Skip to main content

Potential Markers for Problematic Internet Use: A Telephone Survey of 2,513 Adults

  • Elias Aboujaoude, Lorrin M. Koran, Nona Gamel, Michael D. Large and Richard T. Serpe...

The Internet has positively altered many aspects of life. However, for a subset of users, the medium may have become a consuming problem that exhibits features of impulse control disorders recognized in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition.


This is the first large-scale epidemiological study of problematic Internet use through a random-digit-dial telephone survey of 2,513 adults in the United States. Given the lack of validated criteria, survey questions were extrapolated from established diagnostic criteria for impulse control disorders, obsessivecompulsive disorder, and substance abuse. Four possible diagnostic criteria sets were generated.The least restrictive set required the respondent to report an unsuccessful effort to reduce Internet use or a history of remaining online longer than intended, Internet use interfering with relationships, and a preoccupation with Internet use when offline.


The response rate was 56.3%. Interviews averaged 11.3 minutes in duration. From 3.7% to 13% of respondents endorsed ≥1 markers consistent with problematic Internet use. The least restrictive proposed diagnostic criteria set yielded a prevalence of problematic Internet use of 0.7%.


Potential markers of problematic Internet use seem present in a sizeable proportion of adults. Future studies should delineate whether problematic Internet use constitutes a pathological behavior that meets criteria for an independent disorder, or represents a symptom of other psychopathologies.

Corresponding author
Please direct all correspondence to; Elias Aboujaoude, MD, MA, Stanford University School of Medicine, Impulse Control Disorders Clinic, Room 2363, 401 Quarry Road, Stanford, CA 94305; Tel: 650-498-5035, Fax: 650-714-3144.
Hide All
1. Two-thirds of active U.S. Web population using broadband, up 28 percent year-over-year to an all-time high, according to Nielsen//Netratings [press release]. Nielsen//Netratings Web site. Available at: http://www, Accessed September 1, 2006.
2.Young, KS. Caught in the Net: How to Recognize the Signs of Internet Addiction—and a Winning Strategy for Recovery. New York, NY: John Wiley & Sons; 1998.
3.Shapira, NA, Goldsmith, TD, Keck, PE, Khosla, UM, McElroy, SL. Psychiatric features of individuals with problematic internet use. J Affect Disord. 2000;57:267272.
4.Treuer, T, Fabian, Z, Furedi, J. Internet addiction associated with features of impulse control disorder: is it a real psychiatric disorder? J Affect Disord. 2001;66:283.
5.Black, DW, Belsare, G, Schlosser, S. Clinical features, psychiatric comorbidity, and helathrelated quality of life in persons reporting compulsive computer use behavior. J Clin Psychiatry. 1999;60:839844.
6.Goldsmith, TD, Shapira, NA. Problematic internet use. In: Hollander, E, Stein, DJ, eds. Clinical Manual of Impulse-Control Disorders. Arlington, Va: American Psychiatric Publishing, Inc.; 2006:291308.
7.Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington, DC: American Psychiatric Association; 1994.
8.Brenner, V. Psychology of computer use: XLVII. Parameters of internet use, abuse and addiction: the first 90 days of the Internet Usage Survey. Psychol Rep. 1997;80(3 pt 1 ):879882.
9.Beard, KW, Wolf, EM. Modification in the proposed criteria for Internet addiction. Cyberpsychol Behav. 2001;4:377383.
10.Shapira, NA, Lessig, MC, Goldsmith, TD, et al.Problematic internet use: proposed classification and diagnostic criteria. Depress Anxiety. 2003;17:207216.
11.Greenfield, DN, Davis, RA. Lost in cyberspace: the web @ work. Cyberpsychol Behav. 2002;5:347353.
12.DeAngelis, T. Is internet addiction real? Monitor on Psychology. 2000;31:15.
13.The American Association for Public Opinion Research. Standard Definitions: Final Dispositions of Case Codes and Outcome Rates for Surveys. Ann Arbor, Mich: AAPOR; 2000.
14. Behavioral Risk Factor Surveillance System. Behavioral Risk Factor Surveillance System Summary Data Quality Report. Centers for Disease Control and Prevention Web site. Available at: Accessed March 1, 2006.
15.Greenberg, JL, Lewis, SE, Dodd, DK. Overlapping addictions and self-esteem among college men and women. Addict Behav. 1999;24:565571.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

CNS Spectrums
  • ISSN: 1092-8529
  • EISSN: 2165-6509
  • URL: /core/journals/cns-spectrums
Please enter your name
Please enter a valid email address
Who would you like to send this to? *


Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed