Skip to main content Accessibility help

The Shorter PROMIS Questionnaire and the Internet Addiction Scale in the Assessment of Multiple Addictions in a High-School Population: Prevalence and Related Disability

Published online by Cambridge University Press:  07 November 2014



Taking into account the importance of act prevention on the development of addictions, we assessed the presence of multiple addictions in an adolescent high-school population, also assessing the prevalence of Internet abuse and the impact on disability.


Adolescence seems to be a critical period of addiction vulnerability, based on social but also neurobiological factors.The earlier onset of behavioral/substance dependence seems to predict greater addiction severity, morbidity, and multiple addictive disorders.


Data were collected from a sample of 275 students in Florence, Italy, high schools through surveys distributed in classes. The sample had an average age of 16.67±1.85 years (52.4% males, 47.6% females). To assess multiple addiction we used the 16 subscales of the Shorter PROMIS Questionnaire, to assess Internet addiction prevalence we used the Internet Addiction Scale, and to quantify disability symptoms, we used the Sheehan Disability Scale.


Caffeine abuse, sex, relationship submissive, gambling, food starving, and food bingeing have raised highest scores. 5.4% of the students were found to be Internet addicted similar to other countries. Disability seemed strongly correlated to the subscale of alcohol, gambling, sex, tobacco, food starving and food bingeing, shopping, exercise, and Internet addiction. Gambling, sex, caffeine abuse, compulsive help dominant, work, Internet addiction, relationship dominant, and relationship submissive in this sample were strongly related to substance dependence.


Level of concerns unexpected compared to the level reported in other countries for the behavioral compulsions, have been highlighted. Behavioral addictions are multiple, a source of disability, and they are related to substance abuse. It has yet to be clarified if they are a temporary phenomenon occurring in adolescents or if they are a stable trait, accounting as marker for the development of substance abuse.

Original Research
Copyright © Cambridge University Press 2006

Access options

Get access to the full version of this content by using one of the access options below.


