Research on Internet Addictive Behaviours among European Adolescents



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Funded by the European Union Safer internet plus Research on Internet Addictive Behaviours among European Adolescents Εditors: Artemis Tsitsika, Eleni Tzavela, Foteini Mavromati and the EU NET ADB Consortium

The Consortium University Medical Center of the Johannes Gutenberg University Mainz (UMC Mainz) University of Akureyi Iceland IVO Addiction Research Institute Netherlands The Central Authority for Media and Communication in Rhineland Palatinate (LMK) Germany Nobody s Children Foundation Poland University of Medicine and Pharmacy lasi Romania Protegeles Spain Adolescent Health Unit (A.H.U) University of Athens Greece Overall Coordinator Quantitative Component Coordinator Qualitative Component Co-coordinator: Greece Institution: Adolescent Health Unit (A.H.U.) Second Dpt of Pediatrics - University of Athens P. & A. Kyriakou Children s Hospital Chairman: Univ.-Prof. Chryssa Tzoumaka-Bakoula Qualitative Component Coordinator: Germany Institution: Outpatient Clinic for Computer Game and Internet Addictive Behaviour Mainz/ Clinic and Polyclinic for Psychosomatic Medicine and Psychotherapy at the University Medical Center of the Johannes Gutenberg- University Mainz Chairman: Univ.-Prof. Dr. Reinhard Urban 2 Research on Internet Addictive Behaviours among European Adolescents

Definition Internet Addictive Behaviour (IAB) is defined as a behavioural pattern characterized by a loss of control over internet use. This behaviour potentially leads to isolation and neglect of social, academic and recreational activities or personal hygiene and health. Aim of Study Among European adolescents: Evaluate the prevalence and determinants of IAB Qualitatively assess the development of IAB Increase awareness among the wider public regarding IAB Enhance the knowledge base required for the development of prevention and intervention strategies relating to IAB a. Quantitative component Methodology Questionnaire including: 1. Internet use (Socio-demographic data, family, school achievement, internet usage characteristics, parental control) 2. Internet Addiction Test (IAT; Young, 1998), 3. Gaming (AICA-S; Wölfling, Müller & Beutel, 2010), 4. Gambling (SOGS-RA; Winters, Stinchfield, & Fulkerson, 1993) and 5. Psychosocial characteristics (YSR; Achenbach & Rescorla, 2001) Representative sample from each country up to 2000 questionnaires / country (final sample of 13.300 questionnaires) Adolescents 14-17 years old Data collection: October 2011 May 2012 b. Qualitative component Interviews of adolescents showing signs of IAB (IAT score > 30) Up to 20 interviews / country (124 final interviews) Full-stepwise approach of Grounded Theory (Strauss & Corbin, 1990) Adolescents 14-17 years old Data collection: June 2011 - June 2012 3

RESULTS I. Quantitative component Authors Tsitsika Artemis (Greece), Janikian Mari (Greece), Tzavela Eleni (Greece), Schoenmakers Tim (Netherlands), Olafsson Kjartan (Iceland), Halapi Eva (Iceland), Tzavara Chara (Greece), Wojcik Szymon (Poland), Makaruk Katarzyna (Poland), Critselis Elena (Greece), Müller Kai W. (Germany), Dreier Michael (Germany), Holtz Sebastian (Germany), Wölfling Klaus (Germany), Iordache Andreea (Romania), Oliaga Ana (Spain), Chele Gabi (Romania), Macarie George (Romania), Richardson Clive (Greece) 1. Internet Addictive Behaviour (IAB) Dysfunctional Internet Behaviour (DIB) Internet Addictive Behaviour (IAB) (IAT score > 70) At risk for IAB (IAT score >40) Addictive Behaviour 1.2% of the total sample presents with IAB, while 12.7% with at risk IAB (13.9% DIB) Spain, Romania, and Poland show higher prevalence of DIB, while Germany and Iceland the lowest in the study Figure 1 Boys, older adolescents and those whose parents have lower educational level are more likely to exhibit DIB Figure 2 The group of DIB has lower psychosocial well-being Table 1 Gambling, social networking and gaming are strongly associated with DIB, while watching videos/movies was not related to DIB and doing homework/research was negatively associated with DIB, indicating that the more adolescents use the internet for homework/research the less signs of DIB they show Table 2 4 Research on Internet Addictive Behaviours among European Adolescents

