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  • Chapter 14:
  • “INTERNET ADDICTION: THE EMERGENCE OF A NEW CLINICAL DISORDER” byYoung, K. University of Pittsburgh at Bradford Published in CyberPsychology and Behavior, Vol. 1 No. 3., pages 237-244, Paper presented at the 104th annual meeting of the American Psychological Association, Toronto, Canada, August 15, 1996.Young, K. S. (1996). Pathological Internet Use: A case that breaks the stereotype. Psychological Reports, 79, 899-902.Young, K. S. (1996). Caught in the Net, New York: NY: John Wiley & Sons. p. 196.
  • If you are a heroin abuser and you want to take home a free dose of methadone then you must turn up negative drug screens 5x in a week.
  • CBT shown to be an effective treatment for compulsive disordersmonitor thoughts identify thoughts that trigger addictive feelings and actionslearn to respond with new coping skills and ways to prevent relapseCognitions: correct distorted, negative thoughts: e.g., “Life is always unfair to me.” Behavior: -establish baseline of compulsive behaviors-moderate online behaviors so dysfunctional behaviors discontinued-non-online computer life (social, occupational) enhanced
  • 70-90% of students procrastinate before beginning an academic assignmentTime management = > better predictor of GPA than SAT’s4 personality factors related to procrastinating:highly distractible, low organization skillsfear of failureperfectionismpassive aggressive1. Negative impact on quality of work (Tice and Baumeister, 1997)2. more stress from last minute work anxiety and ill health effects (Tice and Baumeister, 1997)3. failure to allot enough time/plan forinterruptions > leads to trying to multitask insteadof planning and blocking out time > task may notget done. desire to minimize time on task – safeguard personal time2. desire to optimize efficiency – concentrate academic work into focused time frame3. closer proximity to the reward of completing task/getting feedback – get the “rush” of sudden release of stress
  • P+of+a+ch+4+++2+11+14 1

    1. 1. Coping Process Chapter 4 February 11, 2014
    2. 2. Clarification • What is the difference between COPING and ADJUSTMENT?
    3. 3. Clarification • COPING=>efforts to master, reduce, or tolerate demands created by “stress” • ADJUSTMENT=>psychological processes through which people manage or cope with the demands and challenges of everyday life. • The stress response (physiological) requires some behavior
    4. 4. Seesaw Metaphor • Differently weighted bodies desire the pleasure of seesawing 0000 00 __________________________ ^ Adjusting=decision on where to sit Coping=action of assuming position & riding
    5. 5. Overview of Coping • When various needs are strong and persistent, we experience heightened arousal (stress) • Meeting important needs tends to reduce stress levels, momentarily, back to optimal • Coping is about restoration of homeostasis
    6. 6. Recall Maslow’s Hierarchy of Needs • Physiological Needs=>Air, Water, Food, Temperature Regulation, Homeostasis (e.g., between rest and activity), (sex) • Social Needs=>Affiliation, Intimacy, Family, (sex) • Having met needs, through coping behaviors, we experience: Satisfaction, Fulfillment, Safety, Homeostasis
    7. 7. Figure 2.15 Maslow’s hierarchy of needs. According to Maslow, human needs are arranged in a hierarchy, and individuals must satisfy their basic needs first, before they progress to higher needs. In the diagram, higher levels in the pyramid represent progressively less basic needs. People progress upward in the hierarchy when lower needs are satisfied reasonably well, but they may regress back to lower levels if basic needs cease to be satisfied.
