Vol. 5, no.
1/2013 STYLES OF COMMUNICATION
The Relationship between
Compulsive Behaviour and Internet Addiction
Maria Rosita Cecilia, PhD Student
Monica Mazza, Researcher
Silvia Cenciarelli, MA Student
Marta Grassi, MA Student
Vincenza Cofini, Researcher
University of L’Aquila, Italy
mariarosita.cecilia@graduate.univaq.it
monica.mazza@cc.univaq.it
vincenza.cofini@cc.univaq.it
Abstract: A variety of behavioural and emotional problems among university students is due to
Internet Addiction (Alavi et al. 2012, Rusconi et al. 2012). In 2013 a survey is conducted on a sample
of 532 students of University of L‘Aquila. The purpose is to investigate Internet use patterns and the
correlation between Internet Addiction disorder and compulsive behaviour. Two self-administered
questionnaires are used: the Internet Addiction Test and the Cognitive Behavioural Assessment 2.0.
517 students show signs of Internet Addiction, which is moderate for 31% of respondents and severe
for 1% of them. 5% shows intrusive thoughts and compulsive behaviours. The symptoms of
obsessive-compulsive disorder are statistically associated with Internet Addiction (chi² test=23.53,
p=0.000). Among young people there is a relationship between compulsive behaviour and Internet
Addiction. This relationship has significant effects on treatment of Internet Addiction.
Keywords: problematic internet use; mental health; behavioral assessment
1. Introduction
The scientific study of behaviour and mental processes follows human socio-
cultural evolution. The Internet is considered the most important breakthrough in
interpersonal communication of the 20th century. It has been providing many
benefits to its users. Its basic features, such as widespread usability and access,
have created a circulation of data of any kind, at any distance, with limited costs
and maximum speed (Di Maria, Cannizzaro 2001). Over the past decade, Internet
usage has grown on a global scale enabling new forms of social interaction,
activities, and organizing. However, people actually spend too much time online.
This situation has raised many concerns in areas such as personal privacy and
identity (Milne et al. 2004), distribution of copyrighted materials (Goldsmith, Wu
2006) and mental health (Yau et al. 2013). The increasing popularity and frequency
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of Internet use have led to an increasing number of reports highlighting potential
negative consequences of overuse (Kuss et al. 2013), in fact people can become
addicted to the Internet which could be used in an uncontrolled way, thus
producing many negative effects on user‘s psychological well-being (Kraut et al.
1998), the formation and maintenance of personal relationships, group
memberships and social identity (Lemmens, Valkenburg, Peter 2011), the
workplace (Young 1999), and community involvement (John et al. 2004). The
concept of ―Internet Addiction‖ has been proposed as an explanation for
uncontrollable, damaging use of this technology (Keith et al. 2001). Symptoms of
Internet overuse are compared to the criteria used to diagnose other addictions.
Moreover, neuroscientific evidence has indicated parallels between Internet
Addiction and substance-related addiction disorders and pathological gambling (Ko
et al. 2009; Kuss, Griffiths 2012). In particular, pathological gambling is compared
to problematic Internet use because of overlapping criteria.
2. The Study
2.1. Objectives
The present study aims to investigate Internet use patterns, gender differences in
Internet use and the specific relationship between Internet Addiction Disorder and
compulsive behaviour in a sample of university students.
2.2. Materials and Methods
The study is conducted in the period June 2012-January 2013. The participants are
students enrolled in various faculties at the University of L'Aquila, Italy.
Participants are assessed with the Internet Addiction Test and the Cognitive
Behavioural Assessment 2.0, which are self-administered by the students after
giving them brief instructions. Young‘s Internet Addiction Test (IAT) is a reliable
and valid measure of addictive Internet use. It consists of 20 items that measure the
severity of self-reported compulsive Internet use: mild (20-39 points), moderate
(40-69 points) and severe (70-100 points) (Young 1998a; Young 1998b). The IAT
is one of the most widely used scales for assessing Internet Addiction (Kim et al.
2012) and it received a psychometric evaluation for its Italian version (Ferraro et al.