Figure 1. Percentage of adolescents at risk for IAB or with IAB, by country Figure 2. Percentage of adolescents at risk for IAB and with IAB (dysfunctional internet behaviour - DIB), by gender, age and parental educational level. Table 1. Psychosocial characteristics (YSR) for adolescents with functional internet behaviour FIB vs dysfunctional internet behaviour - DIB (IAT) Table 2. Presented odds ratios (OR) for the effect of internet activities on having DIB 5

2. High risk behaviour Grooming 63% of total sample communicate with strangers online 9.3% of those communicating with strangers online state that this experience was perceived as harmful for them (5.4% of total sample) 45.7% of those communicating with strangers online have gone on to meet face to face someone who they first met on the internet (28.4% of total sample) Risk of grooming is higher in Romania, Germany and Poland, and lowest in Greece Sexual Content 58.8% of the total sample are exposed to sexual images 32.8% of those exposed to sexual images state that this experience was harmful (18.4% of total sample) More boys than girls have been exposed to sexual images Cyberbullying 21.9% of total sample experience bullying online 53.5% of those bullied state that this experience was harmful (11.2% of total sample) More girls than boys experience bullying Romania and Greece have the higher percentages, while Iceland and Spain the lower. Risk vs harm Although a significant number of adolescents may be exposed to internet risks, a much lower number experiences harm Key point Educate young people to deal with risks, so that they do not experience harm 6 Research on Internet Addictive Behaviours among European Adolescents

3. Internet activities Social Networking 92% of total sample are members of at least one Social Networking Site (SNS) 39.4% of adolescents spend at least 2 hours on SNS on a normal school day Using SNS more than 2 hours daily is associated with DIB More girls than boys use SNS Having more than 500 online friends is associated with DIB Gambling 5.9% of total sample gamble online, while 10.6% gamble in real life Romania and Greece have the higher gambling percentages (online and in real life) Adolescents who gamble have 3 times higher risk of exhibiting DIB Gaming 61.8% of total sample are gamers Adolescents who play games have 2 times higher risk of exhibiting DIB Gaming more than 2.6 hours / day is associated with DIB Boys are more likely to abuse or be addicted to gaming 7

RESULTS II. Qualitative component Authors Dreier Michael (Germany), Tzavela Eleni (Greece), Wölfling Klaus (Germany), Mavromati Foteini (Greece), Duven Eva (Germany), Karakitsou Chryssoula (Greece), Macarie George (Romania), Veldhuis Lidy (The Netherlands), Wοjcik Szymon (Poland), Halapi Eva (Iceland), Sigursteinsdottir Hjordis (Iceland), Oliaga Ana (Spain), Tsitsika Artemis (Greece) Navigating adolescent pathways: A grounded theory study on adolescents internet use and addictive behaviours 1. Role of internet in adolescence Adolescents are especially attracted to the internet because of their developmental characteristics (teen thirst and curiosity) for: - getting answers on a wide range of questions - attaining fast and most current information - keeping in touch with existing and new contacts - having fun The internet eases (facilitates) everyday life in adolescence, however some teenagers need to feel boosted (empowerment) Empowerment comes through positive online encounters (being liked, gaining excellence in games, feeling equal and filling empty time) Empowerment may fill a void, when it comes to adolescents with deficient offline social skills Easiness vs Empowerment Adolescents with under developed offline skills may: - experience a high degree of empowerment through internet and thus, - are more vulnerable to the development of Dysfunctional Internet Behaviour (DIB) 8 Research on Internet Addictive Behaviours among European Adolescents

2. Strategies Adolescents, following their personal online journeys of exploration (digital pathways) develop various strategies, in order to handle the phenomenon of being always online : - Adaptive strategies (effort to balance online and offline engagements): self-monitoring prioritizing exploring offline alternatives - Maladaptive strategies (effort to maintain increased online engagement): bypassing parental control normalisation legitimizing use The properties that determine the strategies are: self regulation readiness for change (motivation in changing behaviours that cause objective difficulties) 3. Processes leading to digital outcomes Adolescent developmental thirst and internet being so fascinating for youth, is a combination frequently predisposing to a period of intense online engagement ( Always Online and Checking Out mode) Self regulation and readiness for change, result to the strategies used to deal with the Always Online and Checking Out mode Process outline: As a result of adaptive and maladaptive strategies used, in order to deal with the always online mode, participants progressed on their current online position (types of internet users at risk of having / had DIB digital outcomes) 9

