In a recent study published in the Journal of Psychiatric Research, researchers describe the relationship between problematic internet use (PIU) and the symptoms of attention deficit hyperactivity disorder (ADHD).
Background
Excessive use of the internet has become a potential public health concern worldwide. In fact, according to the Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-5), internet gaming disorder, gaming, and gambling disorder are considered specific mental health problems associated with excessive internet use.
To date, PIU has not been defined by either DSM-5 or the International Classification of Diseases 11th Revision (ICD-11). Nevertheless, PIU can be characterized by impaired control over internet use, negligence in daily life activities due to the increased priority of internet use, and addiction-like symptoms, such as the continuation or escalation of internet use despite negative consequences.
Emerging evidence indicates that PIU can negatively affect mental health and increase the risk of depression, anxiety, emotional distress, social withdrawal, obsessive-compulsive disorder (OCD), and ADHD. Importantly, the clinical symptoms associated with PIU are multifaceted, as an individual’s personality and social cognition can contribute to the amount of gratification they experience while using the internet.
PIU can also intensify existing psychological disorders like ADHD. For example, addiction-like social media use has been shown to exacerbate ADHD symptoms like impulsivity, hyperactivity, and attention deficit.
Study design
The current study adopted a meta-analytical approach to elucidate the relationship between PIU and ADHD symptoms. To this end, the researchers searched different scientific databases to identify relevant studies published between 1996 and 2023. Specifically, peer-reviewed, cross-sectional studies that measured PIU in terms of general internet addiction and investigated its association with ADHD symptoms were included in the meta-analysis.
The final screening led to the identification of 24 studies, which comprised a total sample size of 18,859 participants with an average age of 18.4 years, published between 2004 and 2023. On average, the selected studies had a low risk of bias.
Important observations
A total of 19 studies with 21 effect sizes were analyzed to investigate the association between PIU and ADHD symptoms. The analysis revealed a significant positive association between internet addiction and attention deficit.
Similarly, regarding hyperactivity, the meta-analysis, including six studies with seven effect sizes, revealed a significant positive association with internet addiction. The meta-analysis of eight studies with nine effect sizes also showed a significant positive association between internet addiction and impulsivity.
The findings of the sub-group analysis identified the age of participants as a significant moderating variable for attention deficit, in which larger effect sizes were observed in adults compared to children or adolescents. However, these subgroup differences between children or adolescents and adults were not observed for impulsivity and hyperactivity.
Considering participants’ clinical types, significant differences were only observed for ADHD. Specifically, non-clinical participants were associated with higher effect sizes than clinical participants. Thus, study participants who are not clinically diagnosed with ADHD might be more affected by internet addiction.
Further statistical analysis revealed significant gender differences for attention deficit and hyperactivity. In both outcomes, significantly higher effect sizes were observed in male participants compared to females.
Study significance
PIU is significantly associated with ADHD-related symptoms, with clinically undiagnosed adult males considered to be a potential risk group in the association between internet addiction and attention deficit. Males also appear to be more susceptible to the relationship between internet addiction and hyperactivity as compared to females.
Several mechanisms have been proposed to be responsible for the association between PIU and ADHD symptoms. For example, internet use often involves numerous attentional shifts through multi-tasking, which may negatively impact cognitive functioning. Internet use for extended periods of time may also reduce resting time for the brain, which is particularly important in the brains of individuals with attention-related disorders.
One limitation of this meta-analysis is its cross-sectional approach, which is unsuitable for explaining cause-and-effect relationships. Nevertheless, the impact of internet use on ADHD symptoms necessitates the need for additional studies, particularly those investigating the efficacy of possible interventions to reduce internet use or manage ADHD symptoms. Further studies are also needed to better understand how internet use at specific ages, including children and teenagers, may increase the risk of ADHD-related symptoms.
Journal reference:
- Augner, C., Vlasak, T., & Barth, A. (2023). The relationship between problematic internet use and attention deficit, hyperactivity and impulsivity: A meta-analysis. Journal of Psychiatric Research. doi:10.1016/j.jpsychires.2023.10.032.
