Propriety of Internet Use Time for Internet Addiction among Korean Adolescents

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1 Vol.128 (Healthcare and Nursing 26), pp Propriety of Internet Use Time for Internet Addiction among Korean Adolescents Eun Sun So 1, Young-Ran Chin 2 1 Chonbuk National University, 2 Chungwoon University, San 2-20 Geumam-dong, Deokjin-gu, Jeonju-si, Jeonllabuk-do, South Korea soeunjee@naver.com 25 Daehak-gil, Hongseong-eup, Hongseong-gun, Chungnam, 32244, South Korea chinyr@chungwoon.ac.kr Abstract. In order to respond to the increasingly serious problem of internet addiction, there is a need for a more convenient method for early detection and intervention of those at high-risk. This study evaluated the self-reported internet use cut-off values for internet addiction among Korean adolescents aged 12 to 18 years old. The data was obtained from the K-scale, which is based on the 20 Youth Health Behaviors online survey data. The cut-off values for risk of internet addiction were determined using a receiver operating characteristics curve analysis. This study determined that, independent of smart phone use time, 2 hours and 30 minutes of use for high-risk internet addiction and 2 hours for potential risk of internet addiction were appropriate. We conclude that intensive care and active efforts for preventing internet addiction are required for those using the Internet for more than 2 hours a day. Keywords: Adolescent, Internet Addiction, Internet use time, Korea 1 Introduction The prevalence of internet addiction in Korea is the highest in the teens among all age groups and has been growing from 10.4% in 21 to 12.5% in 24 [1]. For adolescents, excessive internet use is associated with academic [2], psychological [3], and physical problems [4]. However, the definition and diagnostic criteria for internet addiction varies from country to country. In Korea, internet addiction is defined as a phenomenon that is accompanied by withdrawal symptoms and tolerance that has a negative effect on daily life [5]. In Korea, the KS Scale, developed by the Korean National Information Society Agency, is generally used to assess the risk of internet addiction [6]. Based on this measurement, daily use of 4 hours or more is considered high risk for internet addiction, and 3 hours or more indicates potential risk. However, these criteria have not been validated by independent research. Therefore, the purpose of this study is to establish criteria for high risk and potential risk of internet addiction among Korean adolescents. The specific objectives are ISSN: ASTL Copyright 26 SERSC

2 Vol.128 (Healthcare and Nursing 26) first to compare the frequency and characteristics of risk groups for internet addiction, and second, to set the internet use criteria to determine internet addiction. 2 Methods Data and Participants We performed a secondary data analysis of the 20 Korea Youth Risk Behavior Web-Based Survey (KYRBS), a cross-sectional study. The KYRBS was conducted annually by the Korean Centers for Disease Control and Prevention (KCDC) and the Ministry of Health and Welfare of Korea to evaluate the prevalence of health-risk behaviors among Korean students aged between years (grades 7 to 12) [7]. To select a nationally representative sample, a complex sampling method including multistage sampling, stratification, and clustering was employed. A total of 74,980 students were eligible for the study, and 73,238 students completed the survey with the response rate of 97.7%. We analyzed data on 73,238 students who answered questions about Korean Internet Addiction Proneness Scale for Youth-Short Form: Self Report (KS Scale) Variable measurement The 'KS Scale' was used to assess the risk of internet addiction [6]. The KS scale consists of 20 items, each rated on a 4-point scale (1-4), to screen for youth who are prone to problematic internet use, and it consists of six domains: 'disturbance of adaptive function', 'positive anticipation', 'withdrawal', 'virtual interpersonal relationship', 'deviant behaviors', and 'tolerance'. It is defined as high risk (definite) group for internet addiction is when the total scores 53 or satisfies all of the following criteria; 'disturbance of adaptive function domain' scores 17, 'withdrawal domain' scores 11, and 'tolerance domain' scores 13. It is defined as potential risk group for (probable) internet addiction when it meets one of the following criteria; 48 total scores 52, 'disturbance of adaptive function domain' scores 15, 'withdrawal domain' scores 10, or 'tolerance domain' scores 12. Cronbach's alpha score for the KS Scale for middle school students was at the time of development. Internet use time was measured by the average daily internet operating time for the last 30 days. Sociodemographic variables included sex, school level, and household socioeconomic status (SES). Household SES was measured by 5-scales (low, middle-low, middle, middle-high, and high). Data analysis Based on the complex survey design, all data were weighted by the proportions in each sex, school year, and grades within each geographic area. Descriptive statistics and chi-squared tests were used to demonstrate internet addiction characteristics and compare demographic and internet use time characteristics according to internet addiction groups. The receiver operating characteristics (ROC) curve was used to present the optimal thresholds for each parameter of internet use time associated with an 24 Copyright 26 SERSC

