“Internet Behaviors and Addiction Among Adolescents in Six Asian Countries”

Epidemiology of Internet Behaviors and Addiction Among Adolescents in Six Asian Countries” (Mak 2014)

Please note: This post is more relevant for researchers and clinicians.

Research Paper Breakdown:

  • Survey/Questionnaire
  • Screened and compared Internet behaviors and addiction in adolescents in six Asian countries.
  • 5,366 adolescents
  • Aged 12–18 years
  • Six Asian countries: China, Hong Kong, Japan, South Korea, Malaysia, and the Philippines.
  • Internet Addiction Test (IAT) and Chen Internet Addiction Scale- Revised (CIAS-R) to screen for symptoms of “addictive Internet use”.

Weaknesses of Study:

  • Difficult to generalise an Asia-based study for Western adolescents.
  • Using the IAT. In my opinion, clinically, the IAT is not particularly relevant anymore, especially in adolescents (I will post about this soon).
  • The IAT specifies that you should not include school/work related use. This was not made clear in the study and could be a confounding factor.
  • Screening using a scale is not the same as diagnosing a condition.

Strengths of Study:

  • Surveyed many countries in Asia.
  • Relatively high number of participants.

What were their main findings?

  • Of the six Asian countries, the Philippines has the highest prevalence of “addictive Internet use” according to the IAT and the CIAS-R.
  • The prevalence of CIAS-R defined addictive Internet user was much higher compared to the IAT (up to 5 times more prevalent).

Other Interesting aspects of the study:

  • Japan has the highest prevalence (38.6%) of daily online gaming, second highest (32.8%) frequency of Internet use of more than 3 times a day. However, this does not correlate to high prevalence of IAT or CIAS-R defined addictive Internet user (according to CIAS-R Japan has the lowest prevalence of addictive Internet use).
  • You would think that (in Japan’s case) online Internet gaming would significantly contribute to addictive Internet use. Do we conclude that there is something else about the Internet that is more addictive than gaming? Or does this confirm that the Internet is a complex and “dirty” thing to research? Is there is something else about the Internet, other than Internet Gaming that makes it “addictive”.
  • Asked about “Internet misbehaviours” ie. pretending to be different person, communicating with strangers and giving out your password etc. (I’m not really sure how to explain the relevance of this).
  • Asked about Internet safety course attendance. For all countries this seemed to be quite common (but does it make a difference?).
  • The discussion about Neo-Confucianism in Asia and individuality in Western culture. Discusses how social media provides a space for expression. From my experience, I would expand on this and report that the collective Confucian culture within these Asian countries is a source of pressure for adolescents, with subsequent use of the Internet to relieve stress.
  • Cybercafes are the most common form of Internet access in the Philippines, whereas all other countries the home is most common.

Some problems (or things that just don’t add up) with this study:

  • They report that China has a relatively high smartphone ownership because they are producers. Actually, according to their figures this is incorrect, China has the lowest smartphone ownership despite being a major manufacturer.
  • They also report that bandwidth availability and connectivity is a possible factor. Philippines has the poorest bandwidth availability and connectivity, yet according to the study has the highest prevalence of Internet Addictive users.
  • These surveys cannot explain what this problem actually is and if it is really an “addiction”.

What can we learn from this?

  • It just confirms that “in Asia Internet technology is popular and adolescents are using it often.”
  • Studying Internet behaviour is very difficult via a survey. There is so much overlap with school/work, social and leisure activities. The IAT and CIAS-R do not help us understand the reasons behind such behavior, it just confirms that it is happening.


Mak, K. K., Lai, C. M., Watanabe, H., Kim, D. I., Bahar, N., Ramos, M., … & Cheng, C. (2014). Epidemiology of internet behaviors and addiction among adolescents in six Asian countries. Cyberpsychology, Behavior, and Social Networking17(11), 720-728.

Click to access cyber-epidemic.pdf