Cyber Addiction and the Role of Social Anxiety Disorders among College-Going Students of the Central Kashmir: A Cross-Sectional Study : Malaysian Journal of Psychiatry

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Original Article

Cyber Addiction and the Role of Social Anxiety Disorders among College-Going Students of the Central Kashmir: A Cross-Sectional Study

Paul, Fayaz Ahmad,; Swain, Mamata1; Banerjee, Indrajeet

Author Information
Malaysian Journal of Psychiatry: Jan–Jun 2022 - Volume 31 - Issue 1 - p 39-43
doi: 10.4103/mjp.mjp_11_22
  • Open

Abstract

INTRODUCTION

Internet addiction is commonly thought of as an impulse-control disorder that has a negative and harmful impact on one’s psychological and physical well-being.[1] Bricolo in 2012 proposed that the most reliable and valid criteria for conceptualizing Internet addiction were using the adapted Diagnostic and Statistical Manual of Mental Disorders (4th ed., DSM-IV; American Psychiatric Association, 1994).[2] The signs and symptoms of Internet addiction include restlessness when attempting to minimize or stop surfing the Internet, unsuccessful attempts, and efforts to control excessive use, cravings, feelings of distress, social anxiety, and continuous online surfing regardless of the negative effects on social and psychological well-being among the users.[3]

According to various research studies, college-going students are the most vulnerable group in society when it comes to developing Internet addiction.[4] The Internet is considered an excellent source for socialization with others through the formation of close and strong relationships, especially for students who have social anxiety or discomfort in face-to-face interaction.[5] According to the DSM-5, social anxiety is fear or worry in social circumstances, especially when an individual is under scrutiny or faces the risk of negative judgments by others.[6]

Social anxiety disorder is a debilitating mental health illness that affects 12%–16% of the population.[7] Various research studies highlight that individuals affected with social anxiety sufferers frequently have comorbid conditions such as depression, suicidal thoughts, and drug addiction.[89] It also reduces productivity and has an impact on one’s quality of life. In the current situation, India has the second-largest number of Internet users after China, and the number of Internet users is growing rapidly every year. By 2024, the number of Internet users is expected to reach 638.5 million.[10] The Jammu and Kashmir state has been experiencing a steady increase in the number of Internet users. The figure for March 2020 was 38.4 lakh and by the end of June, it reached 44.3 lakh.

The growth in the number of Internet users has prompted researchers to study the adverse effects of Internet use, especially among youth.[11] Excessive Internet usage has been recognized as a public health risk by the World Health Organization (WHO) despite the fact that Internet addiction is not yet an official diagnosis according to DSM-5.[12] In addition, persons with Internet addiction have been found to have a variety of mental health comorbidities such as sleeplessness, depression, poor self-esteem, and anxiety disorders.[1314]

The present research study was conducted with the aim of estimating social anxiety and Internet addiction among college students and its relationship with social anxiety and Internet addiction among college students of the central part of Kashmir.

MATERIALS AND METHODS

This current cross-sectional study was conducted in three districts of Kashmir among college-going students aged 18–30 years. The researcher conducted the study at these colleges for the following reasons (1) the colleges were located in the central part of the Kashmir division, (2) students contained different streams of academic programs, and (3) students from these colleges represent diverse socioeconomical and geographical backgrounds.

Inclusion criteria

Students aged 18–30 years of age are presently enrolled in professional or nonprofessional degree programs. Both genders were included and students who are willing to participate in the study.

Exclusion criteria

Inability to comprehend the English language, as the questionnaire was in English. Above the age of 30 years will be excluded from the current study.

Sample size of the study

A sample size of 200 participants was recruited. However, to overcome the problems of attrition and incomplete questionnaires, the final sample was 220 students at a precision of 10% and a 95% confidence interval.

