Problematic Internet use - when does 'use' become a problem?

As internet use is ubiquitous, Kavya explains that it's not just about hours spent online, but the negative impact on life aspects like sleep, mental health, and relationships that define problematic use.

Kavya's work showed promising results. By practicing mindfulness meditation for just 10 minutes a day over a month, participants saw significant reductions in symptoms of depression, anxiety, and stress. Remarkably, none of the participants met the criteria for severe problematic internet use by the end of the study, and the improvements were sustained months later.

The key takeaway? Developing a healthy relationship with the internet is essential, and mindfulness can be a powerful tool in achieving this balance.

Pocket Change is a series of pocket-size videos about a key aspect of behaviour change.  Each episode features a BehaviourWorks Australia Researcher explaining their area of expertise in a clear and simple manner.  

Transcript:

Geoff

Hi everyone. This month I'm speaking to Kavya Raj about her work with problematic internet use. Everyone uses the internet I assume, so what is problematic internet use, given that people who are watching this now will be using the internet?

Kavya

Really, really good question. So it's something actually that my PhD looked at - the internet - and it was a question that came up a lot, am I using it problematically? I'm going to give you the the quintessential scientist answer, which is there's still debate on what actually makes it problematic.

Geoff

So it's not hours per day, for instance, or minutes per day?

Kavya

So that's a really interesting thing, that was a line of thinking in the scientific community. But the more we looked into it, the more that we realised, actually, there's a really big discrepancy between how many hours people are spending on the internet, and it's less about the time and it's more about the level of control and how much that behaviour impacts the rest of our life.

Does me being online impact the rest of my life? My work, my friends, my relationships, my mental health, my sleep - is it impacting those things in a negative way?

Geoff

So tell us about the impacts. What is the dark side about the use of the internet?

Kavya

It's really widespread. That's kind of the scary bit, we see that it does have quite serious impacts on people's sleep, and so as you can imagine, you know, people staying up late, just not having as many hours to sleep as they could. We see that it affects their mood. And we see things like symptoms of depression and anxiety and stress. We see that it impacts people's level of loneliness.

Like, it can impact your, professional relationships and your personal relationships. Pretty much every major domain of life, we see some kind of negative consequence when you start hitting that severe end of problematic internet use.

Geoff

And we can't really ignore it because the internet is integral now to, well, if not a billion people to many people in many modern societies. It's our banking, it's our entertainment. It's how we can contact each other. It's how we share information. It's work and leisure, we can't avoid it.

Kavya

No, exactly. Not spending time on the internet or cutting ourselves off from it isn't really a feasible option. And so the question then becomes, will we have access to this thing all the time? Our phones, our computers, all of our devices in our homes are connected to the internet.

How do we form a relationship with this technology so that we can engage with it in a healthy manner, because it's around us all the time? That's really the question. So you have to choose and a target audience for any behavioural intervention.

Geoff

Where do you start? Where did you start?

Kavya

For me, I come from a psychology background. I was always really interested in the mental health side. When you start diving into the literature, what we see is kind of unsurprisingly, it affects young people more than any other type of adult. And so much of what they do is online, you have to access the internet to be able to engage in your studies, but you also have to access the internet to socialise with your peers.

And so it's both a functional tool and potential problem, wrapped up together.

So the more I went into the literature, the more I started to say, actually, this is really affecting young people. And particularly students. And so based on the scope of the issue, I started sort of narrowing down to look at students really specifically. Instead of saying, we're going to fix everyone a little bit, you really have to focus in on the target audience. If you restrict your focus and you do a good job of of following a scientific process for that, you're more likely to have a bigger impact because the tighter your audience is defined, the more specific you can focus your research on your treatments and things on that particular group.

And what works for them rather than what works for everybody, because we're all too different for that to work.

Geoff

So tell us about the Mindful Media Project.

Kavya

It came about from these questions that you're asking. You know - who is this affecting? What kind of audience group do we see who's really experiencing this? And how can we help? And so as I went about it, we started looking more and more at students, particularly university students, because they're at this sort of bridge point of their life where, often, it's the first time out of home, they are largely in control of their own time for the first time in their whole lives.

And what happens at university could have really major consequences for the rest of their professional career. So, that's where we started. And when we looked at the treatment options that were available to them, it was kind of just a stock standard mental health lens

of treatment, which is pharmacotherapy - some type of medication or psychotherapy. So some form of talk therapy or a combination of the two.

