Internet Addiction: A Review of Current Assessment

Techniques and Potential Assessment Questions

KEITH W. BEARD, Psy.D.

ABSTRACT

The concept of Internet addiction has been proposed as an explanation for uncontrollable
and damaging use of the Internet. Symptoms of excessive Internet use have been compared
to the criteria used to diagnose other addictions such as pathological gambling. Although cri-
teria to diagnose this problem have been proposed, methods of assessing excessive Internet
use are limited. A structured interview based on the criteria proposed by Beard and Wolf is
proposed to aid in the assessment of “Internet addiction.” This, in turn, could aid in the diag-
nosis and intervention of a client who enters treatment reporting difficulties with excessive
Internet use.

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C

YBER

P

SYCHOLOGY

& B

EHAVIOR

Volume 8, Number 1, 2005
© Mary Ann Liebert, Inc.

INTRODUCTION

T

HE WORLD

continues to advance with new tech-

nologies.

1

People are no longer confined by ge-

ographic boundaries because of inventions such as
the television, fax machines, telephones, pagers,
and computers. While many have focused on the
incredible benefits that result from new technology,
there are also some disadvantages. The Internet has
been blamed for decreased family time, strains
upon relationships, decreased productivity in em-
ployment settings, perpetuation of false informa-
tion, and the development or exacerbation of
psychological problems.

2–10

The purpose of this paper is to clarify current in-

formation on the assessment of what is commonly
referred to as “Internet addiction.” First, there will
be a review of some unique characteristics of the
Internet. Then, a model that can be used to concep-
tualize problematic Internet use will be briefly de-
scribed. Finally, some areas to address when
assessing for Internet addiction and other consider-
ations will be discussed. At the outset, it needs to
be made clear that the literature on Internet addic-
tion is quite limited. Although more research is
being conducted on the topic, many of the pub-

lished articles contain information that has not
been empirically researched.

Unique characteristics of the Internet

Certain qualities of this technology have allowed

a unique Internet culture to develop. The Internet
culture has its own set of language, values, stan-
dards, signs, and artifacts.

9,11–15

Understanding this

culture may help to better assess why the Internet
is used in a person’s life and how to best intervene.

A main attraction of the Internet is the ability of a

person to remain anonymous.

9–11,15–18

With this

anonymity, unlike face-to-face communication, de-
mographics have to be announced in order to be
known.

11

An Internet user can take on different per-

sonas when on-line.

1,9,10,14,15

The user may create dif-

ferent profiles with information about himself or
herself. Young

9,10,15

found that some users chose

identities that were an ideal self, which represented
the opposite of what the person is in real life, identi-
ties that fulfilled unmet needs, or identities that rep-
resented an emotion or trait that may be repressed.

Internet users often feel safe to take more emo-

tional risks, be flirtatious, give positive and nega-

Psychology Department, Marshall University, Huntington, West Virginia.

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13905C02.PGS 1/21/05 4:11 PM Page 7

tive feedback to each other, and to express opinions
on-line that they are unable to express to others in
the real world.

3,9,10,14,15,19,20

It is not unusual for two

Internet users to quickly begin asking personal
questions upon first meeting.

1,9,14,15,20

King

20

and

Young

9,10,15

believe that these emotional risks create

a need to continue these bonds and receive the sup-
port that the user is lacking in the real world. How-
ever, support can end quickly and easily by no
longer corresponding to the person. As a result,
there is an illusion of companionship without the
demands often placed on friendships.

Finally, Young

9,10,15

explained that the Internet

environment allows for just about any virtual expe-
rience. A person can use applications such as Multi-
User Dungeons and Dragons (MUDS) or go to
areas on-line and engage in sexual fantasy. The
person could also create a surrogate community
by going into a chatroom and pretending to inter-
act with others or objects in the fabricated cyber-
environment.

11,14

Young

15

states that, once these

unconscious feelings, drives, and experiences are
brought to the conscious mind, it becomes difficult
for some users to suppress them again. Internet
users may begin to desire these unique aspects of
the Internet more and more. As a result, Internet
users may begin to blur their distinction between
their own personality and reality, and their on-line
persona and virtual environment.

PROBLEMATIC USE OF THE INTERNET

The following section explores characteristics of

problematic Internet use. This term is broadly de-
fined as use of the Internet that creates psychologi-
cal, social, school, and/or work difficulties in a
person’s life.

