Association between religiosity or spirituality and internet addiction: A systematic review

Introduction

There is evidence in the literature of both religiosity and spirituality being associated with health status (1), and empirical data indicate that specific aspects of religiosity relate to mental health (2).

Religiosity can be defined as “the self-perceived importance of religion and the degree to which religious beliefs and identities translate into secular attitudes” (3), and includes aspects related to being part of a community who share the same values and interests; spirituality may be seen as an aspect that can be experienced both outside and inside a religious context and characterized by a desire for transcendence, a sense of interconnection and a meaningful sense of life (4). Both religiosity and spirituality could lend a deep sense of purpose in one's own existence, reduce stress, and suggest coping mechanisms (5, 6). Much research in recent years has focused on the role that religiosity and spirituality might have in people's vulnerability to addiction, including behavioral addictions (7, 8). Among the latter, those relating to internet use represent a growing problem (9, 10), especially in adolescents but also in young adults (11), with students accounting for the majority of the latter (12). Various studies have identified internet addiction (IA) as an international phenomenon with an overall prevalence estimated to be around 4.6–4.7% for adolescents, and in the range of 13–18.4% for college students, as compared with 6–15% for the general population (13). Over the years, researchers have described this addiction as a syndrome of intense preoccupation with using the internet (14), involving excessive amounts of time spent online, a compulsive use of the internet, difficulty with managing the time spent on the internet, feeling that the world outside the internet is boring, becoming irritated if disturbed while online, reducing social interaction with “real” people (15), and tried by an experience of loneliness and depression (16). Despite the growing body of research into IA over the last decade, there is still no widely-accepted definition of this condition. People can engage in various activities on the web, some of which are potentially addictive. Young (17) argues that IA could take different forms, such as: information overload (web surfing addiction); computer addiction (to computer games); net compulsions (addiction to online gambling, or online shopping); cyber-sexual addiction (to online pornography, or online sex); and cyber-relationship addiction (to online relationships). Rather than becoming addicted to the medium per se, some users may develop an addiction to specific activities they conduct online (18).

Many negative health outcomes are associated with IA, regarding both general health and mental health, such as mood disorder, poor sleep quality, low self-esteem, impulsivity, and suicide (19–23), in addition, also an association with academic underachievement and vocational struggles was found (24). In Carli et al. (25) emerged that depression and symptoms of ADHD had a consistent correlation with problematic internet use, as well as obsessive-compulsive symptoms. Consequently, there has been growing interest in the role of risk and protective factors related to IA. To better understand the genesis and development of IA, and possible treatment targets, there are many factors to consider: individual characteristics, first of all, but also family- and school-related variables, and environmental variables too (5).

In this review, we focused on those examining religiosity, religious practice and spirituality as individual factors that might be related to IA, and on two specific aspects of IA, i.e., online gaming disorder, online gambling addiction. The population analyzed by the studies included in the review was that of adolescents and young adults (e.g., college students).

This study aimed to perform a systematic review of observational studies evaluating association between religiosity or spirituality and IA, the findings could be of interest for the design of intervention strategies for preventing adolescents and young adults from developing these conditions.

Methods Search strategy

A comprehensive and systematic literature search was conducted in the Pub-Med and Scopus databases to identify observational (cross-sectional, cohort, and case-control) studies investigating the association between religiosity or spirituality (R/S) and IA. Using Boolean operators, the search process involved a search string obtained by combining the terms:

“religiosity” or “spirituality” or “religion” or “faith” or “religious*” with the terms “patholog*” or “problem*” or “addict*” or “compulsive” or “dependen*” or “disorder*,” “excessive” or “addict*” or “compulsive” or “abuse*” or “dependen*” or “disorder*,” and “internet” “video” or “computer” or “mobile phone*” or “cell phone*” or “cellular phone*” or “cellular telephone*” or “mobile telephone*” or “smartphone*” or “nomophobia” or “internet gaming,” “internet game*” or “online gaming” or “internet video game” or “internet gambling.” The search strings are reported in Appendix 1.

The records retrieved from the databases were imported in Endnote and duplicates were removed. The reviewer checked the search hits by reading the article titles and abstracts. If the results of a study were published more than once, only the most complete article was considered in the analysis. The author also checked the reference lists of the papers included in the review for any articles not already considered. Relevant studies cited in the reference lists of the publications already identified were tracked down as well.

In conducting this systematic review, the authors conformed to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement (26).

Data extraction

The following data was extracted from each study: first author's name; year of publication; journal; study design; sampling method; characteristics of the study sample (e.g., age range); measures of outcome and of exposure; results; confounding factors; interactions; and the author's conclusions.

Eligibility criteria

The studies included in the review had to meet the following inclusion criteria:

- a declared measure was used to assess religiosity or spirituality (considering spirituality as an aspect that can be experienced both outside and within a religious context (5), and characterized by a desire for transcendence, a sense of interconnection and a meaningful sense of life (6);

- a declared measure was used to assess different types of IA, as regards online gaming, and online gambling;

- a declared measure was used to assess the association between R/S and IA, or online gaming, or online gambling;

- published any time up until November 2021.

- written in English.

The studies excluded for the purposes of this review were:

- those involving samples that only included individuals who reported belonging to a religion;

- studies that did not distinguish between gambling on- and offline.

Methodological assessment

One author judged the methodological quality of the studies using the Appraisal tool for Cross-Sectional Studies (AXIS) (27). The scoring system conforms to a “yes,” “no,” or “do not know/comment” design. The studies included in the review were categorized into four groups: >15, 10–15, 5–9, and ≤4 AXIS criteria met. Seven studies out of 13 met 10–15 AXIS criteria, six studies met more than 15 AXIS criteria; Appendix 2 outlines the methodological quality of the studies.

Results

Two additional studies that met our inclusion and exclusion criteria were identified from the reference lists of the 11 selected articles, so the review was conducted on 13 articles in all. They were all were observational studies, and all cross-sectional. Figure 1 shows the flow chart of the article selection process.

Figure 1. Flow chart of the article selection process. R/S, Religiosity/spirituality; IA, Internet addictions.

The number of participants enrolled in each study ranged from 97 to 11,956. Six studies were conducted specifically on adolescents (28–33), two on young adults (34, 35), four on mixed samples of adolescents and young adults (36–39), and in only one study the sample consisted only of adults (40). The studies were conducted in different countries: two in the US (30, 35), two in Iran (36, 37), one in Turkey (39), one in China (28), one in Malaysia (31), two in Switzerland (34, 38), one in Poland (40), one in the Czech Republic (29), one in South Korea (33), and one was a multicenter study involving 10 countries: Austria, Estonia, France, Germany, Hungary, Ireland, Israel, Italy, Romania, and Slovenia (32).

The studies included in our review were published between 2012 and 2021.

Ten of the 13 articles selected investigated only religiosity as a predictive factor (28, 30–32, 34–37, 39, 40), while two considered both religiosity and spirituality (29, 33), and one only examined spirituality (38).

Exposure measures

Only five studies used questions from validated questionnaires designed to assess R/S. In general, there was a marked variability in how exposure to R/S was measured. One study measured religiosity using the Religious Background and Behavior Questionnaire (34); one adapted the short form of the Santa Clara Strength of Religious Faith Questionnaire (31); one measured religiosity using a single question from the Global School-Based Pupil Health Survey (GSHS) and the European Values Study (EVS) about self-perception of being a religious person (32); one study measured religiosity using the Religious Belief Scale to ascertain high-school students' religious belief levels (39); one applied the Korean Brief God's Image Scale, which consists of 17 items covering five dimensions (answering, accepting, benevolent, presenting, and nurturing God's image), as a short form of Lawrence's God's Image Scale, which contains 72 items (33). Other studies used ad hoc questionnaires to investigate different domains of religiosity (28, 30, 35–37, 40), such as: praying, self-perception as a religious person, perception of the importance of religiosity, devotion, frequency of attending religious services, religious beliefs, and commitment (30). Finally, two studies (29, 33) investigated spirituality using the adjusted short version of the Spiritual Well-Being Scale (SWBS), and one (38) only measured spirituality by asking to what extent participants believed in a spiritual higher power, and in its supporting and judging roles. Only seven studies (31, 34–39) asked participants about their type of religion (if any).

