{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T06:57:48Z","timestamp":1784357868131,"version":"3.55.0"},"reference-count":41,"publisher":"Oxford University Press (OUP)","issue":"11-12","license":[{"start":{"date-parts":[[2019,4,2]],"date-time":"2019-04-02T00:00:00Z","timestamp":1554163200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Problematic use of video games, social media, and Internet-related activities may be associated with sleep deprivation and poor work performance. The Internet Addiction Test was given to military medical and nursing students and housestaff to assess problematic Internet use.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Medical and nursing students at the Uniformed Services University of the Health Sciences and residents from Naval Medical Center San Diego were contacted via email (n = 1,000) and given a survey that included the Internet Addiction Test (IAT) and questions asking about other specific lifestyle variables. Individuals who received an Internet Addiction Score (IAS) \u226550 were identified as likely experiencing harmful effects of Internet addiction (IA).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of 399 surveys submitted, 68 were omitted due to gross incompletion or failing to finish the entirety of the IAT. Of the participants included, 205 (61.1%) were male and 125 (37.9%) were female. The mean age was 28.6 years old (S.D. = 5.1 years). In regards to training status, completed surveys were assessed for 94 medical residents, 221 School of Medicine students, and 16 Graduate School of Nursing students. Our survey showed 5.5% of the participants (n = 18) indicated problems with Internet use that are concerning for IA.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The study results indicated that our population showed problematic Internet use in the lower range of global estimates of IA. Rates of IA further decreased between medical students and residents. Multiple lifestyle variables were significantly associated with IA score and may serve as indicators of a higher score. Interestingly, the use of social media during sleeping hours was most significantly associated with increased IAS. This paper discusses IA among military medical and nursing trainees and how problematic Internet use may affect work performance and force readiness.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/milmed\/usz043","type":"journal-article","created":{"date-parts":[[2019,4,2]],"date-time":"2019-04-02T12:50:23Z","timestamp":1554209423000},"page":"750-757","source":"Crossref","is-referenced-by-count":8,"title":["Behaviors Associated with Internet Use in Military Medical Students and Residents"],"prefix":"10.1093","volume":"184","author":[{"given":"Gerald","family":"Schmidt","sequence":"first","affiliation":[{"name":"Department of Mental Health, Naval Medical Center San Diego, 34800 Bob Wilson Drive, San Diego, CA 92134"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Valdez","sequence":"additional","affiliation":[{"name":"Department of Graduate Medical Education, Naval Medical Center San Diego, 34800 Bob Wilson Drive, San Diego, CA 92134"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maureen","family":"Farrell","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Naval Medical Center San Diego, 34800 Bob Wilson Drive, San Diego, CA 92134"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Bishop","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Naval Medical Center San Diego, 34800 Bob Wilson Drive, San Diego, CA 92134"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Warren P","family":"Klam","sequence":"additional","affiliation":[{"name":"Department of Mental Health, Naval Medical Center San Diego, 34800 Bob Wilson Drive, San Diego, CA 92134"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew P","family":"Doan","sequence":"additional","affiliation":[{"name":"Department of Mental Health, Naval Medical Center San Diego, 34800 Bob Wilson Drive, San Diego, CA 92134"},{"name":"Department of Ophthalmology, Naval Medical Center San Diego, 34800 Bob Wilson Drive, San Diego, CA 92134"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,4,2]]},"reference":[{"key":"2019121323173794500_usz043C1"},{"key":"2019121323173794500_usz043C2","first-page":"58","article-title":"Internet addiction disorder and problematic use of Google Glass in patient treated at a residential substance abuse treatment