Characteristics of problematic Internet use

Problematic Internet use can be found in any age,

social, educational, and economic range.

10

In the

past, those who are Internet addicted were stereo-
typed as predominantly young, introverted, and
computer-oriented males.

9,21,22

While this stereotype

may have previously been true, the availability of
computers and easy access to the Internet is quickly
challenging this notion.

23

For example, Young

10

re-

ported that 61% of her respondents were women.
While she concedes that the apparent increase in
women users could be the result of women being
more likely to participate in research studies, the in-
crease in women using computers could also be a
result of increased availability of the Internet.

Subjects who met Young’s proposed criteria

7–10

for problematic Internet use described their per-
sonalities as bold, outgoing, open-minded, and as-
sertive. At the same time, many of the Internet
users reported being depressed and lonely, and
having low self-esteem and anxiety. Other common
personality characteristics included having pride in
their intellect and the use of the defense mecha-
nism called “intellectualization.”

4,11,23

Twenty-five percent of those who completed

Young’s survey

8–10,15

on the Internet reported becom-

ing addicted to the Internet within the first 6 months
on-line. Young went on to report that 58% of the re-
spondents met her criteria for Internet addiction
within 1 year. This could mean that new users are
more vulnerable to pathological Internet use. Most
felt intimidated by the computer initially but began
to feel a sense of competency and exhilaration from
mastering the technology and learning to navigate
the applications quickly.

1,4,8–10,15,24

Applications that

allow for two-way communication—such as charac-
ter games, news groups, and email—are the applica-
tions most likely to be abused.

8,10,15,17,25

The survey administered by Young

8,10,15

also

found that her addicted respondents used the In-
ternet an average of 38 h per week. Respondents
admitted to trying to cut down on their Internet use
and failing despite significant problems that their
Internet use was causing. Scherer

21

has found that

Internet-addicted college students use the Internet
an average of 8.1 h per week and engage in email,
the WWW, and library services. They were also
more likely to use the Internet for leisure than non-
addicted students. In general, teens have been
found to use the Internet more hours than adults.

24

The concept of Internet addiction and the mater-

ial aspects of it have been compared to other non-
chemical addictions such as sexual addiction,
eating disorders, compulsive gambling, excessive
television viewing, compulsive buying, and exces-
sive exercise.

1,6,8–10,15,16,21,26–34

Like other addictions,

Internet user’s desire and preoccupation builds
again over time. Finally, relapse prevention tech-
niques that have been used with other chemical
and non-chemical addictions are believed to be ef-
fective with Internet addiction behaviors. Further
research is needed in order to understand all of the
similarities that Internet addiction has with other
impulse control disorders and non-chemical addic-
tions. Griffiths

17

and Young

7,10,22

claim that Internet

addiction, like other addictions, involves the per-
son engaging in the activity excessively. Various
states of arousal, pain, and stress can influence In-
ternet use, resulting in an uncontrollable desire and
preoccupation with the Internet. Therefore, a sense

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BEARD

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of relief from the built-up tension can occur once
the Internet is used.

A proposed model to conceptualize problematic
Internet use

The following is a model that I have proposed for

conceptualizing problematic Internet use. It is
based on the biopsychosocial model of addiction,
integrating biochemical, genetic, psychological, fa-
milial, environmental, and cultural dynamics.

The biological view recognizes that biological or

neurochemical changes may occur in a person en-
gaging in an addictive behavior. For example, there
may be a combination of genes that make a person
prone to developing addictive behaviors.

35

Another

possibility is that the user has an insufficient amount
of serotonin or dopamine, which could contribute to
addictive behaviors.

36,37

Therefore, engaging in ex-

cessive Internet use may alter physiological states
and help the body maintain homeostasis or create a
sense of euphoria. Pharmacology can be used to aid
a person with this aspect of his or her addiction.

A psychological view recognizes that classical

conditioning may play a part in initiating, main-
taining, and changing behavior of those addicted
to the Internet. For example, physiological arousal
may be conditioned to occur to external cues such
as seeing the computer, turning on the computer,
or waiting for Internet information to be down-
loaded. Associations between internal states—
such as excitement, stimulation, pleasure, hope,
and surprise—can then be made, resulting in the
user becoming psychologically dependent on the
feelings and experiences provided from using the
computer.

7,10,17,22,38

Operant conditioning is an-

other psychological aspect that may play a part in
the initiating, maintaining, and changing of behav-
ior of those addicted to the Internet. In terms of ad-
dictive behavior, operant conditioning typically
focuses on the reinforcing aspects, such as
thoughts, feelings, and behaviors, of a substance or
task. Using the Internet may be encouraged by a
variety of reinforcing factors such as gaining and
accessing information quickly and maintaining
contact with people. When problems result from
excessive Internet use, the person will more read-
ily engage in Internet use to receive some relief
from these problems. Additionally, engaging in an
activity such as checking email may follow a vari-
able ratio schedule of reinforcement. Similar to a
slot machine, the user gets a “pay off” with the
varying number of times the email is checked. For
example, the user may check his or her email three
times and be reinforced with an email, and then

check it seven times before she or he is reinforced
again with an email.

A social view recognizes that there may be famil-

ial, social, and cultural dynamics that prompt exces-
sive Internet use. For example, the person may use
the Internet to escape family conflict. However, the
need to use the Internet can create significant dis-
tress or impairment in social, occupational, and
other important areas of functioning, resulting in
continued addictive behavior as an attempt to mask
these problems.

1,6,10,15,19,21,23,24,31

Modeling could play

a role in problematic Internet use. Users can witness
those around them engaging in Internet use as a
way to meet others, be entertained, and solve prob-
lems. As a result, the Internet may be seen as a pri-
mary resource and method of meeting numerous
needs. Furthermore, the environment in which the
Internet is being used could also increase the poten-
tial for pathological use. Using the Internet in the
comfort of one’s home can increase the chances that
the person will not want to leave this environment.
The greater the availability of the Internet, the in-
creased chance that people will engage in Internet
activities. According to some researchers,

21,24

this

could explain why college students, who receive
unlimited and free Internet access through their
school, are at greater risk for developing pathologi-
cal Internet use. Another possible social aspect is
that the person lacks certain social skills that would
enable him or her to fulfill this need for affiliation in
places other than the computer. Likewise, there may
be expectations and peer pressure from friends for
the Internet user to engage in various on-line activi-
ties. Finally, cultural factors such as the push to be a
“technologically advanced society” or the necessity
to use the Internet at work could encourage Internet
use to a point that is detrimental to the person.

ASSESSMENT

Assessment may be done through the adminis-

tration and integration of various assessment in-
struments. Additionally, a clinical interview may
also be an effective way to determine if a person is
engaging in problematic Internet use. Clinical in-
terviews should always be done and can be used in
conjunction with a standardized assessment instru-
ment or in isolation.

Standardized tests specifically assessing excessive
Internet use

There are a limited number of standardized tests

that have been developed for assessing problematic

POTENTIAL ASSESSMENT QUESTIONS FOR INTERNET ADDICTION

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Internet use. Young

7–9,15

developed one of the first

questionnaires that assessed Internet addiction.
She initially developed a short eight-item question-
naire that was a modification of the criteria for
compulsive gambling. The significant findings
from this questionnaire prompted the development
of a larger and more comprehensive instrument
called the “Internet Addiction Test,” consisting of
20 questions. The questionnaire was developed to
help respondents in three ways. First, for those
who already identify as being an Internet addict,
the questionnaire helps to assess in what areas the
problem has impacted the person’s life. Second, for
those who are not sure if they are Internet addicted,
the questionnaire will help them determine
whether they meet Young’s criteria

10

for Internet

addiction and assess the impact it has had on their
daily living. Finally, Young’s questionnaire was de-
veloped to help those who believe that they know
someone who is pathologically using the Internet
by allowing that person to rate the Internet user or
to give this questionnaire to the user.

Since the development of the Internet Addiction

Test, other assessment instruments have been de-
veloped to assess for Internet addiction. Caplan

39

described the Generalized Problematic Internet
Use Scale (GPIUS). Results from a preliminary
study indicate that the GPIUS is reliable and valid.
A factor analysis identified seven sub-dimensions,
including mood alteration, perceived social bene-
fits available online, negative outcomes associated
with Internet use, compulsive Internet use, exces-
sive amounts of time spent online, withdrawal
symptoms when away from the Internet, and per-
ceived social control available online. These sub-
scales were correlated with psychosocial health
variables including: depression, loneliness, shy-
ness, and self-esteem.

