Skip to main content

Internet addiction: prevalence, discriminant validity and correlates among adolescents in Hong Kong

  • King-Wa. Fu (a1), Wincy S. C. Chan (a2), Paul W. C. Wong (a3) and Paul S. F. Yip (a3)

Despite increasing concern over the potential adverse effects of excessive internet use, especially in young people, there is some debate over its definition, magnitude and discriminant validity.


To examine the prevalence of adolescents' internet addiction in Hong Kong, China; to test its differentiation from other correlates; and to examine its relationships with correlates in a representative community sample of adolescents.


A two-wave panel household survey with 208 adolescents (aged 15–19 years) was conducted. Participants were asked to self-report their patterns of internet usage, symptoms of internet addiction, suicidal ideation, psychiatric symptoms and psychosocial conditions during the study period.


The prevalence rate for having five or more symptoms of internet addiction was estimated to be 6.7% (95% CI 3.3–10.2). The discriminatory characteristic of internet addiction was marginally demonstrated. Positive dose–response relationships were found between the number of symptoms of internet addiction and 1-year changes in scores for suicidal ideation and depressive symptoms.


Evidence supports the specificity of internet addiction and its symptoms seem to co-occur with individuals' suicidal ideation and depressive symptoms.

    • Send article to Kindle

      To send this article to your Kindle, first ensure is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the or variations. ‘’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Internet addiction: prevalence, discriminant validity and correlates among adolescents in Hong Kong
      Available formats
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Internet addiction: prevalence, discriminant validity and correlates among adolescents in Hong Kong
      Available formats
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Internet addiction: prevalence, discriminant validity and correlates among adolescents in Hong Kong
      Available formats
Corresponding author
King-Wa Fu, Journalism and Media Studies Centre, G24, Eliot Hall, Pokfulam Road, The University of Hong Kong, Hong Kong, China. Email:
Hide All

