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Current Pharmaceutical Design, 2014, 20, 4053-4061 4053

Social Network Site Addiction - An Overview

Cecilie Schou Andreassen1,2,* and Ståle Pallesen1

1
Department of Psychosocial Science, University of Bergen, Norway; 2The Bergen Clinics Foundation, Norway

Abstract: Research into frequent, excessive, and compulsive social network activity has increased the last years, in which terms such as
“social network site addiction” and “Facebook addiction” have been used interchangeably. The aim of this review is to offer more
knowledge and better understanding of social network site addiction (SNS-addiction) among researchers as well as clinicians by present-
ing a narrative overview of the research field in terms of definition, measurement, antecedents, consequences, and treatment as well as
recommendations for future research efforts. Seven different measures of SNS-addiction have been developed, although they have to a
very little extent been validated against each other. The small number of studies conducted so far on this topic suggests that SNS-
addiction is associated with health-related, academic, and interpersonal problems/issues. However such studies have relied on a simple
cross-sectional study design. It is therefore hard to draw any conclusions about potential causality and long-term effects at this point, be-
yond hypothetical speculations. Empirical studies suggest that SNS-addiction is caused by dispositional factors (e.g., personality, needs,
self-esteem), although relevant explanatory socio-cultural and behavioral reinforcement factors remain to be empirically explored. No
well-documented treatment for SNS-addiction exists, but knowledge gained from Internet addiction treatment approaches might be trans-
ferable to SNS-addiction. Overall, the research on this topic is in its infancy, and as such the SNS-addiction construct needs further con-
ceptual and empirical exploration. There is a great demand for studies using careful longitudinal designs and studies which include objec-
tive measures of both behavior and health based on broad representative samples.

Keywords: Social network, addiction, Facebook, social media, assessment, antecedents, consequences, treatment.

INTRODUCTION
Lately, behavioral addictions have received increased attention
in the media as well as from researchers. In line with the increased
use of social network sites (SNS), SNS-addiction has recently been
proposed as a new behavioral addiction. In this paper we present an
updated overview of this concept and critically discuss definitions,
assessment, antecedents, consequences, and treatment of this phe-
nomenon.
Online social network sites (SNSs) have become immensely
popular during the last decade, and have become as ubiquitous as
television in our everyday life. It is likely that such sites have over
one billion users worldwide. Such sites are defined as web-based
services that allow individuals to: 1) construct a public or semi-
public profile within a bounded system, 2) articulate a list of other
users with whom they share a connection, and 3) view and trans-
verse their list of connections and those made by others within the
system [1].
Online social networking serves several important functions for
the individual – such as establishing and developing relationships,
building identity, and creating meaning. Not surprisingly, a lack of
social contact on- or offline (i.e., social isolation) is associated with
a range of psychological as well as somatic problems [2, 3]. Despite
the positive aspects of online socializing, some seem to be driven
by inner and outer forces to use SNSs excessively and compul-
sively. These are denoted as online social network addicts [4, 5].
Research into frequent, excessive, and compulsive social network
activity has increased over the last years, in which terms such as
“social network addiction,” “social network disorder,” “overuse of
social networking sites,” “addiction to social networking sites,”
“Facebook addiction” and “Facebook dependence” have been used
interchangeably [4-7]. SNS-addiction may have implications for
health and well-being, thus more knowledge of this condition and
scientific research efforts is of vital importance [4, 8].
*Address correspondence to this author at the Department of Psychosocial
Science, University of Bergen, Christiesgt. 12 NO-5015 Bergen, Norway;
Tel: +47 48041699; Fax: +47 55589879;
E-mail: cecilie.andreassen@psych.uib.no
WHAT IS SOCIAL NETWORK SITE ADDICTION?
“Addiction” has been defined as “a persistent behavioral pattern
characterized by: a desire or need to continue the activity which
places it outside voluntary control; a tendency to increase the fre-
quency or amount of the activity over time; psychological depend-
ence on the pleasurable effects of the activity; and, a detrimental
effect on the individual and society.” [9]. Traditionally, addiction
has been understood as an excessive and uncontrollable dependence
on chemical substances, such as alcohol and illicit drugs. In recent
years, however, researchers have come to recognize strong similari-
ties between such chemical addictions and excessive non-chemical
behaviors. In line with this, Griffiths [10] proposed that all addic-
tions, chemical and non-chemical, share six common core compo-
nents: (i) salience (i.e., preoccupation with online social networking
sites), (ii) mood modification (i.e., use of online social network
sites to avoid dysphoria), (iii) tolerance (i.e., ever increasing use of
online social network sites in order to obtain the initial mental and
physiological effect), (iv) withdrawal (i.e., dysphoria when prohib-
ited from using online social network sites), (v) conflict (i.e., the
social networking disrupts own as well as others’ needs), and (vi)
relapse (i.e., falling back into old behavioral patterns after a period
in control over or absence of online social networking). Further-
more, research has shown that chemical and behavioral addictions
share some similarities in neurobiology [11, 12], co-morbidity [13],
reaction to treatment [14], cognitive processes involved [15], and
socio-cultural factors [16]. It has therefore been argued that exces-
sive and compulsive behaviors towards quite ordinary and neces-
sary activities such as eating, exercising, shopping, and working
should be regarded as addictions [17]. So far, pathological gam-
bling is the only behavioral addiction that has been formally recog-
nized in the formal psychiatric nosology [18]. In the recent and 5th
edition of Diagnostic and Statistical Manual for Mental Disorders
(DSM-5) pathological gambling (now named Gambling Disorder)
was moved from the “Impulse-Control Disorders Section” to the
“Substance-Related and Addictive Disorders Section” [19], giving
it status as a true addiction. In addition “Internet Gaming Disor-
ders” was included as a “Condition for Further Study” in the DSM-
5 [19]. Other conditions, such as kleptomania and pyromania, that