Davis

25

described the use of the Online Cognition

Scale (OCS) and a study that focused on procrasti-
nation, impulsivity, and social rejection as key ele-
ments of problematic Internet use. By using this
instrument and other measures of procrastination,
rejection, sensitivity, loneliness, depression, and
impulsivity, it was concluded that problematic In-
ternet use consists of four dimensions: diminished
impulse control, loneliness/depression, social com-
fort, and distraction. Davis has recommended this
instrument for clinical assessment of problematic
Internet use and as an employment screening in-
strument.

Although the findings from these preliminary

studies are promising, additional research is
needed. The need for more research is based on

some criticisms regarding these assessment instru-
ments. Additional research would help solidify the
reliability and validity of these measures. Further-
more, these instruments are based on different the-
oretical underpinnings and do not agree on the
underlying dimensions that make up problematic
Internet use. Another criticism is that some items
do not relate to addiction. There are also general
concerns related to using a self-report method of
assessing for Internet addiction. Test takers may
not answer honestly. Questions may be answered
in such a manner that will present the test taker in a
certain way. No “lie” scale has been developed to
account consistently for this type of responding.
Another general concern with self-report measures
is that participants may not understand various
questions or misinterpret the various test items.
Additionally, there is also a problem with the par-
ticipant pool. Participants were obtained from web
sites or undergraduate courses leaving the poten-
tial for a selection bias to occur and no adequate
control group to use as a comparison. Furthermore,
there could be slight nuances in the administration
and order of various tests along with factors on a
web page that may influence how people re-
sponded as well as the number of valid responses
obtained. Although some of the studies looked at
various applications on the Internet, these instru-
ments do not take into account all of the different
types of applications that make up the Internet.
This could include things such as email, games,
pornography, and chatrooms. As a result, an inac-
curate assessment of the types and extent of abuse
that could be occurring is obtained since a person
may show addictive behaviors toward one applica-
tion, but not others.

A few other instruments try to assess problem-

atic Internet use, but they are criticized even more
than the instruments already described. One test is
the Internet-Related Addictive Behavior Inventory
(IRABI), which consists of 32 true-false questions.
King

20

reported on other Internet addiction ques-

tionnaires found on the Internet such as the McSur-
vey by Steve Thompson. Questions address things
such as the level of the respondents’ physical dis-
tress, whether the Internet had a negative impact
on their lives, and if they perceived a real life deficit
in personal relationships. The researcher goes on to
discuss a 6–7-point Likert scale questionnaire de-
veloped by Egger. Questions included items related
to the urge to use the Internet when off-line, antici-
pation of his or her next Internet usage, feeling
guilty over his or her Internet usage, and lying to
friends about how much time they spent on-line.

10

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Clinical interview

Since there are numerous limitations to the cur-

rent standardized instruments that assess for Inter-
net addiction, I recommend, for now, the clinical
interview be the primary method of assessment.
Assessing for Internet addiction needs to include
an understanding of the presenting problem. This
should consist of general information that helps to
define the parameters of the problematic behavior,
the impact the behavior has on the client’s life, and
the level of motivation to change.

32

It is necessary to evaluate the level of motivation

that the Internet addict has to change. Several
investigators

32,40–42

have described assessing the

motivation to change within six stages: Precontem-
plation, Contemplation, Decision, Action, Main-
tenance, and Relapse. A client may be in the
Precontemplation stage of motivation, when he or
she denies the problem and is resistant to treat-
ment. During the Contemplation stage, the client
begins to explore the pros and cons of partaking in
addictive behavior. The Determination stage occurs
when the client gains self-efficacy and is deter-
mined to make some change. The Actions stage oc-
curs when the client implements plans for change.
The Maintenance stage is a continuation of the
change process and achievement of personal goals.
Finally, there is the Relapse stage, which is an ex-
pected part of the change process. The goal is to re-
duce problems that occur with relapse and help the
client move back into the Contemplation, Determi-
nation, and Action stages.

