Pathological internet use and its correlation with big five inventory traits among first-year undergraduate medical students
Sumit Ramkrishna Shakya, Dimple D Dadarwala, Ritambhara Y Mehta
Department of Psychiatry, Government Medical College, Surat, India
Date of Decision 26-Jul-2020
Date of Web Publication 25-Nov-2020
Dr. Sumit Ramkrishna Shakya
A-322 Vrajdham Society, Near Jambua Jakatnaka, Maneja, Vadodara - 390 013, Gujarat
DOI: 10.4103/aip.aip_1_20
Context: The explosive growth of the internet in the last decade has had a huge impact on psychological research in understanding its role in communication and interpersonal behavior. There has been increased interest in the addictive potential of the internet and the effect this can have on psychological well-being. Aims: To study the prevalence of pathological internet use (PIU) and the correlation between PIU and big five personality traits among first-year MBBS students. Settings and Design: The present study with cross-sectional design was conducted in one of the government medical colleges of Gujarat. Subjects and Methods: First-year MBBS students (n = 226) newly admitted in Government medical college, Surat in the year 2018–2019 were enrolled in the study. The internet use pattern was assessed using PIU scale, and the evaluation of their personality traits was done using The Big 5 Inventory. Statistical Analysis Used: Statistical analysis was done by Chi-square test and independent samples t-test. Results and Conclusions: Results showed that prevalence of PIU among first-year MBBS students was high (68.28%). Students who did not take MBBS by their own choice and were living in hostel had more PIU, whereas it was almost equal in both the genders and family type. PIU was found less in students with conscientiousness and openness personality traits and high in students with neuroticism personality trait (P < 0.05). PIU is predictable by measuring the personality characteristics of the students.
Keywords: Internet addiction, pathological internet use, personality traits
Shakya SR, Dadarwala DD, Mehta RY. Pathological internet use and its correlation with big five inventory traits among first-year undergraduate medical students. Ann Indian Psychiatry 2020;4:135-9
Shakya SR, Dadarwala DD, Mehta RY. Pathological internet use and its correlation with big five inventory traits among first-year undergraduate medical students. Ann Indian Psychiatry [serial online] 2020 [cited 2021 Jan 21];4:135-9. Available from: https://www.anip.co.in/text.asp?2020/4/2/135/301423
The explosive growth of the internet in the last decade has had a huge impact on psychological research in understanding its role in communication and interpersonal behavior. There has been increased interest in the addictive potential of the internet and the effect this can have on psychological well-being.[1] Symptoms of internet addiction disorder (sometimes referred to in literature as "pathological internet use" or "internet dependency") often include increased preoccupation with online activities, tolerance (e.g., spending increased amounts of time in chat rooms), and symptoms of withdrawal when not online (e.g., anxiety, depression).[2] Griffiths has added salience (whereby the internet becomes the most important thing in the person's life), mood modification (where the internet is used to change mood states), and relapse (where the person returns to the addictive behavior, even after a period of abstinence).[1] Eventually, internet use becomes pathological when it interferes with major aspects of life functioning, such as significant relationships, occupation, school, mental health, and physical health.
Early researches on computer addicts were attempts to describe a typical user. Shotton found that a typical computer addict was male, technologically sophisticated, highly educated, introverted, and less sociable.[3] Kandell reported that there are a number of reasons why college students are particularly vulnerable to becoming addicted to the internet.[2] Beginning student life is challenging, as it involves developing one's sense of identity (e.g., gaining independence, deciding on a career path, and fitting in with peers). These factors can cause psychological symptoms such as depression or stress if the student is finding it difficult to adapt. Parents play a crucial role in that, if they do not allow their child enough independence at home, the student will have problems and may turn to addictive behaviors as a coping mechanism. Another important part of student life is to develop intimate relationships with romantic partners. If someone is finding it difficult to form romantic relationships because of, for example, shyness or low self-confidence, the internet provides a perfect medium for interaction through chat rooms or e-mail. However, this type of communication is not as emotional or rich as face-to-face interaction, and the person only gets to see the good aspects of their chat partner. Internet behavior is characterized by disinhibition (i.e., people reveal things about themselves that they would not ordinarily do in real life because of the anonymity of the internet); hence, many people find this aspect of internet liberating.[4]
Another factor for increased addiction among students is the availability of the internet. While people in the wider society tend to pay for the amount of time they spend on the internet, students are most often provided with free and readily available access. In some universities, access is even provided in the Halls of Residence, and 24-h access is often available in computer laboratories.
Low self-esteem has been linked to addictive behaviors.[5] Craig reported that people who hold negative evaluations about themselves use addictive substances to escape or withdraw from their low self-beliefs.[6] The results of studies also indicated that there is strong correlation between pathological internet use (PIU) and personality features, such as high approval motivation, low self-esteem, extraversion, poor social relationships, and high self-monitoring.
Few empirical studies that exist on internet addiction have been conducted in the United States (US) and have focused on the US college student population, which is culturally biased and not representative of the whole population of internet users.