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4054 Current Pharmaceutical Design, 2014, Vol. 20, No. 25
some regard as behavioral addictions [20], are also included in the
DSM-5, but are here listed under disruptive, impulse-control, and
conduct disorders [19]. In addition, several other potential behav-
ioral addictions have been put forward by scholars in recent years,
among others Internet addiction [21].
In terms of the latter some have argued that Internet addiction is
a rather empty and shallow concept and that it is behavior related to
the specific content of the Internet to which one can become ad-
dicted [22, 23]. In line with this, Young has proposed five types of
Internet addiction, specified by the addictive content/material: (i)
cybersexual addiction, (ii) cyber-relationship addiction, (iii) net
compulsions (obsessive online gambling, shopping or day trading),
(iv) information overload (compulsive web surfing or database
searches), and (v) computer addiction (obsessive computer game
playing) [24]. As a result of the social media “revolution”, re-
searchers have had their attention drawn to a new excessive behav-
ior, denoted as social network site (SNS) addiction [5] which corre-
sponds well with the second subtype of Internet addiction listed
above [24]. Launched in 2004 by Mark Zuckerberg, Facebook is
clearly the one online SNS that has received most attention so far
with its one billion users worldwide [25]. Because of this, some
researchers have developed measures to specifically measure addic-
tion to Facebook [4, 8, 26, 27]. However, this approach has recently
been criticized. Instead of developing scales specifically to measure
Facebook addiction, it is stated that the term SNS-addiction would
be more appropriate [28, 29]. However, we have argued that since
Facebook is not identical to other SNSs, and since it is used as a
generic concept by many, the term and specific assessment of Face-
book addiction are warranted [30].
Rooted in the addiction paradigm, SNS-addiction can be de-
fined as being overly concerned about SNSs, driven by a strong
motivation to log on to or use SNSs, and to devote so much time
and effort to SNSs that it impairs other social activities, studies/job,
interpersonal relationships, and/or psychological health and well-
being. Facebook addiction may be considered as a specific subtype
of this. The SNS addict may subjectively experience loss of control,
where s/he continues to engage in the excessive social networking
activity despite negative consequences and attempts of modification
or control.
In the wake of the increasing range of SNSs and new technol-
ogy to easily access these, we may be witnessing an increase in
SNS-addiction. Concerns have been raised about negative conse-
quences, especially for younger people [5]. Bearing in mind that
research in this field has barely started, it is too early to establish
accurate prevalence estimates. The limited number of studies aim-
ing at estimating the prevalence of SNS-addiction suggest that
younger users are more prone to develop SNS-addiction than older
users [4, 17, 31] and suggest a female preponderance [4]. However
some studies have not found an association between SNS-addiction
and age [7, 8] or gender [7, 8, 31]. In a recent review of Internet
addiction, Sussman et al. [32] estimated that 2% of the general
adult U.S. population is Internet addicted. Estimates have in several
studies been a lot higher, especially in the younger populations
[32]. Few studies have attempted to estimate the prevalence of
SNS-addiction, mostly because few instruments with well-defined
cut-offs exist. Still, in a study of 418 undergraduate students in
Lima, Peru, it was estimated that 8.6% fulfilled the criteria for
Facebook addiction [6]. In that study, a questionnaire of Internet
addiction with 8 two-choice items (yes/no) [33] was adapted for
assessment of Facebook addiction and a cut-off of 5 or more was
used to define its addiction [6]. In a study of 277 Macau young
smartphone users about 12% was categorized as probable problem-
atic users of SNSs [7]. Here, addiction to SNSs was assessed by a
modified version of Young’s 20-item Internet Addiction Test [34].
All items were answered on a Likert scale ranging from 1 (“never”)
to 5 (“always”). Problematic use was defined as a composite score
of 50 or above [7].
Andreassen and Pallesen
As online SNSs have become ordinary and inevitable in our
everyday life, it is becoming increasingly difficult for many people
to know if they are addicted to social media. Importantly, one
should recognize that there is a difference between SNS-
engagement and SNS-addiction [31]. Some people might spend
many hours on SNSs as a part of their job (e.g., business marketing
strategists, online journalists, etc.). Thus, defining SNS-addiction
solely as time spent on these sites would be misleading, as people
can spend much time on social networks for many different reasons
without “meeting the criteria” for SNS-addiction. For many SNS
addicts, as with other addictive behaviors, the social networking
becomes the individual’s main strategy to cope with stress or act as
a mechanism to escape from self [35]. In a differential-diagnostic
perspective it is therefore important to rule out potential medical
reasons that may cause such excessive behavior, bipolar disorders,
as well as recognizing that not all excessive social networking is
pathological, for example overuse related to vacations or having a
job that requires extensive use of SNSs.
ASSESSMENT OF SOCIAL NETWORK SITE ADDICTION
Although several measures assessing computer and Internet