While assessing the stage of motivation, a gen-

eral history on the client can be obtained. In keep-
ing with the biopsychosocial model and the
diagnostic criteria proposed by Beard and Wolf,

16

information on biological factors, psychological
factors, and social factors, should be reviewed to
help the mental health professional understand
how the Internet has impacted these domains.
Table 1 shows sample questions, grouped accord-
ing to these domains, which can be used by a
mental health professional during a face-to-face in-
terview with a client. The questions shown in Table
1 are not meant to be a comprehensive set of items.
These questions should be used as a basic sample
of the types of questions that may help focus the
mental health professional in screening for Internet
problems. A thorough history of the client should
be obtained, and a mental status exam should be
completed. Asking additional questions and using
other assessment instruments to measure difficul-
ties such as risk taking, motivation level, anxiety, or

POTENTIAL ASSESSMENT QUESTIONS FOR INTERNET ADDICTION

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T

ABLE

1. S

AMPLE

Q

UESTIONS FOR A

S

CREENING

I

NTERVIEW

A

SSESSING

P

ROBLEMATIC

I

NTERNET

U

SE

Presenting problem

1. When did you begin to notice problems with

your Internet use?

2. How long have you used the Internet?
3. What was going on in your life when you

began using the Internet?

4. What was going on in your life when you

began to have difficulties with your Internet
use?

5. How much time do you spend on the Inter-

net each day? Week? Month?

6. Do you ever feel preoccupied with the Inter-

net (e.g., think about previous on-line activ-
ity or anticipate next on-line session)?

7. What is the longest amount of time you have

spent using the Internet in one setting?

8. In what location does your Internet use occur?
9. What time of the day does the Internet use

occur?

10. Who is around when you use the Internet?

11. What do you enjoy about the Internet?

12. What do you dislike about the Internet?
13. What Internet sites/applications (e.g., chat

rooms, email, MUDS, instant messaging) do
you use, and what effect do they have on
you?

14. Have you ever stayed on-line longer than

originally intended?

15. In what ways has your Internet use inter-

fered with your daily activities?

16. Have you ever contemplated or tried cutting

down on your Internet use but couldn’t?

17. What helps or makes the situation better?
18. What hurts or makes the situation worse?
19. Have you ever lied to family members, ther-

apist, or others to conceal the extent of your
involvement with the Internet?

20. How did you feel when attempting to cut

down or stop your Internet use?

21. Why did you decide to seek help now?

Biological areas

1. Are you experiencing any health concerns? If

so, please describe.

2. How have these health concerns been im-

pacted by your Internet use?

3. What treatment you have received for these

health concerns?

4. Does your Internet use interfere with your

sleep?

(continued)

13905C02.PGS 1/21/05 4:11 PM Page 11

depression should be considered. Greenfield and
Orzak

43

state that this may be especially important

if there is a concern about a comorbid disorder. Ad-
ditionally, a referral to a physician for a medical
evaluation should be made to rule out physiologi-
cal problems that could be causing the current
problems.

The biological domain may include exploration

into the client’s family history of addiction. Since
some addictions have been linked to genes, this
may provide support that the client has a biological
predisposition for addiction problems. There may
also be medical conditions as a result of excessive
Internet use such as the person reporting little

12

BEARD

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5. How many hours a night do you typically

sleep?

6. Does your Internet use interfere with eating

regularly?

7. How many meals a day do you typically eat?
8. Have you recently gained or lost any weight?
9. What exercise patterns do you engage in?

10. What non-prescription medication do you

take? How much? How often?

11. What prescription medication do you take?

How much? How often?

12. What substances or behaviors do you or oth-

ers feel you have been addicted to in the
past?

13. What kind of alcohol do you currently use?

How much? How often?

14. In the past?
15. What drugs do you currently use? How

much? How often?

16. In the past?
17. Is there a history of addiction in your family?

If so, who and what?

Psychological areas

1. How do you feel before using the Internet?
2. What are your thoughts before using the In-

ternet?

3. Have you ever used the Internet to help im-

prove your mood or change your thoughts?

4. What is your environment like before using

the Internet?

5. How do you feel while using the Internet?
6. What are your thoughts while using the In-

ternet?

7. What is your environment like while using

the Internet?

8. How do you feel after using the Internet?
9. What are your thoughts after using the Inter-

net?

10. What is your environment like after using

the Internet?

11. Have you ever felt anxious, depressed or iso-

lated when off-line?