    8. 8. Needs=>Coping Behaviors=>Satisfaction • Needs can be personality based • Needs can vary in importance from time to time • Needs can be related to need satisfaction in the past or imagined future • Needs tend to be cyclical • Needs are ever present through life
    9. 9. Coping Strategies of Limited Value • Giving Up=>”learned helplessness” • Acting Aggressively=>cyber-bullying • Indulging Yourself=>booze, carbs, drugs, movies, internet addiction • Blaming Yourself=>negative self talk • Defensive Coping
    10. 10. Defensive Coping, fig. 4.3 • Defense Mechanisms for Coping: Denial of reality Fantasy Intellectualization Undoing Overcompensation
    11. 11. Constructive Coping, fig. 4.4 • Appraisal Focused -detecting & disputing negative self talk *Problem Focused -seek social support & impulse control time management, better assertiveness *Emotion Focused -releasing pent up emotions, exercise meditate
    12. 12. Rational-Emotive Behavior Therapy Albert Ellis (1913-2007)=> -altering one’s patterns of irrational thinking to reduce maladaptive emotions and behavior -Catastrophic thinking=>unrealistic appraisals of stress that exaggerate the magnitude of one’s problems
    13. 13. Altering Client’s Patterns of Irrational Thinking
    14. 14. Ellis A=>Activating event produces stress B=>Belief system=> negative thinking, catastrophic thinking, “musterbating” C=>Consequences of negative thinking results in emotional distress (anger, outrage, anxiety, depression)=> sympathetic ns overdrive=>coping strategies of limited value
    15. 15. Ellis: The roots of catastrophic thinking • MUSTERBATING -I must have acceptance and love from certain people -I must perform well in all endeavors -others must behave the way I believe -Events must go the way I like
    16. 16. Other roots of negative thinking • Upbringing • Life experiences • Personality • Inheritance
    17. 17. Problem-Focused Constructive Coping • Clarify the problem=>break it down into simple components (ex., how many stressors do I have), prioritize, plan *Generate alternative course of action=> “plan A,” “plan B,” “plan C” *Evaluate alternatives and select a course of action *Take action while maintaining flexibility
    18. 18. Emotion-Focused Constructive Coping Emotional Intelligence=>the ability to perceive, regulate, use and express emotion (love, sadness, fear, anger, joy) Forgiveness Exercise Meditation/Relaxation Spirituality
    19. 19. Self-Actualized People Cope in Healthy Ways (fig 2.18) • • • • • • • • • • • • • Clear perception of reality Spontaneity, simplicity and naturalness Problem centered (“PASSION”) Detachment and need for privacy Autonomy (avoid “herd” thinking only) Continued freshness of appreciation Mystical peak experiences Feeling of kinship (one with human race) Strong friendships (but limited in number) Democratic character structure (egalitarian) Ethical distinction between means and ends Philosophical, non-hostile sense of humor Balance between polarities in personality
    20. 20. Mindfulness and Coping, 3 minute meditation http://www.youtube.com/watch?v=cDflnqo0TQ s
    21. 21. • Meditation (10-20 min, 1x daily) 1. Breath Watching 2. Exhale Pause Watching: Inhale (“I”), Exhale (“AM”), Pause (Very..Relaxed..And..At..Peace.. Right..Now) 3. Mantra 4. Mind Watching (use monitoring words @ every 5 seconds like “image,” “words,” “quiet.”