program","volume":"41c","author":"Yung","year":"2014","journal-title":"Addict Behav"},{"issue":"7","key":"2019121323173794500_usz043C3","doi-asserted-by":"crossref","first-page":"e839","DOI":"10.7205\/MILMED-D-14-00597","article-title":"Excessive video game use, sleep deprivation, and poor work performance among U.S. Marines treated in a military mental health clinic: a case series","volume":"180","author":"Eickhoff","year":"2015","journal-title":"Mil Med"},{"issue":"6","key":"2019121323173794500_usz043C4","doi-asserted-by":"crossref","first-page":"1048","DOI":"10.1001\/jamainternmed.2015.0753","article-title":"Tendon rupture associated with excessive smartphone gaming","volume":"175","author":"Gilman","year":"2015","journal-title":"JAMA Intern Med"},{"issue":"5","key":"2019121323173794500_usz043C5","doi-asserted-by":"crossref","first-page":"233","DOI":"10.3109\/00952990.2010.491884","article-title":"Introduction to behavioral addictions","volume":"36","author":"Grant","year":"2010","journal-title":"Am J Drug Alcohol Abuse"},{"issue":"3","key":"2019121323173794500_usz043C6","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1017\/S1092852900027437","article-title":"Altered regional cerebral glucose metabolism in internet game overusers: a 18F-fluorodeoxyglucose positron emission tomography study","volume":"15","author":"Park","year":"2010","journal-title":"CNS Spectr"},{"issue":"1","key":"2019121323173794500_usz043C7","doi-asserted-by":"crossref","first-page":"e30253","DOI":"10.1371\/journal.pone.0030253","article-title":"Abnormal white matter integrity in adolescents with internet addiction disorder: a tract-based spatial statistics study","volume":"7","author":"Lin","year":"2012","journal-title":"PLoS One"},{"key":"2019121323173794500_usz043C8","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1111\/nhs.12192","article-title":"Internet addiction and physical and psychosocial behavior problems among rural secondary school students","volume":"17","author":"Gur","year":"2015","journal-title":"Nurs Health Sci"},{"issue":"6","key":"2019121323173794500_usz043C9","doi-asserted-by":"crossref","first-page":"598","DOI":"10.1016\/j.jadohealth.2008.11.011","article-title":"The associations between aggressive behaviors and internet addiction and online activities in adolescents","volume":"44","author":"Ko","year":"2009","journal-title":"J Adolesc Health"},{"key":"2019121323173794500_usz043C10","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1097\/NMD.0000000000000452","article-title":"Personality disorders in female and male college students with Internet addiction","volume":"204","author":"Wu","year":"2016","journal-title":"J Nerv Ment Dis"},{"key":"2019121323173794500_usz043C11","first-page":"441","article-title":"The association between internet addiction and disordered eating attitudes among Turkish high school students","volume-title":"Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity","year":"2015"},{"issue":"3","key":"2019121323173794500_usz043C12","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1016\/j.adolescence.2013.03.008","article-title":"Recognizing internet addiction: prevalence and relationship to academic achievement in adolescents enrolled in urban and rural Greek high schools","volume":"36","author":"Stavropoulos","year":"2013","journal-title":"J Adolesc"},{"issue":"2","key":"2019121323173794500_usz043C13","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1016\/j.ijnurstu.2005.02.005","article-title":"Internet addiction in Korean adolescents and its relation to depression and suicidal ideation: a questionnaire survey","volume":"43","author":"Kim","year":"2006","journal-title":"Int J Nurs Stud"},{"key":"2019121323173794500_usz043C14","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1016\/j.pnpbp.2012.05.013","article-title":"Abnormal brain activation of adolescent internet addict in a ball-throwing animation task: Possible neural correlates of disembodiment revealed by fMRI","volume":"39","author":"Kim","year":"2012","journal-title":"Prog Neuropsychopharmacol Biol Psychiatry"},{"issue":"2\u20133","key":"2019121323173794500_usz043C15","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1016\/j.pscychresns.2012.02.001","article-title":"Impaired inhibitory control in \u2018internet addiction disorder\u2019: a functional magnetic resonance imaging study","volume":"203","author":"Dong","year":"2012","journal-title":"Psychiatry