Recruitment of participants

Three colleges were selected randomly (Srinagar, Budgam, and Ganderbal); these three college students in 1st year, 2nd year, and 3rd year were recruited through stratified random sampling to achieve the required sample size. Valid informed consent was taken from the participants, and after that tools were administered to college-going students.

Tools used for the study

Sociodemographic performa

It is a semistructured performa used for the purpose of the current study; the researchers developed a questionnaire to gather information regarding student demographics which includes, gender, age, current college year, marital status, and the purpose of Internet use.

Social Interaction Anxiety Scale

To assess the social anxiety disorder among college-going students, the Social Interaction Anxiety Scale (SIAS) which was developed by Mattick and Clarke, in 1998 was used.[15] It is a 20-item scale rated on five points, ranging from 0 to 4. Various research studies which have been conducted in the past highlight the internal consistency (Cronbach’s alpha) of SIAS ranged from 0.88 to 0.93 and its test-retest reliability was 0.92.[15] A score of more than 34: social phobia probable, i.e., the situation of irrational social fear avoidance and impairment, and a score of more than 43: social anxiety probable, i.e., generalized social fear across numerous social situations with avoidance and impairment.

Young’s Internet addiction test

To assess Internet addiction among college students, Young’s internet addiction test (IAT) was used.[16] The IAT evaluates Internet use in terms of the degree of preoccupation, inability to control use, extent of hiding or lying about online use, and continued online use regardless of negative outcomes of behavior.[17] It is a 20-items scale based on a five-point Likert scale. The score of the total scale ranges from 20 to 100, and the scores above 50 indicate Internet addiction.[18] In the current study, the internal consistency using Cronbach’s alpha has been reported as 0.889. This scale has been validated in various countries including the Indian population also.[19]

Statistical analysis

Data analysis was performed using IBM SPSS Statistics (version 23.0). The categorical data were compared using the Chi-square test, and quantitative data were compared using the Student’s “t” test. Quantitative data were described using mean ± standard deviation (SD). Categorical data were described using counts and percentages and correlation was measured using Pearson’s R.

Ethical consideration

All the participants of the study were informed about the purpose of the current research study and they were assured regarding the confidentiality of the information obtained. Written informed consent was taken from the participants. Ethical clearance for performing this study was obtained from the Institutional Ethics Committee.

RESULTS

Table 1 shows the sociodemographic characteristics of the participants. In the present research study, a total of 220 college-going students from three colleges in Central Kashmir were recruited. The sample comprised predominately of males 57.70%. The mean student age was 22.07 (SD = 1.36 years, range = 18–30 years). Majority of the participants 40.45% are studying in 1st year. The majority (96.80%) of the participants were single, and only seven participants were married. The majority of students use the Internet for chatting purposes and it was rated the highest (29.55%) reason for Internet use. The Internet use for social networking and entertainment purpose was ranked second and third number and the Internet used for academic purposes was ranked lowest (20.45%). In this study, almost 95% of the participants used the Internet through their personal cell phones.

T1
Table 1:
Sociodemographic profile of the participants (n=220)

In Table 2, it shows that social phobia was present in 53.93% of the participants with moderate Internet addiction compared to none in the Internet addiction and mild Internet addiction group. Social anxiety was present in 28.57% of the participants with moderate Internet addiction compared to none in the Internet addiction and mild Internet addiction group. Social phobia and social anxiety were present in all the participants in the group with severe Internet addiction among college students of Central Kashmir.

T2
Table 2:
Distribution of social anxiety with respect to Young’s Internet Addiction Test Score groups among college students of Central Kashmir (n=220)

The results of the study show that a total of 79 (35.90%) college students had social phobia and 55 (25.0%) students had social anxiety. The majority of the participants in our study had mild Internet addiction 105 (47.72%) followed by moderate Internet addiction 91 (41.36%), severe Internet addiction was seen among the nine participants (4.10%) and no Internet addiction was reported by 15 students (6.81%).