And these are really great treatment options for a lot of mental health conditions. They can be really powerful, but it's sort of general line of treatment for all conditions. It's not specific to this particular behaviour. What we see is that the more that the behaviour worsens, the more difficult it is to regulate that behaviour, right? So much of what we do is we have an emotion or we have a thought, a behaviour is automatically triggered. It's that automatic part that's really key.

Perhaps I feel this sense of stress, something I get an email that email triggers an immediate emotional reaction and physical reaction of stress. And I think, oh my God, I can't deal with this. And without really realising, I have behaved by picking up my phone and gone straight to Facebook to try and disengage. The idea is that through mindfulness, you actually become more aware of that entire process.

So then the question of the intervention becomes, how do I get people to do this behaviour consistently enough and for long enough to see the benefits that I want to see and overcome?

Geoff

And the barrier to meditation is the 'hippie thing', that it's a religious thing that I don't have a tradition of or can understand?

Kavya

Exactly. So the way that we do it from a behavioural science perspective is you identify your audience, you identify the behaviour. For us, the behaviour was we needed people to practice a set type of mindfulness meditation every day for ten minutes a day for a month.

We all know exercise is great for us. We all know that we should be doing it. But it's hard, but it's hard and there's a lot of things that stop us from doing it. And so it was okay, well, what are the barriers? You already mentioned people find it a bit hippie dippy, totally fair. Yes, it's based in a spiritual tradition. I might not be from that spiritual tradition. I might not be from that religion. You know, can I do this?

Geoff

But what if you reframed it as ‘this is what the top sports people in the world do’? That it works. And I don't have to shave my head or become a monk. This control of the mind stuff actually works.

Kavya

Yeah, exactly. What you're talking about there is behaviour change technique. So if the barrier that people are facing is this sense of social shame or I don't really feel motivated because I don't see people in my social group doing this or I don't think this is socially normal, you can take the technique to change that barrier. It's persuasion. By taking a really credible person that has a lot of influence and getting them to say, actually, this is great and whatever, that's one technique, and there's a whole host of techniques you can use.

So we looked at all the barriers and we found that the main barriers that they're facing - the time, the cost of it, the knowledge of how to do it, the knowledge of why it's important. The motivation, the capability, like having the skills to do it. And that's the mapping process as you go. Here's my audience. Here's my behaviour.

These are all the things stopping people from doing the behaviour. How do I reduce those barriers? How do I get rid of those hurdles?

Geoff

So, what were the findings? What was the result of that?

Kavya

So it's still in the process of being published, but what we found was that after 30 days of engaging in this was a really small sample. This was a proof of concept study. So the idea was, does this work? Yes or no? If it does, then you invest in a much larger study to really figure out how it's working. But we had a small group of 26 students and 24 of them completed, which is really high for an intervention. So generally you have attrition, you have dropout.

And what we found is actually 90 something percent of people engaged and were retained until the very, very end. The other thing was, not just will they stay until the end, will they actually do the daily behaviour? And most of them did.

So the retention, engagement really, really high, which is really promising. Students can do it. They can do it consistently enough every day for a month. Then we looked at the mental health outcomes, and we saw that it's significantly from beginning to end, significantly reduced the severity of their symptoms of depression, anxiety and stress. All three which, if anyone's ever been a student before or if anyone remembers being in their early 20s this time, it's a really high stress time. And it's when you're really vulnerable to experiencing things like depression and anxiety.

And then my favourite bit was every single person that was in the study had what we call severe PIU, severe problematic internet use, by the end of the study, the people, the 24 out of the 26 who had completed - not one of them met the threshold for severe, problematic internet use. Every single one of them. The severity had dropped so low, that they did not meet that criteria anymore.

And any good behavioural scientist or psychology scientist will tell you it's not enough to just look at what happens right at the end of the treatment. If you want good outcomes, you've got to look at what happens a month, two, three months afterwards. We checked in with them again and they hadn't gotten worse. They had stayed exactly where they were. So none of them had gotten worse with their internet use. none of them had gone back to that severe threshold. They had all maintained that level of improvement, which is really exciting.

Geoff

That's a good news story. Thank you very much.

Kavya

Thank you for having me.