Background and aims:
Problematic usage of the internet (PUI) refers to maladaptive patterns of specific online activities such as gaming, social networking, online shopping, or pornography use. Building on theoretical frameworks such as the I-PACE model and the incentive-sensitization theory, the present multicenter study (N = 1,015) examined automatic approach and avoidance tendencies toward internet-related cues.

Methods:
Using an explicit Approach-Avoidance Task (AAT), reaction times to addiction-related and neutral stimuli were assessed and related to symptom severity, cue reactivity, and outcome expectancies.

Results:
Across all user groups (non-problematic, risky, pathological), participants displayed relative approach tendencies toward internet-related stimuli, with pathological users showing the strongest differentiation between addiction-related and neutral cues. Associations between approach tendencies and both cue reactivity and gratification were best described as linear, with higher cue reactivity and greater experienced gratification being associated with stronger approach tendencies. For symptom severity, curve estimation analyses provided evidence for significant, albeit weak, quadratic associations, suggesting that at high symptom severity approach as well as avoidance tendencies may occur.

Discussion and Conclusions:
Overall, these findings indicate that approach tendencies toward internet-related cues increase gradually with reward experiences and cue-reactivity, while at higher levels of symptom severity approach or avoidance responses may be observed suggesting that motivational responses remain heterogeneous. From a clinical perspective, approach–avoidance tendencies may serve as behavioral markers relevant to the development and maintenance of PUI and may help inform individualized prevention and intervention strategies targeting cognitive-motivational processes underlying problematic internet use.