A Meta-Analysis of Treatment Interventions for Internet Addiction Among Korean Adolescents

The Effect of Distress Tolerance Training on Problematic Internet Use and Psychological Wellbeing Among Faculty Nursing Students: A Randomized Control Trial

Background

Distress tolerance skills have the potential to decrease problematic internet use and improve psychological wellbeing by cognitive reframing and goal-oriented problem-solving.

Aim

To assess the impact of distress tolerance training on problematic internet use and psychological wellbeing among university nursing students.

Methods

A randomized control trial used at the faculty of nursing using simple random sampling method. Tools: Distress Tolerance Scale, problematic internet use questionnaire, and Ryff psychological wellbeing scale. Data were collected from 60 nursing students over a period of 4 months.

Results

Distress tolerance level was increased among study group from 20.75±14.29 to 72.75±24.09 and sustained for 3 months to 62.44 ±20.77 with statistically significant (f=7.090, p=0.006) and large effect size 0.75. When compared to no change among the control group as mean scare start by 22.35±14.29 to 23.44±16.09 and after 3 months to 21.75± 17.44 with insignificant difference (f=0.454, p=0.574). The mean score of problematic internet use shows highly statistically significant decrement in the study group between three period of time (pretest= 62.93, immediately post= 52.13, and post 3 months=52.70) with large effect size 0.78 (f=95.029, p<0.001), in compared to control group that showed insignificant no changes (pretest= 64.0±14.54, immediately post= 63.13±12.87, and post 3 months=63.53±11.36) with (f=1.012, p=0.332). In addition, the total mean score of psychological well-being was increased immediately after therapy and later for three months of therapy (pretest= 128.47, immediately post=148.77, and post 3 months= 153.60) with highly statistically significant (f=41.197, p<0.001) with effect size 0.85, compared to no change among control group (pretest=125.97±32.58, immediately post= 126.23±30.86, and post 3 months=126.43±29.78) with (f=0.208, p=0.698).

Conclusion

Efficacy of distress tolerance skills intervention had been proven in altering poor psychological wellbeing among students with problematic internet use. It helps students to learn new skills and use more adaptive strategies to overcome distress tolerance difficulties.

Relationship between depression, smartphone addiction, and sleep among Chinese engineering students during the COVID-19 pandemic

BACKGROUND

Existing research has demonstrated that depression is positively related to smartphone addiction, but the role of sleep has not been discussed thoroughly, especially among engineering undergraduates affected by the coronavirus disease 2019 pandemic.

AIM

To evaluate sleep as a mediator of the association between smartphone addiction and depression among engineering undergraduates.

METHODS

Using a multistage stratified random sampling method, a cross-sectional survey was conducted among 692 engineering undergraduates from a top engineering university in China, and data were collected by self-reported electronic questionnaires. The data included demographic characteristics, such as age, gender, the Smartphone Addiction Scale-Short Version (SAS-SV), the 9-item Patient Health Questionnaire, and the Pittsburgh Sleep Quality Index. Pearson correlation and multiple linear regression analyses were used to examine the association between smartphone addiction and depression, while structural equation models were established to evaluate the possible mediating role of sleep.

RESULTS

Based on the cutoffs of the SAS-SV, the rate of smartphone addiction was 63.58 percent, with 56.21 percent for women and 65.68 percent for men, among 692 engineering students. The prevalence of depression among students was 14.16 percent, with 17.65 percent for women, and 13.18 percent for men. Smartphone addiction was positively correlated with depression, and sleep played a significant mediating effect between the two, accounting for 42.22 percent of the total effect. In addition, sleep latency, sleep disturbances, and daytime dysfunction significantly mediated the relationship between depression and smartphone addiction. The mediating effect of sleep latency was 0.014 [P < 0.01; 95% confidence interval (CI): 0.006-0.027], the mediating effect of sleep disturbances was 0.022 (P < 0.01; 95%CI: 0.011-0.040), and the mediating effect of daytime dysfunction was 0.040 (P < 0.01; 95%CI: 0.024-0.059). The influence of sleep latency, sleep disturbances, and daytime dysfunction accounted for 18.42%, 28.95%, and 52.63% of the total mediating effect, respectively.

CONCLUSION

The results of the study suggest that reducing excessive smartphone use and improving sleep quality can help alleviate depression.