Outcome measures

The studies also varied in their approach to measuring the outcome. Twelve studies investigated IA (28, 30–33, 35–39); and three examined gaming (28, 29, 34); none specifically measured online gambling. In four studies (28, 36–38), severity of IA was assessed using Young's IA Test (IAT) (41). In two others, another version adapted by Young was also used to measure IA (32, 39). Other studies used various questionnaires: The Excessive Internet Use scale (29, 41), the Short Problematic Internet Use Test (SPIUT) (30, 42, 43), the Internet addiction scale (44) (adapted from an instrument validated by Charlton and Danforth) (31), the I-scale (Internet addiction scale developed by Kim et al.) (35). One study (33) used the Korean Smartphone Addiction Proneness Scale for Youth and Adults. One used an unvalidated ad hoc questionnaire (40).

To measure internet gaming disorder (IGD), one study used the C-SURF questionnaire, which included a modified version of the game addiction scale (GAS) (34). In one study IGD was investigated using questions about how often respondents spent playing video games, and for how long, and self-reported addiction to this type of behavior (40). Another study measured IGD with a single ad hoc question: “How many hours a day do you usually play games online in your free time?” (29).

Tables 1, 2 provide details of the observational studies identified and included in the review.

Table 1. Overview of studies. Materials and methods.

Table 2. Overview of study findings.

Among the 12 studies that investigated IA in relation to religiosity, six found an inverse association between them (30, 31, 33, 35–37), three found no evidence of any association (32, 39, 40), and one identified a direct association (28). The only study that investigated both religiosity and spirituality (29) was conducted on adolescents in the Czech Republic. It found that attributing more value to both religiosity and spirituality coincided with a lower probability of IA, but attributing more value only to spirituality or only to religiosity (assessed here in terms of the amount of religious practice) was associated directly with a greater IA.

Of the eight studies showing a protective effect of religiosity against IA (29–31, 33–37), six were conducted on adolescents: two in Iran (36, 37), one in the Czech Republic (29), one in the US (30), one in Malaysia (31), and one in South Korea (33). The other two studies were conducted on particular samples of adults: young army recruits in Switzerland in one case (34), and international undergraduate students at a research institution in the US in the other (35).

Three studies (32, 39, 40) found no evidence of any association between religiosity and IA: one was a study on a nationally-collected representative sample of adults in Poland (40), one involved young adolescents in Turkey (39); and one (32) was conducted on a large sample of more than 10,000 adolescents from numerous European countries (e.g., Italy, Spain, Germany, France and Austria, among others). Finally, a study conducted in China (28) on a sample of adolescents found religiosity directly associated with IA: this study measured religiosity with a single, ad hoc question.

The only study investigating spirituality unrelated to any religion found a direct association with IA (38). It was conducted on young Swiss people in further, post-compulsory education. While it found no evidence of any association between belief in a “spiritual higher power” or in the “supporting role of a higher power” and IA, but it also showed that the risk of IA was increased significantly by the “judgmental role” of such a higher power.

Two out of three studies investigating IGD in particular found an inverse association between higher levels of religiosity and IGD (29, 34), and one found no such association (40). No studies specifically investigating the association between online gambling and R/S came to light.

Discussion

This systematic review investigated the association between religiosity and the emerging internet addictions in adolescents and young adults. Most of the studies reviewed found lower levels of internet addiction associated with religiosity (30, 31, 33, 35–37), one study found lower levels of internet addiction associated with religiosity only when combined with spiritual belief (29), while more than one in four found no statically significant association (32, 39, 40), and only one found a direct association (28). The study only investigating spirituality (38) found a growing attitude toward internet addiction in the spiritual group. Among three studies investigating online gaming addiction in particular, one found an inverse association between religiosity and gaming (34), one found an inverse association between religiosity or spirituality and gaming (29) and one found no association (40). Our database search identified no studies specifically investigating religiosity or spirituality and online gambling.