addiction have existed for some time [13], we know of only seven
recently developed self-report measures assessing SNS (predomi-
nately Facebook) addiction that have been published in peer-
reviewed literature [4, 6-8, 26, 27, 31]. Beside these, scales like the
Online Sociability Test [36], Motives for Facebook Usage Scale
[8], and the Facebook Attitude Scale [37] exist – but seem irrele-
vant when it comes to measuring addictive use of SNSs per se.
Below a short overview of the seven specific SNS-addiction meas-
ures is presented (see Table 1).
The first scale to measure addictive usage of SNSs was the
Addictive Tendencies Scale developed by Wilson et al. [27] in a
sample of 201 college students. The scale consists of three items
answered on a 7-point Likert scale ranging from 1 (“Strongly dis-
agree”) to 7 (“Strongly agree”). High scores indicate high levels of
addictive tendencies in relation to SNS use. The item-pool reflects
salience (“One of the first things I do each morning is to log onto a
social networking Internet site [e.g., MySpace or Facebook]”), loss
of control (“I find it hard to control my use of a social networking
site [e.g., MySpace or Facebook]”), and withdrawal symptoms (“I
feel lost when I cannot access my social networking site [e.g.,
MySpace or Facebook]”); and is based on previous research meas-
uring addiction in relation to text messaging and instant messaging
services [38]. The original study obtained an alpha of .76, and the
scale correlated positively with reported time spent using SNSs.
The scale could be criticised for leaving out several central aspects
of addiction, such as mood modification, tolerance, conflict, and
relapse.
Based on an addiction approach, Elphinston and Noller devel-
oped the Facebook Intrusion Questionnaire (FIQ) to measure Face-
book intrusion in a sample of 342 Australian undergraduate stu-
dents. The questionnaire consists of eight items answered on a 7-
point Likert scale ranging from 1 (“Strongly disagree”) to 7
(“Strongly agree”) (e.g., “I lose track of how much I am using
Facebook” and “Arguments have arisen with others because of my
Facebook use”), thus yielding a total overall score ranging from 8
to 53. Mean scores (25.89) indicate moderate levels of Facebook
intrusion. Cronbach’s alpha was .85 [26]. The items are based on
Brown’s behavioral addiction components (cognitive salience, be-
havioral salience, interpersonal conflict, conflict with other activi-
ties, euphoria, loss of control, withdrawal, and re-
lapse/reinstatement) [39], and the Mobile Phone Involvement Ques-
tionnaire by Walsh et al. [40]. When factor analysing the FIQ, one
dimension accounting for 49% of the total variance was found,
supporting a unidimensional model [26]. So far, no further evalua-
tion of the FIQ’s psychometric properties has been performed, thus
it needs further validation – especially in more representative sam-
Social Network Site Addiction
ples. Although the name of the scale suggests that it assesses a
somewhat narrow aspect of addiction (intrusion), the items do, on
face value, seem to be rather broad in scope. Future studies are
needed to determine whether the scale is general enough to be con-
sidered as a scale assessing Facebook addiction.
Recently, also based on an addiction approach, Andreassen et
al. [4] developed the Bergen Facebook Addiction Scale (BFAS) to
measure Facebook addiction in a sample of 423 Norwegian stu-
dents. The questionnaire consists of six items answered on a 5-point
Likert scale ranging from 1 (“Very rarely”) to 5 (“Very often”)
(e.g., “Felt an urge to use Facebook more and more” and “Used
Facebook so much that it has had a negative impact on your
job/studies”). Initially, a pool of 18 items, three reflecting each of
the six core elements of addiction (salience, mood modification,
tolerance, withdrawal, conflict, and relapse) [10] was constructed.
The item within each of each of the six addiction elements with the
highest corrected item-total correlation was retained in the final
scale. Thus, the overall score ranges from 6 to 30, all adhering to a
time frame of one year. Although the original study did not provide
cut-off estimates, scoring 3 or above on at least four of the six items
has been proposed as a liberal way to classify someone as a Face-
book addict, whereas scoring 3 or above on all six items was sug-
gested as a more conservative approach. The usefulness of the pro-
posed cut-off values for categorization of Facebook addition with
the BFAS should be pursued in future studies [4]. The BFAS has
demonstrated appropriate psychometric properties, with high inter-
nal consistencies (alpha=.83, .86), three-week test-retest reliability
(.82) and an acceptable factor structure (RMSEA=.046, CFI=.99).
In addition, BFAS has shown good discriminative and convergent
validity. BFAS was also recently used in another study of the rela-
tionship between seven behavioral addictions and the five-factor
model of personality [17]. The scale is currently being translated
into several languages (Turkish, Polish, English, French, Italian,
Spanish, German, Indonesian and more).
Turel and Serenko [31] developed two SNS scales, one reflect-
ing engagement and one assessing addiction. The items were based
on the Charlton and Danforth [41] scales, originally developed to
assess engagement and addiction to video games. Only items with a
loading higher than .60 in the original study were included. After
some modification the model (including both scales) had good psy-
chometric properties (CFI=.99, RMSEA=.050, and SMRS=.054).
All standardized loadings were above .60. Cronbach’s alpha was
