2× · see citing works
“Moreover, neuropathological alterations have been documented with internet gaming disorder and pornography addiction (6, 7).”
BackgroundNatural course of behavioral addictions: a 5-year longitudinal study
Thege, B. K., Woodin, E. M., Hodgins, D. C., & Williams, R. J. (2015) · BMC Psychiatry · doi:10.1186/s12888-015-0383-3 · Cited by 172 · see citing works
Associations Among Resilience, Stress, Depression, and Internet Gaming Disorder in Young Adults
Yen, J., Lin, H., Chou, W., Liu, T., & Ko, C. (2019) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph16173181 · Cited by 145 · see citing works
Mo, P., Chan, V. W. Y., Chan, S., & Lau, J. (2018) · Addictive Behaviours · doi:10.1016/j.addbeh.2018.01.027 · Cited by 141 · see citing works
Cheng, Y.-S., Tseng, P.-T., Lin, P.-Y., Chen, T.-Y., Stubbs, B., Carvalho, A. F., Wu, C.-K., Chen, Y.-W., & Wu, M.-K. (2018) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.17r11761 · Cited by 130 · see citing works
Perceived stress and associated factors among medical students
Saeed, A. A., Bahnassy, A., Al-Hamdan, N. A., Almudhaibery, F. S., & Alyahya, A. Z. (2016) · Journal of Family and Community Medicine · doi:10.4103/2230-8229.189132 · Cited by 120 · see citing works
Ibrahim, N. K., Al-Kharboush, D., El-Khatib, L., Al-Habib, A., & Asali, D. (2013) · Europe PMC (PubMed Central) · Cited by 106 · see citing works
Dwulit, A. D., & Rzymski, P. (2019) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph16101861 · Cited by 95 · see citing works
Anand, N., Jain, P., Prabhu, S., Thomas, C., Bhat, A., Prathyusha, P. V., Bhat, S. U., YOUNG, K. S., & Cherian, A. V. (2018) · Indian Journal of Psychological Medicine · doi:10.4103/ijpsym.ijpsym_135_18 · Cited by 76 · see citing works
Cybersex Addiction Among College Students: A Prevalence Study
Giordano, A. L., & Cashwell, C. S. (2017) · Sexual Addiction & Compulsivity · doi:10.1080/10720162.2017.1287612 · Cited by 48 · see citing works
Herpertz, S., Schneider, I., Schmahl, C., & Bertsch, K. (2018) · Psychopathology · doi:10.1159/000488357 · Cited by 46 · see citing works
Substance and Non-substance Addiction
Tao, R., Shi, J., & Zhang, X. (2017) · Advances in experimental medicine and biology · doi:10.1007/978-981-10-5562-1 · Cited by 28 · see citing works
Gautam, D. S. (2018) · Journal of Medical Science And clinical Research · doi:10.18535/jmscr/v6i5.61 · Cited by 1 · see citing works
Flagged first, then by citations
Research works printed but not linked: 1
- [19]Young KS Abreu CNde. Internet Addiction: A Handbook and Guide to Evaluation and Treatment. Hoboken, NJ: John Wiley & Sons (2010). p. 22– 4.
Cited by
Sorted by citations
The association between internet addiction and sleep quality among medical students in Saudi Arabia
Hammad, M. A., Alyami, M. H., & Awed, H. S. (2024) · Annals of Medicine · doi:10.1080/07853890.2024.2307502 · Cited by 43 · see citing works
Gavurová, B., Khouri, S., Ivanková, V., Rigelský, M., & Mudarri, T. (2022) · Frontiers in Public Health · doi:10.3389/fpubh.2022.893845 · Cited by 42 · see citing works
Jing, Z., Yang, W., Lei, Z., Junmei, W., Hui, L., & Tianmin, Z. (2025) · PLOS One · doi:10.1371/journal.pone.0329466 · Cited by 33 · see citing works
“Both longitudinal and cross-sectional studies have shown that anxiety is a major risk factor for internet addiction [15,16].”