2007). The CBA 2.0 battery includes a series of questionnaires that investigate
broad issues of potential clinical interest and identify areas of current dysfunctions
(Bertolotti et al. 1995). It has been validated in 2304 healthy subjects and 6175
chronic patients subdivided by sex and age (Zotti et al. 1991; Bertolotti et al. 1995).
Only the Maudsley Obsessive-Compulsive Questionnaire Revised (MOCQ-R),
Italian version, of the Cognitive Behavioural Assessment Primary Scales (CBA
2.0), is administered. The MOCQ-R is one of the most used tests in clinical
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psychology for assessing the obsessive and compulsive symptoms in psychiatric
patients and it is used as a screening tool in nonclinical population. The Italian
version, which includes 21 dichotomous items, provides an overall score, for the
subjective evaluation of obsessive-compulsive symptoms. The MOCQ-R consists
of 3 indices that study thought patterns and compulsive behaviours: the MOCQ-R1
(Checking Subscale), the MOCQ-R2 (Cleaning Subscale) and the MOCQ-R3
(Doubting-Ruminating Subscale). Scales scores at or above the 95th percentile are
in the severe problem range (Bertolotti, Sanavio et al. 1997). The statistical
analysis is processed with the software Stata 12\ME. The chi-square test or Fisher's
exact test are used to examine differences with categorical variables. One way-
Anova model is used to assess the differences between means.
3. Results
Table 1. 532 University Students Participated in This Study and Their Ages Ranged
from 18 to 51 (22 Years ± 4). 331 (62%) Are Female
Socio-demographic characteristics Total sample (N=532)
Gender n %
Male 201 38
Female 331 62
Age Mean SD
22 4
The analysis of the scores obtained from the IAT shows that 517 students have
signs of Internet Addiction, which is mild for 68%, moderate for 31%, and severe
for 1% of the respondents. According to several studies (Egger, Rauterberg 1996;
Hall, Parsons 2001) the one-way Anova shows that there is no statistically
significant gender difference in the IAT (F(1;530)=1.96, p=0.1621). Every item of the
IAT is categorized in dichotomous variables: yes (Often/Always) and no
(Rarely/Occasionally/Frequently). Table 2 shows gender differences in IAT scores
for dichotomous variables (Often/ Always).
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Table 2. Gender Differences in IAT Scores
Variables Often/Always
chi²test/
M F
Fisher's
n n p
exact
(%) (%)
test
How often do you find that you stay on- 72 119
0.00 0.976
line longer than you intended? (35.8) (36.0)
How often do you neglect household 46 50
5.12 0.024
chores to spend more time on-line? (22.9) (15.1)
How often do you prefer the
3 2
excitement of the Internet to (1.5) (0.6)
1.06 0.303
intimacy with your partner?
How often do you form new
21 35
relationships with fellow on-line (10.5) (10.6)
0.00 0.963
users?
How often do others in your life
31 31
complain to you about the amount of (15.4) (9.4)
4.46 0.035
time you spend on-line?
How often do your grades or school
40 77
work suffers because of the amount (19.9) (23.3)
0.82 0.364
of time you spend on-line?
How often do you check your email
14 11
before something else that you need (7.0) (3.3)
3.70 0.054
to do?
How often does your job
17 23
performance or productivity suffer (8.5) (7.0)
3.70 0.054
because of the Internet?
How often do you become defensive
17 23
or secretive when anyone asks you (8.5) (7.0)
0.41 0.522
what you do on-line?
How often do you block out
disturbing thoughts about your life 11 26
1.10 0.295
with soothing thoughts of the (5.5) (7.9)
Internet?
How often do you find yourself
8 11
anticipating when you will go on-line (4.0) (3.3)
0.16 0.692
again?
How often do you fear that life
15 10
without the Internet would be (7.46) (3.02)
5.51 0.019
boring, empty, and joyless?
How often do you snap, yell, or act 12 13 1.17 0.280
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annoyed if someone bothers you (6.0) (3.9)
while you are on-line?
How often do you lose sleep due to 37 33
7.79 0.005
late-night log-ins? (18.4) (10.0)
How often do you feel preoccupied
4 2
with the Internet when off-line, or (2.0) (0.6)
2.15 0.142
fantasize about being on-line?