3 Vol.128 (Healthcare and Nursing 26) increase in the prevalence of the internet addiction groups with the best combination of sensitivity and specificity. All the statistical analyses were performed with SPSS 20.0 (IBM Corp., Armonk, NY, USA). 3 Results Of the total of 73,238 adolescents analyzed, high risk for internet addiction was 3.0% (N= 2,196), and potential risk for internet addiction was 11.9% (N=8,722). Compared to the no internet addiction group, the demographic and internet use time characteristics of the high risk and potential risk groups were as follows: male, high school student, from a lower household SES, and longer internet use. The differences were greater in the high risk group for internet addiction (Table 1). Table 1. Demographic and internet use characteristics according to internet addiction group n (%) Variables (Internet addiction) Total High risk group Potential risk group No. Sex Male (52.8) (69.3) (61.7) (51.0) School level High (49.9) (49.6) (55.2) (49.1) Household High SES (6.9) (7.9) (4.6) (7.2) Middle-high (23.1) (17.5) (19.2) (23.8) Middle (46.4) (39.7) (45.8) (46.8) Middle-low (17.7) (20.6) (22.9) (16.9) Internet use Low 4523 (5.9) 322 (14.4) 695 (7.6) 3506 (5.4) time Mean ± (minute) SD p Figure 1 and 2 present the internet use time optimal values by maximizing sensitivity and specificity for internet addiction by using a ROC curve. For high risk of internet addiction, the internet use time was minutes (sensitivity 75.0%, specificity 66.0%, p <.0). For potential risk for internet addiction, the internet use time was minutes (sensitivity 71.0%, specificity 54.4%, p <.0). Copyright 26 SERSC 25

4 Vol.128 (Healthcare and Nursing 26) Fig. 1. Receiver-operating characteristic curves for internet use time associated with an increase in high risk and potential risk for internet addiction among adolescents. 3 Conclusions In this study, Korean adolescents demonstrated a 3.0% high risk of internet addiction and 11.9% potential risk of internet addiction. The higher risk groups for internet addiction tended to be male, high school, in a lower household SES, and use the internet longer. For high risk of internet addiction, the use time criteria was minutes, and for potential risk, it was minutes. The findings in the K-scale tools were shorter than 4 hours and 3 hours, for high and potential risk, respectively. This study suggests that intensive care and active efforts for preventing internet addiction are required for those using internet more than 2 hours a day in the future. References 1. Park, S.K., Kim, J.Y., Cho, C.B.: Prevalence of Internet addiction and correlations with family factors among South Korean adolescents,. Adolescence, Vol.43, pp (2008) 2. Kim, D.H., So, W.Y.: The relationship between daily internet use time and school performance in Korean adolescents, Central European Journal of Medicine, Vol.7, No.4, pp (22) 3. Block, J.J.: Issues for DSM-V: Internet addiction, American Journal of Psychiatry, Vol.165, pp (2008) 26 Copyright 26 SERSC

5 Vol.128 (Healthcare and Nursing 26) 4. Kwon, J.H., Chung, C.S., Lee, J.: The effects of escape from self and interpersonal relationship on the pathological use of internet games, Community Mental Health Journal, Vol.47, pp (21) 5. National Information Society Agency, Directions of legislation improvement for prevention and solution of internet addiction (20) 6. National Information Society Agency, K-scale adolescents self-diagnostic questions and commentary (22) 7. Korean Centers for Disease Control and Prevention, 22 Korea Youth Risk Behavior Web-Based Survey. Ministry of Health and Welfare of Korea (22) Copyright 26 SERSC 27