For people with anxiety, depression, or addictions, the internet can be helpful or harmful. While we can find new information, connect to resources, and use creative online coping mechanisms, the online world can be a trap and become a new place for us to engage in unhealthy, maladaptive behaviors. Medical professionals refer to these negative internet behaviors as Problematic Internet Use (PIU), but some may refer to it as internet addiction. By definition PIU refers to a range of repetitive impairing behaviors, such as excessive video gaming, cybersex, online buying, gambling, streaming, social media use, online searching for health-related info and inability to control the amount of time spent interfacing with digital technology. The reported prevalence of PIU ranges from 1% to 36.7% (Young 1999, Ko, Yen et al. 2012). 

Just as a mental disorder causes distress and impairs functioning, PIU could negatively impact one’s social, emotional, and financial well-being. While some studies show that PIU might be related to other mental illnesses, research also shows PIU could also be a stand-alone problem apart from comorbid disorders (Chamberlain, Ioannidis et al. 2018; Finkenauer, Pollmann et al. 2012). More research is needed to fully understand the populations at risk for PIU. To do so, researchers can use tools such as Young’s Internet Addiction Test, but this measurement has some limitations (Young 1999).

PIU is hard to recognize because many innocent actions can eventually become a PIU behavior. You can be following your passion and googling a topic of interest on your smartphone until thumb hurts from scrolling and your phone is out of battery. You want show a friend a video you saw online the other day, and hours go by and your friend has left, but you are still looking for that video. Or, you can become so emotionally attached to social media platforms that you can fall asleep counting the comments on your latest post, hoping to beat someone by getting more likes than the other user. 

This proposed study intends to look deeper into the PIU and investigate the factors driving PIU's onset and development. Among this broad topic, we are looking for patients input to narrow and refine our three research questions:
➢      Define PIU Prevalence:

• Through the recruitment and screening of participants who would respond to an online screening questionnaire, we can assess individuals for PIU in order to determine its prevalence in the NYC area. 

➢     Assess Comorbid Conditions impact: 

• By using key online clinical questionnaires and digital health measurements, we can look for correlations between PIU and physical and/or mental conditions and to determine the prevalence of conditions co-occurring with PIU.

➢     Create an adequate Digital health Intervention: 

• With mobile app interventions (for example, limiting the time a user can be on a specific app or use smartphone in general) and providing continuous feedback on users internet behaviors, we could evaluate interventions that might reduce PIU incidence.

Patient advocate’s feedback is needed to drive innovation further
We seek your help, your time, and your knowledge. You are the experts on your experiences, so we rely on you to tell us your needs. We welcome patient health advocates, family members and other stakeholders to reach out to us directly to help shape screening tools, participate in a design of a study, and develop outcome measures for a global innovative research project related to early detection, treatment and prevention of problematic internet use and its comorbidities. No previous knowledge about clinical research is required. Your time commitment could be as little as sending an email with feedback on this post.

We look forward to hear from you your story, get your feedback on different digital apps and to jointly develop innovative patient-centered studies, which could really make a change in your or your loved ones’ quality of life. You can also leave a comment on the blog post and share this post with your friends and family in order to spread the word about how others could get involved.

You can contact us at [email protected]

References:
1.    Chamberlain, S. R., K. Ioannidis and J. E. Grant (2018). "The impact of comorbid impulsive/compulsive disorders in problematic Internet use." J Behav Addict: 1-7.

2.    Finkenauer, C., M. M. Pollmann, S. Begeer and P. Kerkhof (2012). "Brief report: examining the link between autistic traits and compulsive Internet use in a non-clinical sample." J Autism Dev Disord 42(10): 2252-2256.

3.    Ko, C. H., J. Y. Yen, C. F. Yen, C. S. Chen and C. C. Chen (2012). "The association between Internet addiction and psychiatric disorder: a review of the literature." Eur Psychiatry 27(1): 1-8.
4.    Young, K. S. (1999). "The research and controversy surrounding internet addiction." Cyberpsychol Behav 2(5): 381-383.

Co-written by:

Dr. Vera Nezgovorova is a clinical research fellow in the Autism, Obsessive Compulsive Spectrum disorders, Anxety and Depression program at Montefiore Medical Center at Albert Einstein College of Medicine, Bronx, NY. She is interested in digital behavioral health interventions, pharmacogenomics and technological advances in healthcare.

Kyra Citron attends Duke University as a double major in Psychology and Gender, Sexuality, and Feminist Studies. As an advocate and academic, she is interested in an intersectional approach to psychopathology research.