Document Type : Original Article


1 Department of Psycholinguistics, School of Medicine, Ilam University of Medical Sciences

2 Departments of Psychiatry

3 Departments of Epidemiology

4 Psychology, Psychosocial Injuries Research Center, Ilam University of Medical Sciences, Ilam, Iran


BACKGROUND: Internet is one of the most advanced modern communication technologies. Despite
the positive uses of internet, the existence of extreme behaviors and its harmful consequences has
attracted the attention of all. The aim of this study was to determine the relationship between internet
addiction with anxiety and educational performance.
MATERIALS AND METHODS: This research is a descriptive correlative study. The statistical
population of the study includes a total number of 4401 female students in the high school in the city
of Ilam‑Iran in the academic year of 2017–2018. The sample size includes353 students estimated
using Cochran’s formula. They were selected by random cluster sampling. For data collection, the
Young’s Internet Dependency Questionnaire, Academic Performance Inventory, and Marc et al.,
anxiety Scale were used. Data were analyzed at the significant level of α = 0.05.
RESULTS: The results showed a positive and significant correlation between internet dependency
and students’ anxiety (P < 0.01). There is also a negative and significant correlation between internet
dependency and academic performance of students (P < 0.01), and also a negative and significant
correlation between anxiety and educational performance of students (P < 0.01).
CONCLUSION: On the one hand, the results indicate a high prevalence of internet dependency and
its significant relationship with anxiety and academic performance in students, and on the other hand,
the negative effect of internet dependency on the students’ educational performance. Therefore, it is
necessary to design some intervention programs to prevent harm to students who are increasingly
interacting with internet. In addition, raising the level of the students’ awareness on the complications
of internet addiction and the proper use of the internet seems to be necessary.


