Slides about internet addiction

1. Internet
Addiction &
Its Treatment

2. Outline
□What is Addiction?
□What is Internet Addiction?
□T
ypes of Internet Addiction
□What makes internet use addictive?
□Symptoms & Complications
□Treatment

3. What is
addiction?
• Addiction is a treatable, chronic medical
disease involving complex interactions
among brain circuits, genetics,the
environment, and an individual’s life
experiences.People with addiction use
substances or engage in behaviors that
become compulsive and often continue
despite harmful consequences.
• Adopted by theASAM Board ofDirectors
September15,2019
•

4. Addiction
Chemical Behavioural

5. Common Core Qualities of Behavioural
Addiction
 Repetitive or compulsive engagement in a
behaviour despite negative consequences
 Diminished control over problematic behaviour
 Urge or craving prior to engagement in
problematic behaviour

6.  Impairment in major areas of functioning
 Tolerance
 Withdrawal

7. Maslow’s Hierarchy of Needs

9. What is Internet Addiction?
• Studies on Internet addiction originated in the US by Dr. Kimberly
Young, who presented the first research on Internet addiction in
1996 ,her paper “Internet Addiction: The Emergence of a New
Disorder”.

10. • Internet addiction is characterized by excessive or poorly controlled
preoccupations, urges or behaviours regarding computer use and
internet access that lead to impairment or distress.
• Shaw & Black 2008

11. Labels
Internet
Addiction
Disorder
Pathological
Internet use
Internet
Dependence
Internet
Overuse
Compulsive
Internet Use
Internet
Addiction

12. Terminology
• Different terminology  different criteria 
different assessment tools  different results
• Smart media overdependence:
• Salience
• Failure of Self-control
• Serious consequences

13. Overdependence
Addiction
Overuse
Dependence
Problematic
use
Salience
Self
Control
Failure
Serious
consequences

14. • Prevalence of problematic internet users are between
2.4% - 49.2%, depending on the populations studied and
questionnaires used (Mak 2014, Melissa 2015, Hasmida 2011,
Yong 2011, Zainuddin 2013, Moslehpour 2014)
• At risk: Young populations, prevalence rates of
problematic use of games/ online social networking - 8%
(King, Delfabbro, & Delfabbro, 2012)

15. Local Epidemiological Data
• The median total hours spent online by students
during school days was 3 hours & 5 hours on
weekends (Norharlina 2014)
• Social networking, getting information, playing
games online (18.9%) and downloading songs or
movies (Ke 2014, Mak 2014, Melisa 2015)
• Almost all of the students accessed the internet
from their own homes (Mak 2014, Melisa 2015)

16. Local Epidemiological Data:
Comorbidities
• Low self-esteem (Melisa 2015)
• Depression, social anxiety (Norharlina 2013, Normala 2013, Wan Salwina
2013, Ke 2014)
• Significant behavior and social functioning problems
(Norharlina 2013, Normala 2013, Wan Salwina 2013)
• Lower levels of personal contentment, sad, bored
and unhappy (Ke 2014)
• ADHD (Saramah 2014, Akramul 2016)

17. Excessive gaming/Internet use
• A significant public health burden across the world (Kuss & Lopez-
Fernandez, 2016; Mak et al, 2014)
• Links to:
• anxiety and depression (King, Delfabbro, Zwaans, & Kaptsis, 2013)
• physical health problems (Kelley & Gruber
, 2012)
• school disconnection (Lawrence et al., 2015)
• decreased job productivity and unemployment (Young, 2010)
• social isolation (Ceyhan & Ceyhan, 2008)

18. internet Addiction
• Double-edged sword
• Functional use vs excessive use of the Internet
• Differences with substance addiction (e.g. tobacco) –clear public
health burdens, clear research-informed guidelines on how harm is
caused
• Organized prevention efforts do not intend to use internet at its
lowest possible point, nor impose restrictions upon healthy users.

19. INTERNET ADDICTION DISORDER
(IAD) - DIAGNOSTIC
CRITERIA
• A maladaptive pattern of internet use, leading to clinically significant
impairment or distress as manifested by three (or more) of the following,
occurring at any time in the same 12-month period:
• (I)Tolerance, as defined by either of the following:
• (A) A need for markedly increased amounts of time on Internet to achieve
satisfaction
• (B) Markedly diminished effect with continued use of the same amount of
time on Internet.
• (Ivan Goldberg, M.D.)