In Table 3, it shows that there was an increasing trend of SIAS scores with increasing grades in the Internet addiction group, and the difference among the groups with respect to SIAS scores was significant (Kruskal–Wallis test, P = 0.0001).

T3
Table 3:
Distribution of social interaction anxiety scale scores with respect to Young’s Internet Addiction Test Score groups among college students of Central Kashmir (n=220)

In Figure 1, it clearly shows that there was a positive correlation between the Internet addiction score and the social anxiety scale (Pearson correlation = 0.994, P < 0.001). The R2 value was estimated to be 0.987 of the variation in social anxiety score could be accounted for by the variations in Internet addiction scores.

F1
Figure 1:
Correlation between social anxiety and Internet addiction among the study participants (n=220)

DISCUSSION

The present study found that college-going students of the central part of Kashmir primarily use the Internet for chatting purposes, which is consistent with previous research findings.[4] which indicates that college students primarily use the Internet to communicate with other individuals. Internet technology promotes college students’ social lives because it allows them to communicate in a convenient manner and occupies little of their time.[20]

Regarding the medium of Internet use, the current research study highlights that college-going students in the central part of Kashmir prefer to access the Internet through their mobile phones, compared to those who use college computer laboratories. Few participants use the computer laboratories at their respective colleges, and the results of the study can be explained in different approaches. Internet services on college grounds are limited in scope by restricted periods and different filter programs.[21] Mobile phones offer an interesting feature for college students. Students can use their smartphones while riding in a car, walking to class, etc. Cell phones can also offer access to the Internet from mobile phone companies and outside universities’ domains.

A total of 220 college-going students were selected for the purpose of the study. The disorders of social anxiety and social phobia were determined to be 25.0% and 35.90%, respectively. A positive correlation was observed between Internet addiction and social anxiety disorder. To assess social anxiety, a variety of tools and techniques have been utilized. In a country like India, social anxiety was reported to be 5.9% to 7.8% among urban university students using SIAS.[2223] Operate the SIAS, Singh et al. found that 21% and 22% of postgraduate students had social anxiety and social phobia, respectively.[24]

The prevalence of social anxiety disorder varies widely from 8.5% in Nigeria to 23.7% in China, according to a study conducted by incoming Chinese University students in (2015).[2526] Social anxiety disorder was found to be 32.8% in Ethiopia, using Social Phobia Inventory and it was reported that the prevalence of social anxiety disorder found in the study is comparable to some of the previous international studies.[27] One of the research studies conducted in Ahmadabad used the Social Phobia Inventory to assess high school teenagers in Gujarat (2004) and the results of the study revealed that 12.8% of the students had a social anxiety disorder.[28]

A study was conducted in Delhi (2009) among adolescents in an urban public school; using the Liebowitz Social Anxiety Scale and the results highlight that social phobia was to be 10.3% which was more frequent among female students.[29] The prevalence of social anxiety was 30.7%, and the prevalence of social phobia was 38.3%, according to a study conducted in (2016) among teenage schoolchildren in northeastern states of India using the Liebowitz Social Anxiety Scale and Social Phobia Inventory.[30] The prevalence of Internet addiction in the current study among college students was mild in 47.72%, moderate in 41.36%, and severe in 4.10%. This is consistent with the frequency found in previous Indian research.

According to Grover et al., Internet addiction is mild in 54% of resident doctors at a tertiary care hospital in North India and moderate in 8.2%. None of the resident doctors had a severe addiction.[31] In a research conducted by Saikia et al., the prevalence of Internet addiction was mild in 65.4%, moderate in 13.5%, and severe in 1.9%. In addition, it also reported that there is a significant link/association between Internet addiction and anxiety (P < 0.0001).[32] Various research studies were conducted among university students from China and Israel, as well as secondary school teenage populations in Turkey, and the results revealed that a significant association between social anxiety and Internet addiction was found, which is similar to the current study.[3334]

Internet addiction is becoming a growing public health concern where on one spectrum lies necessary use and on the excessive use that leads to various comorbidities as stated earlier. This highlights the need for building a strategy for screening and management of the individual with social anxiety disorder. According to the WHO, excessive use of the Internet can lead to a number of physical and mental health problems, but it can also be used for beneficial purposes if used in a guided manner.