    22. 22. RSA Breathing Respiratory Sinus Arrhythmia Inhale 3 seconds, exhale 7 (more PS) Inhale 7 seconds, exhale 3 seconds (more S) Inhale 5 seconds, exhale 5 seconds (maintenance)
    23. 23. Part 2 • Self-indugence as a way of coping • Methods of reducing addictive behavior
    24. 24. Self-Indulgence is a common “coping” response to stress (Tice et al, 2001) • • • • • • • • • Eating sweets and starches – rarely broccoli Restricting food intake Drinking alcohol Getting high Using other kinds of drug: opiates Nicotine – smoking cigarettes, chewing shopping Gambling Internet immersion
    25. 25. Forms of Internet addiction • • • • • • shopping online sex pornography online gaming online gambling social networks • Global pattern of Internet use (Davis, 2001) – global problem with addiction
    26. 26. Internet addiction • Kimberly Young (1996, 1998): • Internet addiction: spending an inordinate amount of time on the Internet and inability to control online use • Used as a coping strategy – immerse oneself in online world
    27. 27. Signs of addiction: Young’s shortened Internet addiction test • Do you feel preoccupied with the Internet (think about previous online activity or anticipate next online session)? • Do you feel the need to use the Internet with increasing amounts of time in order to achieve satisfaction? • Have you repeatedly made unsuccessful efforts to control, cut back, or stop Internet use? • Do you feel restless, moody, depressed, or irritable when attempting to cut down or stop Internet use? • Do you stay on-line longer than originally intended? • Have you jeopardized or risked the loss of significant relationship, job, educational or career opportunity because of the Internet? • Have you lied to family members, therapist, or others to conceal the extent of involvement with the Internet? • Do you use the Internet as a way of escaping from problems or of
    28. 28. Addictive behaviors: how are they alike? • Do you feel preoccupied with __________________)? • Do you feel the need to use ________with increasing amounts of time in order to achieve satisfaction? • Have you repeatedly made unsuccessful efforts to control, cut back, or stop _____________use? • Do you feel restless, moody, depressed, or irritable when attempting to cut down or stop __________ use? • Do you participate in ________ longer than originally intended? • Have you jeopardized or risked the loss of significant relationship, job, educational or career opportunity because of_____________________? • Have you lied to family members, therapist, or others to conceal the extent of involvement with_______________? • Do you use _____________ as a way of escaping from problems or of relieving a dysphoric mood?
    29. 29. The Problematic and Risky Internet Use Screening Scale (PRIUSS) for Adolescents and Young Adults • May affect between 4‐15% of adolescents and young adults • Average score of average users: 14 +/- 9.6 (1 S.D.) • Average score of at-risk users: 21 +/- 12.1 (1 S.D.) • If use <= 6 hours per day =average • If use > 6 hours per day = high risk
    30. 30. In the news: almost recognized as a real addiction Video clip: http://www.youtube.com/watch?v=wtA-AmrbX4Q -DSM 5: Both sex and Internet addictions are included in appendix -Internet has no boundaries -like gambling you are looking for the “hit” – the video or message that will be exciting/interesting -will power gets exhausted -suggests limiting time on Internet
    31. 31. Signs of Internet addiction • sense of being out of control with time expended • anxious, depressed or empty when not online use is so excessive it interferes with work, school, home life – disruption of time • dysfunctional use leads to secrecy and hiding dependence
    32. 32. Lauren Jelenchick, MPH Candidate Adolescent Health Research Team, Department of Pediatrics, Univ. of Wisconsin, Madison Factor 1 – Social Consequences • Problems with communicating face to face • Experience increased social anxiety • Fail to create real-life relationships • Offline relationships suffer • Choose to socialize online instead of in-person • Skip out on social events
    33. 33. Lauren Jelenchick (2012, 2013) Factor 2 – Emotional Consequences • Feel anxious when away from internet • Feel irritated when not using the internet • Experience feelings of withdrawal when not using the internet • Feel angry when away from the internet • Feel vulnerable when the internet isn't available
    34. 34. Lauren Jelenchick (2012, 2013) Factor 3 – Risky and Impulsive Internet Use • Allow time on the internet to negatively affect your school performance • Lose motivation to do other things that need to get done • Neglect responsibilities • Avoid other activities in order to stay online • Put internet use in front of important, everyday activities • Lose sleep due to nighttime internet use • Use the internet excessively
    35. 35. In the news: almost recognized as a real addiction Video clip: In 2008, China began to list Internet addiction as a clinical diagnosis category http://www.youtube.com/watch?v=jqctG3NnDa0 China’s Web Junkies 1:30-7:00 minutes Internet Addiction Treatment Center near Beijing -DSM 5: Both sex and Internet addictions are included in appendix -Internet has no boundaries -like gambling you are looking for the “hit” – the video or message that will be exciting/interesting -will power gets exhausted -suggests limiting time on Internet
    36. 36. China’s Web Junkies (New York Times 1/14) youtube commentary:”this is completely retarded treating people like this, just limit their usage, learn how to set the router for limited use. The only thing you accomplish by doing this to your children is turning them into mental cases”
    37. 37. Problem-focused constructive coping: reducing addictive behaviors The process of change: problem =>motivation to change =>method of change Problems are there to be solved.