Six out of 11 of the studies reviewed (30, 31, 33, 35–37) found that religiosity acted as a protective factor against IA. In particular, Atwood's study (30) on a sample of students in the USA found religious commitment a major factor that seemed to outweigh the impact that teens' primary source of internet access had on their behavior. Teens who were strongly religious and had a strong attachment to their parents were less likely to use the internet or smartphones in problematic ways. Two Iranian studies included in our review also found that the influence of religious beliefs was more powerful than the family variable, and adolescents with stronger religious beliefs tended to be less affected by IA (36, 37).

These results are supported by a recent study, which found that a faith-based and spiritual approach helps people to feel grounded, calm, resilient, and present in difficult environments (45). Attributing a religious dimension to existence is often related to optimism, generosity and gratitude, and to the opportunity to lend meaning to life (46). On the other hand, excessive internet use has been described as a coping strategy, part of a psychological and behavioral effort to reduce the stress caused by external or internal events experienced as physically or mentally demanding (47). Religious people could consequently be less likely to resort to escaping into a self-created virtual online world. In agreement with Koo et al. (35), the present findings could also be explained by a better self-control and greater ability to delay gratification in religious adolescents and young adults, which could weaken any dependence on addictive behavior such as an excessive internet use. It has been reported, moreover, that there is a strong positive correlation between loneliness and Internet addiction among adolescents (48). Van Olphen et al. (49) claims that being integrated in a community of faith is an important source of social support.

None of studies included in our review showed an inverse association between spirituality and IA. On the contrary, one study (29) found that spirituality without the combined religiosity can constitute a risk factor for IA and a study conducted on Swiss adolescents (38) found that the risk of excessive internet use was increased particularly by the idea of a higher spiritual power with a “judgmental role,” in the sense of a negative image as a punisher. Regarding this finding, it seems appropriate to consider the role of spiritual beliefs in relation to the separation-individualization process and the transition from adolescence to adulthood. “Rule-breaking” behavior is common among adolescents during the process of separation-individualization (50). Chen et al. (38) wrote that their findings also suggest that the relationship between the perceived “judgmental role” of a spiritual power and an adolescent's excessive internet use might not be simply causal, but also interactive, and modified (and motivated) by a normal process of adolescent separation-individualization. Furthermore, aspects such as self-actualization and individualism, inherent to some types of spirituality could play an important role (51, 52) and, as suggested by Sussman et al. (53), adolescents search for meaning, purpose and identity, and this desire for transcendence might lead them to addiction behavior. Shim (33) noted that this somewhat counterintuitive point is still being explored by various research groups, and highlighted the complicated relationships between spirituality and addictive behavior more generally. As a consequence—according to Grubbs and Grant (8), the links between religion/spirituality and internet-related addictions are much less clear than those between religion/spirituality and other addictive behavioral disorders. These mixed results point to the need for further work to clarify the nuanced relationship between religion/spirituality and risky online behaviors.

Two (29, 34) of the three studies that looked at the association between religiosity and problematic gaming behavior found that higher levels of religiosity coincided with lower levels of gaming in general, and a lower risk of addictive gaming tendencies. In a study (34) on a sample of young Swiss army recruits, Braun found that a stronger belief in God was associated with a lower gaming frequency and smaller scores on a game addiction scale. A Czech study on adolescents (29) found that respondents who attended religious services and were more spiritual were less likely to make excessive use of the internet or computer games. Malinakova et al. (29) hypothesized that, in families with a greater religiosity/spirituality, parents tend to keep a more careful eye on adolescents' behavior and risk of addictions; their religiosity/spirituality may also promote their child's internalization of adult behavioral norms. Plante et al. (54) found that using online games to avoid stress is a predictor of symptoms of gaming addiction. This points to the idea that addicted gamers use gaming as a means of escape from reality (55), whereas previous research (34, 56–58) underscored how a belief in God may represent a strategy for coping with stressful life events. When something stressful happens, people who are more religious resort to a more functional style of coping with difficulties, finding support in the religious communities to which they belong (59), or adopting behaviors such as prayer or gestures that carry an intrinsic meaning for them, reducing stress and promoting resilience. Kim et al. (60) also suggested that religious people may not sufficiently gratified by immersing themselves in a virtual world. It seems difficult to explain the protective effect of religious practice against online gaming, however (4). Lewczuk et al. (40) found no statistically detectable links between religiosity and IGD in a Polish adult sample. On the other hand, they found that adolescents experiencing a “moral incongruence”—in the sense of a sense of distress connected with others' disapproval when they engaged in their addictive behavior—could be more at risk of IGD. Previous studies had already suggested that a problem of “moral incongruence” related to high levels of religiosity could predict addictive behavior (61).