above .70. The scale was developed based on data from a sample of
194 American business school students. The addiction subscale
contained a total of five items (e.g., “When I am not using this so-
cial networking website, I often feel agitated” and “I have made
unsuccessful attempts to reduce the time I interact with this social
networking website”). All items are scored on a 7-point Likert
scale. Higher scores reflect higher levels of SNS-addiction [31].
In order to assess Facebook dependence Wolniczak and co-
workers developed, based on a scale for Internet addiction [33], an
eight-item questionnaire assessing worries, concern, satisfaction,
time of use and efforts to reduce it, control, and other activities
involved in Facebook. The questionnaire consists of eight two-
choice questions (yes/no). A score of 5 or more is regarded as sug-
gestive of Facebook dependence. In all, 418 Peruvian students
completed the questionnaire [6].
A very new addition to the tool-box is the Facebook Addiction
Scale (FAS) developed by Koc and Gulyagci [8]. FAS consists of
eight items answered on a 5-point Likert scale ranging from 1 (“Not
true”) to 5 (“Extremely true”), thus the overall score ranges from 8
to 40 (e.g., “My Facebook use interferes with doing social activi-
ties” and “I have attempted to spend less time on Facebook but
have not succeeded”). High scores on FAS indicate Facebook ad-
diction. The item pool is drawn from existing research on Internet
addiction [34, 42], reflecting more or less the same content as the
Current Pharmaceutical Design, 2014, Vol. 20, No. 25 4055
FIQ [26]. In their study among 447 Turkish college students the
FAS showed good psychometric properties (SRMR=.04, CFI=.97,
=.84), and correlated positively with other scales of Facebook use
[8].
The newest scale developed to assess SNS-addiction seems to
be a 20-item (e.g., “How often do you try to cut down the amount
of time you spend on social network sites and fail?”) inventory
modified from Young’s Internet Addiction Test [34]. Respondents
are asked how often they experienced obsession, compulsion, or
problems related to the use of SNSs on a 5-point Likert scale, where
higher scores indicate higher levels of symptomatology. The scale
was administered to 316 Chinese participants. The Cronbach’s al-
pha was .92 [7].
Together, the seven specific measures emphasize somewhat
different aspects of SNS-addiction. Most of them are brief, which
may make them suitable for epidemiological studies. Compared to
the diagnostic criteria for Internet Gaming Disorder, several of the
aforementioned scales seem to have overlapping criteria/items.
Still, few scales have incorporated the issue of loss of interest in
previous hobbies and entertainment, and deception of other about
the time devoted to the behavior in question, both of which are
specified as criteria for Internet Game Disorder [19]. However, it is
debatable whether the criteria for Internet Game Disorder and other
addictive behaviors found in the DSM-5 should be used as a start-
ing point or as a gold standard for the development of instruments
assessing SNS-addiction. Thus, this should be the topic for future
studies as well as for future conceptual and theoretical refinement.
Very few of the aforementioned scales have been cross-validated
against each other, thus it is currently not clear if the scales actually
assess the same construct. It should also be noted that some of the
aforementioned scales specifically pertain to Facebook addiction,
whereas others are more generic in nature. Some adolescents may
prefer other SNSs than Facebook in order to avoid multiple connec-
tions with family members, or in order to avoid negative conse-
quences of Facebook activity for future job roles. Recently, concern
about governmental surveillance of SNSs might also have moti-
vated some to stop using SNSs or to change from one to another
SNS. These issues should be taken into consideration when assess-
ing SNS-addiction.
ANTECEDENTS AND CORRELATES OF SOCIAL NET-
WORK SITE ADDICTION
SNS-addiction is a complex phenomenon that probably is
formed, triggered, and reinforced by a variety of antecedents. In the
following, the theoretical and empirical framework for potential
dispositional, socio-cultural, and reinforcing antecedents of SNS-
addiction cited in the literature will be briefly presented.
Neurobiological perspectives on addiction are worth mention-
ing, although no studies have examined the neurobiological corre-
lates of SNS-addiction so far. This perspective focuses on disrupted
neurotransmission, especially in dopaminergic, serotonergic, or
opioid systems [43]. The fact that other behavioral addictions have
been treated with medications affecting these systems, supports this
hypothesis [44]. Furthermore, neuroimaging studies of SNS-related
conditions, such as Internet and gaming addiction provide compel-
ling evidence for the similarities between these and substance-
related addictions in terms of brain activation patterns, and suggest
common underlying mechanisms for behavioral and substance-
related addictions [45]. The SNS addict behavior can thus be related
to the brain’s reward-system, where the SNS experience influences
the chemical reward systems in the brain that release endorphines,
dopamine and noradrenalin – resulting in an emotional “high”.
Research shows that SNS addicts are more prone to experience a
variety of negative feelings such as depression, anxiety and loneli-
ness than non-SNS addicts [8], which supports the assumption that
they are more biologically predisposed for experiencing negative
4056 Current Pharmaceutical Design, 2014, Vol. 20, No. 25 Andreassen and Pallesen