12. How well do you think you cope with vari-

ous events in your life?

Social areas

1. How has your Internet use caused problems

or concerns with your family?

2. What psychological/psychiatric illnesses

have members of your family experienced?

3. What is your overall degree of satisfaction

with your family?

4. How has your Internet use caused problems

or concerns with your significant other?

5. What is your overall degree of satisfaction

with your significant other?

6. How has your Internet use caused problems

or concerns with your child/children?

7. What is your overall degree of satisfaction

with your child/children?

8. How has using the Internet caused problems

or concerns with your social activities and
friendships?

9. What is your overall degree of satisfaction

with your friendships?

10. How do others in your life use the Internet

(e.g., email, IM)?

11. What is your overall degree of satisfaction

with school/work?

12. How has using the Internet interfered with

your performance at school or work?

13. Have you ever been in trouble with the au-

thorities because of your Internet use?

14. What are your social/leisure/hobby activi-

ties?

15. How would you rate your social skills?
16. How would you rate your communication

skills?

Relapse prevention areas

1. Do you believe that you have a problem with

your level of Internet use?

2. What seems to trigger Internet use?
3. What do you see as the benefits and costs of

continued Internet use?

4. What is your level of determination to

change your current Internet patterns?

5. What plans have you implemented in the

past to deal with your level of Internet use?

6. Have these plans worked?

T

ABLE

1. (C

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)

T

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1. (C

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)

13905C02.PGS 1/21/05 4:11 PM Page 12

sleep, going for hours without eating, headaches,
back and neck pain, carpal tunnel syndrome, and a
decrease in one’s immune system.

7–9

Minkoff and Drake

44

commented that it is rare

for a client to come to therapy and only have an ad-
diction problem. Usually, there is some pre-existing
psychiatric illness in addition to the addiction
problem. The psychological domain can help to as-
sess this possibility. The client’s thoughts and feel-
ings while on- and off-line should be assessed in
order to determine if there is psychological depen-
dence. This could occur when numbing or pleasur-
able feelings are obtained from Internet use, which
can be very reinforcing to the person.

The social domain is used to determine how the

Internet has impacted the client socially. This may
be especially important since it is usually others in
the addicted person’s life that recognize the prob-
lem and seek help for the user.

10

This domain can

also examine environmental aspects such as where
the Internet use occurs and the types of applica-
tions used.

CONCLUSION

Beard

2

comments that mental health profession-

als need to be aware of this growing phenomenon,
commonly called “Internet addiction,” and the role
that we can take in addressing problematic Internet
use and abuse. Difficulties with this new technol-
ogy should be examined in a proactive manner
rather then waiting for the crisis to occur and then
“picking up the pieces.” Introducing new technol-
ogy and simultaneously using psychology to coun-
teract negative effects may lessen the onset of
difficulties and the development of crises.

Mental health professionals need to be alerted to

the fact that many individuals may be reluctant to
seek treatment, believing that the clinician will not
take his or her difficulties seriously. Also, community
mental health agencies, college counseling centers,
and employee assistance programs should develop
seminars and groups to increase community, staff,
and employee’s knowledge of the effects of Internet
use on the campus. Further, employee assistance pro-
grams should educate human resources managers
how the Internet may affect employees, services that
are available to the employee who demonstrates a
problem with Internet usage, and other alternatives
instead of suspension and termination.

2,25

The continuing debate over the existence of Inter-

net addiction will probably go on for some time. Re-
gardless of whether or not Internet addiction is a true
“addiction,” there are people developing a harmful

dependence on the Internet. Likewise, there are
many unknown factors remaining that need to be ex-
plored. What may be an appropriate assessment or
intervention for one person may be different for an-
other. This process is very complex but researchers
are attempting to refine the numerous procedures
and factors in assessing, diagnosing, and intervening
with problematic Internet users.

16

Hopefully, as this

population of Internet users is examined, the means
of understanding, evaluating, and treating them may
become clearer and more effective.

REFERENCES

1. Kandell, J.J. (1998). Internet addiction on campus: the

vulnerability of college students. CyberPsychology &
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Address reprint requests to:

Keith W. Beard, Psy.D.

Psychology Department

Marshall University

1 John Marshall Dr.

Huntington, WV 25755

E-mail: [e-mail]

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