Res"},{"key":"2019121323173794500_usz043C16","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1016\/j.pnpbp.2013.07.007","article-title":"Reward\/punishment sensitivities among internet addicts: Implications for their addictive behaviors","volume":"46","author":"Dong","year":"2013","journal-title":"Prog Neuropsychopharmacol Biol Psychiatry"},{"key":"2019121323173794500_usz043C17","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1016\/j.biopsycho.2013.07.009","article-title":"What makes Internet addicts continue playing online even when faced by severe negative consequences? Possible explanations from an fMRI study","volume":"94","author":"Dong","year":"2013","journal-title":"Biol Psychol"},{"key":"2019121323173794500_usz043C18","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1371\/journal.pone.0020708","article-title":"Microstructure abnormalities in adolescents with internet addiction disorder","volume":"6","author":"Yuan","year":"2011","journal-title":"PLoS One"},{"issue":"1","key":"2019121323173794500_usz043C19","doi-asserted-by":"crossref","first-page":"e53055","DOI":"10.1371\/journal.pone.0053055","article-title":"Cortical thickness abnormalities in late adolescence with online gaming addiction","volume":"8","author":"Yuan","year":"2013","journal-title":"PLoS One"},{"key":"2019121323173794500_usz043C20","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1186\/1744-9081-9-11","article-title":"Reduced orbitofrontal cortical thickness in male adolescents with internet addiction","volume":"9","author":"Hong","year":"2013","journal-title":"Behav Brain Funct"},{"key":"2019121323173794500_usz043C21","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1016\/j.ejrad.2009.10.025","article-title":"Gray matter abnormalities in Internet addiction: a voxel-based morphometry study","volume":"79","author":"Zhou","year":"2011","journal-title":"Eur J Radiol"},{"key":"2019121323173794500_usz043C22","doi-asserted-by":"crossref","first-page":"1308","DOI":"10.1016\/j.ejrad.2013.01.031","article-title":"Gray matter and white matter abnormalities in online game addiction","volume":"82","author":"Weng","year":"2013","journal-title":"Eur J Radiol"},{"issue":"3","key":"2019121323173794500_usz043C23","doi-asserted-by":"crossref","first-page":"e59902","DOI":"10.1371\/journal.pone.0059902","article-title":"Altered default network resting-state functional connectivity in adolescents with Internet gaming addiction","volume":"8","author":"Ding","year":"2013","journal-title":"PLoS One"},{"key":"2019121323173794500_usz043C24","doi-asserted-by":"crossref","first-page":"e57831","DOI":"10.1371\/journal.pone.0057831","article-title":"Decreased functional brain connectivity in adolescents with Internet addiction","volume":"8","author":"Hong","year":"2013","journal-title":"PLoS One"},{"issue":"3","key":"2019121323173794500_usz043C25","doi-asserted-by":"crossref","first-page":"428","DOI":"10.1016\/j.psychres.2011.05.017","article-title":"Excessive Internet gaming and decision making: do excessive World of Warcraft players have problems in decision making under risky conditions?","volume":"188","author":"Pawlikowski","year":"2011","journal-title":"Psychiatry Res"},{"issue":"2","key":"2019121323173794500_usz043C26","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1016\/j.neulet.2011.05.047","article-title":"Male Internet addicts show impaired executive control ability: evidence from a color-word Stroop task","volume":"499","author":"Dong","year":"2011","journal-title":"Neurosci Lett"},{"issue":"11","key":"2019121323173794500_usz043C27","doi-asserted-by":"crossref","first-page":"e48961","DOI":"10.1371\/journal.pone.0048961","article-title":"Cognitive biases toward Internet game-related pictures and executive deficits in individuals with an Internet game addiction","volume":"7","author":"Zhou","year":"2012","journal-title":"PLoS One"},{"key":"2019121323173794500_usz043C28","first-page":"75","article-title":"Decision-making and prepotent response inhibition functions in excessive internet users","volume-title":"CNS spectrums","year":"2009"},{"key":"2019121323173794500_usz043C29","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1089\/cpb.1998.1.237","article-title":"Internet addiction: the emergence of a new clinical disorder","volume":"1","author":"Young","year":"1998","journal-title":"Cyberpsychol Behav"},{"key":"2019121323173794500_usz043C30","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1089\/cpb.2004.7.443","article-title":"The psychometric properties of the internet