CYBERPSYCHOLOGY & BEHAVIOR

Volume 11, Number 3, 2008© Mary Ann Liebert, Inc.DOI: 10.1089/cpb.2007.0095

The Association between Internet Addiction and Beliefof Frustration Intolerance: The Gender Difference

CHIH-HUNG KO, M.D.,1,2 JU-YU YEN, M.D.,1,2,3 CHENG-FANG YEN, M.D., Ph.D.,1,4

CHUNG-SHENG CHEN, M.D.,1,2,4 and SHING-YAW WANG, M.D.1

ABSTRACT

This study evaluated the association between Internet addiction and frustration intolerance,the gender difference of frustration intolerance, and the gender differences of the associationbetween Internet addiction and frustration intolerance. Participants were 2,114 students (1,204male and 910 female) who were recruited to complete the Chen Internet Addiction Scale andFrustration Discomfort scale. Females had higher scores on the subscale of entitlement andemotional intolerance and the total scale of the frustration intolerance. There was a signifi-cant gender difference on the association between Internet addiction and frustration intoler-ance. The association was higher in male adolescents. Regression analysis revealed male ado-lescents with Internet addiction had higher intolerance to frustration of entitlement andemotional discomfort, and female adolescents with it had higher intolerance to emotional dis-comfort and lower tolerance to frustration of achievement. Frustration intolerance should beevaluated for adolescents with Internet addiction, especially for males. Rational emotive be-havior therapy focusing on different irrational beliefs should be provided to male and femaleadolescents with Internet addiction.

273

INTRODUCTION

AS A PERVASIVE PART of modern life, the Internethas become an important part of the adoles-

cent’s life. It brings negative as well as positive in-fluences to adolescents.1 Maladaptive Internet usehas been termed as Internet addiction by Young.2 Arecent study found 19.8% of adolescents had Inter-net addiction,3 and it was associated with depres-sion, hostility, and substance experience.4,5 Thus, itis an important issue of mental health among ado-lescents.

Until now, there have been no conclusive diag-nostic criteria for Internet addiction. Ko et al. havedeveloped diagnostic criteria based on systemic di-agnostic interview to identify adolescents with In-ternet addiction.6 The core symptoms in their crite-ria includes preoccupation, uncontrolled impulse,usage more than intended, tolerance, withdrawal,impairment of control, excessive time and effortspent on the Internet, and impairment of decision-making ability. The diagnostic criteria with good di-agnostic accuracy (95.4%) were utilized to define In-ternet addiction in this study.6

1 Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan.2 Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan.3 Department of Psychiatry, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan.4 Department of Psychiatry, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan.

Cognitive behavior therapy has been utilized toeffectively treat behavior addiction such as patho-logical gambling.7 From a clinical perspective, ef-fective cognitive behavior therapy depends onwhether the cognitions related to the focus prob-lem can be identified. Irrational beliefs are re-ported by rational emotive behavior therapists(REBT) to be central to emotional and behaviorproblems. Irrational beliefs may be groupedwithin two separate categories: the intolerance offrustration/discomfort and the evaluation of self-worth.8 Intolerance of frustration represents thedemand that reality should be as we wish it to be.It is reported to be associated with problems ofself-control.9 Adolescents with Internet addictionare usually characterized with low frustration tol-erance in clinical investigation. Thus, to evaluatewhether adolescents with Internet addiction haveintolerance of frustration could provide essentialinformation to determine the focus of REBT for In-ternet addiction among adolescents.

The Frustration-Discomfort Scale (FDS) was de-veloped by Harrington to measure frustration intol-erance beliefs.10 The scale includes four dimensions:emotional intolerance, discomfort intolerance, enti-tlement, and achievement. The emotional intoler-ance subscale demonstrates the belief that emo-tional distress is unbearable and must quickly berelieved or avoided. The discomfort intolerancesubscale reflects beliefs that life should be free ofhassles, effort, and inconvenience. Demands forfairness and immediate gratification are included inthe entitlement subscale. Lastly, the achievementsubscale reflects demands for high standards andintolerance of these standards being frustrated.10 Aprevious report revealed that different dimensionsof frustration intolerance have differential relation-ships with specific self-control problems.9 Thus, itis necessary to evaluate which dimension of frus-tration intolerance is associated with Internet ad-diction and must be abated in REBT for Internet ad-diction.

