Internet Compulsion Disorder: Should We Include It in the DSM?

By Bill Davidow

Just as fast-food executives have capitalized on reward circuitry in our brains, savvy Internet entrepreneurs could influence our every action

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How would a fast-food business executive build a very profitable Internet business? He would use techniques similar to those perfected by McDonald's, Coca Cola, Nestle, and Kraft.

Over hundreds of thousands of years, our hunter-gather ancestors ate diets that were mostly vegetarian and low in fat, salt, and sugar. As a result, the reward systems in our brains created a craving for high-energy fat-rich, sugar-laden, and salty foods. 

By leveraging this reward circuitry, fast-food executives captured a sizable portion of the U.S. population, which now eats almost nothing but junk food. The incidence of obesity has risen from around 15 percent in the 1980s to 30 percent today, and is forecast to rise to 40 percent over the next decade.

The strategic fast-food-executive-turned-Internet-entrepreneur would capitalize on the fact that algorithms for tracking behavior as visitors linger on pages and traverse their way around a site are built into most Internet applications. He would use those results to design products that hijack the neurobiological reward circuitry in our brains. He would learn to bombard customers with enticing alerts and reminders. He would design seductive reward systems. He might give customers virtual credits, based on how continuously they pounded away at a game or stayed glued to a social networking site.

In its current form, the vast majority of us will be able to use the Internet to enhance our lives. But there is already a subset of users unable to cope with the challenges.

In doing so, he would pinpoint the fastest route to our brain's pleasure center.

One of the great things about the Internet is that running an Internet test kitchen is very cheap. Software programs -- including the infamous cookies -- enable application developers to analyze user behavior. Using these tools, the company can not only monitor the crowd's behavior and create products that appeal to large groups but also create experiences designed for the individual. Imagine a recipe tailored to each user with the equivalent of just the right amount of sugar, fat, and salt -- a customized potato chip, burrito, healthy snack, or gummy bear. The food industry, of course, has been designing just such recipes for decades.

There's more good news for the Internet entrepreneur. He won't have to waste a lot of time doing brain research before creating his products. Studies on cigarette, drug, and gambling addiction, along with other forms of compulsive behavior, provide the Internet entrepreneur with yet another design handbook.

The release of the neurotransmitter dopamine acts to turn on the pleasure circuits in our brain. Each inhalation of nicotine generates a small and almost instant dopamine release in our brains -- instant gratification. If this instant-gratification technique works well for cigarettes -- and, many argue, for engineered fast food -- why not use it for video games, Facebook, or instant online dating services?

The right swipe on the touch screen in Angry Birds delivers an instant hit. The constant updating on Facebook pages with interesting tidbits from friends generates the warm feelings that come from close engagement with the "in" crowd. MeetMoi.com will link you up with "singles within a few miles from you who can meet you tonight" -- no need to go through eHarmony's tedious process of communicating with someone before a face-to-face meeting.

Of course, there's something always happening on Twitter. Text messaging, instant messaging, a continuous flow of emails and alerts, keep us returning to our mobile devices and computers to stay permanently engaged. What can be better than an alert when your favorite stock rises or your team wins a key game?

Casinos also excel at keeping customers engaged. We know from studies of the brain that surprising events that deliver unpredictable rewards give us shots of dopamine. It is a mild form of the pleasure rush one gets from injecting heroin and snorting cocaine. For a fraction of gamblers, those shots lead to addiction.

So design your shopping service to deliver an unexpected discount. Yesterday's eBay, where people spent hours and days at a time seeking bargains, is today's Groupon, where the rewards are even quicker. Twitter loves to tell subscribers that some "noted" person mentioned them, prompting a race to the site to find out if said luminary has hundreds of thousands of followers -- what a rush.  Financial management firms love to make customers go through sophisticated login procedures even when giving non-secret information. It makes users feel like they're members of an exclusive club and keeps them coming back.

Internet entrepreneurs are still perfecting their techniques. But those techniques are already wickedly effective -- and the effects are pernicious.

Just look at what I call Internet Compulsion Disorder -- ICD -- going on around you: people who can't put down their smart phones and kids sending and receiving hundreds of text messages a day. Many families no longer have dinner together. They sit at the same table but use their iPhones to check in with virtual friends on Facebook. The person weaving from lane to lane on the freeway is thumbing away on his BlackBerry.

Maybe mental health professional will determine that the Internet is as addictive as gambling. There is already a lot discussion about including Internet addiction in DSM V, the Diagnostic and Statistical Manual of Mental Disorders.

In its current form, the vast majority of us will be able to use the Internet to enhance our lives. But there is already a subset of users unable to cope with the challenges. The reward circuits in those with ICD have been hijacked. The opportunities provided by the Internet to these unfortunates are so appealing that some fail in school, spend time in virtual affairs on Second Life, destroy their marriages, or become unproductive in their work lives and lose their jobs.

We should all be concerned about the potential spread of ICD. Obesity was a problem when it affected 15 percent of the population in the 1980s. It is a health catastrophe when it affects 30 percent. One can only hope that Internet providers do not become as proficient as fast-food chains.  But the opportunity is too compelling and the entrepreneurs too smart: they're compelled to give it a try, and they'll probably succeed. It's a strategy the fast-food-executive-turned-Internet-entrepreneur won't be able to resist. It's just great business.

Image: Shestakoff/Shutterstock.

This article available online at:

http://www.theatlantic.com/health/archive/2011/12/internet-compulsion-disorder-should-we-include-it-in-the-dsm/249905/