Table 1. Overview of existing SNS-addiction measures

Instrument Background Sample Methodology Items Sub- Scoring /cut-off

scales

Addictive Ten- Based on three items 201 students Calculation of internal 3 items answered None A composite score is
dencies Scale assessing salience form an Austra- consistency (
= .76) along a 7-point scale calculated by adding
[27] related to mobile lian university ranging from “strongly the scores of the 3
phone addiction [38] disagree” to “strongly items, No cut-off sug-
agree” gested

Facebook Intru- Based on Brown’s 342 students EFA identifying one 8 items answered None A composite score is
sion Question- behavioral addiction form an Austra- component explaining along a 7-point scale calculated by adding
naire (FIQ) [26] components [39] and lian university 49.2% of the variance ranging from “strongly the scores of the 8
the Mobile Phone (
= .85) disagree” to “strongly items, No cut-off sug-
Involvement Ques- agree” gested
tionnaire [40]

Bergen Facebook Based on Brown’s 423 college with CFA, RMSEA = 0.05, 6 items answered None A composite score is
Addiction Scale behavioral addiction university stu- CFI = .99 (
= .83) along a 5-point scale calculated by adding
(BFAS) components [39] and dents in Norway ranging from “very the scores of the 6
[4] Griffiths components rarely” to “very often” items, Polythetic cut-
model of addiction off: scoring 3 or above
[10] on at least 4 items,
Monothetic cut-off:
scoring 3 and above on
all 6 items

Social Network- Based on short ver- 194 students at Overall CFA to the 5 items answered None A composite score is
ing Website sions of the Charlton an American addiction scale and along a 7-point scale calculated by adding
Addiction Scale and Danforth scales business school related constructs, ranging from com- the score on the 5 items
[31] [41] differentiating RMSEA = 0.05, CFI = pletely agree to com- divided by 5. No cut-off
between addiction 0.98 (
= .86) pletely agree suggested
and engagement

Facebook De- Based on a question- 418 students Calculation of internal 8 items answered None A composite score is
pendence naire of Internet from a univer- consistency (
= .67) along a two-choice calculated by adding all
Questionnaire [6] addiction [33] sity in Peru scale (yes/no) the endorsed items. A
score of 5 or more
indicate Facebook
addiction

Facebook Addic- Based on Young’s 447 students EFA based on data 8 items answered None A composite score is
tion Scale (FAS) Internet Addiction from a college from half of the sam- along a 5-point scale calculated by adding
[8] Test [34] and the in Turkey ple: One factor ranging from “not the scores of all items.
Problematic Internet emerged explaining true” to “extremely No cut-off suggested
Use Scale 2 [86] 50% of the variance. true”
CFA on data from the
other half of the sam-
ple confirmed a one-
factor solution:
SRMR = 0.04, CFI =
0.97
(
= .86)

Addictive Ten- Based on Young’s 316 adult Chi- Calculation of internal 20 items answered None A composite score is
dencies Towards Internet Addiction nese (18-40 consistency (
= .92) along a 5-point scale calculated by adding all
SNSs [7] Test [34] years) recruited ranging from “never” the endorsed items. A
by emails and to “always” score of 50 or more
snow balling indicate problematic
techniques Facebook use