Strength and limitations

This is the first study (to our knowledge) to systematically review the evidence of the association between people's R/S and the risk of IA and other internet-related addictive behavior. This review has a number of limitations to consider, however. First, the various studies reviewed used different tools to measure both religiosity and IA, preventing any quantitative meta-analysis. They were also all cross-sectional, making it impossible to draw any causal inferences. That said, the particular nature of the exposure examined prevents the use of a more robust study design, such as a randomized and controlled trial, to clarify the possible existence of a cause-and-effect relationship, and possibly identify which components of religiosity have a protective role in discouraging the onset of IA. As a consequence, the results of these observational studies remain important for the purposes of better adapting interventions and shaping the social context to prevent IA, especially in adolescents and young adults.

Conclusion

The findings of this review point to a protective role for religiosity against internet-related addictions. These results could be of the utmost importance when considering the strategies needed to prevent such addictions, and the environmental and social settings in which in adolescents and young adults are at greatest risk.

Author contributions

AB conceptualized the study and approved the final manuscript as submitted. LM and FD conducted literature searches and provided summaries of previous research studies. FD and AB wrote the first draft of the manuscript. All authors contributed to and have approved the final manuscript.

Conflict of interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Publisher's note

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.

Supplementary material

The Supplementary Material for this article can be found online at: https://www.frontiersin.org/articles/10.3389/fpubh.2022.980334/full#supplementary-material

Abbreviations

C-SURF, Cohort Study on Substance Use Risk Factors; EVS, European Values Study; GAS, Game Addiction Scale; GSHS, Global School Based Pupil Health Survey; IA, Internet addiction; IAS, Young's Internet Addiction Scale; IAT, Young's IA Test; IGD, Internet gaming disorder; MIU, maladaptive Internet use; OR, odds ratio; PIU, problematic Internet use; R/S, religiosity/spirituality; s-IAT, short version of the Internet Addiction Test; SPIUT, Short Problematic Internet Use Test; WHO, World Health Organization; YDQ, Young Diagnostic Questionnaire for Internet Addiction; RD, religious denomination; RA, religious attendance.

References

1. Mishra SK, Togneri E, Tripathi B, Trikamji B. Spirituality and religiosity and its role in health and diseases. J Relig Health. (2017) 56:1282–301. doi: 10.1007/s10943-015-0100-z

PubMed Abstract | CrossRef Full Text | Google Scholar

3. Kiang M, Cupid J, Ahmed S, Lepock JR, Girard TA. Religiosity is associated with less prediction of the typical: an event-related brain potential study. Biol Psychol. (2020) 153:107884. doi: 10.1016/j.biopsycho.2020.107884

PubMed Abstract | CrossRef Full Text | Google Scholar

4. Moreira-Almeida A, Neto FL, Koenig HG. Religiousness and mental health: a review. Revista brasileira de psiquiatria. (2006) 28:242–50. doi: 10.1590/S1516-44462006005000006

CrossRef Full Text | Google Scholar

5. Benson PL, Roehlkepartain EC, Rude SP. Spiritual development in childhood and adolescence: toward a field of inquiry. Appl Dev Sci. (2003) 7:205–13. doi: 10.1207/S1532480XADS0703_12

CrossRef Full Text | Google Scholar

6. King PE, Boyatzis CJ. Religious and spiritual development. In: ME Lamb, RM Lerner, editors, Handbook of Child Psychology and Developmental Science: Socioemotional Processes. New York, NY: John Wiley and Sons, Inc. (2015). p. 975–1021. doi: 10.1002/9781118963418.childpsy323

PubMed Abstract | CrossRef Full Text | Google Scholar

8. Grubbs JB, Grant JT. Spirituality/religion and behavioral addictions. In: DH Rosmarin, HG Koenig, editors, Handbook of Spirituality, Religion, and Mental Health. (2020). p. 139–57. doi: 10.1016/B978-0-12-816766-3.00008-2