Participants information & Informed consent letter To whom it may concern I am a medical doctor specializing in Psychiatry at the University

of Stellenbosch, South Africa. I have a keen interest in impulse control disorders and am conducting a survey on the experience of people suffering from problematic internet use who visits internet addiction websites or who participates in an internet addiction support group. I would greatly appreciate it if you could take ten to fifteen minutes of your valuable time to complete this questionnaire and return it to me via e-mail: 12695165@sun.ac.za. I assure you that your e-mail address will be kept strictly confidential, even when this research is submitted for publication. Please see the informed consent form and mark on the questionnaire at question 1 to indicate that you accept to voluntarily participate in this study and read and understood the informed consent form. I hope that the results of this project would contribute positively to the recognition and management of pathological internet use, as well as assist mental health professionals in the management of clients with problematic internet use. This study has been reviewed and approved by the Committee for Human Research at the University of Stellenbosch and will be conducted according to the ethical guidelines and principles of the international Declaration of Helsinki, South African Guidelines for Good Clinical Practice and the Medical Research Council (MRC) Ethical Guidelines for Research. Please feel free to contact me at 12695165@sun.ac.za if you have any questions. Your cooperation would be greatly appreciated. Yours thankfully, Belinda Bruwer

PARTICIPANT INFORMATION LEAFLET AND CONSENT FORM

TITLE OF THE RESEARCH PROJECT:

A survey of Internet websites and Internet based support groups dedicated to the management of Internet addiction.
REFERENCE NUMBER: N06/09/176 PRINCIPAL INVESTIGATOR: Dr Belinda R Bruwer ADDRESS: 12695165@sun.ac.za You are being invited to take part in a research project. Please take some time to read the information presented here, which will explain the details of this project. Please ask the study doctor any questions via e-mail about any part of this project that you do not fully understand. It is very important that you are fully satisfied that you clearly understand what this research entails and how you could be involved. Also, your participation is entirely voluntary and you are free to decline to participate. If you say no, this will not affect you negatively in any way whatsoever. You are also free to withdraw from the study at any point, even if you do agree to take part. This study has been approved by the Committee for Human Research at Stellenbosch University and will be conducted according to the ethical guidelines and principles of the international Declaration of Helsinki, South African Guidelines for Good Clinical Practice and the Medical Research Council (MRC) Ethical Guidelines for Research.

What is this research study all about? The study investigates the usefulness and possible problems related to participating in an internet support group for people with internet addiction or visiting an internet addiction-related website. The aims of my project are to determine the demographic characteristics of people who use resources on the internet for their problematic internet use, as well as how users experience the internet support groups/ websites. We also examine type of problematic internet activity, impact of problematic internet use on a persons life and treatment options available online. I hope that this study will have a positive impact in recognition and management of internet addiction in the future.

A questionnaire will be posted 2-weekly on the mailing list/ website from November 2006 to March 2007 after consent is obtained from the list and website owners. Any visitor to the selected internet addiction website or participant in the selected internet addiction support group during this time can voluntarily complete the questionnaire and return it to me at 12695165@sun.ac.za. The email address of the participants will be kept strictly confidential. The questionnaire will take about 10 15 minutes to complete and I hope to receive at least 100 questionnaires back. Why have you been invited to participate? Anyone visiting a selected internet addiction website or participating in the selected internet addiction support group during the study period can voluntarily complete and return the questionnaire.

What will your responsibilities be? Please complete the questionnaire and return it to 12695165@sun.ac.za

Will you benefit from taking part in this research? Internet addiction is a relatively new area in psychiatry and a limited amount of research has been done up to date. This research project intends to stimulate further research in this field and aims to benefit people suffering with internet addiction. Your contribution will be greatly appreciated to aide in influencing the recognition and management of this condition. Are there any risks involved in your taking part in this research? None. Who will have access to your personal information (e-mail address)? The information collected will be treated as confidential and protected. If it is used in a publication or thesis, the identity of the participant will remain anonymous. Only the principal investigator will have access to the e-mail addresses of participants.

Will you be paid to take part in this study? No, you will not be paid to take part in the study.

Is there any thing else that you should know or do? You can contact Dr Belinda Bruwer at 12695165@sun.ac.za should you have any further queries or encounter any problems.

