Problematic Internet use among teens, and how to measure it

A team of our (smart) researchers from SMAHRT descended on Washington, D.C. last weekend for the Pediatric Academic Societies annual meeting. SMAHRT = Social Media and Adolescent Health Research Team, which is based at Seattle Children’s Research Institute. This week, we’ll feature some of their new research. Megan Moreno, MD, leads the group and is a senior author on all of the research studies. Some of the researchers are based at other academic institutions, demonstrating the collaborative spirit of SMAHRT.

Internet connection The concept of “problematic Internet use” has been kicked around for the last 10 years or so. Are younger people using the Internet too much? Are certain online behaviors harmful for teens and young adults? My research focuses on adolescent health and Internet use, and how we can help teens who might be struggling.

When the Internet becomes a problem

How do we define risky, problematic use? It’s defined as Internet use that is risky, excessive or impulsive in nature, and that leads to adverse life consequences – physical, social, emotional or functional impairment.  Social or emotional impairment means the person is choosing to spend more time socially online instead of creating relationships in real life. An example of functional impairment means you’re not sleeping at night because you’re staying up to use the Internet, or you’re not doing well in school because you’re spending too much time online. Someone might feel irritated or anxious when not able to use the Internet on daily basis.

One of our motivations from the research perspective is that there is no clear picture of problematic Internet use, how to measure it and how to identify people who may be struggling.  One of our goals with this research was to develop a screening tool that could be used in clinical settings and schools. The tool would assess how young people are using the Internet and how it may be affecting their health and wellbeing. If we have a screening tool, we can start to identify the problem when kids are growing up, and starting to use the Internet.

This screening instrument—including 18 questions—could be used as a survey for research purposes or it could be a questionnaire teens fill out in the doctor’s office or other social settings like schools, with counselors or similar staff. The scale we’ve used assesses emotional wellbeing, social wellbeing, and risky, problematic Internet use.

A sample question on the survey is: How often does the patient or client choose to socialize online instead of in person?

For our study and to develop the screening tool, we worked with older teens, adolescent health providers, pediatricians, counselors and psychologists, among others. We sought advice from a group of college students to come up with screening guidelines.  And we also looked at other health measures –depression, social anxiety and ADHD—to see what screening tools were being used for those conditions.

What should parents watch for?

In the first phase of our study, more than 700 undergraduate students ages 18 to 25 took a preliminary questionnaire. In the second part of our study, more than 300 students took the survey along with general Internet use questions and mental health condition questions.

What did we find? Young people who scored high on the problematic Internet use screening tool were more likely to also report being depressed, having social anxiety and ADHD. It’s pretty concerning.

What’s my advice for parents? The Internet is a pretty integral part of daily life for most people. We need to improve how we talk about Internet use with younger people. We ask teens: Do you wear your seatbelt, and how much alcohol are you drinking? Discussing Internet use hasn’t traditionally been a part of that type of conversation, but it needs to be.

Lauren Jelenchick, MPH, is a first-year medical student and enrolled in the Medical Scientist Training Program (MD/PhD) at the University of Minnesota.