How often do you find yourself
42 74
saying ―just a few more minutes‖ (20.9) (22.4)
0.16 0.692
when on-line?
How often do you try to cut down
11 15
the amount of time you spend on- (5.5) (4.5)
0.24 0.626
line?
How often do you try to hide how 7 8
0.52 0.472
long you’ve been on-line? (3.5) (2.4)
How often do you choose to spend
7 5
more time on-line over going out (3.5) (1.5)
2.21 0.137
with others?
How often do you feel depressed,
moody or nervous when you are off- 3 5
0.00 0.987
line, which goes away once you are (1.5) (1.5)
back on-line?
Men neglect household chores to spend additional time online (M=23% vs F=15%;
chi² test=5.12, p=0.024), they fear that life without the Internet would be boring,
empty, and joyless (M=7% vs F=3%; chi² test=5.51, p=0.019) and they lose sleep
due to prolonged use of the Internet (M=18% vs F=10%, chi² test=7.79, p=0.005)
more often than women. Moreover, men usually receive more complaints from
other people such as friends or relatives, than women (M=15% vs F=9%, chi²
test=4.46, p=0.035).
Women block out disturbing thoughts about their life with soothing thoughts of the
Internet more often than men, but there is no statistically significant gender
difference (M=6% vs F=8%, chi² test=1.10, p=0.295). Based on the MOCQ-R, 5%
of the respondents (95%CI: 3.20%-6.95%) is in the severe problem range, 5% has
checking compulsions (95%CI: 3.20%-6.95%), 7% (95%CI: 4.95%-9.34%) has
obsessions and compulsions associated with symmetry or exactness and about 6%
(95%CI: 3.83%-7.82%) has contamination and cleaning symptoms. A significance
association between gender and Checking Subscale (Fisher‘s exact test=8.61,
p=0.002) is reported, but there are no gender differences in Cleaning Subscale
(Fisher‘s exact test=1.36, p=0.161), Ruminating Subscale (Fisher‘s exact test=0.76,
p=0.245) and MOCQ-R Total score (Fisher‘s exact test=0.80, p=0.247). The chi-
square test is used to examine the relationship between MOCQ-R Subscales scores
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and Internet Addiction levels. There is a significant association between Internet
Addiction levels and Ruminating Subscale (chi² test=30.95, p=0.000). MOCQ-R
Total score analysis displays that the symptoms of obsessive-compulsive disorder
are statistically associated with Internet Addiction (chi² test=23.53, p=0.000).
4. Conclusion
According to the international epidemiological studies, about 1% of general
population and about 3–13% of adolescents has shown signs of Internet Addiction
(Lin, Ko, Wu 2011). The present study shows that 517/532 students have signs of
Internet Addiction, and despite of the findings in different studies (Seyyed Salman
Alavi et al. 2011; Young 1998), Internet Addiction is not more common in males
than in females. The gender gap in Internet use is rapidly diminishing, in fact, in
this study there is no relationship between gender and Internet Addiction. Many
evidences show a variety of behavioural and emotional problems in young subjects
with Internet problematic use (Bozkurt et al. 2013; Dong, Hu, Lin 2013). This is a
newly emergent disorder and it is associated with a variety of psychiatric problems
(Ko et al. 2012), including several similar to those found in addictions (Brenne
1997). Several studies found that obsessive-compulsive symptoms are the most
related symptoms in both genders in Internet addicts (Chou, Condron, Belland
2005; Kim et al. 2006). This study displays that the symptoms of obsessive-
compulsive disorder are statistically associated with Internet Addiction. This
relationship has significant effects on treatment of Internet Addiction among young
people.
References
Alavi, Seyyed S.; Alaghemandan, Hamed; Maracy, Mohammad R., Jannatifard, Fereshte; Eslami,
Mehdi & Ferdosi, Masoud (2012). Impact of Addiction to Internet on a Number of Psychiatric
Symptoms in Students of Isfahan Universities, Iran. International Journal of Preventive Medicine.
Feb;3(2):122-7. PubMed PMID: 22347609; PubMed Central PMCID: PMC3278877.