Internet addiction has been reported to be moreprevalent among male than female adolescents.4

Ko has reported that Internet addiction was asso-ciated with self-esteem for male, but not for fe-male, students.11 This may indicate there is a gen-der difference on the mechanism of Internetaddiction. However, the gender difference of thefrustration intolerance of adolescents and its relationship with Internet addiction has not beenevaluated.

Thus, the study aimed to (a) evaluate the association between Internet addiction and

frustration intolerance; (b) explore the genderdifferences of frustration intolerance; and (c) investigate gender differences in the associationbetween Internet addiction and frustration intolerance.

MATERIAL AND METHOD

Three senior high schools and seven vocationalhigh schools in southern Taiwan were randomly se-lected in this study. Two classes were randomly se-lected from each grade. In the selected classes, aninformed consent form was provided to each stu-dent. Then, participants who signed the form wereinvited to complete the measurement anonymously.Recruited were 2,114 students (1,204 male, 910 fe-male), and their mean age was 16.26 years (SD �0.99, range 15–23 years). Additionally, this studyhad been approved by the Institutional ReviewBoard (IRB) of Kaohsiung Medical University Hos-pital.

Measurement

Chen Internet Addiction Scale (CIAS). The CIASconsists of 26 items, scored on a 4-point Likert scale.The total scores of the CIAS ranged from 26 to 104.Higher CIAS scores indicated increased severity ofInternet addiction. In the original study, the inter-nal reliability of the instrument and its subscalesranged from 0.79 to 0.93, and correlation analysesyielded significantly positive correlations of totalscale and subscale scores of CIAS with the hoursspent weekly on Internet activity.12 According to thediagnostic criteria of Internet addiction,6 the 63/64cutoff point of CIAS has highest diagnostic accuracy(87.6%), accepted sensitivity (67.8%), and specificity(92.6%).3 Accordingly, those with CIAS scores of 64or more were classified as the Internet addictiongroup.

The FDS. The revised FDS,10 used in the presentstudy, consisted of 28 items with four scores rang-ing from 28 to 140. The higher score indicated higherfrustration intolerance belief. It consisted of foursubscales: discomfort intolerance, entitlement, emo-tional intolerance, and achievement. The Cron-bach’s alphas were 0.84 to 0.88. The revised sub-scales showed unique relationships with specificpsychological problems and evidence of convergentand divergent validity.9 In this presenting study, itsCronbach’s alphas of total scale and subscales were0.78 to 0.93.

KO ET AL.274

Statistical analysis

The participants completing the CIAS and FDSwere enrolled in the final analysis. The participantswere classified as Internet addiction group accord-ing to the CIAS. The associations between the scoresof FDS and gender and Internet addiction were eval-uated by t test. Then, an analysis of variance by thegeneral linear model procedure was utilized to as-sess whether the association between scores of CAISand FDS was influenced by gender. Then, the asso-ciation between FDS and CIAS was analyzed formale and female respectively. Meanwhile, the asso-ciations between CIAS score and subscale of FDSwere evaluated with linear multiple regression formale and female respectively. All statistical analy-ses were performed using the SPSS computer pack-age program. A p value less than 0.05 was consid-ered significant.

RESULTS

The data of 1,992 (94.2%) participants (1,130 boysand 862 girls) were entered into the final statisticalanalysis. There was no difference on gender be-tween adolescents enrolled and excluded (�2 � 0.72,p � 0.40). The mean age was 16.26 � 0.99 (range:15–23). There were 785 (39.4%), 638 (32.0%), and 569(28.6%) students from grades 10, 11, and 12 respec-tively. Within them, 364 (18.3%) students were clas-sified under Internet addiction. The prevalence rateof males (22.6%) was significantly higher than fe-males (12.6%; �2 � 32.23, p � 0.001).

In Table 1, the t test revealed that females hadhigher scores than males on subscales of entitle-ment, emotional discomfort, and total scores of FDS.

Adolescents with Internet addiction had higherscores on four subscales and the total scale.

The general linear model analysis revealed thatthe interaction terms of FDS and gender are sig-nificantly associated with CIAS scores (Table 2).This finding indicated that the association be-tween FDS and CIAS was moderated by the gen-der effect. Then, evaluating the association be-tween FDS and CIAS for males and femalesseparately revealed that the association washigher in males (r � 0.028, p � 0.001) than in fe-males (r � 0.014, p � 0.001). Linear regressionanalysis (shown in Table 3) indicated that CIASwas positively associated with discomfort intoler-ance and negatively associated with achievementintolerance among females. However, the CIASwas positively associated with entitlement intol-erance and discomfort intolerance among males.This result further supports the gender differenceof the association between FDS and CIAS.