Systematic reviews and meta-analyses of treatment interventions for Internet use disorders: Critical analysis of the methodical quality according to the PRISMA guidelines

RATIONALE

As a result of concerns about predominantly online behavioral addictions, an increasing number of systematic reviews and meta-analyses (SRMA) of treatment interventions for internet use disorders (IUD) are being recorded. This review was designed to (a) systematically identify the evidence base of SRMA and to (b) critically appraise the quality of reporting according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

METHODS

Four databases were searched until August 2022 to systematically identify SRMA. PRISMA indicators were evaluated on a three-level response format to obtain an overall score operationalizing the quality of reporting (score range: 0-84). Additionally, the percentage of adherence to the PRISMA indicators was calculated.

RESULTS

Reporting quality of 23 SRMA, comprising 12 systematic reviews and 11 meta-analyses was evaluated. Quality scores ranged from 25 to 77 (M: 52.91; SD: 17.46). Results of the critical appraisal revealed deviations from the PRISMA indicators, including missing information on (a) registration of a study protocol, (b) statistical synthesis methods (c) evaluation of certainty of evidence, and (d) risk of bias assessment. Eleven (47.83%) of the SRMAs partially adhered, and twelve (52.17%) completely adhered to the PRISMA indicators.

CONCLUSION

This first critical appraisal on the reporting quality of SRMA on treatment interventions for IUD highlights limitations of the evidence base. Inadequate reporting compromises the practical utility and validity of SRMA and may complicate ongoing efforts of consensus on evidence-based interventions for IUD. Future research should focus on sufficient and transparent reporting of the methodological approach.

Effects of different interventions on internet addiction: A meta-analysis of random controlled trials

OBJECTIVE

To evaluate the effects of different interventions on Internet addiction (IA), a meta-analysis and network meta-analyses were performed.

METHODS

We searched PubMed, Cochrane, Embase, Web of Science, PsycINFO, ProQuest, CNKI, WanFang, VIP database, and CBM from their inception to August 2021 to identify randomized controlled trials (RCTs) where the effects of interventions on IA were assessed. The risk of bias was evaluated according to the Revised Cochrane risk-of-bias tool for randomized trials (RoB2). The R studio Software and Stata 14.0 were used to perform traditional meta-analysis and network meta-analyses.

RESULTS

A total of 59 RCTs including 3832 participants were incorporated into meta-analysis. The results of the traditional meta-analysis of 24 studies showed that CBT, group counseling, sports intervention, and Internet-based intervention could significantly reduce IA levels (SMD = -1.90, 95%CI: -2.26 to -1.55, P < 0.01, I² = 85.9%) as compared to no-treatment control groups. Network meta-analyses based on different scales showed that combined interventions had the highest probability of being the best interventions for IA (SUCRA = 91.0 % based on IAT; SUCRA = 89.0 % based on CIAS).

DISCUSSION

Most interventions have significant effects on the treatment of IA. Compared with single interventions, combined interventions showed a more pronounced improvement in Internet addiction symptoms.

Online dialectical behavioral therapy for adults with internet addiction: A quasi-experimental trial during the COVID-19 pandemic

The pathological use of the Internet has surged during the pandemic, even though service provisions were negatively impacted. Telepsychiatry can be used as a solution to maintain psychiatric addiction services. This study examined the efficacy of online group dialectical behavioral therapy (DBT) for Internet addiction (IA), compared to cognitive behavioral therapy (CBT). Participants were divided into two arms for 8 weeks: the experimental arm received eight sessions of online DBT skill group training (n = 20), and the control arm received four sessions of online individual CBT (n = 20). All participants were required to complete a sociodemographic and Internet use survey, the Internet Addiction Test (IAT), and the University of Rhode Island Change Assessment (URICA). All participants completed the therapy. Of the 40 participants, six (15%) perceived the need for therapy and one (2.5%) participant had a history of seeking IA therapy. In the pre-post comparison, significant improvements were noted in the IAT and URICA scores as well as Internet use duration for both arms. No significant differences were observed across the arms and in the time-by-arm interaction. Online group DBT is a viable alternative to online CBT in an acute constrained setting, although further studies are required to scrutinize its long-term efficacy. Trial Registration: ISRCTN17273762.

