Impulsivity Correlates With Problematic Internet Use in Young Adults With ADHD

Impulsivity stands out as the principal dimension linked to problematic internet use among young adults formally diagnosed with attention-deficit/hyperactivity disorder, according to a clinical investigation conducted in Italy. While previous research has documented overlapping clinical features between attention-deficit/hyperactivity disorder and problematic online engagement, earlier evidence has derived predominantly from children, adolescents, or non-clinical general population samples. Consequently, questions remained regarding which specific psychological dimensions sustain this relationship in adult clinical cohorts who have received a structured medical diagnosis.

To examine this relationship directly, researchers performed a retrospective, cross-sectional evaluation of young adults consecutively assessed at a second-level specialized outpatient clinic for adult ADHD located in Milan, Italy. The clinical cohort comprised patients between the ages of 18 and 38 years. To confirm diagnostic eligibility, clinicians administered the semi-structured Diagnostic Interview for ADHD in Adults, commonly designated as the DIVA-5. This standardized assessment systematically established diagnoses while simultaneously providing comprehensive symptom counts for childhood and adult presentations of inattention as well as hyperactivity and impulsivity.

Study participants completed an extensive battery of standardized psychometric instruments to capture behavioral tendencies, symptom severity, and overall psychological functioning. Problematic digital technology engagement was evaluated using the Internet Addiction Test. To analyze the prespecified dimensions of interest, the investigators administered the Barratt Impulsiveness Scale to quantify impulsivity and the Difficulties in Emotion Regulation Scale to gauge emotional dysregulation. The protocol also incorporated two distinct ADHD symptom questionnaires, dedicated measures assessing depressive and anxiety symptoms, an inventory tracking trait anxiety, and an assessment evaluating overall quality of life.

Among the clinical cohort, two hundred and fourteen patients completed the evaluations with a valid Internet Addiction Test score, producing an overall sample mean score of 52.96 with a standard deviation of 15.16. Categorical stratification of these results revealed that 22.9 percent of the patients fell into the category of average internet users, whereas 62.1 percent demonstrated problematic internet usage patterns. An additional 15.0 percent of the evaluated young adults met the criteria for highly problematic internet users, indicating that problematic engagement was widespread across the clinical sample.

Statistical analyses incorporated correlation testing adjusted with corrections for multiple comparisons, structured group comparisons, multivariable linear regression models, and bootstrapped mediation analyses. The correlational results revealed that problematic internet use was significantly correlated with impulsivity, yielding a correlation coefficient rho of 0.345, and with emotional dysregulation, which showed a correlation coefficient rho of 0.229. Both of these observed correlations successfully survived corrections for multiple statistical testing, highlighting their prominence relative to other assessed clinical variables.

In contrast to the clear correlations observed with impulsivity and emotional dysregulation, the study identified no significant statistical association between problematic internet use and the four core symptom counts derived from the DIVA-5 clinical interviews. Specifically, correlation coefficients between online behavior and symptom counts ranged from 0.004 to 0.119. Similarly, scores obtained from the two supplemental ADHD symptom questionnaires, measures of trait anxiety, and quality-of-life assessments failed to display any statistically significant association with problematic internet engagement.

When evaluated within a multivariable linear regression framework, impulsivity emerged as the most consistent and robust correlate of problematic internet behavior, registering an unstandardized coefficient b of 0.317 with a significance level of p less than 0.001 and a standardized beta of 0.33. Emotional dysregulation exhibited a notably weaker association that varied across different model specifications, yielding an unstandardized coefficient b of 0.091 at a significance level of p equal to 0.052. Furthermore, general clinical severity, ADHD presentation type, formal symptom counts, and diverse demographic and clinical covariates were not significantly associated with problematic internet use in the model.

Mediation analysis identified an indirect association between ADHD severity and internet use through impulsivity, with an indirect effect of 1.56 and a 95 percent confidence interval from 0.41 to 2.96. The authors observed that although core symptom severity did not directly predict internet problems, the associated confidence intervals remain compatible with weak effects, suggesting that clinical assessments of problematic internet behavior should not be restricted solely to the most severely impaired patients.

The authors emphasized important limitations inherent to the research framework, noting that the retrospective and cross-sectional design precludes any direct causal inferences regarding whether impulsivity actively generates problematic online habits. Because the data reflect cross-sectional observations gathered at a specialized outpatient clinic, the findings demonstrate statistical associations rather than longitudinal trajectories.

Subject of Research: Association of impulsivity and emotional dysregulation with problematic internet use in young adults with ADHD

Article Title: Impulsivity is the principal correlate of problematic internet use in young adults with attention-deficit/hyperactivity disorder: a cross-sectional clinical study

Article References: Giacovelli, L., Fedeli, D., Martiadis, V., Vanzetto, S., Cerioli, M., Larini, L., Landi, P., Venturi, V., Viganò, V., Reibman, Y. L., Gesi, C., & Dell’Osso, B. (2026). Impulsivity is the principal correlate of problematic internet use in young adults with attention-deficit/hyperactivity disorder: a cross-sectional clinical study. Frontiers in Psychiatry, 17, Article 1974570. https://doi.org/10.3389/fpsyt.2026.1974570

Image Credits: AI Generated

DOI: 10.3389/fpsyt.2026.1974570

Keywords: attention-deficit/hyperactivity disorder, ADHD, problematic internet use, internet addiction, impulsivity, emotional dysregulation, young adults, clinical psychiatry, cross-sectional study, DIVA-5, Internet Addiction Test, Barratt Impulsiveness Scale, Difficulties in Emotion Regulation Scale, behavioral addiction, multivariable regression, mediation analysis