Challenges in Internet Addiction Disorder: Is a Diagnosis Feasible or Not?

Pathological Internet Use-An Important Comorbidity in Child and Adolescent Psychiatry: Prevalence and Correlation Patterns in a Naturalistic Sample of Adolescent Inpatients

Background

Few studies have examined the prevalence of problematic internet use (PIU) in young people undergoing inpatient treatment in child and adolescent psychiatry centers. The aims of our study were thus (a) to assess the frequency of comorbid PIU in a sample of adolescent psychiatric inpatients and compare it with a control group of nonreferred adolescents and (b) to gain insights into correlations between PIU and psychiatric comorbidities.

Methods

111 child and adolescent psychiatry inpatients (CAP-IP, mean age 15.1 ± 1.4 years; female : male 72.4% : 27.6%) undergoing routine psychodiagnostics were screened for the presence of PIU. The widely used Compulsive Internet Use Scale (CIUS) was chosen for this purpose. Prevalence rates of PIU were then compared to matched nonreferred control subjects from a school sample. Additionally, comorbidities of inpatients with PIU were compared to inpatients without PIU.

Results

Our inpatient sample showed a much higher prevalence of PIU than that found in previous populational samples of young people. Compared with a matched school sample, addictive internet use was 7.8 times higher and problematic internet use 3.3 times higher among our adolescent sample. PIU was significantly associated with characteristic patterns of psychopathology, that is, suicidality, difficulties in establishing stable and consolidated identity, and peer victimization.

Conclusion

PIU among adolescents undergoing inpatient psychiatric treatment is much more frequent than among their peers in the general population and is associated with specific patterns of psychopathology.

Adolescent Internet Abuse: A Study on the Role of Attachment to Parents and Peers in a Large Community Sample

Adolescents are the main users of new technologies and their main purpose of use is social interaction. Although new technologies are useful to teenagers, in addressing their developmental tasks, recent studies have shown that they may be an obstacle in their growth. Research shows that teenagers with Internet addiction experience lower quality in their relationships with parents and more individual difficulties. However, limited research is available on the role played by adolescents' attachment to parents and peers, considering their psychological profiles. We evaluated in a large community sample of adolescents (N = 1105) the Internet use/abuse, the adolescents' attachment to parents and peers, and their psychological profiles. Hierarchical regression analyses were conducted to verify the influence of parental and peer attachment on Internet use/abuse, considering the moderating effect of adolescents' psychopathological risk. Results showed that adolescents' attachment to parents had a significant effect on Internet use. Adolescents' psychopathological risk had a moderating effect on the relationship between attachment to mothers and Internet use. Our study shows that further research is needed, taking into account both individual and family variables.

Associations among Different Internet Access Time, Gender and Cyberbullying Behaviors in Taiwan's Adolescents

With the increasing convenience of social networking sites and their interconnectedness with human interaction, verbal and image bullying have turned digital, making cyberbullying a new form of bullying attracting the attention of researchers, social workers, and schools. This study focuses on the status quo of attitude toward cyberbullying and cyberbullying behavior, explores associations of attitude toward behavior on cyberbullying behavior in gender and different internet access times. In a cross-sectional survey, adolescents were surveyed through self-report questionnaires, 13,864 respondents were received among 150 high schools in Taiwan. Statistical analyses were performed using structural equation modeling (SEM). The study revealed that attitude toward cyberbullying has a direct effect on cyberbullying behavior; among the greatest direct impact were when students use the Internet during the time frame 10:00–14:00. Parents and schoolteachers pay special attention to students using the Internet during this time frame 10:00–14:00 and give guidance, express care, and help those being bullied to communicate and use the Internet in a correct manner. Among genders, male student attitude toward behavior has a greater effect than those of female students. Both male and female students know what cyberbullying is and have witnessed, heard of, or personally encountered cyberbullying behavior. We recommend students talk to parents or teachers or other people who care to reduce the negative effects of cyberbullying. We hopeful that the conceptualization model presented in this study serves as an activator for researches on attitude toward cyberbullying and cyberbullying behavior, and serves a guide and a call to attract more researches in this area.

Not good enough? Further comments to the wording, meaning, and the conceptualization of Internet Gaming Disorder

In their commentary, Kuss, Griffiths, and Pontes (2016) criticize the use of the term "Internet" in the recently proposed diagnosis for Internet Gaming Disorder (IGD) and its use as one of the included diagnostic criteria. We agree with the exclusion of the term "Internet" in the diagnosis, but have some considerations to the comments regarding the nine criteria for IGD. Specifically, we discuss the meaning, the wording, and the importance of the criteria, as well as the importance of distress or functional impairment in the proposed diagnosis. We also address the possibility of categorizing IGD as a subtype of a general behavioral addiction diagnosis.

A randomized efficacy trial of a cognitive-behavioral group intervention to prevent Internet Use Disorder onset in adolescents: The PROTECT study protocol

Background

The reduction of prevalence rates of Internet Use Disorder (IUD) and its effective treatment are at high priority in both public health and educational policies. School-based preventive interventions facilitate a low-threshold approach for individuals with IUD, who are typically characterized by high therapy avoidance. Moreover, indicated approaches which target adolescents at high-risk show larger effects than universal prevention programs. Simultaneously, they reduce unnecessary burden for the majority of high-school students that is not at-risk. The PROTECT group intervention for indicated prevention of IUD in school settings was developed based on these preventive strategies.

Methods

Three-hundred and forty adolescents, aged 12–18 years, from 40 secondary schools in Germany, screened for high-risk of IUD onset, are randomly assigned to a) PROTECT preventive intervention group or b) assessment only control group. The tested intervention consists of a cognitive-behavioral 4-session brief-protocol. Follow-up assessments are at 1, 4 and 12 months after admission. Primary outcome is the 12-months incidence rate of IUD. Secondary outcomes are the reduction of IUD and comorbid symptoms as well as the promotion of problem solving, cognitive restructuring and emotion regulation skills.

Conclusion

The indicated preventive intervention PROTECT follows the APA-guidelines for psychological prevention, i.e., it is theory- and evidence-based and addresses both risk-reduction and strength-promotion, it considers current research and epidemiology and ethical standards such as professional secrecy and is designed as a systemic intervention at the school-level. It is expected that the intervention decreases risk of IUD onset (incidence rate).

Trial registration

ClinicalTrials.gov: NCT02907658.