Internet addictions outside of Europe: A systematic literature review

Abstract Background and aims The growing problem of Internet addiction has been acknowledged through the inclusion of Gaming Disorder in the American Psychiatric Association's fifth Diagnostic and Statistical Manual of Mental Disorders in April 2013. In response to a recent review report on the research published in Europe since the adoption, this review summarizes and investigates studies published outside of Europe between April 2013 and September 2019. Methods Literature on Internet addiction was included and reviewed critically following the PRISMA guidelines, with the objectives to (i) highlight the main findings in explorative and intervention studies and (ii) to investigate the cultural similarities and differences within the extra-European regions. A critical look is cast on the validity and reliability of the studies in question. Results A total of 64 studies met the inclusion criteria. The majority of studies investigated Internet addiction and Internet gaming addiction; however, studies on addiction to online gambling, online pornography, and social media addiction were also included. Demographically East Asia was highly represented through studies from China, Japan, and South Korea. Prevalence rates of generalised Internet addiction varied from 12.6% to 67.5%. The main findings revealed a range of risk factors associated with online addictions, such as psychological distress, mood disorders, suicidality, impulsivity, aggression, and sleep problems. Most of the intervention studies made use of a cognitive behavioural therapy approach, although other interventions appeared effective in reducing addiction symptoms. Further katamnestic research is needed to follow up on intervention studies. Conclusions Based on the consistent findings of positive associations between online addictions and mental health problems across cultures in combination with relatively high prevalence rates amongst adolescents and university students, further research is needed and prevention strategies and treatment offers require developing and implementing.