Impact of Short-Term Intensive-Type Cognitive Behavioral Therapy Intervention on Internet Addiction among Chinese College Students: A Randomized Controlled Trial

The object of this study is to examine the effects of a short-term intensive-type Cognitive Behavioral Therapy (CBT) intervention to prevent internet addiction among Chinese college students. We conducted a randomized controlled trial applying a group counseling intervention program based on CBT. Data included 21 participants in the intervention group and 22 participants in the control group. The results showed that the intervention program reduced college students’ internet addiction symptoms and procrastination and improved their sense of coherence. Regarding the sustained effect, internet addiction symptoms decreased and perceived social support from significant others improved in college students. However, the intervention program did not significantly reduce their average daily internet use time and psychological stress. Overall, this study developed a short-term intensive-type intervention program based on CBT theory, which is complementary for Chinese college students with internet addiction.

Does Group Size Matter? Group Size and Symptom Reduction Among Incarcerated Women Receiving Psychotherapy Following Sexual Violence Victimization

Survivors Healing from Abuse: Recovery through Exposure (SHARE) is an eight-week therapy group for incarcerated women who have experienced sexual violence victimization. SHARE requires each member to complete an imaginal exposure and to listen when others share their experiences of victimization. While trauma-focused group interventions including SHARE are associated with reductions in internalizing symptoms, little work has examined how group characteristics predict symptom decreases. The purpose of this study was to examine whether group size was associated with symptom changes pre- to post-treatment. Participants (n=140 across 29 groups) completed self-report measures of posttraumatic stress symptoms before and after completing SHARE. Multilevel modeling revealed the majority of the variance in post-treatment symptoms was attributed to individual factors rather than group factors. Symptom change was comparable for groups of two to eight women; declines in symptom improvement were observed at a group size of ten participants.

Current Research and Viewpoints on Internet Addiction in Adolescents

PURPOSE OF REVIEW

This review describes recent research findings and contemporary viewpoints regarding internet addiction in adolescents including its nomenclature, prevalence, potential determinants, comorbid disorders, and treatment.

RECENT FINDINGS

Prevalence studies show findings that are disparate by location and vary widely by definitions being used. Impulsivity, aggression, and neuroticism potentially predispose youth to internet addiction. Cognitive behavioral therapy and medications that treat commonly co-occurring mental health problems including depression and ADHD hold considerable clinical promise for internet addiction.

SUMMARY

The inclusion of internet gaming disorder in the DSM-5 and the ICD-11 has prompted considerable work demonstrating the validity of these diagnostic approaches. However, there is also a movement for a conceptualization of the disorder that captures a broader range of media-use behaviors beyond only gaming. Efforts to resolve these approaches are necessary in order to standardize definitions and clinical approaches. Future work should focus on clinical investigations of treatments, especially in the USA, and longitudinal studies of the disorder's etiology.

A Qualitative Study of Practitioners' Views on Family Involvement in Treatment Process of Adolescent Internet Addiction

Despite emerging evidence of the effectiveness of a family-focused approach as an Internet addiction (IA) treatment modality for adolescents, little research has been done to explore family involvement in the treatment process from the clinician's perspective. This study employed a qualitative design to examine practitioners' views pertaining to the roles and challenges of family participation in IA intervention. In total, 10 practitioners working with adolescents with IA were interviewed. Thematic analysis was used to analyze the transcribed interviews. Three overreaching themes were synthesized: That family involvement in IA intervention is challenging yet important; shifting the focus from the adolescent to the relationship; and provision of individualized services and intervention to address the heterogeneous nature of cases. The findings show that family participation in IA treatment is successful in enhancing positive outcomes. The needs of adolescents with IA and family members are addressed through individual counseling and psychoeducation, respectively. Conjoint therapy sessions foster effective communication, improve family interactions and functioning, and restore relationships. However, caution regarding family dynamics is required when considering whether family involvement is appropriate. Practitioners need to establish therapeutic alliances and be flexible when working with family members in terms of the degree and arrangement of participation.

Treatments for internet addiction, sex addiction and compulsive buying: A meta-analysis

BACKGROUND AND AIMS

Internet addiction, sex addiction and compulsive buying are common behavioral problems, which share similarities with gambling disorder and substance use disorders. However, little is known about the efficacy of their treatments. The objective of this meta-analysis was to examine the efficacy of the treatments of such problem behaviors, and to draw parallels to gambling disorder and substance use disorders in terms of treatment response.

