Do you feel preoccupied with the Internet (think about previous on-line activity or anticipate next on-line session)?
Do you feel the need to use the Internet with increasing amounts of time in order to achieve satisfaction?
Have you repeatedly made unsuccessful efforts to control, cut back, or stop Internet use?
Do you feel restless, moody, depressed, or irritable when attempting to cut down or stop Internet use?
Do you stay on-line longer than originally intended?
Have you jeopardized or risked the loss of significant relationship, job, educational or career opportunity because of the Internet?
Have you lied to family members, therapist, or others to conceal the extent of involvement with the Internet?
Do you uses the Internet as a way of escaping from problems or of relieving a dysphoric mood (e.g., feelings of helplessness, guilt, anxiety, depression)?
Patients were considered "addicted" when answering "yes" to five (or more) of the questions and when their behavior could not be better accounted for by a Manic Episode. Young (1996) stated that the cut off score of "five" was consistent with the number of criteria used for Pathological Gambling and was seen as an adequate number of criteria to differentiate normal from pathological addictive Internet use. I should note that while this scale provides a workable measure of Internet addiction, further study is needed to determine its construct validity and clinical utility. I should also note that a patient’s denial of addictive use is likely to be reinforced due to the encouraged practice of utilizing the Internet for academic or employment related tasks. Therefore, even if a patient meets all eight criteria, these symptoms can easily be masked as "I need this as part of my job," "Its just a machine," or "Everyone is using it" due to the Internet’s prominent role in our society.
Cognitions
Addictive thinkers, for no logical reason, will feel apprehensive, when anticipating disaster (Twerski, 1990). While addicts are not the only people who worry and anticipate negative happenings, they tend to do this more often than other people. Young (1996) suggested that this type of catastrophic thinking may contribute to addictive Internet use in providing a psychological escape mechanism to avoid real or perceived problems. In subsequent studies, she found that maladaptive cognitions such as low self-esteem and worth, and clinical depression triggered pathological Internet use (Young, 1997a, Young 1997b). Young (1997a) hypothesized that those who suffer from deeper psychological problems may be the ones who are drawn the most to the anonymous interactive capabilities of the Internet in order to overcome these perceived inadequacies.