addiction test","volume":"7","author":"Widyanto","year":"2004","journal-title":"Cyberpsychol Behav"},{"key":"2019121323173794500_usz043C31","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1159\/000355076","article-title":"Assessment of problematic internet use by the compulsive Internet use scale and the Internet addiction test: a sample of problematic and pathological gamblers","volume":"20","author":"Guertler","year":"2014","journal-title":"Eur Addict Res"},{"issue":"25","key":"2019121323173794500_usz043C32","doi-asserted-by":"crossref","first-page":"4026","DOI":"10.2174\/13816128113199990617","article-title":"Internet addiction: a systematic review of epidemiological research for the last decade","volume":"20","author":"Kuss","year":"2014","journal-title":"Curr Pharm Des"},{"key":"2019121323173794500_usz043C33","doi-asserted-by":"crossref","first-page":"755","DOI":"10.1089\/cyber.2014.0317","article-title":"Internet addiction prevalence and quality of (real) Life: a meta-analysis of 31 nations across seven world regions","volume":"17","author":"Cheng","year":"2014","journal-title":"Cyberpsychol Behav Soc Netw"},{"key":"2019121323173794500_usz043C34","first-page":"244","article-title":"Digital devices and distracted doctoring","volume":"132","author":"Dossey","year":"2015","journal-title":"Tex Dent J"},{"key":"2019121323173794500_usz043C35","doi-asserted-by":"crossref","first-page":"1306","DOI":"10.4187\/respcare.03483","article-title":"Electronic distractions of the respiratory therapist and their impact on patient safety","volume":"59","author":"Papadakos","year":"2014","journal-title":"Respir Care"},{"issue":"4","key":"2019121323173794500_usz043C36","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1037\/a0020023","article-title":"Bupropion sustained release treatment decreases craving for video games and cue-induced brain activity in patients with Internet video game addiction","volume":"18","author":"Han","year":"2010","journal-title":"Exp Clin Psychopharmacol"},{"key":"2019121323173794500_usz043C37","doi-asserted-by":"crossref","first-page":"703","DOI":"10.1089\/cpb.2007.0249","article-title":"French validation of the internet addiction test","volume":"11","author":"Khazaal","year":"2008","journal-title":"Cyberpsychol Behav"},{"key":"2019121323173794500_usz043C38","doi-asserted-by":"crossref","first-page":"953","DOI":"10.1186\/s12889-015-2281-5","article-title":"Validation and psychometric analysis of the Internet Addiction Test in Spanish among college students","volume":"15","author":"Fernandez-Villa","year":"2015","journal-title":"BMC Public Health"},{"key":"2019121323173794500_usz043C39","first-page":"280","article-title":"The relationship between Internet addiction and academic success of secondary school students","volume":"20","author":"Turel","year":"1999","journal-title":"Anthropologist"},{"key":"2019121323173794500_usz043C40","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1111\/ajad.12110","article-title":"New developments on the neurobiological and pharmaco-genetic mechanisms underlying internet and videogame addiction","volume":"24","author":"Weinstein","year":"2015","journal-title":"Am J Addict"},{"key":"2019121323173794500_usz043C41","doi-asserted-by":"crossref","first-page":"1841","DOI":"10.1016\/j.chb.2013.02.014","article-title":"Computers in human behavior motivational, emotional, and behavioral correlates of fear of missing out","volume":"29","author":"Przybylski","year":"2013","journal-title":"Comput Human Behav"}],"container-title":["Military Medicine"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/milmed\/article-pdf\/184\/11-12\/750\/31510149\/usz043.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/milmed\/article-pdf\/184\/11-12\/750\/31510149\/usz043.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,12,14]],"date-time":"2019-12-14T04:18:34Z","timestamp":1576297114000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/milmed\/article\/184\/11-12\/750\/5425726"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,4,2]]},"references-count":41,"journal-issue":{"issue":"11-12","published-online":{"date-parts":[[2019,4,2]]},"published-print":{"date-parts":[[2019,12,1]]}},"URL":"https:\/\/doi.org\/10.1093\/milmed\/usz043","relation":{},"ISSN":["0026-4075","1930-613X"],"issn-type":[{"value":"0026-4075","type":"print"},{"value":"1930-613X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2019,11]]},"published":{"date-parts":[[2019,4,2]]}}}