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      The role of self-esteem in Internet addiction within the context of comorbid mental disorders: Findings from a general population-based sample

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          Background and aims

          Internet Addiction (IA) has consistently been related to comorbid psychiatric disorders and lowered self-esteem. However, most studies relied on self-report questionnaires using non-representative samples. This study aims to analyze the relative impact of self-esteem and comorbid psychopathology with lifetime IA in a population-based sample of excessive Internet users using clinical diagnoses assessed in a personal interview.


          The sample of this study is based on a general population survey. Using the Compulsive Internet Use Scale, all participants with elevated Internet use scores were selected and invited to a follow-up interview. Current DSM-5 criteria for Internet gaming disorder were rephrased to apply to all Internet activities. Out of 196 participants, 82 fulfilled the criteria for IA. Self-esteem was measured with the Rosenberg’s Self-Esteem Scale.


          Self-esteem is significantly associated with IA. For every unit increase in self-esteem, the chance of having IA decreased by 11%. By comparison, comorbidities such as substance-use disorder (excluding tobacco), mood disorder, and eating disorder were significantly more likely among Internet-addicted than in the non-addicted group. This could not be reported for anxiety disorders. A logistic regression showed that by adding self-esteem and psychopathology into the same model, self-esteem maintains its strong influence on IA.

          Discussion and conclusions

          Self-esteem was associated with IA, even after adjustment for substance-use disorders, mood disorder, and eating disorder. Self-esteem and psychopathology should be considered in prevention, intervention measures, as well as in the conception of etiological models.

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          Most cited references 49

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          Friend networking sites and their relationship to adolescents' well-being and social self-esteem.

          The aim of this study was to investigate the consequences of friend networking sites (e.g., Friendster, MySpace) for adolescents' self-esteem and well-being. We conducted a survey among 881 adolescents (10-19-year-olds) who had an online profile on a Dutch friend networking site. Using structural equation modeling, we found that the frequency with which adolescents used the site had an indirect effect on their social self-esteem and well-being. The use of the friend networking site stimulated the number of relationships formed on the site, the frequency with which adolescents received feedback on their profiles, and the tone (i.e., positive vs. negative) of this feedback. Positive feedback on the profiles enhanced adolescents' social self-esteem and well-being, whereas negative feedback decreased their self-esteem and well-being.
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            Psychology of computer use: XL. Addictive use of the Internet: a case that breaks the stereotype.

             Sarah Young (1996)
            This case involves a homemaker 43 years of age who is addicted to using the Internet. This case was selected as it demonstrates that a nontechnologically oriented woman with a reportedly content home life and no prior addiction or psychiatric history abused the Internet which resulted in significant impairment to her family life. This paper defines addictive use of the Internet, outlines the subject's progression of addictive on-line use, and discusses the implications of such addictive behavior on the new market of Internet consumers.
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              The comorbid psychiatric symptoms of Internet addiction: attention deficit and hyperactivity disorder (ADHD), depression, social phobia, and hostility.

              To: (1) determine the association between Internet addiction and depression, self-reported symptoms of attention deficit and hyperactivity disorder (ADHD), social phobia, and hostility for adolescents; and (2) evaluate the sex differences of association between Internet addiction and the above-mentioned psychiatric symptoms among adolescents. A total of 2114 students (1204 male and 910 female) were recruited for the study. Internet addiction, symptoms of ADHD, depression, social phobia, and hostility were evaluated by the self-report questionnaire. The results demonstrated that adolescents with Internet addiction had higher ADHD symptoms, depression, social phobia, and hostility. Higher ADHD symptoms, depression, and hostility are associated with Internet addiction in male adolescents, and only higher ADHD symptoms and depression are associated with Internet addiction in female students. These results suggest that Internet addiction is associated with symptoms of ADHD and depressive disorders. However, hostility was associated with Internet addiction only in males. Effective evaluation of, and treatment for ADHD and depressive disorders are required for adolescents with Internet addiction. More attention should be paid to male adolescents with high hostility in intervention of Internet addiction.

                Author and article information

                Journal of Behavioral Addictions
                J Behav Addict
                Akadémiai Kiadó (Budapest )
                26 December 2018
                December 2018
                : 7
                : 4
                : 976-984
                [ 1 ]Department of Psychiatry and Psychotherapy, University of Lübeck , Lübeck, Germany
                [ 2 ]Institute of Social Medicine and Prevention, University Medicine Greifswald , Greifswald, Germany
                Author notes
                [* ]Corresponding author: Katrin Sevelko; Department of Psychiatry and Psychotherapy, University of Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany; Phone: +49 176 7069 5363; Fax: +49 451 500 3480; E-mail: katrin.sev@
                © 2018 The Author(s)

                This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium for non-commercial purposes, provided the original author and source are credited, a link to the CC License is provided, and changes – if any – are indicated.

                Page count
                Figures: 1, Tables: 4, Equations: 0, References: 49, Pages: 9
                Funding sources: This work was supported by German Federal States and German Federal Ministry of Health.
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