Search Results for: internet addiction

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Internet Addiction Treatment, A Systematic Review

In previous posts I already expressed my doubt about this phenomenon: Internet Addiction. The biggest problem with studies defining a new syndrome is usually that they don’t use validated diagnostic tools but mostly some severity scale. Internet Addiction is not clearly defined in the recent scientific publications and research. Some researchers have adapted substance use disorder, while others reference pathological gambling, resulting in an inconsistent definition of Internet addiction.

Being as it is, therapeutic research was done with such a creaky concept as Internet Addiction is. A recent systematic review according to the CONSORT statement has recently been published.
In this review of 8 treatment studies several key limitations were found.

  • inconsistencies in the definition and diagnosis of Internet addiction,
  • a lack of randomization and blinding techniques,
  • a lack of adequate controls or other comparison groups,
  • insufficient information concerning recruitment dates, sample characteristics, and treatment effect sizes.

Only one of the eight study was a Randomized Controlled Trial RCT, others were pre-test/post-test design. No clear definitions were used, one study referred to internet addiction as an impulse control disorder, others as substance abuse disorders. Only five studies used a diagnostic instrument. Most studies used “psychological interventions”: cognitive behavior therapy (CBT), motivational interviewing (MI), reality training, or a combination of psychological and/or counseling therapies within a self-devised treatment program. Two studies by the same group used pharmacologic interventions: a psychostimulant and an antidepressant, only one study used a control group and the treatment regimes varied between studies.

Each study utilized its diagnostic tool for Internet addiction as an outcome measure, with some studies also including measures of anxiety, depression, self-esteem, and behavioral functioning.

The results of the studies were favorable in seven, but the authors did not report the estimated effect sizes nor their precision, most outcomes were qualified as: “having a powerful outcome”, “improving the maladaptive behavior”, “clearly suggest that the program is effective”, “very effective to improve Internet addiction level”, “improved clinical symptoms and visual attention, associated with reduced severity of Internet video game play” and “effective at ameliorating the common symptoms”

A lot of work still has to be done, what do you think?

ResearchBlogging.org
King, D., Delfabbro, P., Griffiths, M., & Gradisar, M. (2011). Assessing clinical trials of Internet addiction treatment: A systematic review and CONSORT evaluation Clinical Psychology Review, 31 (7), 1110-1116 DOI: 10.1016/j.cpr.2011.06.009

 

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Digital Divide in Internet Addiction?

Internet adiction

The digital divide in this post refers to the disparity in Internet access between developed and developing countries. In a recent published study they explored Internet addiction among university students in China and the United States to develop a better understanding of Internet addiction in a cross-national setting. Three hundred fourteen respondents were evaluated on 10 Internet addiction symptoms and five Internet addiction dimensions. And the conclusion was:

We conclude that Internet addiction may result as an artifact of the stage of Internet adoption within a society.

More information on the non existent diagnosis of Internet addiction can be found on this blog in Internet Addiction Research Disappointing

The digital divide has many derivatives and meaning. There is a generational digital divide since elderly people use social networking and user generated content on the Internet strikingly less than younger people, this indicates a gap between digitally literate users and the elderly.

Researchers also found evidence for a social capital divide on My Space based on age. They did a study of user profiles among teenagers and older users of MySpace. MySpace is one of many online social networking site, but one of the largest. You can find the the age differences in online social networking between teenagers and older users of MySpace:

The digital divide also exists among different races as far as discussing internet health information. Among all Internet users, Whites had higher levels of discussing Internet health information with a health care provider about Internet health information than Blacks and Asians, moreover this is the same for the Internet users who are immigrants.

ResearchBlogging.org
Lixuan Zhang, Clinton Amos, William C. McDowell (2008). A Comparative Study of Internet Addiction between the United States and China CyberPsychology & Behavior, 11 (6), 727-729 DOI: 10.1089/cpb.2008.0026

 

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Internet Addiction Research Disappointing

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I am not a firm believer of Internet Addiction. One of the main features of addiction is having complaints, suffer complications of the addiction. The main features of an addiction are social and/or emotional problems leading to doctors visit or other forms of help seeking. So what we are looking for is teenagers using the Internet as there only way to communicate, play and doing that at night. Anyone can explain to them why that isn’t healthy. Internet is mostly defined as excessive use, withdrawal, tolerance and negative consequences. If these flimsy characteristics are followed most of us suffer from all kinds of addictions such as work addiction, sports addiction, chocolate addiction well may be you can think of a few more.