EFA = Explorative factor analysis, CFA = Confirmatory factor analysis

Social Network Site Addiction
affect. Thus one can speculate that SNS addicts use these sites in
order to regulate feelings (e.g., core element of addiction – mood
modification).
Current research has reported a link between SNS-addiction and
several personality traits [4, 17, 27]. According to the Five Factor
Model of Personality (FFM) [46], personality traits are relatively
firmly established, differ between individuals, and affect behavior.
The SNS addict’s behavioral pattern can thus be understood in
terms of underlying and possibly genetically based personality
traits. The FFM of personality comprises five main dimensions:
“neuroticism” (e.g., being nervous and sensitive), “extraversion”
(e.g., being energetic and outgoing), “openness to experience” (e.g.,
being imaginative and inventive), “agreeableness” (e.g., being sym-
pathetic and friendly), and “conscientiousness” (e.g., being orga-
nized and efficient). To the best of our knowledge, only three pre-
vious peer-review published studies have investigated how the di-
mensions of the FFM of personality correlate with SNS-addiction
[4, 17, 27]. The study by Andreassen et al. [4] using the BFAS
reported that Facebook addiction was strongly and positively re-
lated to neuroticism and extraversion, and negatively to conscien-
tiousness. In their second study they found that Facebook addiction
was related to high scores on extraversion and openness, and low
scores on conscientiousness [17]. Wilson et al. [27] reported Face-
book addiction to be positively related to extraversion and inversely
related to conscientiousness. These findings indicate that people
who are anxious and socially insecure may use SNSs because they
find it easier to communicate via social media (i.e., social compen-
sation hypothesis) [38]. In line with this, previous research has
reported an association between low self-esteem and SNS-addiction
[27]. Also, people who are organized and more ambitious tend to be
less at risk from developing Facebook addiction. They will proba-
bly use social media in a controlled and organized way as part of
work and networking. Extraverted people may be at risk of devel-
oping Facebook addiction as a means to stimulate their social needs
even more (i.e., the rich get richer hypothesis) [36]. Narcissism has
been hypothesized to be linked to SNS-addiction as on such sites
they have the opportunity to present themselves very favourably
[47]. Impulsivity has also been linked to SNS-addiction [7].
SNS-addiction could also be understood in terms of satisfying
innate basic psychological needs for autonomy, competence, and
relatedness. According to self-determination theory [48], these three
needs are basic motivations for all human behavior. Especially the
need for relatedness, which reflects the need to maintain meaning-
ful relations with and to feel appreciated by significant others, is
relevant here. For example, when feeling unrelated, the person may
use SNSs excessively in order to feel more related, particularly if
this motive is given high priority by the individual in question [48].
Internal pressure or obsession with online social networking could
therefore be associated with unsatisfied basic needs, which may be
satisfied through social media. So far, no studies have investigated
the underlying basic motivations that may be associated with SNS-
addiction, although studies have shown that need for belongingness
[49] and feelings of loneliness [50] are related to SNS-addiction.
Additionally, this is also supported by studies showing that addic-
tive Internet use was motivated by need for social contact and re-
ducing loneliness [32]. Finally, Koc and Gulyagci [8] reported that
Facebook addiction was positively related to motives of making
new friends, sharing assignments with classmates, and following
daily news on Facebook.
A third theoretical perspective suggests that basic cognitions
and cognitive processes can help explain the process of developing
SNS-addiction. Basic cognitions such as schemata, core beliefs,
expectations, attributions, and automatic thoughts are assumed to
activate behavior [51]. Thus, if a person holds self-schemata that
s/he is a poor maker of social connections, and holds a core belief
Current Pharmaceutical Design, 2014, Vol. 20, No. 25 4057
that excessive online social networking equals social skills, then
SNS-addiction behavior may be activated as a result. Studies link-
ing poor self-esteem and social dysfunction to SNS-addiction sup-
port this theory [8, 27]. Self-efficacy, or the perceived ability to
handle specific situations well [52], may also be relevant in explain-
ing the development of SNS-addiction. In general, people are moti-
vated to enhance positive self-evaluations. Thus, when self-efficacy
related to online social media is greater than self-efficacy related to
non-social media settings, it may drive the person to choose social
media over non-media socializing (i.e., meeting friends offline) for
the purpose of maintaining a positive self-image and in order to
strengthen the sense of mastery. Cognitive theory has to a little
extent been tested empirically, and thus more empirical validation
is needed. However Wu et al. [7] found an inverse relationship
between SNS-addictions and Internet self-efficacy. They explained
their findings suggesting that those who are very skillful and com-
petent with Internet tools are more likely to get hooked by other
Internet activities than SNSs. They did however find that outcome
expectancies in terms of SNSs were positively associated with ad-
diction to such sites [7].
SNS-addiction can also be understood in a socio-cultural per-
spective, where SNS-addiction is a product of the social and cul-
tural experiences individuals have in their childhood, adolescence,
and in adulthood. On the family side, certain types of family dy-
namics and a variety of negative experiences influence the individ-
ual within the system. Some studies show that overdemanding or
overprotecting parents are associated with later addiction develop-
ment, as a compensatory strategy [53] and/or a surrogate for under-
appraisal during childhood (Dittmar, 2005). Principals in social
learning [52] can also be relevant in explaining SNS-addiction be-
havior, where the individual is influenced by observing excessive
online social network behavior of significant others (e.g., family
members, peers) or exposed to role models in the media (bloggers,
celebrities, advertisements). On a superior level, the culture’s
emphasis on social media, availability, availability (e.g., mobile
phones), as well as peer competition (e.g., who has the biggest
friend-list or the most “likes”) regarding social networking, which
may also play an important part in the development of SNS-
addiction. Cross-cultural studies do suggest that different culturally
based motivation may be at play in terms of SNSs, indicating that
Asian subjects, compared to American subjects, put more emphasis
on bridging social capital than bonding social capital [54]. Whether
such differences relate to the addictive potential of SNSs is cur-
rently unknown.
Based on learning theory [55], the development of SNS-
addiction and corresponding behavior is explained by various prin-
ciples of learning. As long as the right reinforcing conditions are
present, this model suggests that anyone can be led into or out of
SNS-addiction. Following the principles of operant reinforcement,
SNS-addiction behavior occurs, is nurtured, and sustained because
similar behavior in the past has led to positive outcomes, such as
praise and approval from peers (e.g., “likes”), more friends, or be-
cause the behavior has led to avoidance of negative outcomes such
as difficulties in face to face conversation (e.g., unwanted blushing)
or unwanted leisure (e.g., boredom). In line with this, the sprout for
