She eventually felt depressed, anxious, and irritable whenever she was not in front of her computer. In an effort to avoid what she referred to as "withdrawal from the Internet," she engaged in activities to stay on-line as long as she could. The subject canceled appointments, stopped calling real life friends, reduced her interpersonal involvement with her family, and quit social activities she once enjoyed, e.g., bridge club. Further, she stopped performing routine chores, such as the cooking, cleaning, and grocery shopping, that would take her away from being on-line.

The subject did not see her compulsive use of the Internet as a problem; however, significant family problems developed subsequent to her overuse of the Internet. Specifically, her two teenage daughters felt ignored by their mother, as she was always sitting in front of the computer. Her husband of 17 years complained about the financial cost of the on-line service fees which he paid (up to $400.00 per month), and about her loss of interest in their marriage. Despite these negative consequences, the subject denied that this behavior was abnormal, had no desire to reduce the amount of time she spent on-line, and refused to seek treatment despite repeated requests from her husband. She felt it was natural to use the Internet, denied anyone could be addicted to it, felt her family was being unreasonable, and found an unique sense of excitement through on-line stimulation that she would not give up. Her continual overuse of the Internet eventually resulted in becoming estranged from her two daughters and separated from her husband within one year of the purchase of her home computer.

The interview with this subject took place six months subsequent to these events. At that time, she admitted having an addiction to the Internet "like one would to alcohol." Through the loss of her family she was able to reduce her own use of the Internet with no therapeutic intervention. However, she stated that she was unable to eliminate on-hne use completely without external intervention nor was she able to reestablish an open relationship with her estranged family.

DISCUSSION

Given the recent surge in access to information technologies (Graphics, Visualization, and Usability Center, 1995), we have a new generation of diverse computer users. As this case suggests, contrary to the stereotype of a young, male, computer-savvy on-line user as the prototypic Internet "addict," new consumers of the Internet who do not match this general stereotype are just as susceptible. Given the severity of the family impairment in this case, future research should focus on the prevalence, characteristics, and consequences of this type of addictive behavior.

This case suggests that certain risk factors may be associated with the development of addictive use of the Internet. First, the type of application utilized by the on-line user may be associated with the development of Internet abuse. The subject in this case became addicted to chat rooms which is consistent with prior research that has found highly interactive applications available on the Internet (e.g., virtual social chat rooms, virtual games called Multi-user Dungeons played in real time simultaneously with multiple on-line users) to be most utilized by its consumers (Turkle, 1984, 1995). Research may document that, in general, the Internet itself is not addictive, but perhaps specific applications play a significant role in the development of Internet abuse. Secondly, this subject reported a sense of excitement when using the Internet which can be paralleled to the "high" experienced when people become addicted to video games (Keepers, 1990) or gambling (Griffiths, 1990). This implies that the level of excitement experienced by the on-line user while engaged in the Internet may be associated with addictive use of the Internet.

Based upon the issues raised here, it would be beneficial to adapt the brief questionnaire (Young, 1996) for use in classifying cases of such Internet abuse. By monitoring such cases, prevalence rates, further demographic information, and implications for treatment can be obtained. More significantly, one may show whether this type of behavior is implicated in or acts as a substitute for other established addictions, e.g., chemical dependencies, pathological gambling, sexual addictions, or if it is a co-morbid factor with other psychiatric disorders, e.g., depression, obsessive-compulsive disorders.

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