Moreover, it seems that people mistake the medium for the message. When they hear that folks are “addicted to the Internet”, they blame the Internet, the medium, for the problem, whereas the Internet is simply provides a new source of behaviors for people who would have had behavioral addictions anyway. Even incorporating this new medium into our culture will be accompanied by getting used to, finding the right balance in your daily routine.

Even in a recent editorial of the American Journal of Psychiatry Internet Addiction is proposed as a new diagnosis in DSM V. Now the American Journal of Psychiatry used to be a serious peer reviewed journal although some of us doubt this feature for a while now.

Beside the these previous mentioned objections to the new diagnosis of Internet Addiction a recent Metasynthesis of the recent quantitative research on this matter came to the following conclusion:

previous studies have utilized inconsistent criteria to define Internet addicts, applied recruiting methods that may cause serious sampling bias, and examined data using primarily exploratory rather than confirmatory data analysis techniques to investigate the degree of association rather than causal relationships among variables.

This study was done to find answers to the questions: How has Internet addiction been measured? What aspects of the Internet addiction phenomenon have been investigated by academic researchers?

  • The biggest problem with studies defining a new syndrome is usually that they don’t use validated diagnostic tools but mostly some severity scale. This is also the trouble with research for depression in the medical ill patients. If someone is severely ill and you use an Hamilton Depression Rating Scale they will almost all have high scores not because they are depressed but because the feel horrible due to their somatic illness.
  • Another big problem is that Internet Addiction is not clearly defined in the recent scientific publications and research. Some researchers have adapted substance use disorder, while others reference pathological gambling, resulting in an inconsistent definition of Internet addiction. Many researchers, due to the complex nature of the topic, do not provide a clear definition of Internet addiction.
  • Besides not using a clear definition researchers used different scales for measuring Internet Addiction, and these scales have not been standardized for efficient cross-study comparisons.
  • Most of the studies used Internet-based survey formats as well as used high school and university student samples. The different sample selection criteria across the studies have brought varying conclusions on the prevalence of Internet addiction. Studies on Internet Addiction focus on adolescents. In trying to recruit samples outside of schools most of these sample recruitment methods suffer from sampling bias. This makes generalizing the findings of the study to other populations troublesome to say the least. The sample selection criteria are still far from the randomization principle and raise questions regarding sample coverage errors.
  • Studies on Internet addiction have focused on “proving” the existence of Internet addiction or identify the characteristics of Internet addicts. The analysis methods employed were thus exploratory rather than confirmatory.

How was this study done?
A study was included if it used human participants and a quantitative instrument to measure Internet addiction. To ensure quality and completeness, only fulllength articles in peer-reviewed journals or conference proceedings were considered. Searches of academic databases and of Google and Yahoo! using keywords Internet addiction, Internet addicted, problematic Internet usage, and computer addiction
resulted in 120 articles spanning the period 1996–2006. If you want the whole database of articles please follow this link which downloads a excel file with all the references (120). For this review they used 61 articles from the 120.

Important they didn’t use the important criteria of a prospective design nor using a control group nor randomized attribution to two conditions. That’s the meaning of quantitative data, just counting numbers, not an experimental prospective study design.

In the end the research on this subject until now is biased. This review names the most important flaws from these publications. They offer suggestions to improve the research on this subject. To my opinion their recommendations don’t go far enough. If you want to prove the validity of a concept randomized prospective trials with clear hypothesis before hand are needed. What do you think.

Doctor Shock is not alone, Blogroll against Internet Addiction:
Mind Hacks
How to split an atom
The Metaverse Journal

ResearchBlogging.org
Sookeun Byun, Celestino Ruffini, Juline E. Mills, Alecia C. Douglas, Mamadou Niang, Svetlana Stepchenkova, Seul Ki Lee, Jihad Loutfi, Jung-Kook Lee, Mikhail Atallah, Marina Blanton (2008). Internet Addiction: Metasynthesis of 1996–2006 Quantitative Research CyberPsychology & Behavior, 2147483647-5 DOI: 10.1089/cpb.2008.0102

 

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Predicting Internet Addiction or Splitting Straws?