Exploring Internet gaming disorder: an updated perspective of empirical evidence (from 2016 to 2021)
Mestre‐Bach, G., Fernández‐Aranda, F., & Jiménez‐Múrcia, S. (2022) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2022.152319 · Cited by 30 · see citing works
Garg, S., Kharb, A., Verma, D., Antil, R., Khanna, B., Sihag, R., & Lamba, D. (2023) · General Psychiatry · doi:10.1136/gpsych-2022-100997 · Cited by 23 · see citing works
Chen, M., & Zhang, X. (2024) · Acta Psychologica · doi:10.1016/j.actpsy.2024.104535 · Cited by 16 · see citing works
Understanding Psychological and Psychopathological Facets in Love Addiction: Preliminary Results
Cavalli, R. G., ILARG Consortium, Tacchino, C., & Velotti, P. (2024) · Sexual Health & Compulsivity · doi:10.1080/26929953.2024.2392202 · Cited by 10 · see citing works
Internet Gaming Disorder and Psychological Distress: a PRISMA systematic review
Gursesli, M. C., Guazzini, A., Thawonmas, R., Valenti, C., Duradoni, M., & Thawonmas, R. (2025) · Heliyon · doi:10.1016/j.heliyon.2025.e43518 · Cited by 13 · see citing works
Mapping the links between sexual addiction and gambling disorder: A Bayesian network approach
Hunt, B. R., Zarate, D., Gill, P. R., & Stavropoulos, V. (2023) · Psychiatry Research · doi:10.1016/j.psychres.2023.115366 · Cited by 9 · see citing works
AlQarni, A. M., Boubshait, L. A., Alnufaily, D. A., Alalwan, S. J., Fardan, H. A., Alabdulmhsin, M., Alotaibi, M. N., & Boubshait, N. (2024) · Psychology Research and Behavior Management · doi:10.2147/prbm.s466605 · Cited by 8 · see citing works
Lu, R., Zhou, J., Zhao, S., Ou, W., Ge, J., Yang, Y., Chen, Y., Wen, J., & Hu, L. (2025) · Current Psychology · doi:10.1007/s12144-025-07281-5 · Cited by 5 · see citing works
Zhang, Y., Zhong, Y.-L., Luo, J., He, J., Lin, C., Zauszniewski, J. A., Zhou, J.-H., Chen, Y., Wu, C.-Y., Wang, S.-R., et al. (2023) · Frontiers in Public Health · doi:10.3389/fpubh.2023.986550 · Cited by 4 · see citing works
Problematic Pornography Use in the Middle East: What We Know and What We Don’t - A Scoping Review
Engelhardt, R., Borgogna, N. C., Ray, C., Jafari, M., Way, B. M., Maes, J., Bőthe, B., Zaki, J. G., Trommer, D., & Kraus, S. W. (2026) · Current Addiction Reports · doi:10.1007/s40429-026-00743-1 · Cited by 2 · see citing works
Sancho-Cantus, D. (2024) · Global Journal of Addiction & Rehabilitation Medicine · doi:10.19080/gjarm.2024.07.555718 · Cited by 2 · see citing works
Age-Related Differences in Digital Addiction: A Systematic Review
Papp, O. (2024) · Erdélyi Társadalom · doi:10.17177/77171.299 · Cited by 1 · see citing works
Hagag, A. M., Shehata, A. G. S. F., Abdelhamed, A. M., Ahmed, G. A., Ghanem, O. A., Akwaisah, A., & Abdelghani, M. (2026) · Scientific Reports · doi:10.1038/s41598-026-56057-9 · Cited by 1 · see citing works
Pornography consumption among medical students in Syria: Prevalence, patterns, and predictors
Al‐Bitar, A., Al‐Masalma, D., Adi, M., & Haydar, T. (2026) · PLoS ONE · doi:10.1371/journal.pone.0347631 · Cited by 1 · see citing works
HUBUNGAN DEPRESI DAN PERILAKU KONFORMITAS DENGAN KEJADIAN INTERNET GAMING DISORDER PADA REMAJA
Muchlis, A. (2024) · Healthy Tadulako Journal (Jurnal Kesehatan Tadulako) · doi:10.22487/htj.v10i2.1030 · Cited by 1 · see citing works
Social Media Short Video Addiction for the Elderly: A Bibliometric Analysis
Jie, Z., & Ibrahim, O. (2024) · International Journal of Academic Research in Business and Social Sciences · doi:10.6007/ijarbss/v14-i12/24105
Relationship between Internet Addiction and Sleep Quality among Saudi Medical Students
Arayıcı, M. E., Arayici, S. G., Geyiktepe, O. E., & Şimşek, H. (2025) · Bulletin of pioneering researches of medical and clinical science · doi:10.51847/f7zd25fgvy
From clicks to crashes: Proneness to online shopping addiction and how it costs emotionally
Makhdoom, T. (2026) · Social Sciences & Humanities Open · doi:10.1016/j.ssaho.2026.102721
- Authors
- Hakami, A. Y., Ahmad, R. G., Alsharif, A., Ashqar, A., AlHarbi, F. A., Sayes, M., Bafail, A., Alqrni, A., & Khan, M. A.
- Affiliations
- King Saud bin Abdulaziz University for Health Sciences (SA)
- King Abdullah International Medical Research Center (SA)
- Corresponding author
- Hakami, Alqassem Y.
- ORCID
- Venue
- Frontiers in Psychiatry
- Publisher
- Frontiers Media SA
- Published
- 2021-08-17
- Volume
- 12
- Pages
- 727798-727798
- ISSN
- 1664-0640 (ISSN-L)
- PMC
- PMC8416092
- OpenAlex
- W3193638153
- Cited by
- 21
- References
- 30
- Citations by year
- 2026: 4 · 2025: 4 · 2024: 8 · 2023: 3 · 2022: 2
- FWCI
- 4.50
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Frontiers in Psychiatry (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- 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
- behavioral addiction, internet addiction, internet gaming disorder, pornography addiction, medical students, stress, anxiety, prevalence, problematic internet use, Saudi Arabia
About these checks
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 ›
Are you an author, or do you see a problem with this page? Request a review