20. • (II)Withdrawal, as manifested by either of the following:
• (A) The characteristic withdrawal syndrome
• (1) Cessation of (or reduction) in Internet use that has been heavy and prolonged.
• (2)Two (or more) of the following, developing within several days to a month after
Criterion 1:
• (a)psychomotor agitation –
• (b)anxiety –
• (c)obsessive thinking about what is happening on Internet –
• (d)fantasies or dreams about Internet –
• (e) voluntary or involuntary typing movements of the fingers.
• (3)The symptoms cause distress or impairment in social, occupational or other important
area of functioning
• (B)Use of Internet or a similar on-line service is engaged in to relieve or avoid
withdrawal symptoms

21. • (III)Internet is often accessed more often or for longer periods of time than was
intended.
• (IV)There is a persistent desire or unsuccessful efforts to cut down or control Internet
use.
• (V)A great deal of time is spent in activities related to Internet use
• (e.g. organizing files of downloaded materials; researching Internet vendors, trying new
browsers.)
• (VI)Important social, occupational, or recreational activities are given up or reduced
because of Internet use.

22. • DESTRUCTIVE CONSEQUENCES
• (VII)Internet use is continued despite knowledge of having a persistent or recurrent
physical, social, occupational, or psychological problem that is likely to been caused or
exacerbated by Internet use ie
• □ sleep deprivation, marital difficulties, lateness forearly morning appointments,
neglect of occupational duties.
• □ Isolation
• □ Job loss

23. ICD 11 Gaming Disorder
4 criteria Discarded criteria with
controversies
Loss of control Preoccupation
Prioritizing game over other
activities
Tolerance
Continued gaming despite
negative consequents
Withdrawal
Significant impairment Lying
Escape/mood modification

24. KW Beard 2005 -Assessment
• One of the more accepted diagnostic assessments of Internet Addiction
Disorder has been proposed by KW Beard’s 2005 article in CyberPsychology
and Behavior. Beard proposes five diagnostic criteria in the identification of
Internet Addiction Disorder in the general population:
• Is preoccupied with the Internet (constantly thinks about past use or future
use)
• Needs to use the Internet with increased amounts of time to gain satisfaction
• Has made unsuccessful efforts to control, cut back, or stop use of the Internet
• Is restless, moody, depressed, or irritable when attempting to control Internet
use
• Has stayed online longer than originally intended

25. • In addition, Beard (2005) suggests at least one of the following must also be
present in a diagnosis of Internet Addiction Disorder:
• Has jeopardized or risked the loss of a significant relationship,job,
educational, or career opportunity because of the Internet
• Has lied to family members, therapists, or others to conceal their involvement
with the Internet
• Uses the Internet as a way of escaping from problems or to relieve a
dysphoric mood (e.g., guilt, anxiety, depression, helplessness)

26. INTERNET ADDICTION COMPARED
TO SUBSTANCE ABUSE DISORDER
• Criteria for substance abuse that applies to Internet addiction:
• □ Recurrent substance use resulting in a failure to fulfill major role obligations
at work, school, or home
• □ Continued substance use despite having persistent or recurrent social or
interpersonal problems caused or exacerbated by the effects of the substance
(DSM-IV-TR,2000)

27. INTERNET ADDICTION COMPARED TO
IMPULSE
CONTROL DISORDER
• Criteria for impulse control disorder such as gambling that applies to Internet
addiction:
• □ Preoccupation with gambling
• □ Repeated unsuccessful efforts to control, cut back, or stop gambling
• □ Gambling as a way of escaping from problems
• □ The significant loss of a relationship, job, or educational or career opportunity because of
gambling

28. TYPES OF INTERNET
ADDICTION
Web surfer (Blogging)
Online Shopping
Pornography/Cybersexual
Chat rooms/online dating/social networking
Gaming (video/computer) and online gambling
Email

29. FOUR AREAS
WITH ADDICTIVE
POTENTIAL
• Internet-pornography
• Chat Apps (Whatsapp)
• Online-Games
• Internet-Gambling

30. WHAT MAKES
INTERNET USE
ADDICTIVE?
• It is accessible 24/7
• It can be anonymous
• It feels secure
• It is easy to use
• It provides the illusion of connection
• It can be inexpensive
• It is fun and very engaging

31. • Internet Addiction Disorder
, in addition to other
dependency disorders,seem to affect the
pleasure center of the brain.
• The addictive behavior triggers a release of
dopamine to promote the pleasurable experience
activating the release of this chemical.
• Over time,more and more of the activity is
needed to induce the same pleasurable response,
creating a dependency.