You can contact the Committee for Human Research at +2721-938 9207 if you have any concerns or complaints that have not been adequately addressed by your study doctor. You can keep a copy of this information and consent form for your own records. PLEASE ANSWER QUESTION 1 OF QUESTIONNAIRE TO INDICATE WHETHER YOU READ AND UNDERSTAND THE INFORMED CONSENT FORM AND IF YOU CHOOSE TO PARTICIPATE VOLUNTARILY IN THIS STUDY. Declaration by participant By signing below, I ... agree to take part in a research study entitled A survey of Internet websites and support groups that are dedicated to the management of Internet addiction.

I declare that: I have read or had read to me this information and consent form and it is written in a language with which I am fluent and comfortable. I have had a chance to ask questions and all my questions have been adequately answered. I understand that taking part in this study is voluntary and I have not been pressurized to take part. I may choose to leave the study at any time and will not be penalized or prejudiced in any way.

Signed at (place) ................................ on (date) ...... 2006.

...................................................................... ................................................................... Signature of participant Signature of witness (Please answer question 1 of the questionnaire to indicate that you read and understood the informed consent. Feel free to e-mail me at 12695165@sun.ac.za if you have any questions.) Declaration by investigator I (name) .. declare that:

 I explained the information in this document via e-mail. I encouraged him/her to ask questions via e-mail. I am satisfied that he/she adequately understands all aspects of the research, as discussed above

I did not use a interpreter Signed at (place) ................................ on (date) ...... 2006. Signature of investigator ........................... Signature of witness

Questionnaire: Internet addiction websites

Please indicate website where you obtained the questionnaire:.

1. Ive read the informed consent form and understand the contents. I hereby wish to participate voluntarily in this study (Please mark your answer with a cross) a) Yes b) No

2. What is your interest in Pathological Internet Use (PIU) (also called problematic internet use or internet addiction)? (please mark your answer with a cross) a) I have PIU b) My child has PIU c) My husband/wife/girlfriend/boyfriend (significant other) has PIU (please specify) d) My friend has PIU e) I am a psychiatrist treating PIU f) I am a psychologist treating PIU g) I am an allied mental health professional h) Other (please specify)

3. How old are you? (please fill in the blanks) ..years old

4. Are you male or female (mark your answer with a cross) a) male b) female

5. What area of employment are you in? (please fill in blanks) . 6. Are you a student? (mark your answer with a cross) a) Yes b) No

7. If yes to question 6, please indicate which level of studying you are currently involved in. a) Primary education b) Secondary education c) University: Pre-graduate d) University: Postgraduate d) College e) Part-time study f) Other, please specify briefly.

8. At what age did you first start using the internet? (please fill in the blanks) . years old

9. At what age did you realize that you had a problem with internet use? (please fill in the blanks if applicable) .years old

10. Which areas of your daily life are mostly affected by your problematic internet use? (Please answer even if you dont have PIU) (You can mark more than one answer with a cross) a) Not applicable, I dont have PIU b) Work

c) Social d) Family e) Friends f) Exercise g) Spiritual/ religious activities h) Other, please specify

11. What type of internet activity do you find that you spend the most time on? (please mark your answer with a cross) (Please answer even if you dont have PIU) a) Not applicable, I dont have PIU b) Online gambling c) Online shopping d) Cyber sexual addiction e) Educational/ searching for information f) Purposeless surfing on the net g) Cyber relationships h) Computer games i) Other, please specify.

12. If you have PIU (or if your child, significant other, friend has PIU, has this diagnosis been made by a professional? (mark your answer with a cross) a) Yes b) No

13. If no to question 11, please specify how the diagnosis of PIU was made. (mark your answer with a cross) a) Internet b) Family c) Friends d) Other, please specify

14. If you have PIU (of if your child, significant other, friend has PIU), has this been professionally treated? (mark your answer with a cross) a) Yes, previously but not presently b) Yes, previously and presently c) No

15. How long have you been visiting this website? (mark your answer with a cross) a) Less than one week b) 1 week to 1 month c) 1 to 3 months d) 3 to 6 months e) 6 to 12 months f) more than 12 months

16. How did you hear about this website? (mark your answer with a cross) a) By surfing the internet b) From a member of the support group c) From a psychiatrist d) From a psychologist e) From an allied mental health professional f) From a family member or significant other g) From a friend h) Other (please specify)

17. How often do you visit this website? (mark your answer with a cross) a) More than once a day

b) Once a day c) Less than once a day d) Weekly e) Monthly f) Other (please specify) ..

18. How much time do you spend per week making use of the services provided by this website? (mark your answer with a cross) a) Less than one hour per week b) 1 2 hours per week c) 2 5 hours per week d) More than 5 hours per week

19. Do you visit any other internet addiction websites as well? (mark your answer with a cross) a) Yes b) No If yes, please specify .