Alavi, Seyyed S.; Maracy, Mohammad R.; Jannatifard, Fereshte & Eslami, Mehdi (2011). The Effect
of Psychiatric Symptoms on the Internet Addiction Disorder in Isfahan's University Students. Journal
of Research in Medical Sciences 16(6): 793–800. PMCID: PMC3214398.
Bargh, John A. & McKenna, Katelyn Y.A. (2004). The Internet and Social Life. Annual Review of
Psychology.
Beard, Keith W. & Wolf, Eve M. (2001). Modification in the Proposed Diagnostic Criteria for
Internet Addiction. Cyberpsychology & Behavior 4.3: 377-383.
Bertolotti, Giorgio; Michielin, Paolo; Sanavio, Ezio; Vidotto, Giulio &Zotti, Anna M. (1997).
Batteria CBA-2.0. [In:] Del Corno, Franco and Lang, Margherita. La diagnosi testologica. Test
neuropsicologici, test d‟intelligenza, test di personalità, testing computerizzato. Milano: Franco
Angeli.
29
Vol. 5, no. 1/2013 STYLES OF COMMUNICATION
Bertolotti, Giorgio; Sanavio, Ezio; Angelino, Elisabetta; Seghizzi, Paolo; Vidotto, Giulio; Bettinardi,
Ornella & Zotti, Anna M. (1995). Psychophysiological Reactivity, Depression, Neuroticism and Type
a Behavior: An Interactive effect?. Stress Medicine 11:123 – 9.
Bozkurt, Hasan H.; Coskun, Murat; Ayaydin, Hamza; Adak, Ibrahim; Zoroglu, Salih S. (2013)
―Prevalence and patterns of psychiatric disorders in referred adolescents with Internet addiction.‖ [In:]
Psychiatry and Clinical Neurosciences 67(5):352-9.
Brenner, Viktor (1997). Psychology of Computer Use: XLVII. Parameters of Internet Use, Abuse and
Addiction: The First 90 Days of the Internet Usage Survey. Psychological Reports 80 (3 Pt 1):879-82.
PubMed PMID: 9198388.
Chou, Chien; Condron, Linda & Belland, John C. (2005). A Review of the Research on Internet
Addiction. Educational Psychology Review 17(4):363–88.
Di Maria, Franco & Cannizzaro, Stefania (2001). Reti telematiche e trame psicologiche. Nodi,
attraversamenti e frontiere di Internet/ Computer Networks and Psychological Plots. Nodes, and
Border Crossings of the Internet. Franco Angeli.
Dong, Guangheng; Hu, Yanbo & Lin, Xiao (2013). Reward/Punishment Sensitivities among Internet
Addicts: Implications for their Addictive Behaviors. Progress in Neuro-Psychopharmacology &
Biological Psychiatry. Jul 19;46C:139-145. doi: 10.1016/j.pnpbp.2013.07.007. PubMed PMID:
23876789.
Egger, Oliver & Rauterberg, Matthia (1996). Internet Behavior and Addiction. Work &
Organizational Psychology Unit (IFAP), Swiss Federal Institute of Technology (ETH); Zurich.
Ferraro, Giovanni; Caci, Barbara; D‘Amico, Antonella & Di Blasi, Marie (2007). Internet Addiction
Disorder: An Italian Study. Cyberpsychology & Behavior 10:170–5.
Goldsmith, Jack & Wu, Tim (2006). Who Controls The Internet? Illusions Of A Borderless World.
Oxford University Press.
Hall, Alex S. & Parsons Jeffrey (2001). Internet Addiction: College Student Case Study Using Best
Practices in Cognitive Behavior Therapy. Journal of Mental Health Counseling 23(4):312–27.
Kim, Kyunghee; Ryu, Eunjung; Chon, Mi-Young; Yeun Eun-Ja; Choi, So-Young; Seo, Jeong-Seok &
Nam, Bum-Woo (2006). Internet Addiction in Korean Adolescents and its Relation to Depression and
Suicidal Ideation: A Questionnaire Survey. International Journal of Nursing Studies 43(2):185–92.
Kim, Seog J.; Park, Doo-Heum; Ryu, Seung-Ho; Yu, Jaehak & Ha, Jee H. (2012). Usefulness of
Young's Internet Addiction Test for Clinical Populations. Nordic Journal of Psychiatry, Dec 18.