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TABLE 1. ASSOCIATIONS BETWEEN FOUR DIMENSIONS OF FRUSTRATION-DISCOMFORT SCALE AND GENDER AND INTERNET ADDICTION

Gender Internet addiction

Male (1,130) Female (862) Yes (N � 364) No (N � 1628)Mean � SD Mean � SD t Mean � SD Mean � SD t

Discomfort 20.30 � 5.76 20.49 � 5.34 �0.74 22.66 � 5.80 19.87 � 5.41 8.77***intolerance

Entitlement 19.37 � 5.62 19.91 � 5.43 �2.17* 21.98 � 5.34 19.07 � 5.45 9.34***Emotional 19.38 � 6.01 20.57 � 5.46 �4.61*** 21.87 � 5.71 19.46 � 5.74 7.26***

intoleranceAchievement 17.55 � 5.57 17.37 � 5.24 0.73 19.44 � 5.71 17.04 � 5.26 7.75***Total scale 76.60 � 20.64 78.35 � 18.73 �1.97* 85.95 � 20.30 75.44 � 19.24 9.32***

*p � 0.05; ***p � 0.001.

TABLE 2. ASSOCIATION OF CHEN INTERNET

ADDICTION SCALE SCORES WITH INTERACTION TERM

OF GENDER AND FRUSTRATION-DISCOMFORT SCALE

df Mean square F P

Male 1 7.387 0.05 0.832FDS 1 14038.432 85.59 �0.001Male � FDS 1 1312.654 8.00 0.005Error 1988 164.024

Note: ANOVA was used with the general linearmodel procedure to determine whether the interac-tion term of gender and FDS was associated withscores of Chen Internet Addiction Scale.

FDS, Frustration Discomfort Scale.

DISCUSSION

This is the first study to test the association be-tween belief of frustration intolerance and Internetaddiction in adolescents. The result revealed ado-lescents with Internet addiction hold higher irra-tional beliefs of frustration intolerance. Accordingto the “ABCDE” model of REBT, when facing an ac-tivating event, the irrational belief will cause thedysfunctional sequence.13 Previous reports havefound that frustration intolerance is associated withbehavior avoidance.9 Because Internet provides im-mediate reinforcement such as a feeling of control,synchronous interaction with others, and the free-dom of self-representation,14 when facing stressfulevents in real life, beliefs of frustration intolerancemay make adolescents unwilling to tolerate nega-tive emotional events, and they may be more likelyto escape from the unaccepted frustrations of dailylife and seek immediate gratification from the In-ternet and become vulnerable to Internet addiction.

On the other hand, since many adolescents ex-perience the Internet early in life, immediate rein-forcement provided by the Internet might also in-fluence their beliefs. If pleasure could always beexperienced without coping with frustration online,long-term exposure to Internet activity may alsomake adolescents believe that life should be as com-fortable as it is in Internet. Without effective inter-vention for such beliefs, these adolescents may pre-fer Internet activity and enter a vicious cycle.However, the causal relationship between frustra-tion intolerance and Internet addiction should befurther clarified by prospective study.

The result also revealed that female adolescentsare more likely to hold the belief of intolerance toemotional distress and unfairness. It has been re-ported that female adolescents worry more aboutlack of confidence issues.15 This may contribute totheir belief for entitlement. Female adolescents also

have a more negative problem orientation and en-gage in more thought suppression.15 This may re-sult in more emotional distress, such as depressionand anxiety, which have been reported to be moreprevalent in female adolescents.16 This prevalencemay be associated with their emotional intolerancebelief. Hill and Linch have argued that the genderrole for female adolescents brings conflict overachievement and results in depression because offears that success will be perceived as unattractiveand because of heightened self-consciousness overphysical appearance.17 The conflict associated withthe gender role might also account for their beliefof entitlement and emotional intolerance.