internet addiction

    • Problematic Internet Use (PIU) of male students is higher than that of female students. On the Problematic Internet Usage Scale (PIUS) male students scores are higher compared to female students on all subscales such as negative consequences of Internet (NCI; 17 items), social benefit/social comfort (SB/SC; 10 items), except on excessive use(EU; 6 items).
    • The students with psychological symptoms demonstrate more PIU.
    • The students using the Internet from mostly their homes may feel more also have higher PIU scores
    • Those students that use the Internet mostly at night also score higher on the PIU.
    • Using the Internet for social interactions is a risk factor in the development of PIU
    • Solely using the Internet for fun, passing time and feeling relieved can result in problematic Internet use.
    • Scores on the PIUS were not significantly higher for individuals with addiction problems than that of those having no addiction problems.

I am not a firm believer of Internet Addiction. That doesn’t mean there is absolutely no problematic Internet use, or using the Internet for gambling or other forms of established addictions. People described as having Internet addiction can have problems and can suffer but this isn’t due to the Internet but to other problems such as depression, anxiety and others, either way they can use kratom high to better the condition, you will find the term kratom high being thrown around in blogs and other forums. Also white borneo kratom offers users quite a few noticeable benefits related to brain function .One can’t help but wonder how a herb with such benefits could get you high, check the official site for more info. This research discussed here confirms this to my opinion.

In this article the authors gathered data from 437 students of a Turkish University. Most recent publications of Internet addiction are by Chinese authors, and the Chinese Government has a very special relationship with Internet. You can read about China’s Crackdown on Internet in a post on this blog. To relief from stress you prefer kratom who’s benifit given below.

What benefits do you get from red vein kratom? Some of these include 

  • Relieves pain 
  • Produces relaxation 
  • Sharpens your mental focus 
  • Brightens your mood 

These Turkish students were send instruments to measure problematic internet use the PIUS

Problematic Internet Usage Scale (PIUS). The PIUS is a Likert-type scale developed with Turkish students by Ceyhan et al with the assumption that the severity of Internet use shows continuity from normal to pathologic use. The PIUS consists of 33 items rated on a 5-point scale ranging from not appropriate at all to very appropriate. The range of the PIUS scores varies between 33 and 165, and the high
scores on the scale indicate that an individual’s Internet usage is unhealthy and may create a tendency to Internet addiction.

Brief Symptom Inventory (BSI)

The BSI is composed of the items having the highest distinctive features of Symptom Checklist–90 (SCL-90). The score range of the BSI varies between 0 and 212, and the high scores on the scale indicate high frequency of the individuals’ psychological symptoms.

And a questionnaire developed by the researchers about addictions, online experiences, time of day surfing, and reasons for using the Internet was used.

These were healthy students, they didn’t receive the questionnaires because they had complaints or were doing not well on school. One of the main features of addiction is having complaints, suffer complications of the addiction, this was not the case in student selection in this research. The main features of an addiction are social and/or emotional problems leading to doctors visit or other forms of help seeking. Moreover, withdrawal, tolerance, relapse are among the features of a real addiction.

Most of their findings can be explained. Male students use the Internet more to get social benefit/social comfort. This might be explained since males experience more difficulties in establishing intimate relationships, which is one of the developmental tasks, so they prefer communicating through the Internet rather than face to face and express their own feelings and thoughts better when online.

The fact that more psychological symptoms leads to more Internet use can be explained by the fact that the students who experience distress,difficulties, disturbances, and poor psychological well-being may use the Internet excessively for distraction, for coping with or avoiding their problems, and for social relief or rescue.

Using the Internet more at home is because this may be less restricted and cheaper.

So what we are looking for is teenagers using the Internet as there only way to communicate, play and doing that at night. Anyone can explain to them why that isn’t healthy. Seeking help for psychological problems on the Internet can be of use but going to a professional for help is more efficient. Internet can’t replace professional help yet.

ResearchBlogging.org
Ceyhan, A.A. (2008). Predictors of Problematic Internet Use on Turkish University Students. CyberPsychology & Behavior, 11(3), 363-366. DOI: 10.1089/cpb.2007.0112

 

3 comments

Internet Addiction


A couple of weeks ago I posted on Internet Addiction in the DSM V?