1. Holden, C. ‘Behavioral’ addictions: do they exist? Science. 2001;294:980982.CrossRefGoogle ScholarPubMed
2. Grant, JE, Brewer, JA, Potenza, MN. The neurobiology of substance and behavioral addictions. CNS Spectr. 2006;11:924930.CrossRefGoogle ScholarPubMed
3. Coventry, KR, Norman, AC. Arousal, erroneous verbalisations and the illusion of control during a computer-generated gambling task. Br J Clin Psychol. 1998;89:629645.CrossRefGoogle Scholar
4. DeCaria, CM, Begaz, T, Hollander, E. Serotonergic and noradrenergic function in pathological gambling. CNS Spectr. 1998;3:3847.CrossRefGoogle Scholar
5. Pallanti, SP, Bernardi, S, Quercioli, L, DeCaria, C, Hollander, E. Serotonin dysfunction in pathological gamblers: increased prolactin response to oral m-CPP versus placebo. CNS Spectr. 2006;11:956964.CrossRefGoogle ScholarPubMed
6. Roth, K. Sexual addiction in alcohol abuse and dependence. Clinical, nosologic and psychoanalytic aspects [German]. Nervenarzt. 1992;63:157162.Google Scholar
7. Orford, J. Excessive Appetites: A Psychological View of Addictions. New York, NY: Wiley: 1985.Google Scholar
8. Christensen, GA, Farber, RJ, DeZwaan, M. Compulsive buying descriptive characteristics and psychiatric morbidity. J Clin Psychiatry. 1994;55:511.Google Scholar
9. Furst, DM, Germone, K. Negative addiction in male and female runners and exercisers. Percept Mot Skills. 1993;77:192194.CrossRefGoogle ScholarPubMed
10. Phillips, CA, Rolls, S, Rouse, A, Griffiths, MD. Home video game playing in schoolchildren: a study of incidence and patterns of play. J Adolesc. 1995;18:687691.CrossRefGoogle Scholar
11. Cummings, C, Gordon, JR, Marlatt, GA. Relapse: prevention and prediction. In: Miller, WR, ed. The Addictive Behaviours: Treatment of Alcoholism, Drug Abuse, Smoking and Obesity. New York, NY: Pergamon: 1980:291321.Google Scholar
12. Aubin, H-J, Laureaux, C, Tilikete, S, Barrucand, D. Changes in cigarette smoking and coffee drinking after alcohol detoxification in alcoholics. Addiction. 1999; 94:411416.CrossRefGoogle ScholarPubMed
13. Young, KS. Psychology of computer use: XL. Addictive use of the Internet: a case that breaks the stereotype. Psychol Rep. 1996;79(3 pt 1):899902.CrossRefGoogle ScholarPubMed
14. Griffiths, M. Psychology of computer use: XLIII. Some comments on ‘addictive use of the Internet’ by Young. Psychol Rep. 1997;80:8182.CrossRefGoogle ScholarPubMed
15. Shapira, NA, Goldsmith, TD, Keck, PE Jr, Khosla, UM, McElroy, SL. Psychiatric features of individuals with problematic internet use. J Affect Disord. 2000;57:267272.CrossRefGoogle ScholarPubMed
16. Young, KS. Internet addiction: the emergence of a new clinical disorder. Cyberpsycol Behav. 1998;1:237244.CrossRefGoogle Scholar
17. Diagnostic and Statistical Manual of Mental Disorders. 4th ed. text rev. Washington, DC: American Psychiatric Association: 2000.Google Scholar
18. Young, KS. Caught in the Net. New York, NY: John Wiley & Sons; 1998.Google Scholar
19. Anderson, KJ. Internet use among college students: an exploratory study. J Am Coll Health. 2001;50:2126.CrossRefGoogle Scholar
20. Chou, C. Internet heavy use and addiction among Taiwanese college students: an online interview study. Cyberpsycol Behav. 2001;4:573585.CrossRefGoogle ScholarPubMed
21. Ko, CH, Yen, JY, Chen, CC, Chen, SH, Yen, CF Proposed diagnostic criteria of Internet addiction for adolescents. J Nerv Ment Dis. 2005;193:728733.CrossRefGoogle ScholarPubMed
22. Nichols, LA, Nicki, R. Development of a psychometrically sound internet addiction scale: a preliminary step. Psychol Addict Behav. 2004;18:381384.CrossRefGoogle ScholarPubMed
23. Giovino, GA. Epidemiology of tobacco use among US adolescents. Nicotine Tobacco Res Suppl. 1999:1:S31S40.CrossRefGoogle ScholarPubMed
24. Grant, BF. Prevalence and correlates of alcohol use and DSM-IV alcohol dependence in the United States: results of the National Longitudinal Alcohol Epidemiologic Survey. J Stud Alcohol. 1997;58:464473.CrossRefGoogle ScholarPubMed
25. Warner, LA, Kessler, RC, Hughes, M, Anthony, JC, Nelson, CB. Prevalence and correlates of drug use and dependence in the United States: results from the National Comorbidity Survey. Arch Gen Psychiatry. 1995;52:219229.CrossRefGoogle ScholarPubMed
26. Lesieur, HR, Klein, R. Pathological gambling among high school students. Addict Behav. 1987;12:129135.CrossRefGoogle ScholarPubMed
27. Anthony, JC, Petronis, KR. Early-onset drug use and risk of later drug problems. Drug Alcohol Depend. 1995;40:915.CrossRefGoogle ScholarPubMed
28. Winter, KC, Stinchfield, R, Fulkerson, J. Adolescent Gambling Behavior in Minnesota: A Benchmark. Report to the Department of Human Services Mental Health Division. Duluth, Minn: Center for Addiction Studies, University of Minnesota; 1990.Google Scholar
29. Burge, AN, Pietrzak, RH, Petry, NM. Pre/Early adolescent onset of gambling and psychosocial problems in treatment-seeking pathological gamblers. J Gambl Stud. 2006;22:263274.CrossRefGoogle ScholarPubMed
30. Chambers, RA, Taylor, JR, Potenza, MN. Developmental neurocircuitry of motivation in adolescence: a critical period of addiction vulnerability. Am J Psychiatry. 2003;160:10411052.CrossRefGoogle ScholarPubMed
31. Evenden, JL. Varieties of impulsivity. Psychopharmacology (Berl). 1999;146:348361.CrossRefGoogle ScholarPubMed
32. Christo, G, Jones, SL, Haylett, S, Stephenson, GM, Lefever, RM, Lefever, R. The Shorter PROMIS Questionnaire: further validation of a tool for simultaneous assessment of multiple addictive behaviours. Addict Behav. 2003;28:225248.CrossRefGoogle ScholarPubMed
33. Sheehan, DV. The Anxiety Disease. New York, NY: Scribner; 1983.Google Scholar
34. Leon, AC, Shear, MK, Portera, L, Klerman, GL. Assessing impairment in patients with panic disorder: the Sheehan Disability Scale. Soc Psychiatry Psychiatr Epidemiol. 1992;27:7882.CrossRefGoogle ScholarPubMed
35. SPSS for Windows. Chicago, Ill: SPSS, Inc.; 1989.Google Scholar
36. Bernstein, GA.Carroll, ME, Thuras, PD, Cosgrove, KP, Roth, ME. Caffeine dependence in teenagers. Drug Alcohol Depend. 2002;66:16.CrossRefGoogle ScholarPubMed
37. Guerrini, I, Gentili, C, Guazzelli, M. Alcohol consumption and heavy drinking: a survey in three Italian villages. Alcohol Alcohol. 2006;41:336340.CrossRefGoogle ScholarPubMed
38. Crouch, BI, Caravati, EM, Booth, J. Trends in child and teen nonprescription drug abuse reported to a regional poison control center. Am J Health Syst Pharm. 2004;61:12521257.CrossRefGoogle ScholarPubMed
39. Huang, B, Dawson, DA, Stinson, FS, et al. Prevalence, correlates, and comorbidity of nonmedical prescription drug use and drug use disorders in the United States: results of the National Epidemiologic Survey on Alcohol and Related Conditions. J Clin Psychiatry. 2006;67:10621073.CrossRefGoogle ScholarPubMed
40. Greenfield, DN. The nature of Internet addiction: psychological factors in compulsive Internet use. Paper presented at: Annual Meeting of the American Psychological Association: May 1999. Boston, Mass.CrossRefGoogle Scholar
41. Yang, CK, Choe, BM, Baity, M, Lee, JH, Cho, JS. SCL-90-R and 16PF profiles of senior high school students with excessive internet use. Can J Psychiatry. 2005;50:407414.CrossRefGoogle ScholarPubMed
42. Kim, K, Ryu, E, Chon, MY, et al. Internet addiction in Korean adolescents and its relation to depression and suicidal ideation: a questionnaire survey. Int J Nurs Stud. 2006;43:185192.CrossRefGoogle ScholarPubMed
43. Kim, HS. Internet addiction treatment: the faster, the better. Publication Ethics. 2001;276:1215.Google Scholar
44. Armstrong, L, Philips, JG, Saling, LL. Potential determinantes of heavier Internet usage. International Journal of Human-Computer Studies. 2000;53:537550.CrossRefGoogle Scholar
45. Reynolds, WM, Mazza, JJ. Assessment of suicidal ideation in inner-city children and young adolescents: reliability and validity of the Suicidal Ideation Questionnaire-JR. School Psych Rev. 1999;28:1730.Google Scholar
46. Charney, DS, ed. Impact of substance abuse on the diagnosis, course and treatment of mood disorders (theme issue). Biol Psychiatry. 2004;56:703818.Google Scholar
47. Brown, KT, Coventry, L. Queen of Hearts: The Needs of a Woman with Gambling Problems. Melbourne, Australia: Financial and Consumer Rights Council; 1994.Google Scholar
48. Griffiths, M, Sutherland, I. Adolescent gambling and drug use. J Community Appl Soc Psychol. 1998;8:423427.3.0.CO;2-B>CrossRefGoogle Scholar
49. Mitchell, P. Internet addiction: genuine diagnosis or not? Lancet. 2000;355:632.CrossRefGoogle ScholarPubMed
50. Berke, J, Hyman, SE. Addiction, dopamine, and the molecular mechanism of memory. Neuron. 2000;25:515532.CrossRefGoogle Scholar
51. Carnes, P. The obsessive shadow. Professional Counselor. 1998;13:1517.Google Scholar
52. Desai, RA, Maciejewski, PK, Pantalon, MV, Potenza, MN. Gender differences in adolescent gambling. Ann Clin Psychiatry. 2005;17:249258.CrossRefGoogle ScholarPubMed
53. Lanzi, G, Rossi, G, Balottin, U, et al. Eating behavior disorders. Epidemiologic study of 434 adolescents. Minerva Pediatr. 1997;49:249260.Google ScholarPubMed

