This document discusses internet addiction and provides an overview of the topic. It begins by outlining how internet addiction came to be studied as a disorder and some of the key players in the field. It then discusses attempts to diagnose internet addiction using psychological tests and molecular tools like examining Delta FosB expression. The dangers of internet addiction are examined by looking at case studies and the biological mechanisms involved like dopamine dysregulation. The document ends by proposing future directions for research, including examining the epigenetic factors related to increased vulnerability to internet addiction.

1. MUST TO KNOW
ABOUT
INTERNET
ADDICTION
for
14th EdukCircle International
Convention on Psychological
Communication
September, 2016
MILEN SANTIAGO RAMOS MA MSc PhD
Clinical Psychology * Neuroscience * Criminology
PSYCHSERV, Inc.

2. IN THIS DISCUSSION WE WILL TACKLE
HOW DID IT COME ABOUT
ATTEMPT TO DIAGNOSE
USING PSYCHOLOGICAL TEST
USING BIOMOLECULAR TOOLS
DETERMINATION OF DANGERS THAT IT
PRESENT/PROGNOSTICATION
PROMOTING INTERNET WELLNESS
FUTURE RESEARCH TO PURSUE
ROLE OF EPIGENETICS IN FURTHER
SPREAD (INTERGENERATIONAL
TRANSFER

3. BEHAVIORAL ABUSE/ ADDICTION
GAMBLING, SEX , INTERNET ,
PORNOGRAPHY
VS
PHYSIOLOGIC ABUSE /ADDICTION
ADDICTION TO COCAINE,
METHAMPHETAMINE HYDROCHLORIDE,
KETAMINE,BARBITURATES, ALCOHOL,
ECSTACY (PARTY DRUG)

4. Internet addiction disorder (IAD), now
more commonly called
problematic Internet use (PIU),
compulsive Internet use
(CIU), Internet overuse, problematic
computer use, or pathological computer
use, refers to excessive computer use
which interferes with daily life.

5. It is listed as a "condition for further study"
in DSM-5 from 2013, but not recognized as a
disorder.
HOW DID IT COME ABOUT

6. PLAYERS IN THE FIELD
IVAN GOLDBERGH
Eric Nestler
KIMBERLY YOUNG

7. IAD was originally
proposed as a disorder in a
satirical hoax by Ivan
Goldberg, M.D., in 1995
He took pathological
gambling as diagnosed by
the Diagnostic and
Statistical Manual of
Mental Disorders (DSM-IV)
as his model for the
description of IAD.

8. The IAT was utilized in
outpatient and inpatient
settings and adapted
accordingly to fit the needs of
the clinical setting. The IAT
was not validated during its
development, but later
studies have established its
validity in English, and also in
Italy and France, making it
the first global psychometric
measure.
Young KS. Internet
addiction: the emergence of a new clinical
disorder. Cyber Psychol Behav.1998;1:237–244.

9. The Chen Internet Addiction
Scale (CIAS) contains 26 items
ranked on a 4-point Likert
scale, wherein a higher total
score indicates a greater
severity of Internet addiction
symptoms. The CIAS was
revised to address
psychometric properties in
adolescents, as well adults.
According to the revised
version, Internet addiction is
prevalent in 18% of Hong Kong
Chinese adolescents
Ko CH, Yen JY, Chen CC. Proposed diagnostic criteria of Internet addiction
for adolescents. J Nerv Ment Dis. 2005;193:728–733. [PubMed]

10. Eric J. Nestler, M.D., Ph.D., is the Nash
Family Professor of Neuroscience,
Chairman of the Department of
Neuroscience and Director of the
Friedman Brain Institute at theMount
Sinai Medical Center in New York. His
focus
in neuropsychopharmacology concentrat
es on forming a molecular approach
to psychiatry and furthering the
understanding of the molecular basis of
both depression and drug addiction,
using animal models to study the way
drug use or stress affects the brain.His
addiction research largely centers
around ΔFosB (a master control protein
that induces addiction) and
associated epigenetic remodeling in
the medium spiny neurons of the nucleus
accumbens.
Molecular neurobiology of drug addiction. Chao J, Nestler EJ.Annu Rev Med. 2004;
55:113-32.