Medicalize problems again. In an editorial in the American Journal of Psychiatry Internet Addiction is proposed as a new diagnosis in DSM V. Now the American Journal of Psychiatry used to be a serious peer reviewed journal although some of us doubt this feature for a while now.

On Mind Hacks there is another post about this editorial.

Why we have to describe this as an addiction still completely baffles me.

 

5 comments

Internet Addiction in DSM V?


Medicalize problems again. In an editorial in the American Journal of Psychiatry Internet Addiction is proposed as a new diagnosis in DSM V. Now the American Journal of Psychiatry used to be a serious peer reviewed journal although some of us doubt this feature for a while now.

As arguments reports are used instead of studies published in peer reviewed journal. These reports come from South Korea:

Using data from 2006, the South Korean government estimates that approximately 210,000 South Korean children (2.1%; ages 6–19) are afflicted and require treatment. About 80% of those needing treatment may need psychotropic medications, and perhaps 20% to 24% require hospitalization

Now this looks like an epidemic to me, not a psychiatric diagnosis.

Also China is mentioned as suffering from this problem

At a recent conference, Tao Ran, Ph.D., Director of Addiction Medicine at Beijing Military Region Central Hospital, reported 13.7% of Chinese adolescent Internet users meet Internet addiction diagnostic criteria—about 10 million teenagers.

Now we all know why China wants to restrict Internet access and Internet cafes.
An explanation for Internet addiction could be a creative manner of censorship by the Chinese government. Internet is a relatively new phenomena in China, a side effect of its booming economy and technological advances, but how to control this development and how to fit it in with its communist government? Indeed Internet addiction.

And you can read about the treatment options for Internet addiction in a previous post on this blog: Electroshock treatment for Internet addiction
By the way this treatment was implemented by the same Mr Ran Director of Addiction Medicine at Beijing Military Region Central Hospital.

I hope the committee for the DSM V will be more critical about their task and evidence for this diagnosis. This proposal has nothing to do with pharmaceutical industries I hope.

What do you think should there be a diagnosis of Internet Addiction in the next DSM V?

 

7 comments

Electroshock treatment for Internet Addiction in China?


Journalist unhesitatingly use electroshock to draw attention to old news. Informationliberation.com has an old story about China clinic gives ‘web addicts’ shock treatment.

Besides it being old news e.g. compared to these articles back in 2005 on: usa today and BBC NEWS, although the best is from Washingtonpost.com february 2007. They all report about the same clinic:The Internet Addiction Treatment Center in Daxing County. Moreover, in Western studies no consensus exists as to whether Internet addiction really exists.

About electroshock, my expert opinion of the scene from the video presented with the article of therawstory.com and information from techdirt.com it is not about ECT but something probably comparable to transcranial direct current stimulation.

The so-called Internet addiction is in many cases not an ailment, but just a symptom of some deeper problem, some of them may even need a long term drug rehab because of their other addictions. Descriptions of the deeper problems can be read on techdirt.com and on The Herald Tribune.
It mostly comes down to:

“The main cause of Internet addiction is that parents’ expectations for their children are too high,” said Xu.

With education perceived by many parents as the only means of advancement in an ultracompetitive society of 1.3 billion people, some lock their children up to study and ask teachers to assign extra homework. The pressure can be too much for some children, Xu said, especially if they fail.

“Then they escape to the virtual world to seek achievements, importance and satisfaction, or a sense of belonging.”

Another explanation for Internet addiction could be a creative manner of censorship by the Chinese government. Internet is a relatively new phenomena in China, a side effect of its booming economy and technological advances, but how to control this development and how to fit it in with its communist government?

Even anonymous blogging is prevented in China

Delegates at the National People’s Congress, China’s annual session of Parliament, have proposed stricter criminal punishments for Internet café operators who admit minors, and have flagged restrictions on violent games.

The Internet Addiction Treatment Center in Daxing County uses a blend of therapy and military drills to treat the children with “Internet addiction”. It is a government-funded center, run by an army colonel under the Beijing Military Hospital. It is one of a handful of clinics treating patients with Internet addictions in China.

Patients, overwhelmingly male and aged 14 to 19, wake up in dormitories at 6:15 a.m. to do morning calisthenics and march on the cracked concrete grounds wearing khaki fatigues. Drill sergeants bark orders at them when they are not attending group and individual counseling sessions. Therapy includes patients simulating war games with laser guns.