SNS-addiction can develop early when being popular on social
media is often rewarded with popularity from the environment,
while having few friends on Facebook can lead to punishment in
terms of being left out, laughed at or bullied. Thus children are
motivated to be active on Facebook in exchange for positive feed-
back, and establish a pattern that is repeated later in life. Getting
positive feedback on Facebook has been linked to better self-esteem
[27], and thus these attempts at securing a positive reward are re-
peated in an attempt to sustain them, and develop into operant con-
ditioned responses when unpleasant feelings re-occur. At present,
however, the learning theory of SNS-addiction remains unexplored.
4058 Current Pharmaceutical Design, 2014, Vol. 20, No. 25
CONSEQUENCES OF SOCIAL NETWORK SITE ADDIC-
TION
In the following, outcomes and consequences of SNS-addiction
– within the work/study domain, the family/interpersonal domain,
health and well-being, will be discussed.
Previous research suggests that excessive usage of SNSs is
related to lower average grade points and academic achievement
[56]. This makes sense, as one criterion for addiction is that the
addictive behavior comes into conflict with other activities [10]. It
is therefore likely that excessive online social networking distracts
the individual in work or study-related activities. Studies have fur-
ther shown that four out of five employees visit SNSs for personal
purposes while at work [57]. Employers typically fear that such use
may reduce productivity, and as such cause economic loss [58]. In
line with this, a case study of a mid-twenties Facebook-addicted
woman reported that she lost her job because of the distraction her
social networking caused [59]. It is also plausible to believe that
extensive SNS use for personal purposes during working hours
infects co-workers to do so as well, thus having a contagious effect.
However, it is also possible that regularly checking one’s SNSs
during work hours has an inspiring and refreshing effect, boosting
creativity [60]. When the online social networking becomes com-
pulsive and excessive, it may cause inefficiency, causing one to
show up late for meetings, stay logged on during meetings, and be
distracted and unfocused.
Spending a great amount of time on SNS activities seems to be
the core element in any definition of addiction [10]. Since time is a
fixed unit, this must have consequences for time spent on non-SNSs
activities; thus SNS-addiction may also influence the domestic
arena. Thus family/interpersonal conflicts may be a potential con-
sequence of SNS-addiction. In fact, another central aspect of addic-
tion is down-prioritizing hobbies, leisure activities, exercise, family
members or friends – the so called conflict component [10]. In line
with this, one item in the FIQ is “Arguments have arisen with oth-
ers because of my Facebook use”. However, no studies have been
conducted that examine the relationship between SNS-addiction
and family functioning. One study investigated however how usage
of SNSs spills over in romantic relationships [26]. The results sug-
gest that excessive online social networking is related to jealousy
and relationship dissatisfaction, and to cyber-stalking and surveil-
lance from the partner. Excessive use of SNSs may also lead one to
replace real relationships with cyber-relationships, something that
may have a negative impact on the development of offline commu-
nication skills – especially for younger people [61].
One potential and suggested consequence of SNS-addictions is
impaired sleep [4]. Studies show that frequent use of electronic
media such as computers and mobile phones in the evening and in
the bedroom is associated with delayed bedtimes and rising times
[62, 63]. In one study, the authors showed that people scoring high
on Facebook addiction reported delayed bedtimes and rise times,
both on weekdays and weekends, compared to respondents with
lower scores on Facebook addiction [4]. The association between
Facebook addiction and poor sleep was also confirmed in a more
recent study [6]. From a great body of research we know that poor
sleep is associated with several negative psychological, social, and
somatic outcomes [64-66]. Thus SNS-addiction may not only be
directly related to poor sleep – but also indirectly by causing other
problems, for example, poor grades [67] and impaired work per-
formance [68]. As mentioned above, one study indicated that Face-
book users reported a negative impact on academic achievement
[56]. A case study reported insomnia as one consequence of exces-
sive online social networking [59]. Further, a recent study reported
a link between Facebook addiction and insomnia, somatic symp-
toms, social dysfunction, depression, and anxiety [8].
Furthermore, it has been argued that SNS-addiction is detrimen-
tal to self-esteem and well-being [69]. A study reported that the
Andreassen and Pallesen
more users get negative feedback from peers via online social net-
works, the less self-esteem they gain, leading to lower well-being
[69]. Spending excessive time on online social networking, and
forgoing real relationships, may thus lead to a lower quality of life.
Despite the consequences summerized here are primarily nega-
tive and long-term, SNS addicts have probably received some
short-lived positive outcomes from performing their addictive be-
havior. These may be stress-relief, enhancing self-esteem, bolster-
ing interpersonal relationships, as well as regulating negative feel-
ings by experiencing an emotional lift from their online social net-
working behavior, building social identity, and escaping negative
feelings. In sum, although different potential outcomes of SNS-
addiction have been suggested, empirical support for the majority
of these notions is sparse.
TREATMENT
So far no well documented treatment for SNS-addiction specifi-
cally exists. However, it could be beneficial to look at evidently
good treatment results for other addictive behaviors, which may
also be useful for clinicians in cases of this kind. In a recent meta-
analysis of treatment of Internet addiction, a total of 16 single stud-
ies were included. Effects size estimates suggested high treatment
effects in terms of improvement of Internet addiction (g=1.61), time
spent online (g=0.94), depression (g=0.90), and anxiety (g=1.25).
The meta-analysis revealed that there were no differential effects
between pharmacological compared to psychological interventions
on Internet addiction status [70].
Therapeutic Interventions
Several studies treating Internet addiction have been based on
cognitive-behavioral therapy (CBT). According to this approach,
catastrophic thinking, negative core beliefs, and cognitive distor-
tions may contribute to excessive Internet use. In therapy, cognitive
restructuring may be used to address these underlying cognitions
and rationalizations (“Just a few more minutes won’t hurt”). In
terms of behavior, interventions typically aim at lifestyle changes
without the Internet. An Internet log is normally kept through
treatment. In therapy, clients are taught how to relearn to use the
Internet to achieve specific outcomes. Behavior management, both
for computer use and adaptive non-computer behavior, may be used
based on techniques such as assertion training, behavioral rehearsal,
coaching, cognitive restructuring, desensitization, modelling, rein-
forcement, relaxation methods, self-management, and learning new
social skills [71].
Multi-level Counseling
Treatment studies of Internet addiction have also been based on
multi-level counseling programs [72]. Emphasis is typically put on
controlled and healthy use of the Internet, understanding the change
process in terms of the readiness to change model [73], motiva-
tional interviewing [74], family based counseling, multi-level coun-
seling (e.g., involving both peers and family), and use of support