    38. 38. 4 steps in systematic problem solving • “Systematic Problem Solving” is a step-bystep technique for tackling problems (pp. 113 in text) 1. clarify the problem – often people do not know what, exactly, is causing stress. 2. generate alternative courses of action – use “brainstorming” to generate ideas. 3. evaluate your alternatives and select a course of action. 4. take action while maintaining flexibility
    39. 39. Chapt. 4: Coping and hoping to change • Most people with stress and coping problems know they need to change but………….. • most people don’t change, e.g., Internet addiction, eating disorders, alcohol anddrug dependency, procrastination, poor time management, etc. • Why not? • inspirations and barriers to change
    40. 40. Why not change if person admits there is a problem? When addicted/dependent - motivation to change varies Person: • may be perceive self to be weak and incapable • usually ambivalent – pros and cons • sees recovery or change as a distant dream or fantasy • motivation fluctuates
    41. 41. 3 methods of reducing addictive behavior • Contingency management: one of largest effect sizes with addictions=>based on behavior therapies • Motivational interviewing • CBT =>cognitive behavior therapy
    42. 42. Motivational interviewing What can we do to increase motivation to change and improve coping? 2 ways to increase motivation: 1. Increase internal motivation 2. Focus on the positives for staying the same
    43. 43. five types of motivation: Self-Determination Theory (Vansteenkiste et al, 2005) Type of motivation amotivation introjected external motivation motivation identified motivation intrinsic motivation Motivational Force discourage -ment and helplessness expectations/ rewards/ punishments from others & environment guilt, shame, guiltinducing internal pressures personal values/ Commitment external internal enjoyment, pleasure, interest, satisfying, fun internal Locus of impersonal external causality
    44. 44. Motivation to give up internet addiction or alcohol? Intrinsic motivation? Identified motivation (personal values)? Introjected (from someone else) motivation? External motivation? (Expect reward or punishment from outside self)
    45. 45. Decisional balance sheet applied to addiction (Miller and Rollnick, 2002) Positives for staying the same Negatives of change It is the positives for staying the same that keep people stuck Negatives for staying the same Positives of change
    46. 46. Young’s solution: Cognitive Behavior Therapy (CBT) CBT is effective treatment for compulsive disorders Thoughts • monitor thoughts • identify trigger thoughts: “Life is unfair to me.” • learn to respond with new coping skills: Behavior  establish baseline of compulsive behaviors  moderate/eliminate dysfunctional behaviors  enhance non-online computer life (social, occupational)
    47. 47. Optional slides about applying decisional balance sheet to eating disorders
    48. 48. Motivating people: pros and cons example - pros and cons of eating disorders (Gale et al, 2006) Goal: acknowledge, with patient, ways in which eating disorders are either adaptive (friend) or problematic (enemy) How are ED’s adaptive? • In the Gale study (roughly 200 Ss) , the more the pros endorsed and the fewer the cons or negatives endorsed the more positively people feel about remaining with ED
    49. 49. Decisional balance sheet (Miller and Rollnick, 2002) Positives for staying the same: weight management skill to feel good about Negatives of change: possible weight gain It is the positives for staying the same that keep people stuck Negatives for staying the same: continued bone loss Positives of change: more time spent on other activities
    50. 50. pros for anorexia (Gale et al, 2006) safe and structured: -makes me feel safe -gives structure to my life -helps keep control -organizes world -gives purpose -feel protected -secure -get me through life -dependable/consistent skill/special: -something I am good at -ED a skill - in ED, I am an expert -I can do at least one thing better than others -lifts me up above others

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