Altmetric attention score

Full text views

Full text views reflects PDF downloads, PDFs sent to Google Drive, Dropbox and Kindle and HTML full text views.

Total number of HTML views: 0
Total number of PDF views: 78 *
View data table for this chart

* Views captured on Cambridge Core between September 2016 - 27th January 2021. This data will be updated every 24 hours.

Hostname: page-component-898fc554b-q2rfn Total loading time: 0.658 Render date: 2021-01-27T17:02:04.453Z Query parameters: { "hasAccess": "0", "openAccess": "0", "isLogged": "0", "lang": "en" } Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "metricsAbstractViews": false, "figures": false, "newCiteModal": false }

Send article to Kindle

To send this article to your Kindle, first ensure is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

Note you can select to send to either the or variations. ‘’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

The Shorter PROMIS Questionnaire and the Internet Addiction Scale in the Assessment of Multiple Addictions in a High-School Population: Prevalence and Related Disability
Available formats

Send article to Dropbox

To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

The Shorter PROMIS Questionnaire and the Internet Addiction Scale in the Assessment of Multiple Addictions in a High-School Population: Prevalence and Related Disability
Available formats

Send article to Google Drive

To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

The Shorter PROMIS Questionnaire and the Internet Addiction Scale in the Assessment of Multiple Addictions in a High-School Population: Prevalence and Related Disability
Available formats

Reply to: Submit a response

Your details

Conflicting interests

Do you have any conflicting interests? *