Paralleling the rapid growth in internet access is a rise in internet addiction, especially among adolescents, gaining increased attention from the popular media, government authorities, and researchers
. Internet addiction is characterized by a maladaptive pattern of internet use leading to clinically significant impairment or distress
Internet addiction may interfere with people’s daily lives, and had short and long-term effects on their social, psychological and physical well-being. According to previous studies, internet addiction was associated with obsessive-compulsive and depressive disorders, attention-deficit hyperactivity disorder, hostility/ aggressive behaviors, impaired executive control ability, and multiple structural changes in the brain
However, there is currently no standardized definition or diagnosis criteria for internet addiction. Based on empirical diagnostic interviews and epidemiological studies, Young and Ko et al.
[2, 4, 6] proposed their diagnostic criteria for Internet addiction in which withdrawal, poor planning abilities, tolerance, preoccupation, impairment of control, and excessive online time were defined as core symptoms of Internet addiction. Until now, internet addiction is a proposed but unproven disorder, and the upcoming inclusion of Internet addiction in the DSM-V as a disorder in need of further study compels further investigation.
Adolescents (also called teen-ages) usually have poorer self-control, worse self-regulation, and poorer cognition than college-age populations or adults, but they have the same desire for independence as college-age populations or adults do. On the other hand, nowadays, computer use by adolescents is encouraged, and in some courses is required. The use of the internet is logical and common even outside the classroom. Most of the high school libraries, families, and internet café have internet access, and adolescents are easy to have access to the internet. In addition, parents exercise less control over adolescents than younger children in elemental schools or kindergartens. Therefore, adolescents are considered as the most vulnerable group to the temptations of the internet
Current US data suggest that 93% of young people between the ages of 12 and 29 years have used the internet at least once
. According to the statistical report of China Internet Network Information Center, over 500 million people in China had access to the Internet as of September 2011. Of those, approximately 33% were teenagers below 18 years of age and 60% were between 10–29 years of age
In addition to genetic factors such as presence of the SS-5HTTLPR gene, family and environmental factors, previous studies have shown the possibility that personal factors may play a key role in internet use and the development of adolescent internet addiction (AIA)
. Adolescent personality traits that correlated positively with internet addiction included high harm-avoidance, reward dependence, low self-esteem, and low cooperativeness
. Yet previous studies may have limitations. First, some studies that addressed the inherent personality of adolescents susceptible to AIA by using psychological measurements had shown inconsistent results
[11, 12]. Secondly, those studies that were conducted online or on relatively small sample sizes, raising the question of their representativeness of the general population
. Thirdly, some studies found that drinking and smoking behaviors were potential risk factors for AIA, but these two risk factors are surely insufficient to characterize all the risk factors of AIA
[2, 7]. Finally, many studies were performed among college students who were typically 18 years of age, older than the adolescent range of 12–17 years of age.
Therefore, we performed a large cross-sectional survey in 16 high schools of Shanghai city, of which, the aim was to investigate the prevalence of AIA among high school students and to assess whether the students’ personal characteristics had potential impacts on the risk of AIA.