Arabic validation of the Compulsive Internet Use Scale (CIUS)

Khazaal et al. Substance Abuse Treatment, Prevention, and Policy 2011, 6:32 http://www.substanceabusepolicy.com/content/6/1/32 RESEARCH Open Access Arabic validation of the Compulsive Internet Use Scale (CIUS) Yasser Khazaal1*, Anne Chatton1, Khodor Atwi2, Daniele Zullino1, Riaz Khan1 and Joël Billieux3 Abstract Background: The popularity of using the Internet and related applications has grown in Arabic countries in recent years. Despite numerous advantages in terms of optimizing communications among individuals and social systems, the use of the Internet may in certain cases become problematic and engender negative consequences in daily life. As no instrument in the Arabic language is available, however, to measure excessive Internet use, the goal of the current study was to validate an Arabic version of the Compulsive Internet Use Scale (CIUS). Methods: The Arabic version of the CIUS was administered to a sample of 185 Internet users and exploratory and confirmatory analyses performed. Results: As found previously for the original version, a one-factor model of the CIUS had good psychometric properties and fit the data well. The total score on the CIUS was positively associated with time spent online. Conclusion: The Arabic version of the CIUS seems to be a valid self-report to measure problematic Internet use. Background The prevalence of Internet use has increased worldwide during the last decade. Although this provides wonderful opportunities for communication, exchange, and social interactions, it has been accompanied by the development, in some individuals, of an excessive and noncontrollable pattern of use (i.e., problems related to Internet use, difficulty stopping, continuing use despite the intention to stop), leading to the emergence of the concept of Internet addiction [1-4]. The proposed diagnostic criteria [5,6] include obsessive thoughts regarding the Internet, loss of control (Internet usage more than intended or despite the negative consequences), withdrawal symptoms, and tolerance. Internet-related activities and preoccupations disturb major aspects of real life such as time management, sexual life and marriage, work, and academic and financial activities [7,8]. The phenomenon has been associated with several psychiatric disorders and symptoms [9], such as depression and social phobia [10], impulsivity [11,12], and substance misuse [13]. Furthermore, studies carried out on a population with a large * Correspondence: 1 Department of Mental Health and Psychiatry, Geneva University Hospitals, Geneva, Switzerland Full list of author information is available at the end of the article age range showed that younger Internet users were at increased risk for Internet addiction [14,15]. In addition, male gender was possibly linked to Internet addiction [15-18]. This phenomenon was postulated to be linked to intermediate psychosocial variables, such as more “escapism” (avoidance) [11] in males than in females, or to differences related to the Internet applications used, such as online games [19]. Nowadays, there are roughly 65.4 million Internet users in the Arab world, representing only 18.9% of about 347 million persons [20]. Between 2000 and 2010, the growth of Internet use in Arab countries was the highest among the top 10 Internet users by language, or 2500% in comparison to 281% for English-language countries [20]. The Internet seems, furthermore, to play an important role in social changes occurring in the Arab world. Internet-related applications such as Facebook or Twitter have recently played a key role in the Arab street revolutions in 2011, referred to as “Arabic spring.” Unfortunately, despite the growing importance of Internet use in Arabic-speaking countries, there is, to the best of our knowledge, no validated instrument to measure problematic Internet use in Arab-speaking samples. In recent years, several instruments have been developed to assess problematic Internet use, such as © 2011 Khazaal et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Khazaal et al. Substance Abuse Treatment, Prevention, and Policy 2011, 6:32 http://www.substanceabusepolicy.com/content/6/1/32 Young’s questionnaire and the Internet Addiction Test [8,21]. Some of these instruments identify the presence or absence of specific diagnostic criteria (with yes or no questions), diminishing the ability to measure the phenomenon in a more continuous manner from nonproblematic Internet use to its more severe forms. Furthermore, several scales, such as the Internet Addiction Test [21], include items related to psychosocial aspects of Internet use rather than to Internet addiction-related core constructs (e.g., Item 4: Do you form new relationships with fellow online users?). For Meerkerk et al. [22], it seems then necessary to validate, on a large sample, a short questionnaire that measures on its continuum (with Likert scales) the severity of specific core problematic Internet use symptoms. From this perspective, they developed a 14-item Compulsive Internet Use Scale (CIUS) that provides a dimensional score (i.e., severity) of problematic Internet use. The questionnaire covers a number of core components of addictive behaviors such as loss of control, preoccupation, withdrawal symptoms, salience, conflict, and coping (i.e., use of the Internet as an escape strategy). Positive correlations were reported between the amount of time spent online, self-reported problems concerning Internet use, and CIUS scores [22]. Furthermore, high correlations were found with the Online Cognition Scale [23], in particular with the subscale called diminished impulse control [22]. The CIUS was found to have high internal consistency and test-retest validity. Its structure, explored in multiple independent samples, is unifactorial [22]. The CIUS has a number of advantages over other instruments, such as its shortness, which makes it easier to use for screening in clinical settings and in online studies, and its unidimensional structure [22]. Another advantage of the CIUS is that it measures Internet uncontrolled use rather than related psychosocial wellbeing concepts [22]. Several versions (14 to 17 items) of the CIUS [24,25] were presented in papers accepted or published before the publication of the final validated 14-item version [22]. Furthermore, a version in which some items were modified (e.g., going online at the expense of schoolwork) was also proposed for a sample of 10- to 16-yearold school students [25]. The main goal of the present paper was to investigate the psychometric properties of the Arab-language translation of the 14-item CIUS [22] in a sample of people ≥ 15 years of age. Materials and methods Participants A to (...truncated)