Declaration of interest


Hide All
1 Block, JJ. Issues for DSM-V: internet addiction. Am J Psychiatry 2008; 165: 306–7.
2 Cooney, GM, Morris, J. Time to start taking an internet history? Br J Psychiatry 2009; 194: 185.
3 Christakis, DA, Moreno, MA. Trapped in the net: will internet addiction become a 21st-century epidemic? Arch Pediatr Adolesc Med 2009; 163: 959–60.
4 International Telecommunication Union. Information Society Statistical Profiles – Asia and the Pacific. International Telecommunication Union, 2009.
5 China Internet Network Information Center. Statistical Report on Internet Development in China 2009. China Internet Network Information Center, 2009 (
6 Jones, S, Fox, S. Generations Online in 2009. Pew Internet & American Life Project, 2009.
7 Strasburger, VC, Wilson, BJ, Jordan, AB. Children, Adolescents, and the Media (2nd edn). Sage, 2009.
8 Shaw, M, Black, DW. Internet addiction: definition, assessment, epidemiology and clinical management. CNS Drugs 2008; 22: 353–65.
9 Chou, C, Condron, L, Belland, JC. A review of the research on Internet addiction. Educ Psychol Rev 2005; 17: 363–88.
10 Morahan-Martin, J. Internet use and abuse and psychological problems. In Oxford Handbook of Internet Psychology (eds Joinson, AN, McKenna, KYA, Postmes, T, Reips, UD): 331–46. Oxford University Press, 2007.
11 Widyanto, L, Griffiths, M. ‘Internet addiction’: a critical review. Int J Ment Health Addiction 2006; 4: 3151.
12 Young, J. Common comorbidities seen in adolescents with attention-deficit/hyperactivity disorder. Adolesc Med State Art Rev 2008; 19: 216–28.
13 Ko, CH, Yen, JY, Chen, CS, Chen, CC, Yen, CF. Psychiatric comorbidity of internet addiction in college students: an interview study. CNS Spectr 2008; 13: 147–53.
14 Black, DW, Belsare, G, Schlosser, S. Clinical features, psychiatric comorbidity, and health-related quality of life in persons reporting compulsive computer use behavior. J Clin Psychiatry 1999; 60: 839–44.
15 Armstrong, L, Phillips, JG, Saling, LL. Potential determinants of heavier internet usage. Int J Hum Comput Stud 2000; 53: 537–50.
16 Cao, FL, Su, LY, Liu, TQ, Gao, XP. The relationship between impulsivity and Internet addiction in a sample of Chinese adolescents. Eur Psychiatry 2007; 22: 466–71.
17 Caplan, SE. Relations among loneliness, social anxiety, and problematic Internet use. Cyberpsychol Behav 2007; 10: 234–42.
18 Chak, K, Leung, L. Shyness and locus of control as predictors of internet addiction and internet use. Cyberpsychol Behav 2004; 7: 559–70.
19 Kim, K, Ryu, E, Chon, MY, Yeun, EJ, Choi, SY, Seo, JS, et al. Internet addiction in Korean adolescents and its relation to depression and suicidal ideation: a questionnaire survey. Int J Nurs Stud 2006; 43: 185–92.
20 Mathy, RM, Cooper, A. The duration and frequency of internet use in a nonclinical sample: suicidality, behavioral problems, and treatment histories. Psychotherapy 2003; 40: 125–35.
21 Huang, MP, Alessi, NE. Internet addiction, Internet psychotherapy (Reply). Am J Psychiatry 1997; 154: 890.
22 Chan, WSC, Law, CK, Liu, KY, Wong, PWC, Law, YW, Yip, PSF. Suicidality in Chinese adolescents in Hong Kong: the role of family and cultural influences. Soc Psychiatry Psychiatr Epidemiol 2009; 44: 278–84.
23 Young, KS. Internet addiction: the emergence of a new clinical disorder. Cyberpsychol Behav 1998; 1: 237–44.
24 Dowling, NA, Quirk, KL. Screening for internet dependence: do the proposed diagnostic criteria differentiate normal from dependent internet use? Cyberpsychol Behav 2009; 12: 21–7.
25 American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (4th edn) (DSM–IV). APA, 1994.
26 Reynolds, WM. Suicidal Ideation Questionnaire (SIQ): Professional Manual. Psychological Assessment Resources, 1987.
27 Lovibond, PF, Lovibond, SH. The structure of negative emotional states: comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behav Res Ther 1995; 33: 335–43.
28 Taouk, M, Lovibond, P, Laube, R. Psychometric Properties of a Chinese Version of the 21-item Depression Anxiety Stress Scales (DASS21). New South Wales Transcultural Mental Health Centre, Cumberland Hospital, 2001.
29 Cheung, C-K, Bagley, C. Validating an American scale in Hong Kong: the Center for Epidemiological Studies Depression Scale (CES-D). J Psychol 1998; 132: 169–86.
30 Cheung, YB, Liu, KY, Yip, PS. Performance of the CES-D and its short forms in screening suicidality and hopelessness in the community. Suicide Life Threat Behav 2007; 37: 7988.
31 Kuo, WH, Gallo, JJ, Eaton, WW. Hopelessness, depression, substance disorder, and suicidality: a 13-year community-based study. Soc Psychiatry Psychiatr Epidemiol 2004; 39: 497501.
32 Watson, CG, Vassar, P, Plemel, D, Herder, J, Manifold, V, Anderson, D. A factor analysis of Ellis' irrational beliefs. J Clin Psychol 1990; 46: 412–5.
33 Siegel, S, Castellan, NJ. Nonparametric Statistics for the Behavioral Sciences (2nd edn). McGraw-Hill, 1988.
34 Meier, ST. The Chronic Crisis in Psychological Measurement and Assessment: A Historical Survey. Academic Press, 1994.
35 Fornell, C, Larcker, DF. Evaluating structural equation models with unobservable variables and measurement error. J Marketing Res 1981; 18: 3950.
36 Anderson, JC, Gerbing, DW. Structural equation modeling in practice – a review and recommended 2-step approach. Psychol Bull 1988; 103: 411–23.
37 Leung, L. Net-generation attributes and seductive properties of the internet as predictors of online activities and internet addiction. Cyberpsychol Behav 2004; 7: 333–48.
38 Shek, DT, Tang, VM, Lo, CY. Internet addiction in Chinese adolescents in Hong Kong: assessment, profiles, and psychosocial correlates. Scientific World Journal 2008; 8: 776–87.
39 Schaeffer, NC, Presser, S. The science of asking questions. Annu Rev Sociol 2003; 29: 6588.
40 Campbell, DT, Fiske, DW. Convergent and discriminant validation by the multitrait-multimethod matrix. Psychol Bull 1959; 56: 81105.
41 Ryan, ND. Treatment of depression in children and adolescents. Lancet 2005; 366: 933–40.
Recommend this journal