1. Razieh J, Ghasempoor A, Ajdari Z, Sadeghigooghari N. The
relationship between internet addiction and anxiety in the
universities students. Interdiscip J Contemp Res Bus 2012;4:942‑9.
2. Ozturk FO, Ekinci M, Ozturk O, Canan F. The relationship of
affective temperament and emotional‑behavioral difficulties
to internet addiction in Turkish teenagers. ISRN Psychiatry
3. Shek DT, Yu L. Adolescent internet addiction in Hong Kong:
Prevalence, change, and correlates. J Pediatr Adolesc Gynecol
4. Mohebi MD, Ayubi E, Azmoodeh A, Sargolzaie N. The
relationship between identity styles and addiction vulnerability:
A cross‑sectional study among medical students in Zahedan,
South Eastern Iran. Psychiatry Res 2018;268:184‑8.
5. Hosseini BS. Comparison of internet addiction between girl and
boy student of universities of Tehran. Womens Stud 2012; 2:23‑42.
6. Zhou Z, Li C, Zhu H. An error‑related negativity potential
investigation of response monitoring function in individuals with
internet addiction disorder. Front Behav Neurosci 2013;7:131.
7. Salehi Omran E, Abedini Baltork M, Azizi Shomami M,
Keshavarz K. Relationship between internet addiction and
depression among secondary school students in Kordkuy,
Iran, with an emphasis on the type of virtual network. J Educ
Community Health 2018;5:13‑8.
8. Park S, Hong KE, Park EJ, Ha KS, Yoo HJ. The association between
problematic internet use and depression, suicidal ideation and
bipolar disorder symptoms in Korean adolescents. Aust N Z J
Psychiatry 2013;47:153‑9.
9. Kuss DJ, Griffiths MD, Karila L, Billieux J. Internet addiction:
A systematic review of epidemiological research for the last
decade. Curr Pharm Des 2014;20:4026‑52.
10. Kuss DJ, Lopez‑Fernandez O. Internet addiction and problematic
internet use: A systematic review of clinical research. World J
Psychiatry 2016;6:143‑76.
11. Chamberlain SR, Lochner C, Stein DJ, Goudriaan AE, van HolstRJ,
Zohar J, et al. Behavioural addiction‑A rising tide? Eur
Neuropsychopharmacol 2016; 26:841‑55.
12. Association AP. Diagnostic and Statistical Manual of Mental
Disorders (DSM‑5®): American Psychiatric Publishing; 2013.
13. Xu J, Shen LX, Yan CH, Hu H, Yang F, Wang L, et al. Personal
characteristics related to the risk of adolescent internet addiction:
A survey in Shanghai, China. BMC Public Health 2012; 12:1106.
14. Gholamian B, Shahnazi H, Hassanzadeh A. The prevalence
of internet addiction and its association with depression,anxiety, and stress, among high‑school students. Int J Pediatr
15. Tamanaeifar M, Sedighi Arfeei F, Gandomi Z. Relationship
between internet addiction with neuroticism in high school
students, Kashan, Iran. Bimonthly J Hormozgan Univ Med Sci
16. Sung J, Lee J, Noh HM, Park YS, Ahn EJ. Associations between the
risk of internet addiction and problem behaviors among Korean
adolescents. Korean J Fam Med 2013;34:115‑22.
17. Mohammadbeigi A, Mohammadsalehi N. Prevalence of internet
addiction and related risk factors in students. J Guilan Univ Med
Sci 2011;20:41‑8.
18. Anand N, Jain PA, Prabhu S, Thomas C, Bhat A, Prathyusha PV,
et al. Prevalence of excessive internet use and its association with
psychological distress among university students in South India.
Ind Psychiatry J 2018;27:131‑40.
19. Rabiei LE, Masoudi R, Salahshoori A. Assessing the effectiveness
of assertiveness program on depression, anxiety and stress among
high school students. Health Syst Res 2012;8:844‑56.
20. Ho RC, Zhang MW, Tsang TY, Toh AH, Pan F, Lu Y, et al.
The association between internet addiction and psychiatric
co‑morbidity: A meta‑analysis. BMC Psychiatry 2014;14:183.
21. Bidi F, Namdari‑Pejman M, Kareshki H, Ahmadnia H. The
mediating role of metacognition in the relationship between
internet addiction and general health. Addict Health 2012;4:49‑56.
22. Jebreil N, Azizifar A, Gowhary H, Jamalinesari A. Study on
writing anxiety among Iranian EFL students. Int J Appl Linguist
English Lit 2015;4:68‑72.
23. Khamseh F, Roohi H, Ebaady A, Hajiamini Z, Salimi H, Radfar S.
Survey relationship between demographic factors and stress,
anxiety and depression in nurses working in selected hospitals
in Tehran city. J Holistic Nurs Midwifery 2011;21:13‑21.
24. Simcharoen S, Pinyopornpanish M, Haoprom P, Kuntawong P,
Wongpakaran N, Wongpakaran T. Prevalence, associated factors
and impact of loneliness and interpersonal problems on internet
addiction: A study in Chiang Mai medical students. Asian J
Psychiatr 2018;31:2‑7.
25. Durkee T, Kaess M, Carli V, Parzer P, Wasserman C, Floderus B,
et al. Prevalence of pathological internet use among adolescents
in Europe: Demographic and social factors. Addiction
26. Jiang Q, Huang X, Tao R. Examining factors influencing internet
addiction and adolescent risk behaviors among excessive internet
users. Health Commun 2018;33:1434‑44.
27. Mihordin R. Behavioral addiction – Quo vadis? J Nerv Ment Dis
28. Alavi SS, Jannatifard F, Eslami M, Rezapour H. Survey on validity
and reliability of diagnostic questionnaire of internet addiction
disorder in students users. Zahedan J Res Med Sci 2011;13:34‑8.
29. Ramezani M, Namiranian N, Salehi M. Validity and reliability of
the Chen internet addiction scale. J Fundamentals Ment Health
30. Qaltash AO, Barzeghar M. Effect education metacognitive
strategies of academic performance and creativity in fifth grande
students. Educ Psychol Q 2010;1:119‑35.
31. Karimi M, Kiiumars F. Relationship between affective
self‑regulation and study skills with educational performance
of students of Isfahan university of medical science. Iran J Med
Educ 2012;11:1149‑61.
32. March JS, Parker JD, Sullivan K, Stallings P, Conners CK. The
multidimensional anxiety scale for children (MASC): Factor
structure, reliability, and validity. J Am Acad Child Adolesc
Psychiatry 1997;36:554‑65.
33. Sasmaz T, Oner S, Kurt AÖ, Yapici G, Yazici AE, Bugdayci R, et al.
Prevalence and risk factors of internet addiction in high school
students. Eur J Public Health 2014;24:15‑20.
34. Nasiri E, RaeiM, VataniJ, Keshavarz S, Almasi Hashiani A. Survey
the prevalence of internet addiction and its influential factors in
Persian college student in 2011. Middle East J Sci Res 2011;10:50‑3.
35. Yao B, Han W, Zeng L, Guo X. Freshman year mental health
symptoms and level of adaptation as predictors of internet
addiction: A retrospective nested case‑control study of male
Chinese college students. Psychiatry Res 2013;210:541‑7.
36. Schoenfeld D, Yan Z. Prevalence and correlates of internet
addiction in undergraduate students: Assessing with two major
measures. Int J Cyber Behav Psychol Learn 2012;2:16‑34.
37. Do YK, Shin E, Bautista MA, Foo K. The associations between
self‑reported sleep duration and adolescent health outcomes:
What is the role of time spent on internet use? Sleep Med
38. Prasanna C, Koong K, Lai L. Some observations on internet
addiction disorder research. J Inf Syst Educ 2012;11:97‑107.
39. Azizi AE, Dhghan Manshadi SM. The relationship between
internet addiction and anxiety and depression in Jolfa city high
school students in 2013. Community Health J 2016;10:11‑8.
40. Young KS. Internet addiction: The emergence of a new clinical
disorder. Cyberpsychol Behav 1998;1:237‑44.
41. Jafari N, Fatehizadeh M. Investigation of the relationship between
internet addiction and depression, anxiety, stress and social
phobia among students in Isfahan university. Sci J Kurdistan
Univ Med Sci 2012;17:1‑9.