METHODS

Literature search yielded 91 studies totaling 3,531 participants to provide a comprehensive evaluation of the short-term and long-term efficacy of psychological, pharmacological and combined treatments for internet addiction, sex addiction, and compulsive buying.

RESULTS

Psychological, pharmacological, and combined treatments were associated with robust pre-post improvements in the global severity of internet addiction (Hedges's g: 1.51, 1.13, and 2.51, respectively) and sex addiction (Hedges's g: 1.09, 1.21, and 1.91, respectively). For compulsive buying, psychological and pharmacological treatments were also associated with a large-sized pre-post reduction in global severity (Hedges's g: 1.00 and 1.52, respectively). The controlled pre-post and within-group pre-follow-up effect sizes were in the similar range, with few exceptions. Moderator analyses suggest that psychological interventions are effective for reducing compulsive behaviors, especially when delivered face-to-face and conducted over extended periods of time. Combinations of cognitive-behavioral approaches with medications showed an advantage over monotherapies.

DISCUSSION AND CONCLUSIONS

The results suggest that treatments for common behavioral addictions are effective in the short term, similar to those implemented for gambling disorder and substance use disorders, but more rigorous clinical trials are needed.

A meta-analysis of psychological interventions for Internet/smartphone addiction among adolescents

BACKGROUND AND AIMS

Although the peculiarities of problematic Internet use and Internet addiction have been analyzed previously by researchers, there is still no general agreement in the literature as to the effectiveness of psychological interventions for Internet addiction deployed among adolescents. This study sought to investigate the effects of intervention programs for Internet/smartphone addiction among adolescents through a meta-analysis.

METHODS

We searched MEDLINE (PubMed), EbscoHost Academic Search Complete, ProQuest, and PsycARTICLES using a combination of "Internet addiction or phone addiction" AND "intervention or treatment" OR "therapy" OR "program" AND "adolescents," and a combination of the following search terms: "patholog_," "problem_," "addict_," "compulsive," "dependen_," "video," "computer," "Internet," "online," "intervention," "treat_," and "therap_." The studies identified during the search were reviewed according to the criteria and a meta-analysis was conducted on the six selected papers published from 2000 to 2019. Only studies with a control/comparison group that performed preintervention and postintervention assessments were included.

RESULTS

Included studies showed a trend toward a beneficial effect of intervention on the severity of Internet addictions. The meta-analysis suggested significant effects of all included randomized controlled trials (RCTs) and their educational programs.

CONCLUSIONS

Psychological interventions may help to reduce addiction severity, but further RCTs are needed to identify the effectiveness of cognitive behavioral therapy. This study provides a basis for developing future programs addressing addiction problems among adolescents.

Does cognitive-behavioral therapy reduce internet addiction? Protocol for a systematic review and meta-analysis

BACKGROUND

Cognitive-behavioral therapy has been considered as a means for internet addiction, but its long-term effect and the impact of internet addiction types and culture are still unclear.

OBJECTIVE

This study aims to assess the efficacy of cognitive-behavior therapy for internet addiction symptoms and associated other psychopathological symptoms.

METHOD AND ANALYSIS

We will search PubMed, Web of Knowledge, Ovid Medline, Chongqing Vip Database, Wanfang, and China National Knowledge Infrastructure database. Random-effects model in comprehensive meta-analysis software will be used to conduct main meta-analysis. Cochran Q and I are be used to assess heterogeneity while funnel plots and the Egger test are used to assess publication bias. Risk of bias for each study included is assessed by using the Cochrane risk of bias tool. The primary outcome is internet addiction symptom while secondary outcomes are psychopathological symptoms, time spent online, and dropout.

TRIALS REGISTRATION NUMBER

PROSPERO CRD42019125667.