As the technologies including more digitalization emerge, the internet use will continue to evolve. Thus, understanding why some students experience PIU will help college medical counselors and college mental health professionals for the welfare of the medical students.
With this in background, we conducted this study to assess the prevalence and correlation between PIU and big five personality traits among first-year MBBS students.
Subjects and Methods
250 first-year MBBS students newly admitted in one of the government medical colleges of Gujarat in the year 2018–2019and who gave valid informed consent were enrolled in the study, after ethics committee approval and Dean's permission. A semi-structured pro forma was used to assess sociodemographic profile of the patient. Their internet use pattern was assessed using PIU scale, and evaluation of their personality traits was done using The Big 5 Inventory. After collecting data, analysis was done and appropriate statistical tests such as Z–test and Chi-square test were used. After collecting data, anonymity of student's scores was maintained.
Pathological internet use scale
Pathological internet use scale[7] was taken from Morahan-Martin and Schumacher, who found it to have high internal reliability.
It comprised 13 items relating to problems that excessive internet use could be causing such as academic/social problems, interpersonal problems, mood-altering symptoms, and withdrawal symptoms.
For example, items included "I have been told I spend too much time online," "I have routinely cut short on sleep to spend more time online," and "I have got into trouble with my employer or school because of being online."
If participant has 1–3 items positive of the 13 items, it suggests "limited symptoms," but if he has 4 or more items positive, then he is said to have PIU. The scale is high on reliability with an internal consistency of 0.8 and has also has good validity.
Big five inventory
Big five inventory[8] is a personality test which helps to understand why we act the way that we do and how our personality is structured. This test uses the big five factor markers from the International Personality Item Pool, developed by Goldberg and Lewis.
The scale has 1–50 items with a rating of 1–5, where 1 = disagree, 2 = slightly disagree, 3 = neutral, 4 = slightly agree, and 5 = agree. The five factor markers are as follows:
Extroversion (E) is the personality trait of seeking fulfillment from sources outside the self or in community. High scorers tend to be very social while low scorers prefer to work on their projects alone
Agreeableness (A) reflects how individuals adjust their behavior to suit others. High scorers are typically polite and like people. Low scorers tend to "tell it like it is"
Conscientiousness (C) is the personality trait of being honest and hardworking. High scorers tend to follow rules and prefer clean homes. Low scorers may be messy and cheat others
Neuroticism (N) is the personality trait of being emotional
Openness to Experience (O) is the personality trait of seeking new experience and intellectual pursuits. High scorers may day dream a lot. Low scorers may be very down to earth.
Around 226 first-year MBBS students participated in the study with a response rate of 90.4%, of which two-third were males (males 66.4% and females 33.6%). Of the total study group, 94.7% of students had taken MBBS by choice. Around more than half (55%) of the students in the study lived in the hostel, while rest 45% were local students of the district. Around three-fourth of the students (71.9%) lived in a nuclear family, while the rest 28.1% belonged to joint family. The device most commonly used by the study group for internet use was mobile phones (97.3%).
Usage and areas of internet use
Of the total students, 24-h free access was available to around 71.7%. Time spent by different students on internet use is shown in [Table 1]. Majority of the students (44.2%) used internet for a duration of <2 h in a day followed by for 2–4 h (35.8%). Very few medical students (4.9%) used for more than 6 h/day.
Table 1: Time spent by different students on internet use
Areas of internet use are shown in [Table 2]. Almost all medical students (99.1%) used internet for chatting on social media, followed by music/film surfing (94.2%) and information seeking (87.2%). While it was least for cybersex (5.3%) and online gambling (1.3%) among the first-year MBBS students, it could be because even in an anonymous questionnaire students are highly unlikely to admit it.
Table 2: Different areas of use with their prevalence
Prevalence and correlation
The prevalence of PIU among the first-year undergraduate MBBS students was found to be 68.28% [Figure 1]. Further, the prevalence of PIU was higher among those students who did not take MBBS by choice (90.90%) as compared to those who took MBBS by choice (66%) [Figure 2].
Figure 1: The prevalence of pathological internet use among first-year undergraduate MBBS students was found to be 68.28%. Total students - 222
Figure 2: Prevalence of pathological internet use was higher among those students who did not take MBBS by choice (90.90%) as compared to those who took MBBS by choice (66%). Total students who took MBBS by choice - 197. Total students who did not take MBBS by choice - 11
Other important finding that was seen was PIU was higher among students who lived in hostels (75%) as compared to those who lived at home (59%) [Figure 3].
Figure 3: Prevalence of pathological internet use was higher among those students who lived in hostels (75%) as compared to those who were local students of the district (59%). Total students who lived in hostel - 121. Total students who lived locally in the district - 101
The prevalence of PIU among both males and females was found to be equal. In addition, the prevalence of PIU was equal in nuclear and joint family.