groups [72]. Another approach that has been used in the treatment
of Internet addiction is reality therapy, which is often based on
asking the client some basic questions (What are you doing now?
What did you actually do this past week or month? What stopped
you from doing what you want to do? What will you do tomorrow
or in the future?). The aim is to help the clients to establish a
healthy recovery method by exploring with them how they can
meet their basic needs by questioning their deeds, wants, self-
evaluation, and plans as well as choosing more effective behaviors.
Clients are encouraged to explore behavior and evaluate how effec-
tively they are getting what they want, and make plans that will lead
to change. Commitment to the plans is emphasized [75]. In one
treatment study, acceptance and commitment therapy was used for
the treatment of problematic Internet pornography viewing. Ther-
apy focused on the paradoxical nature of attempting to control
Social Network Site Addiction
urges, and that acceptance of these might be a better approach
among others when engaging in actions consistent with not viewing
pornography. Emphasis was also put on behavioral commitment to
values (e.g., spending time with friends), defusion (treating oneself
as the context and perceiving inner experiences as something just
occurring), exercises which help one to be present with inner expe-
riences and external events without being heavily attached to them,
and increased behavioral commitments [76].
Pharamacologic Interventions
In terms of pharmacological treatments of Internet addiction
these have been based on drugs such as Escitalopram [77],
Bupropion [78] and Methylphenidate [79], have been used in the
treatment of video game addiction. It should be noted that only 6 of
the 16 studies in the aforementioned meta-analysis investigating the
effects of treatment for Internet addiction was based on a random-
ized control trial and that none of the studies specifically addressed
SNS-addiction [70].
School and Organizational Interventions
Finally, interventions may also be implemented on a school and
organizational level, although we have currently no knowledge of
such studies focusing on Internet addiction or SNS-addiction. Not
surprisingly, a recent study of 11,018 Norwegian employees found
that work policies prohibiting online social media use for personal
purposes, as well as positive work challenges, both were negatively
related to the use of SNSs for personal purposes at work [80]. The
results suggest that educators and employers can counteract cyber-
slacking (i.e., use of web pages for personal purposes during work-
ing hours), and most likely SNS-addiction, through clear policies
and by offering stimulating and meaningful tasks.
FUTURE RESEARCH DIRECTIONS
Research on SNS-addiction is in its infancy, thus several basic
research questions remain unexplored. So far most studies on SNS-
addiction are based on cross-sectional designs, precluding research-
ers from investigating changes and development over time. In addi-
tion, the lack of longitudinal designs makes it hard to identify po-
tential causal mechanisms which may play a role. Cross-sectional
studies exclusively based on one source of data (e.g., self-report)
are also vulnerable to the common method bias [81]. On the con-
ceptual and operational level there is also a great need of research.
Bearing in mind the specificity debate discussed earlier, it is impor-
tant to investigate which aspect of social network sites might be
specifically problematic or represent an addictive potential. In terms
of research on these issues we have previously [30] suggested sev-
eral different approaches. One approach is to provide explicit initial
instructions to participants to ignore some aspect of the social net-
work content (e.g., games) when completing a survey about addic-
tive usage of SNSs (e.g., Facebook). Another way to approach this
challenge is to investigate which aspect of SNSs is addictive. Such
an approach may entail qualitative interviews with users [82], on-
line-assessment of time spent on different contents of a network site
[83], assessment of physiological arousal when using different as-
pects of a SNS [84], and development of scales that specifically tap
into the different parts of SNSs. Furthermore, the existing and
newly developed measures of online SNS-addiction have not yet
been cross-validated with each other. The making of criteria and
appropriate cut-off scores may add value to SNS-addiction in the-
ory and practice, particularly with regard to facilitating treatment
and estimating prevalences. The majority of previous studies in this
field are based on small student convenience samples, often with a
female preponderance, thus it is important that future efforts inves-
tigate the phenomenon in broader and more representative samples.
Also, no studies have linked online SNS-addiction to biological
parameters, such as immunological, hormonal and metabolic data.
Finally, no treatment studies specifically involving SNS-addiction
exist today.
Current Pharmaceutical Design, 2014, Vol. 20, No. 25 4059
Taken together, drawing upon the existing literature in this
research field, future research directions and efforts should include
further investigation of the structure of particular SNS-addiction
instruments. It is recommended to continue efforts to search for
empirical correlates that will provide valid evidence for the scales
and the SNS-addiction concept in general. Future research which
incorporates potential antecedents and consequences in broad longi-
tudinal comparative research designs, explained within comprehen-
sive theoretical frameworks, would therefore be beneficial.
In the DSM-5 the American Psychiatric Association [19] now
fully recognize non-substance-related disorders (behavioral addic-
tions). Although this so far only pertains to Gambling Disorder
specifically, this shift can also be seen as a step toward a theoretical
foundation for a new class of psychiatric disorders. And, the list of
other behavioral addictions (e.g., sexual addiction, shopping addic-
tion, exercise addiction, SNS-addiction, and workaholism), next in
line behind Internet Gaming Disorders in terms of recognizion by
the psychiatric community, might be long. Being offered an official
name/label for a specific combination of symptoms and suffering
might be a therapeutic act which may provide a sense of mastery
and comfort for those afflicted. This could also instigate sufferers to
seek treatment. On the other hand, putting a diagnostic label to
every excessive behavior that might give pleasure but adverse con-
sequences when taken too far, might create inflation in diagnoses.
There is also the danger that some individuals will hide behind their
diagnosis and use it as permission slips or excuses in service of
their status quo [85]. Where to draw the line between normality and
pathology is a challenge and must be based on empirical studies and
theoretical foundations, as well as practical issues and societal val-
ues.
OVERALL CONCLUSION
SNS-addiction is a new and so far little explored concept. Re-
cently several self-report questionnaires assessing SNS-addictions
have been developed. Due to lack of longitudinal designs, little is
actually known when it comes to antecedents. So far, the few and
cross-sectional based studies on this topic suggest that SNS-
addiction is associated with several negative outcomes. Treatment
studies for SNS-addiction have so far not been conducted. Treat-
ment studies for Internet addiction may be relevant. More longitu-
dinal studies, treatment studies, studies with objective measures of
behavior and health as well as studies (e.g., experimental) that can
identify the addictive elements of SNSs are encouraged.
CONFLICT OF INTEREST
The authors confirm that this article content has no conflicts of
interest.
ACKNOWLEDGEMENTS
Declared none.
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