It is possible that people are not addicted to the internet but to any of the following elements of the internet; availability (1), efficiency (2), reinforcement (3) and anonymity (4). Reinforcement is especially notable in gaming. Vertical gameplay includes continuous reinforcement and a game that continues without the presence of the gamer can lead to FOMO (i.e. fear of missing out).

The online environment enhances or facilitates activities to such an extent that it becomes addictive. Internet addiction can only really exist if specific characteristics of the internet make a real contribution or if the activity is impossible online.

People are almost always on the internet (i.e. permanently connected) which makes it difficult to say whether there is an internet addiction.  It might be more relevant to call it pathological technology use (PTU). The focus of any internet addiction is always on general addiction characteristics that are also central to criteria for gambling addiction and substance abuse.

Internet addiction shares symptoms with substance abuse and pathological gambling in which repeated behaviour plays a role. Addicted online gamers find it difficult to weight long-term benefits and short-term benefits and long-term costs and losses. Excessive gamers prefer a more risky but more attractive option in the short-term. There is high comorbidity with internet addiction. High comorbidity between ADHD and gaming could be due to the fact that both are related to attention issues.

The permanence of being online (i.e. POPC) and the perception of continued closeness with the object of addiction is likely to overwhelm users with problems with self-regulation and self-directedness. POPC is likely to be less relevant for subtypes of internet addiction that require long, continuous sessions (e.g. gaming). The social function of mobile devices urges people to stay online.

General internet addiction consists of loss of control (1), time management issues (2) and craving (3). There are different factors that are involved in general internet addiction:

1. Psychopathological symptoms
   This includes depression and social anxiety.
2. Personality factors
   This includes feelings of low self-efficacy (1), shyness (2), stress vulnerability (3), procrastination tendencies (4) and social isolation (5).
3. Addiction facilitating cognitions
   This includes expectancies and coping behaviours.

There might be a link between internet addiction and slightly reduced social functioning. They score lower on agreeableness (1), have low self-directedness (2) and more social anxiety (3). The increased use of the internet is related to depression and loneliness. Lonely people are more inclined to go online as a means of counteracting negative feelings.

Individual differences in social functioning are related to problematic use of technology. There are several elements that contribute to vulnerability for internet addiction:

1. Permanent access
   The fact that people are permanently online and permanently connected provides a continuous challenge for self-regulation.
2. Usability of smartphones helps the forming of habits
   People teach themselves that smartphones are a useful solution in most situations and this creates habits.
3. Frequent smartphone use is the norm
   People are not surprised when people are using smartphones continuously.
4. Collective self-stabilization
   There is frequent contact with other frequent users which stimulates people to go online a lot.

It is not clear whether there is internet addiction or whether it is more of a phase as the excessive use of technology seems to naturally come to a reduction after a period of time. Self-concept clarity is a negative predictor of internet addiction in adolescents. Internet addiction classification may not take the development of a self-image or combating loneliness into account.

Internet addiction is controversial because it might be a delivering mechanism, not necessarily the thing one is addicted to (1), the overlap with other disorders (2) and the phenomenon is not stable (3). One common symptom of problematic internet use is the lack of knowledge about how long one is spending online or denial about the time spent.

The boundary theory explores the way people manage the boundaries for work life and home life. These boundaries tend to be very permeable due to permanent internet access. The smartphone blurs the boundaries between work time and non-work time. There are different strategies people can take:

• Segmenters
  These people do not use a mobile device for work outside of work.
• Integrators
  These people use a mobile device for work outside of work and have successfully learned how to integrate it.
• Failed segmenters
  These people use a mobile device for work outside of work and are unable to resist the pressure of being continuously available.

Fear of missing out (FOMO) refers to anxiety that an exciting or interesting event may be currently happening elsewhere. This is related to frequent social network use. Younger people and young males, in particular, are susceptible to FOMO.

The features of online games are reinforcement (1), immersion (2), control (3), personalization (4), cooperation (5), interactivity (6), influence on attention (7), narrative (8) and feedback (9). Immersion is linked to the enjoyment of the game. A loss of control may be seen as a challenge but a loss of interactivity is related to reduced enjoyment.

The social cognitive theory states that reinforcement of behaviour of the model (i.e. avatar) causes a change in the behaviour of the observer. There is an increased degree of self-efficacy through in-game training. The self-determination theory states that the motivation to play and the rating of the game depends on the degree to which the game meets the need for autonomy (1), need for competence (2) and the need for connectedness (3). The need for autonomy could be fulfilled by creating control and freedom of choice. The need for competence can be fulfilled by providing feedback and a challenge. The need for connectedness can be fulfilled by providing cooperation.

The self-regulated learning theory states that individuals seek to manage their cognitions, behaviours and learning in pursuit of a given goal. The self-regulatory skills include goal setting, goal monitoring and review of progress.

There are advantages to playing action games:

• Increase in visual sharpness (i.e. acuity).
• Increase in visual detection (i.e. changes in display).
• Improvement of field of view (i.e. players better at locating peripherally presented objects).
• Improvement of processing speed and flexibility (i.e. reduction in attentional blink).

However, playing action games may also have detrimental effects:

• Inadequate inhibition of attention to distractions.
• Decrease in attention for positive facial expressions and negative images.

There are also other advantages of videogames in general:

• Cognitive benefits
  Videogames could lead to durable improvements in cognitive skill after a short period of time which could also reduce gender differences in cognitive skill.
• Motivation and persistence
  Videogames could lead people to become more persistent in daily life.
• Emotional benefits and flow
  Videogames could lead to a more positive mood and flow is a positive and motivating mental state.
• Social benefits
  Videogames could lead to social benefits (e.g. more prosocial behaviour).

Gaming appears to be related to an increase in visual detection and processing (1), a decrease in self-directed attention (2), an increase in attention for game-congruent stimuli (3) and a decrease in attention for game-incongruent stimuli (4).

Operant conditioning might explain addiction to videogames through partial reinforcement through the unpredictability of the reward. Extrinsic rewards in videogames can make people with intrinsic motivation less likely to play.

Serious games are designed to educate and entertain the user and promote behavioural change via the incorporation of prosocial messages embedded within gameplay. Young people may be highly susceptible to learning in a digital environment because they are fluent and immersed in digital media. Many serious games fail because they fail to incorporate the elements that make videogames attractive to many people.