Limitations

However, we came across certain limitations in this study

The major limitation of the current study is its small sample size. Participants in this study were restricted to specific regions only which could limit the generalization of the result. Data were collected from the students who attended the classes therefore; students who did not attend class possibly due to excessive Internet use were unable to participate. In this research study, the personal bias of the respondents in providing the information cannot be ignored.

CONCLUSION

The current research study contributes to the available literature that investigated cyber addiction and the role of social anxiety disorders among the college-going students of central Kashmir. This study highlights that the prevalence of social anxiety (28.57%) and social phobia (53.93%) are both prevalent among the college students of central Kashmir, and cyber addiction was present in more than half of the participants. Internet addiction was associated with social anxiety and social phobia. This highlights the need of raising awareness about cyber addiction, social phobia, and social anxiety disorders in society. In addition, primary care physicians and grassroots workers should be educated to screen youngsters for increasing Internet usage when they appear with psychiatric problems such as social anxiety and social phobias among college-going students.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

Acknowledgment

The author acknowledges Dr. Arif Ali for his kind help and support.

REFERENCES

1. Lee HW, Choi JS, Shin YC, Lee JY, Jung HY, Kwon JS Impulsivity in Internet addiction:A comparison with pathological gambling Cyberpsychol Behav Soc Netw 2012 15 373 7
2. Sim T, Gentile DA, Bricolo F, Serpelloni G, Gulamoydeen F A conceptual review of research on the pathological use of computers, video games, and the Internet Int J Ment Health Addict 2012 10 748 69
3. Young KS Caught in the Net:How to Recognize the Signs of Internet Addiction-and a Winning Strategy for Recovery New York, NY John Wiley & Sons 1998
4. Chen YF, Peng SS University students'Internet use and its relationships with academic performance, interpersonal relationships, psychosocial adjustment, and self-evaluation Cyberpsychol Behav Soc Netw 2008 11 467 9
5. Schoenfeld D Prevalence and correlates of internet addiction in undergraduate students as assessed by two different measures State University of New York at Albany 2011
6. Ruscio AM, Brown TA, Chiu WT, Sareen J, Stein MB, Kessler RC Social fears and social phobia in the USA:Results from the National Comorbidity Survey Replication Psychol Med 2008 38 15 28
7. Stein MB, Walker JR, Forde DR Setting diagnostic thresholds for social phobia:Considerations from a community survey of social anxiety Am J Psychiatry 1994 151 408 12
8. Koyuncu A, Ertekin E, Ertekin BA, Binbay Z, Yüksel Ç, Deveci E, et al. Relationship between atypical depression and social anxiety disorder Psychiatry Res 2015 225 79 84
9. Lydiard RB Social anxiety disorder:Comorbidity and its implications J Clin Psychiatry 2001 62 Suppl 1 17 23
10. Internet Usage in India-Statistics and amp;Facts |Statista; 2018 Available from: https://www.statista.com/topics/2157/internet-usage-in-india/ Last accessed on 2022 Feb 22
11. Chaudhari B, Menon P, Saldanha D, Tewari A, Bhattacharya L Internet addiction and its determinants among medical students Ind Psychiatry J 2015 24 158 62
12. Gupta A, Khan AM, Rajoura OP, Srivastava S Internet addiction and its mental health correlates among undergraduate college students of a university in North India J Family Med Prim Care 2018 7 721 7