The center’s tough-love approach to breaking Internet addiction is unique to China, but necessary in a country with over two million teenage Internet addicts, according to the facility’s staff.

 

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Internet Dependence Questionnaire: Garbage In, Garbage Out

internet addiction

Scales to diagnose Internet Dependence and Internet Addiction prosper. Even when this diagnosis is doubted by scientists and bloggers alike these scales get used very frequently and their publications accepted in peer reviewed journals. It is possible that this diagnosis will be included in the new DSM V. Recent research evaluated the utility of the proposed diagnostic criteria for Internet dependence as measured by Young’s Diagnostic Questionnaire. As much as the diagnosis is debatable this questionnaire shows that the proposed diagnostic criteria do not adequately discriminate individuals scoring no Internet dependence from those currently classified as Internet dependent with this instrument. The most shocking statement in this publication was

Although there is no gold standard against which to evaluate the proposed criteria, an examination of their concurrent validity as measured
by the YDQ with other measures of Internet dependence and clinical interview would contribute to the literature in this area.

What a bout a decent diagnostic interview performed by a experienced clinician? You can only proof the value of such a diagnostic scale by comparing it to the golden standard. The golden standard is usually a diagnostic scale especially those used by experienced clinicians. In the lack of such a scale, an interview with an experienced clinician is still the golden standard.

How was this research done?
The degree to which the cutoff of 5 out of 8 criteria is appropriate to differentiate nondependent from dependent Internet use was evaluated by comparing the Internet usage and psychological dysfunction of individuals scoring 3 and 4 on the Young’s Diagnostic Questionnaire (YDQ) to those scoring 5 or more and those scoring less than 3. This was done with a sample comprised of 424 students (130 males, 293 females,1 unspecified) recruited from universities in Melbourne, Australia. University students were selected because individuals in this demographic have been identified as being at risk for developing Internet dependence. The participants ranged in age from 18 to 50 years. Besides th YDQ another 5 scales were used: Internet Usage Inventory, Depression Anxiety Stress Scale, UCLA Loneliness Scale, Rosenberg Self Esteem Scale, Revised COPE Scale.

The results showed that 4.0% of undergraduate university students were classified as dependent (scoring 5 or more on the YDQ), and a further 9.2% were classified as at risk (scoring3 or 4 on the YDQ). This is a relatively high proportion compared to other publications.

the hypothesis that individuals scoring 3 and 4 on the YDQ would spend less time on the Internet and have a shorter history of use, engage in a narrower range of activities, and display less severe psychological dysfunction than individuals scoring 5 or more was not supported.

Conclusion
The diagnostic criteria for Internet dependence as measured by the YDQ may not adequately discriminate at-risk users from dependent users in terms of their Internet use and psychological functioning. If such a scale doesn’t clearly define the presence or absence of a disorder is that due to the scale, the alleged disorder or the bad design of this study by leaving out a golden standard?

To my opinion the diagnosis doesn’t exist as defined by such a scale and the design of this study didn’t help those advocating this disorder. What do you think?

Related posts on this blog:
Digital Divide in Internet Addiction
Predicting Internet Addiction or Splitting Straws?
Blog Addicted or Internet Addicted?
10 Things you can learn from a Digital Detox Week

ResearchBlogging.org
Nicki A. Dowling, Ph.D, Kelly L. Quirk, BAppSci (2008). Screening for Internet Dependence:
Do the Proposed Diagnostic Criteria Differentiate
Normal from Dependent Internet Use? CyberPsychology & Behavior, 1 DOI: http://www.liebertonline.com/doi/abs/10.1089/cpb.2008.0162

 

4 comments

Blog Addicted or Internet Addicted


The next three weeks Dr Shock is on vacation. This blog has been updated daily for more then a year. Since blogging is fun I will probably keep on blogging during these three weeks but maybe not daily and the long posts your used to.

No cold turkey to prevent withdrawal symptoms from blog addiction or is it Internet addiction? Won’t need shocktherapy for this I hope. But blogging is good for your health, at Living the Scientific Life

By the way there another stupid thing people believe you can get addicted to. Here is a good one: internet dating. Thanks Pure Pedantry

After these three weeks I will probably start with a new design, maybe I will need your help with that, looking forward to all this.

 
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