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

The British Journal of Psychiatry
  • ISSN: 0007-1250
  • EISSN: 1472-1465
  • URL: /core/journals/the-british-journal-of-psychiatry
Please enter your name
Please enter a valid email address
Who would you like to send this to? *


Full text views

Total number of HTML views: 0
Total number of PDF views: 56 *
Loading metrics...

Abstract views

Total abstract views: 305 *
Loading metrics...

* Views captured on Cambridge Core between 3rd January 2018 - 21st April 2018. This data will be updated every 24 hours.

Internet addiction: prevalence, discriminant validity and correlates among adolescents in Hong Kong

  • King-Wa. Fu (a1), Wincy S. C. Chan (a2), Paul W. C. Wong (a3) and Paul S. F. Yip (a3)
Submit a response


Gambling addiction in China: A survey of Chinese psychiatrists

George Sanju, Consultant in addiction psychiatry
07 June 2013

We read with interest the paper (1) on internet addiction published in your journal and we wish to share our findings of a study of another non-substance addiction: gambling addiction. Ours was a survey of psychiatrists in China on their knowledge of and attitudes towards gambling addiction. Gambling, as leisure activity, is common in most cultures and for most it never becomes problematic. However for a minority, approximately 1% (2) of the general population in most Western countries, it develops into gambling addiction. The origins of gambling inChina can be traced to the Xia dynasty (2000 to 1500BC) (3). The Chinese gamble more than most: 2.5 to 4% of Chinese adults are gambling addicts despite most gambling activities, except for state-run lotteries, being banned in mainland China. However illegal gambling is very popular and itis estimated that the size of the illegal gambling industry is at least 10times that of legal gambling (lotteries).

Given the above, we carried out a survey of psychiatrists in China toexplore the following: how often they saw patients with gambling problems,how confident they were in managing these patients, what was their understanding of gambling addiction, and how they saw their perceived roleand feasibility in managing these patients. This, to our knowledge, is thefirst survey of its kind in China.

A questionnaire was sent to 120 psychiatrists working in China and 110 of them responded. Of the 110 psychiatrists, 61 (55.4%) said they had seen gambling addicts in their practice and 50 (45.4%) psychiatrists said they had seen patients who did not meet the threshold for diagnosis but nevertheless had a gambling problem. Only one of the respondents had had any training in the management of gambling addiction. It was encouraging to note that 91 (83%) of psychiatrists saw gambling as a potentially addictive disorder and 98 (89%) saw it as an important public health problem. When asked about the feasibility of 'psychiatrists getting involved in the management of gambling addicts', 22% strongly agreed, 60.9% agreed, 10.9% neither agreed nor disagreed, 5.4% disagreed and 0.9% strongly disagreed.

Although many of the psychiatrists had come across patients with gambling problems, it was shocking that only one of the psychiatrists had had any training in the management of gambling addiction. Nevertheless it was encouraging to note that the majority viewed it as an addictive disorder and saw it as being within their remit.

In our view, there is a great opportunity to introduce programs aimedat increasing the knowledge of psychiatrists in this neglected area of addictions, and thereby improve the treatment provided to gambling addictsin China.


1. King-wa Fu, Wincy S. C. Chan, Paul W. C. Wong, Paul S. F. Yip. Internet addiction: prevalence, discriminant validity and correlates amongadolescents in Hong Kong. BJP 2010, 196, 486-92.

2. Shaffer, H. J., Hall, M. N. & Vander Bilt, J. (1999) Estimating the prevalence of disordered gambling behavior in the US and Canada: a research synthesis. American Journal of Public Health, 89, 1369-1376.

3. Wu Ping-an. Study of Gambling Crime [2006]. Xiangtan: Xiangtan University.

... More

Conflict of interest: None declared

Write a reply


Reply to: Submit a response

Your details

Conflicting interests

Do you have any conflicting interests? *