Problematic interactive media use in teens: comorbidities, assessment, and treatment

Problematic Interactive Media Use (PIMU), aka internet or video game addiction, is increasingly presenting to pediatricians for care. The majority of youth now use mobile media almost constantly to communicate, learn, and entertain themselves, but for some, uncontrolled video gaming, social media use, pornography viewing, and information-bingeing on short videos or websites contribute to functional impairment. PIMU can result in academic failure, social withdrawal, behavioral problems, family conflict, and physical and mental health problems. There is no formal diagnosis to describe the spectrum of PIMU behaviors and therefore no standardized therapeutic interventions. Anticipatory guidance will help identify youth at risk and empower parents to recognize and prevent problems. In addition, epidemiology and etiology indicate that Attention-Deficit/Hyperactivity Disorder (ADHD), affective disorders, and Autism Spectrum Disorder (ASD) may predispose to and, in some cases, result from PIMU, offering opportunities for effective treatment by addressing underlying pathology that is manifesting itself in the interactive media environment. Efforts to establish evidence-based diagnoses, develop and evaluate therapeutic strategies, and to train clinicians in recognition and care of PIMU are reviewed.

School-based Prevention for Adolescent Internet Addiction: Prevention is the Key. A Systematic Literature Review

Adolescents' media use represents a normative need for information, communication, recreation and functionality, yet problematic Internet use has increased. Given the arguably alarming prevalence rates worldwide and the increasingly problematic use of gaming and social media, the need for an integration of prevention efforts appears to be timely. The aim of this systematic literature review is (i) to identify school-based prevention programmes or protocols for Internet Addiction targeting adolescents within the school context and to examine the programmes' effectiveness, and (ii) to highlight strengths, limitations, and best practices to inform the design of new initiatives, by capitalizing on these studies' recommendations. The findings of the reviewed studies to date presented mixed outcomes and are in need of further empirical evidence. The current review identified the following needs to be addressed in future designs to: (i) define the clinical status of Internet Addiction (IA) more precisely, (ii) use more current psychometrically robust assessment tools for the measurement of effectiveness (based on the most recent empirical developments), (iii) reconsider the main outcome of Internet time reduction as it appears to be problematic, (iv) build methodologically sound evidence-based prevention programmes, (v) focus on skill enhancement and the use of protective and harm-reducing factors, and (vi) include IA as one of the risk behaviours in multi-risk behaviour interventions. These appear to be crucial factors in addressing future research designs and the formulation of new prevention initiatives. Validated findings could then inform promising strategies for IA and gaming prevention in public policy and education.

Treatment of Internet Addiction and Internet Gaming Disorder in Adolescence

Internet use is growing year after year and adolescents represent a large proportion of internet users. There is a scholarly interest in teen internet gaming disorder (IGD) and internet addiction (IA) is constantly increasing, but little is known about the treatments of IA and IGD. This study systematically reviews the literature of the last fifteen years, focusing on two main aspects: adolescence, and IA and IGD intervention programs. The inclusion criteria were (1) contain empirical data, (2) include an analysis relating to IA or IGD, (3) include teen samples aged between 13 and 19 years or with an average age within this range, and (4) provide a full-text article published in English. A total number of 17 papers were included, 7 focused on IA and 10 focused on IGD. Prevalence and different treatment-related outcomes are discussed.

Prediction of internet addiction based on information literacy among students of Iran University of Medical Sciences

Background

A considerable group of internet users consists of university users; however, despite internet benefits and capabilities, internet overuse is a threat to societies especially to young people and students.

Objective

The objective of this study was to determine the predictive role of information literacy in internet addiction among students of Iran University of Medical Sciences during 2016.

Methods

This analytical cross-sectional study was conducted in Iran University of Medical Sciences in 2016. Using stratified random sampling method, 365 students from different disciplines were selected. Measuring tools included the Information Literacy Questionnaire, the Yang Online Drug Addiction Scale and the General Health Questionnaire. The collected data were analyzed by Pearson product-moment correlation, independent samples t-test and multiple linear regression using SPSS version 22.

Results

According to this study, 31.2% of students had internet addiction (29.9% were mildly addicted and 1.3% had severe addiction). There was a significant and inverse relationship between higher information literacy and internet addiction (R= −0.45) and (p<0.001). The predictor variable “Information literacy” explained 20% of the variation in the outcome variable “Internet addiction”.

Conclusion

Students play a substantial role in promoting the cultural and scientific level of knowledge in society; the higher their information literacy, the lower the level of Internet addiction, and consequently the general health of society will improve. It seems that wise planning by authorities of Iran’s universities to prevent internet addiction and to increase information literacy among students is needed.