11. BIRTH OF ISIA
International Society on Internet Addiction
roger_ho @nuhs.edu.sg
SINGAPORE
kkmak@graduate.hku.hk
HONGKONG
harlinabahar@yahoo.co.uk
MALAYSIA
psychserv@gmail.com
PHILIPPINES
Hiroko Watanabe
watanabe@sahs.med.osaka-u.ac.jp
JAPAN
Dongil Kim
dikimedu@snu.ac.kr
SOUTH KOREA

12. ATTEMPT TO DIAGNOSE/IDENTIFY
USING PSYCHOLOGICAL TEST
USING MOLECULAR TOOLS

13. ATTEMPT TO DIAGNOSE/IDENTIFY
USING PSYCHOLOGICAL TEST
Problematic Internet Use Questionaire (PIUQ)
Thatcher et al, 2005
Internet Addiction Test (IAS)
Young, 1998
Goldberg Internet Addiction Disorder Scale (GIAD)
Armstrong et al, 2000
Chen Internet Addiction Scale
Yen et al, 2008 (CIAS)
Orman Internet Streee Scale (ISS) – French
VAlleur and Velea, 2002
From Problematic Internet Use
Jane Pei-Chen Chang MD,
MSc et al
Institute of Clinical Medical
Science, China Medical
University and Department
of Psychiatry, China Medical
University Hospital, Taichung,
Taiwan

14. TEMPORAL
PRESENTATION OF
SYMPTOMS
OF INTERNET
ADDICTION
AMONG FILIPINO
ADOLESCENTS
USING THE ISIA IAT
SCALE
At my end I did
tested the waters on
the psychological
effects of internet
exposure

15. The purpose of the study
is to develop stages of
symptoms of internet
addiction as a reflection
of development of
pathology thereby
aiding its recognition as a
disorder
CULLING OF DATA
Responses of one thousand adolescents were
used to determine which among the items in
the time referenced questionaires will give
statistically significant results
One thousand (1000) answered questionaires
was gathered by 10 students. Each handling 100
cases
It is expected to give out the best items
/behavior that will characterize one week use,
2 weeks use as well as 3 months use of internet
exposure.
CHARACTERIZATION OF THE STAGES
Initial stage - affect is very much affected (i.e. crying spells, loss of appetite,
talking less than usual, restlessness in sleep, talking less than usual – and also affecting
the vegetative functions . NOTE: there is no mention here yet whatsoever of the
internet
Middle stage- executive function seems to be in distress (i.e. lack of
concentration or restless ness, difficulties in keeping up with educational activities,
difficulties in look after oneself or taking responsibility for one s independence
Final stage- one s affective disposition and executive/decision making are down
….there is dependence ONLY on one thing …. Internet (i.e. feeling energized online,
feeling life is joyless without the internet, staying online for longer and longer periods of
time

16. prognostication

17. ATTEMPT TODIAGNOSE/IDENTIFY
USING MOLECULAR TOOLS
Addiction neurobiologists have revealed
that all addictions, both chemical and behavioral,
appear to share a single molecular switch

18. Delta fosb
FOSB or FosB is a protein that, in humans, is
encoded by the FOSB gene
The FOS gene family consists of 4 members:
FOS, FOSB, FOSL1, and FOSL2
the FOS proteins have been implicated as
regulators of cell proliferation, differentiation,
and transformation.
FosB has truncated splice variant

19. In the nucleus accumbens, ΔFosB functions as a "molecular
switch" and "master control protein" in the development of
an addiction in other words, once "turned on" (sufficiently
overexpressed) ΔFosB triggers a series of transcription events
that ultimately result in addictive behavior
A medical review from late 2014 argued
that accumbal ΔFosB expression can be used as an addiction
biomarker and
that the degree of accumbal ΔFosB induction by a drug is a
metric for how addictive it is relative to others

20. In the nucleus accumbens, ΔFosB functions as a
"molecular switch" and "master control protein" in the
development of an addiction in other words, once
"turned on" (sufficiently overexpressed) ΔFosB triggers a
series of transcription events that ultimately result in
addictive behavior
A medical review from late 2014 argued
that accumbal ΔFosB expression can be used as an
addiction biomarker and
that the degree of accumbal ΔFosB induction by a
drug is a metric for how addictive it is relative to
others

21. current recent assay used
WESTERN BLOT
One of the most powerful methods for detecting a particular protein
in a complex mixture combines the superior resolving power of gel
electrophoresis, the specificity of antibodies, and the sensitivity of
enzyme assays. Called Western blotting, or immunoblotting, this
three-step procedure is commonly used to separate proteins and
then identify a specific protein of interest
http://www.ncbi.nlm.nih.gov/books/NBK21589/figure/A651/?report=o
bjectonly

22. POSSIBLE PROBLEMS IN INTERNET
ADDICTION DETECTION
1) ANIMAL STUDIES/
POST MORTEM STUDIES
The challenge is its application in live
humans for treatment and prevention
purposes
2) PROBLEMS IN WESTERN BLOTS
Did you know that 41 percent of
researchers say their Western blots fail
at least 25 percent of the time?