Although frustration intolerance is associatedwith Internet addiction and is higher among femaleadolescents, Internet addiction is more prevalent inmales. Further analysis in this study revealed thatgender was a moderator for the association betweenfrustration intolerance and Internet addiction. Itdemonstrated that frustration intolerance is moreassociated with Internet addiction for males. Thegender difference of coping style may explain thehigher impact on male adolescents. It has been re-ported that male adolescents are more likely thanfemale adolescents to use avoidance strategies andemotional distraction coping.18 Since autonomy andindependence are emphasized more on male gen-der role,19 it is possible that when males face stress,they feel “safe” in avoiding rather than seekinghelp, which they may interpret as failure. Thus,male adolescents with higher frustration intolerancemight go online to avoid the stress instead of seek-ing help from others or professional treatment. Onthe other hand, it has been reported that adolescentfemales used more coping approaches and help-seeking behaviors than males.18 Even though theyexperience higher intolerance to frustration, theyare more likely to cope with it by getting help fromother friends or mental health professionals. The

KO ET AL.276

TABLE 3. MULTIPLE REGRESSION ANALYSIS FOR ASSOCIATION BETWEEN SUBSCALE OF

FRUSTRATION-DISCOMFORT SCALE AND CHEN INTERNET ADDICTION SCALE

Male Female

� T � T

Age 0.05 1.62 0.03 0.83Discomfort intolerance 0.10 2.04* 0.17 3.20**Entitlement 0.15 2.70** 0.07 1.25Emotional intolerance 0.02 0.37 0.05 0.99Achievement 0.05 0.88 �0.13 �2.58**

F � 19.81*** R2 � 0.08 F � 6.73*** R2 � 0.04

*p � 0.05; **p � 0.01; ***p � 0.001.

difference of coping patterns may make males morelikely to be addicted to the Internet under frustra-tion intolerance.

The regression analysis revealed that Internet ad-diction was associated with emotional discomfortfor both males and females. It demonstrated that in-tolerance of emotional discomfort was the most as-sociated irrational belief of Internet addiction inFDS. Moreover, male adolescents with a high scoreon the entitlement subscale are more likely to haveInternet addiction. Some Internet activities, such asonline gaming, provide clearer rules to achievehigher scores and reach higher levels sooner thanwhat real-world experience does. The distractionand avoidance coping style of male adolescents18

may explain, in part, why males are more likely tobecome addicted to the Internet under frustrationto entitlement. This result indicated that entitlementshould be evaluated and appropriate interventionsdesigned in treatment of Internet addiction, espe-cially for male adolescents. On the other hand, fe-male adolescents with perfectionistic beliefs are lesslikely to have Internet addiction. Since females aremore likely to have an approach-coping manner andto seek help from others,18 they may not fulfill theirdesire for perfection by making it come true withfantasies via the Internet. Their efforts in the realworld to satisfy their perfectionistic beliefs may pro-tect them from spending too much time in the vir-tual world. However, more comprehensive researchis necessary to explain the gender difference of as-sociation between Internet addiction and frustrationintolerance.

Interventions for adolescents with dysfunctionalbelief of frustration could be developed to disputetheir irrational belief, assimilate more adaptive andrational beliefs, thereby resulting in positive impacton their behavior.13 Because our results demon-strated the association between frustration intoler-ance and Internet addiction, evaluation and inter-vention for frustration intolerance for adolescentswith Internet addiction are indicated, especially formales. REBT focused on frustration intolerancewould benefit them by modifying their perceptionthat frustration is unacceptable and reducing theircompulsion to escape via the Internet to gain non-frustrated satisfaction. Because there is a gender dif-ference on the association between Internet addic-tion and frustration intolerance, REBT focused ondifferent irrational belief should be provided formale and female adolescents with Internet addic-tion.

This study has several limitations that should beconsidered when interpreting its findings. First, ahigher proportion of vocational high school stu-

dents are included than is representative of thegeneral population. Second, all our investigationsrelied on self-reported data from adolescents.Third, the cross-sectional research design of thepresent study could not confirm causal relation-ships between frustration intolerance and Internetaddiction.

CONCLUSION

This study demonstrates that Internet addictionis associated with belief of frustration intoleranceamong adolescents. More attention and REBTshould be focused on irrational beliefs of frustrationintolerance for adolescents with Internet addiction,especially for males. Intolerance to emotional dis-comfort should be emphasized in REBT for bothmale and female adolescents with Internet addic-tion, and the irrational belief of entitlement intoler-ance should be highlighted for male adolescentswith Internet addiction. Further intervention re-search is necessary to evaluate the effect of REBTfor Internet addiction among adolescents.

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Address reprint requests to:Dr. Shing-Yaw Wang

Department of PsychiatryKaohsiung Medical University

100 Tzyou 1st Rd., Kaohsiung City, Taiwan 807

E-mail: siyakin@yahoo.com.tw

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