20. Do you belong to an internet addiction internet support group? (mark your answer with a cross) a) Yes b) No If yes, please specify.

21. How helpful has this website been to you in terms of learning about the symptoms of PIU? (please mark your answer with a cross) (answer even if you are a mental health professional) a) Very helpful

b) Somewhat helpful c) Somewhat unhelpful d) Unhelpful

22. How helpful has the support website been to you in terms of learning about the treatment for PIU? (please mark your answer with a cross) (answer even if you are a mental health professional) a) Very helpful b) Somewhat helpful c) Somewhat unhelpful d) Unhelpful

23. How helpful has the website been to you in terms of tips for how to decrease problematic internet use? (please mark your answer with a cross) (answer even if you dont have PIU) a) Very helpful b) Somewhat helpful c) Somewhat unhelpful d) Unhelpful e) Not applicable I dont have PIU

24. Which services offered by this website do you feel that you benefit from most? (mark your answer with a cross) (you can mark more than one answer) a) General information provided b) E-booklets c) Virtual clinics d) Referral to internet support groups e) Referral to face-to-face support groups f) Referral to virtual therapists

g) Referral to personal therapist h) Other, please specify..

25. How helpful has the website been to you in terms of feeling supported? (please mark your answer with a cross) (answer even if you are a mental health professional) a) Very helpful b) Somewhat helpful c) Somewhat unhelpful d) Unhelpful e) Not applicable I dont have PIU

26. How helpful has the website been to you in terms of realizing that you (or your child, significant other, friend) are not the only person suffering from PIU? (please mark your answer with a cross) a) Very helpful b) Somewhat helpful c) Somewhat unhelpful d) Unhelpful e) Not applicable - I dont have PIU

27. How helpful has the website been to you (or to your child, significant other, friend) in terms of giving a name to the internet use problem? (please mark your answer with a cross) a) Very helpful b) Somewhat helpful c) Somewhat unhelpful d) Unhelpful e) Not applicable - I dont have PIU

28. How helpful has an internet addiction website been in terms of learning about the treatment of internet addiction? (please mark your answer with a cross) (answer even if you are a mental health professional) a) Very helpful b) Somewhat helpful c) Somewhat unhelpful d) Unhelpful

29. How helpful has the website been to you in terms of encouraging you (or your child, significant other, friend) to seek professional advice for PIU? (please mark your answer with a cross) a) Not applicable for example I (or my child, significant other, friend) sought professional help and treatment before joining the support group b) Very helpful c) Somewhat helpful d) Somewhat unhelpful e) Unhelpful

30. How helpful has this website been in terms of learning about cognitive-behavioural therapy for PIU? (please mark your answer with a cross) (answer even if you are a mental health professional) a) Very helpful b) Somewhat helpful c) Somewhat unhelpful d) Unhelpful

31. How helpful has this website been in terms of learning about the 12 steps programme for the treatment of addiction?

(please mark your answer with a cross) (answer even if you are a mental health professional) a) Very helpful b) Somewhat helpful c) Somewhat unhelpful d) Unhelpful

32. Have you (or your child, significant other, friend) attempted following a cognitivebehavioural programme? (please mark your answer with a cross) a) Yes, with good results b) Yes, but without good results c) No d) Not applicable Ive never heard about this programme

33. Have you (or your child, significant other, friend) attempted following the 12 steps programme? (please mark your answer with a cross) a) Yes, with good results b) Yes, but without good results c) No d) Not applicable Ive never heard about this programme

34. Have you ever been mislead by information obtained from the internet addiction website? (mark the best answer with a cross) a) Yes b) Maybe c) I dont think so d) No

If yes or maybe to question number 5, please describe what happened briefly..

35. If you have PIU, has this website been of any help to family or friends? (mark the best answer with a cross) a) Not applicable I dont have PIU b) Not applicable, I did not share my PIU problem with family or friends c) Helpful d) Somewhat helpful e) Somewhat unhelpful f) Unhelpful

36. How much time do you spend on average per week using the internet? (mark the best answer with a cross) a) Less than 10 hours b) 10 to 20 hours c) 21 to 40 hours d) 41 to 50 hours e) More than 50 hours

37. Is there anything else you would like to add or share about the support group? I would particularly be interested in what you found useful and what you did not find useful being a member of the Internet addiction support group/ visiting the PIU website.