4. Digital Outcomes (types of internet users at risk for having / had DIB) or the Model of Four A. Stuck Online Well I used to go out more. Being outside, going swimming, or stuff like that. I haven t being swimming for about 2 years. I haven t been out with my friend in the evening for over 4 months now, such things you neglect. [Boy, 16 Years] - excessive internet use - neglect of main areas of daily routine (school, friends, duties) - specific online activities - negative effects of overuse (sleep disturbance, distress if unable to go online) - difficulty to reduce, even if acknowledging negative impact This type may have thirst for life and offline experiences, however due to deficient social skills he/she feels disappointed, bullied or excluded and thus trapped online. B. Juggling it all Because I am busy and next to that I spend a lot of time on the internet. Then it s hard to manage everything. But I get everything done. [Girl, 15 Years] - balancing to everyday activities and internet use - online and offline presence - stress within a busy schedule This type may have thirst for life and offline experiences, and also a good level of social competence. Online activities may have a strong connection to offline activities (e.g. an adolescent with a lot of friends may highly engage on Facebook etc.). 10 Research on Internet Addictive Behaviours among European Adolescents

C. Coming full cycle I started visiting social networks like Facebook, saying ah, here there are many people, I meet new people, that s nice, staying [online] for more and more time, making comments, uploading stuff and creating a new life in there. Like a virtual reality. Um I think that happened. After a while though, you come full cycle, you start saying «what am I doing now?, you get tired of it, you shut it down, you go out and you start cutting down on the time you spend on it. Just like that; it comes full cycle. [Girl, 17 years] - excessive online pattern - progressive and adaptive change and self-correction - self-correction may come through: a. saturation ( Got sick of it ) b. acknowledging negative consequences (physical problems, aches, academic downfall, parental conflicts etc.) c. motivation (romantic relationship, etc.) This type shows thirst for life, offline experiences and social competencies, however due to the developmental characteristics of the age he/she experiences a cycle of intense internet use and breaks through self correction. D. Killing boredom Well, I really don t care. I just kill time. I feel so bored [Boy, 17 years] - offline environment is perceived as boring - lacking alternative activities of interest - online engagement provides a comfortable time filler - an automatized reaction to boredom This type lacks thirst for life and offline experiences, and may have limited social skills. The Model of Four may consist as a tool for categorizing users with DIB and having an initial prognosis. Types A and D seem to have poorer prognosis and co-morbidity (anxiety, depression, attention disorders etc.). In these cases, DIB may be the tip of the iceberg the expression of an underlying psychosocial difficulty that mainly needs the intervention Types A and D most probably will not self-correct and may need professional help Types B and C seem to be functional users and loss of control is mainly connected with developmental adolescents patterns Types B and C most probably will self-correct and may not need any intervention at all. Type C however, may loose quite a significant time interval during the cycle and some kind of help may be needed 11

Overall Coordinator Quantitative Component Coordinator Qualitative Component Co-coordinator: Greece Tsitsika Artemis, Tzavela Eleni, Janikian Mari, Mavromati Foteini, Critselis Elena, Tzavara Hara Qualitative Component Coordinator: Germany Dreier Michael, Duven Eva, Müller Kai W., Beutel Manfred E., Wölfling Klaus Germany The Central Authority for Media and Communication in Rhineland Palatinate (LMK) Behrens Peter, Holtz Sebastian, Tatsch Isabell Iceland University of Akureyri (UNAK), Olafsson Kjartan, Halapi Eva, Sigursteinsdottir Hjordis Spain Protegeles Oliaga Ana Netherlands IVO Addiction Research Institute Schoenmakers Tim, Veldhuis Lydian Romania University of Medicine and Pharmacy Gr. T. Popa Iasi Macarie George Florian, Chele Gabriela, Iordache Andreea, Stefanescu Cristinel Poland Nobody s Children Foundation, Makaruk Katarzyna, Wojcik Szymon, Wlodarczyk Joanna, Wlodarczyk Zofia, Wildner Ewelina Contact details Artemis Tsitsika and Eleni Tzavela EU NET ADB Overall Coordination Adolescent Health Unit (A.H.U.) Second Dpt of Pediatrics University of Athens P. & A. Kyriakou Children s Hospital 24th Mesogeion Avenue, Athens, GR 11527, Greece Tel. ++210 7710824 info@youth-health.gr Funded by the European Union Safer internet plus