Galton Shen vividly remembers the first time he treated a patient whose suffering was linked to an addiction to the Internet. “He was a young man, just 22, complaining of severe constipation,” says Shen, a physician who shares a clinic with another doctor in Changhua County’s Beidou Township in central Taiwan. “I’ve treated every member of his family over the years, so I knew something about their lifestyles. I asked him some questions about his diet and habits, and it was soon obvious that his problem was a result of not eating regularly and not eating healthy foods,” recalls Shen. “This surprised me because his parents grow their own vegetables.”
The next day, the young man’s mother visited Shen — to discuss her son’s health rather than her own, it turned out. “Pretty soon, I got a clearer picture of what was happening. He wasn’t working or studying, and he was spending at least 100 hours each week in an Internet cafe. Whenever he felt hungry, he’d eat instant noodles or some junk food. He wasn’t drinking enough water, and he wasn’t exercising,” the doctor says.
Shen called the young man in for another consultation. “I told him he needed to reduce his computer use, improve his diet and so on. But I knew my advice probably wouldn’t be effective. I could see it was an addiction, a compulsion that had taken over his life.”
Over the course of his career, Shen has on numerous occasions advised alcoholics to reduce their drinking and smokers to quit. “With smokers and alcoholics, I could refer them to programs that might help. But with this young man, I had nothing to offer.” Within a few months, however, the 22-year-old had drastically reduced the amount of time he spent playing online games. Shen does not take any credit for this. “He began to suffer severe eyestrain. According to his mother, the physical discomfort and warnings from his ophthalmologist pushed him to change his lifestyle,” the doctor notes.
Shen’s diagnosis of the young man took place in 2003, when the study of Web addiction in Taiwan and elsewhere was in its infancy. Among the pioneering researchers in this field locally were Wang Chih-hung, now an associate professor of Guidance and Counseling at National Changhua University of Education, and Ko Huei-chen, currently dean of the College of Humanities and Social Science at Asia University in central Taiwan’s Taichung City and head of the Center for Prevention and Treatment of Internet Addiction, also in Taichung. Since its establishment in 2012, the center has been developing diagnostic criteria for Internet disorders, researching and providing treatment for addicts, and working with various nongovernmental organizations to promote healthy computer use.
When trying to gauge the extent of Internet addiction among a group or in an individual, one of the most commonly used diagnostic tools is the Revised Chen Internet Addiction Scale (CIAS-R). The original CIAS was devised more than a decade ago by Chen Sue-huei, a professor in the Department of Psychology’s Division of Clinical Psychology at National Taiwan University in Taipei.
The CIAS-R comprises 26 questions that are answered on a scale of 1—“Does not match my experience at all”—to 4—“Definitely matches my experience.” The minimum possible score is 26, and the maximum is 104. The CIAS-R is also often used in mainland China and Hong Kong. Cross-border comparisons suggest problematic Internet use in Taiwan is comparable to other societies where inexpensive Web access is almost universal.
For a 2011 study, Ko and her co-authors considered a score of 64 or higher to indicate Web dependency, and concluded that the level of Internet addiction among local college students was 15.3 percent. They found Web addicts not only spent more time using the Internet than non-addicts, but were also more likely to display symptoms of depression, feel unsatisfied with their academic performance, and exhibit lower refusal self-efficacy, which is the ability to ignore the Internet when it is available. The study further suggested that Internet addicts were more likely to be male than female.
Researchers using other methods have come up with similar results. Between 1999 and 2003, Tsai Chin-chung and Sunny S.J. Lin of National Chiao Tung University’s Center of Teacher Education published survey results indicating that around 12 percent of Taiwanese high-school students were addicted to the Internet, spending at least 20 hours online per week.
According to the results of an Asia University-National Cheng Kung University survey of more than 9,000 individuals published in September 2015, young Taiwanese spend a great deal of time on the Web. Excluding school-related online activity, those in the fourth to sixth grades are on the Internet for 57.8 minutes per day. Junior high school students are online for 115.8 minutes daily, while for senior high schoolers the figure is 147.2 minutes. These are weekday averages; on weekends, the daily totals approximately double.
There are five generally accepted categories of Internet addiction. The first is a cyber-sexual addiction to online pornography and adult chat rooms. The second is compulsive shopping, gambling or stock trading. The third is compulsive searching for and consumption of information. The fourth is the obsessive playing of computer games. The fifth is an unhealthy preference for relationships with people online rather than real-world friends and relatives.
The proliferation of smartphones in recent years appears to have altered the nature of Internet dependency. According to experts, the typical addict is less likely than before to be a teenager who engages in overnight binge sessions of gaming at Internet cafes, and more likely to be someone in their 20s who checks their phone for social network updates several times each hour...
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