[Epub ahead of print] PubMed PMID: 23249304.
Ko, Chih-Hung; Liu, Gin-Chung; Hsiao, Sigmund; Yen, Juyu; Yang, Ming J.; Lin, Wei-Chen; Yen,
Chengfang & Chen, Chengsheng (2009). Brain Activities Associated with Gaming Urge of Online
Gaming Addiction. Journal of Psychiatric Research 43(7):739–747.
Ko, Chih-Hung; Yen, Ju-Yu; Yen, Cheng-Fang; Chen, Chia S. & Chen, CC. (2012). The Association
between Internet Addiction and Psychiatric Disorder: A Review of the Literature. European
Psychiatry 27(1):1-8, Epub 2011 Dec 6. Review. PubMed PMID: 22153731.
Kraut, Robert; Patterson, Michael; Lundmark, Vicki; Kiesler, Sara; Mukophadhyay, Tridas &
Scherlis, William (1998). Internet Paradox: A Social Technology that Reduces Social Involvement
and Psychological Well-Being?. The American Psychologist 53(9):1017–1031.
Kuss, Daria J. & Griffiths, Mark D. (2012). Internet and Gaming Addiction: A Systematic Literature
Review of Neuroimaging Studies. Brain Sciences 2(3):347–374.
30
Vol. 5, no. 1/2013 STYLES OF COMMUNICATION
Kuss, Daria J.; Griffiths, Mark D.; Karila, Laurent & Billieux, Joël (2013). Internet Addiction: A
Systematic Review of Epidemiological Research for the Last Decade. Current Pharmaceutical
Design, Aug 29. [Epub ahead of print] PubMed PMID: 24001297.
Lemmens, Jeroen S.; Valkenburg, Patti M. & Peter, Jochen (2011). Psychosocial Causes and
Consequences of Pathological Gaming. Computers in Human Behavior 27(1):144–152.
Lin, Min-Pei; Ko, Huei-Chen & Wu, Joanna Y-W. (2011). Prevalence and Psychosocial Risk Factors
Associated with Internet Addiction in a Nationally Representative Sample of College Students in
Taiwan. Cyberpsychology, Behavior, and Social Networking 14(12):741–746.
Milne, George R.; Rohm, Andrew J. & Bahl, Shalini (2004). Consumers‘ Protection of Online
Privacy and Identity. Journal of Consumer Affairs 38 (2): 217–232.
Rusconi, Anna C.; Valeriani, Giuseppe; Carlone, Cristiano; Raimondo, Pasquale; Quartini, Adele;
Coccanari De' Fornari, Maria A. & Biondi, Massimo (2012). Internet Addiction Disorder and Social
Networks: Statistical Analysis of Correlation and Study of the Association with Social Interaction
Anxiousness. Rivista di Psichiatria/ Journal of Psichiatrics 47(6):498-507, Italian. PubMed PMID:
23160110.
Yau, Yvonne H. C.; Potenza, Marc N.; White, Marney A. (2013). Problematic Internet Use, Mental
Health and Impulse Control in an Online Survey of Adults. Journal of Behavioral Addictions
2(2):72.PubMed PMID: 24294501.
Young, Kimberly S. (1998a). Caught in the Net: How to Recognize the Signs of Internet Addiction
and a Winning Strategy for Recovery. New York: John Wiley & Sons.
Young, Kimberly S. (1998b). Internet Addiction: The Emergence of a New Clinical Disorder.
CyberPsychology & Behavior 3:237–44.
Young, Kimberly S. (1999). Internet Addiction: Symptoms, Evaluation and Treatment. [In:] Vande-
Creek, Leon. Jackson T. (eds.) Innovations in Clinical Practice: A Source Book. Vol. 17. Sarasota,
Fla, USA: Professional Resource Press: S. 19–S. 31.
Zotti, Anna M.; Bettinardi, Ornella; Soffiantino, Francesco; Tavazzi, Luigi & Steptoe, Andrew
(1991). Psychophysiological Stress Testing in Postinfarction Patients. Circulation 83:25 – 35.
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