[Table 3] shows significant positive correlation between PIU and numbers of hours spent by student on internet use for entertainment (P = 0.000) and social networking (P = 0.000). However, the correlation with number of hours spent on education and PIU was not significant (P = 0.526) [Table 3].
Table 3: Correlation between pathological internet use and number of hours spent by student on Internet
As seen in [Table 4], the PIU was negatively correlated and was found lesser in students with higher conscientiousness, agreeableness, extraversion, and openness personality traits (P <0.05). On the other hand, we found that PIU was higher in students with high neuroticism [Table 4].
Table 4: Correlation between pathological internet use and personality traits
A total of 226 first-year medical students out of 250 participated in the study. Beginning college life is challenging as it involves developing one sense of identity, and college students are vulnerable for internet addiction; hence, we chose first-year medical students to find out the prevalence of PIU. We also found correlation of PIU and big five personality traits among the first-year MBBS students.
The prevalence of PIU in our study was around two-third (68.28%) among the first-year MBBS students of Government Medical College, Surat, which was more than the previous studies done on Indian population where around 47% among 188 medical students from Silchar Medical College and Hospital (Silchar, Assam, India).[9] This may be because the criteria and measuring tools used to measure PIU were different. Cutoff point for PIU scale is too liberal.PIU was found equally prevalent in both males and females in our study, unlike previous study in British University where males had three times higher prevalence as compared to females..[10] However, there have also been some studies in the past which showed no gender differences in two groups where a higher number of females had responded to the survey.[11] Hence, it could be possible that males were less likely to respond and admit that they were experiencing problems. Other interesting finding in this study was that the prevalence of PIU was found equally prevalent among students belonging nuclear and joint family which means that the type of family does not affect PIU.
PIU was also found greater among students living in hostel than local students of the district among the first-year MBBS students. The reasons could be absence of parents in hostels, hostel related difficulties like food, accommodation etc. which makes them feel homesick. This could be stressful for the first year medical students who are new to the environment and course and finding it difficult to adapt. Ultimately, may lead to excessive internet use as coping mechanism.
PIU was observed more in students who did not take MBBS by their own choice. This could be because these students wanted to opt for some other course and are using internet as coping mechanism to deal with identity crisis; spending more time on internet for entertainment; and finding internet as liberating. PIU was found more among students who spent more hours on internet for social networking and for entertainment (P <0.05). Similar results were found in medical students in Northeastern India.[9]
PIU was found lesser in students with extraversion (outgoing/energetic), conscientiousness (efficient/organized), and openness (inventive/curious) personality traits (P <0.05) and higher in students with neuroticism (sensitive/nervous) personality trait. Hence, extraversion, conscientiousness, and openness personality traits may function as protective factors. Students with high neuroticism are less talkative, less sociable, more approval seeking, and low on self-esteem; internet provides them a perfect medium for communication as it is not emotional, no face-to-face interaction, socially disinhibiting, and liberal. Students with high neuroticism are sensitive, emotional, and nervous and hence more likely to have higher PIU. Similar results were seen in a study done among college students in Malaysia, which showed that internet addiction was higher in students who were impulsive, sensation seeking, and neuroticism anxious.[12]
Few empirical studies that exist on internet addiction have been conducted in the US and have focused on the US college student population, which is culturally biased and not representative of the whole population of internet users.
As the technologies including more digitalization emerge, the internet use will continue to evolve. Thus, understanding why some students (such as not taking MBBS by choice, staying in hostel, and high neuroticism in students) experience PIU will help college medical counselors and college mental health professionals for the welfare of the medical students.
As the technologies including more digitalization emerge, the internet use will continue to evolve. Internet can be used to make healthy engagement strategies for freshers in academic courses. Thus, understanding why some students (such as not taking MBBS by choice, staying in hostel, and high neuroticism in students) experience PIU will help college medical counselors and college mental health professionals for the welfare of the medical students.
The prevalence of PIU among first-year MBBS students was high (68.28%)
Students who did not take MBBS by their own choice had higher PIU as compared to those who took MBBS by choice. Further, those who were staying in hostel had higher pathological internet compared to local
PIU was found almost equal in both genders, i.e., males and females, and almost equal in nuclear and joint family
PIU can interfere with education. There was significant positive correlation between PIU and numbers of hours spent by student on internet use for entertainment (P = 0.000) and social networking (P = 0.000). However, the correlation with number of hours spent on education and PIU was not significant
PIU was found less in students with extraversion, conscientiousness, and openness personality traits and high with neuroticism personality trait (P <0.05). Hence, PIU is predictable by measuring personality characteristics of students.
This study was approved by Institutional Ethics Committee with reference number GMCS/STU/ETHICS/Approval/171/19 obtained on January 1,2019.
Patient consent statement was taken from each patient as perinstitutional ethics committee approval along with consenttaken for participation in the study and publication of thescientific results / clinical information /image withoutrevealing their identity, name or initials. The patient is awarethat though confidentiality would be maintained anonymitycannot be guaranteed.
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Shakya SR
Dadarwala DD
Mehta RY
pathological internet use
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