32. • According to the Variable Ratio Reinforcement Schedule (VRRS)theory, the
reason why you might be so addicted to Internet activity (e.g., gaming, gambling,
shopping, pornography, etc.), is because it provides multiple layers of rewards.
That is, your constant surfing of the Internet leads to multiple rewards that are
unpredictable.
• Perhaps your addiction to Facebook provides a multiple and unpredictable layer
of rewards in the sense that every time you sign on to read your updates, you get
repeated and unexpected good news.
• Each sign on gives you unpredictable results that keep you entertained and
coming back for more.

33. Complications

34. Physical
Complications
• Backache
• Carpal T
unnel Syndrome
• Headaches
• Insomnia
• Poor Nutrition (failing to eat or eating in
excessively to avoid being away from the
computer)
• Poor Personal Hygiene (e.g., not bathing
• to stay online)
• Neck Pain
• Dry Eyes and other Vision Problems
• Weight Gain or Loss

35. Family or Relationship Problems
• Marriages
• Dating relationships
• Parent-child relationship
• Close friendships

36. Work related or Academic
Problems
• More time is spent “researching” than actuallycompleting assignments.
• Incomplete or Missing Assignments
• Inability to concentrate on real life instruction
• Grades begin to decline
• Skipping classes to stay in chat room
• Absenteeism

37. COMPLICATIONS - PSYCHOLOGICAL
• Alcoholism: Alcohol is being used to get calmer but also to
enhance the sexual excitement.
• Substance abuse (from Cocain to Viagra)
• Depressive Episodes: caused by negative psychosocial
consequences of the cyber-addiction or the break-up of
relationships, isolation
• Suicidal thoughts: out of despair and hopelessness
• Anxiety

38. • Obsessive-Compulsive Behavior: Online addicts develop complex
rituals to conceal their dependency and to make sure their family,
colleagues or company cannot access their “hidden area”.
• Paranoid Thinking: Fear of being discovered and being ashamed
lets them associate even marginal observations with personal
threats.

39. DIFFERENCES
BETWEEN MEN
AND WOMEN
• MEN
□ Kick usually through visual material
□ Sexual excitement with masturbation.
□ Collecting mania (thousands of pictures etc.)
□ Tendency towards violent content.
• WOMEN:
□ „Kick“ through communication (Chat).
□ Romantic stories and images (80 %)
□ Sexual excitement is secondary.

40. Assessment tools
Young’s Internet Addiction T
est
Problematic Internet Use Questionnaire
(PIUQ)
Compulsive Internet Use Scale (CIUS)

41. What are the Treatment Options?
The first step in treatment is the recognition that a problem exists.
Studies have show that self-corrective behavior can be achieved and
successful. Corrective behaviors include software that controls the
Internet use and types of sites that can be visited –with the majority of
professionals in agreement that total abstinence from the computer is
not an effective method of correction.

42. Pharmacological
• Some professionals argue that medications are effective in
the treatment of Internet Addiction Disorder –because if
you are suffering from this condition, it is likely that you are
also suffering from an underlying condition of anxiety and
depression
• It is generally thought that if you treat the anxiety or
depression, the Internet Addiction may resolve in step with
this treatment approach.

43. Non Pharmacological
• Individual, group, or family therapy
• Behaviour modification
• Dialectical Behavioral Therapy (DBT)
• Cognitive Behavioral Therapy (CBT)
• Equine Therapy
• Art Therapy
• Recreation Therapy
• Reality Therapy

44. Early interventions & solution for internet
addiction
1. Parental knowledge and awareness
2. Parental gadget/internet use
3. Limit-setting
4. Alternative activities
5. T
alk early & often about possible harms
6. Emotional connectedness
7. Balance
8. Staying Safe
9. The bigger picture
10. Update ourselves

46. Acknowledgement
1. Dr. Muhammad Adeeb, PAdU Academic Teaching Session
2. Dr. Norliza Chemi, Northern Addiction Updates 2021, August 2021
3. Dr. Harlina Bahar

47. THANK YOU!
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