13. Orsal O, Orsal O, Unsal A, Ozalp SS Evaluation of internet addiction and depression among university students Procedia Soc Behav Sci 2013 82 445 54
14. Goel D, Subramanyam A, Kamath R A study on the prevalence of internet addiction and its association with psychopathology in Indian adolescents Indian J Psychiatry 2013 55 140 3
15. Mattick RP, Clarke JC Development and validation of measures of social phobia scrutiny fear and social interaction anxiety Behav Res Ther 1998 36 455 70
16. Dhir A, Chen S, Nieminen M Psychometric validation of internet addiction test with Indian adolescents J Educ Comput Res 2015 53 15 31
17. Young KS Cognitive behavior therapy with Internet addicts:Treatment outcomes and implications Cyberpsychol Behav Soc Netw 2007 10 671 9
18. Ni X, Yan H, Chen S, Liu Z Factors influencing internet addiction in a sample of freshmen university students in China Cyberpsychol Behav Soc Netw 2009 12 327 30
19. Frangos CC, Frangos CC, Sotiropoulos I A meta-analysis of the reliability of Young's internet addiction test. Inproceedings of the world congress on engineering London, United Kingdom World Congress on Engineering 2012 368 71
20. Lee S Analysis of college students'online life-styles and their psychological profiles in South Korea Cyberpsychol Behav Soc Netw 2010 13 701 4
21. Castells M, Tubella I, Sancho T Transition to the Network Society Barcelona, Spain Editorial Ariel 2007
22. Shepherd RM, Edelmann RJ Reasons for internet use and social anxiety Personality and individual Differences 2005 39 949 58
23. Preeti PD Prevalence of social anxiety disorder and its determinants among undergraduate medical students of East Delhi Int J Community Med Public Health 2019 6 1335
24. Singh A, Khess CR, KJ M, Ali A, Gujar NM Loneliness, social anxiety, social support, and internet addiction among postgraduate college students Open J Psychiatry Allied Sci 2020 11 10 3
25. Bella TT, Omigbodun OO Social phobia in Nigerian university students:Prevalence, correlates and co-morbidity Soc Psychiatry Psychiatr Epidemiol 2009 44 458 63
26. Cheng SH, Sun ZJ, Lee IH, Lee CT, Chen KC, Tsai CH, et al. Factors related to self-reported social anxiety symptoms among incoming university students Early Interv Psychiatry 2017 11 314 21
27. Reta Y, Ayalew M, Yeneabat T, Bedaso A Social anxiety disorder among undergraduate students of Hawassa University, College of Medicine and Health Sciences, Ethiopia Neuropsychiatr Dis Treat 2020 16 571 7
28. Mehtalia K, Vankar GK Social anxiety in adolescents Indian J Psychiatry 2004 46 221 7
29. Chhabra V, Bhatia M, Gupta S, Kumar P, Srivastava S Prevalence of Social Phobia in school-going adolescents in an urban area Delhi Psychiatry J 2009 12 18 25
30. Harikrishnan U, Ali A, Sobhana H Prevalence of social phobia among school going adolescent Int J Indian Psychol 2016 3 74
31. Grover S, Sahoo S, Bhalla A, Avasthi A Problematic internet use and its correlates among resident doctors of a tertiary care hospital of North India:A cross-sectional study Asian J Psychiatr 2019 39 42 7
32. Saikia AM, Das J, Barman P, Bharali MD Internet addiction and its relationships with depression, anxiety, and stress in urban adolescents of Kamrup District, Assam J Family Community Med 2019 26 108 12
33. Weinstein A, Dorani D, Elhadif R, Bukovza Y, Yarmulnik A, Dannon P Internet addiction is associated with social anxiety in young adults Ann Clin Psychiatry 2015 27 4 9
34. Yayan EH, Arikan D, Saban F, Gürarslan Baş N, Özel Özcan Ö Examination of the correlation between internet addiction and social phobia in adolescents West J Nurs Res 2017 39 1240 54
Keywords:

Cyber addiction; social anxiety and social phobia; college students

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