23. DETERMINATION OF DANGERS
THAT IT PRESENT
In the fifth edition of the Diagnostic and
Statistical Manual of Mental Disorders
(DSM-5), Internet Gaming Disorder is
identified in Section III as a condition
warranting more clinical research and
experience.
But why did it call so much attention?

24. THE PHOTOS THAT YOU WILL SEE MAY
OFFEND YOUR SENSIBILITIES

25. CCTV footage shows gamer collapsing in internet
cafe

26. Player found braindead while playing online

27. Delta fosB and DOPAMINE
"Eric Nestler has shown how addictions cause
permanent changes in the brains of animals.
A single dose of many addictive drugs will produce
a protein, called delta FosB that accumulates in the
neurons. Each time the drug is used, more delta
FosB accumulates until it throws a genetic switch,
affecting which genes are turned on or off.

28. Flipping this switch causes changes that
persist long after the drug is stopped,
leading to irreversible damage to the brain’s
dopamine system and rendering the animal
far more prone to addiction.
Non-drug addictions, such as running and
sucrose drinking, also lead to the
accumulation of deltaFosB and the same
permanent changes in the dopamine
system."

30. DOWN REGULATION OF DOPAMINE
RECEPTORS
INHIBITION OF DOPAMINE
TRANSPORTER

31. Many recreational drugs, such
as cocaine and substituted dopamines, INHIBIT
the DOPAMINE TRANSPORTER (DAT), the protein
responsible for removing dopamine from the neural
synapse.
When DAT activity is blocked, the synapse floods
with dopamine and increases dopaminergic
signaling. When this occurs, particularly in the
nucleus accumbens increased D1 and decreased
D2 receptor signaling mediates the "rewarding"
stimulus of drug intake

32. CONTROVERSIAL DEATHS ON THE USE OF STIMULANTS
There is a strong suspicion that cocaine addict died from
mishandling of pollice officers and use of taser

33. During the height of cocaine
addiction many sudden deaths were
witnessed ………
the explanation of
which is called excited delusion

34. It was first identified on institutionalized
chronic psychiatric cases
One of the most serious psychiatric
sequelae of cocaine abuse is excited
delirium, which may be associated with
hyperthermia and sudden death.
Behaviorally, there was extreme
aggression or violence

35. Brain biomarkers for identifying
excited delirium as a cause of
sudden death.
2009 Sep 10;190(1-3):e13-9. doi: 10.1016/j.forsciint.2009.05.012. Epub 2009 Jun 21.
Mash DC, Duque L, Pablo J, Qin Y, Adi N, Hearn WL, Hyma BA, Karch SB, Druid H,
Wetli CV.
Department Neurology, Miller School of Medicine, University of Miami, 1501 NW 9th Avenue, Miami, FL 33136,
USA. dmash@med.miami.edu
1) CNS dysfunction of dopamine
signalling
2) presence of heat shock protein
(HSP 70)

36. HEAT SHOCK PROTEIN
important part of the cell's machinery for protein
folding, and
help to protect cells from stress
Hsp70 proteins can act to protect cells from thermal
or oxidative stress
Hsp70 seems to be able to participate in disposal of
damaged or defective proteins
Finally, in addition to improving overall protein
integrity, Hsp 70 directly inhibits apoptosis

37. Excited Delirium and its medical status
"Excited delirium is not a clinical entity of its own,
but a constellation of symptoms from a varied and
severe underlying process" (Manojlovic et al., 2005
p.38).
While the American Medical Association does not
recognize ED as a medical diagnosis or psychiatric
condition, the National Association of Medical
Examiners has recognized ED (Stephens, Jentzen,
Karch, Wetli, & Mash, 2004) for more than a
decade (Wetli, 2006)

38. CASCADES OF EVENTS LEADING TO DEATH
AMONG ON LINE GAMERS AND COCAINE
ADDICTIONS
TRIGGERED BY
DELTA FOSB, THE
MOLECULAR
SWITCH FOR
ADDICTION
CNS DYSFUNCTION
IN DOPAMINE
SIGNALING IS
PRECIPATED
ANGER /VIOLENCE
AS AN OUTSIDE
INFLUENCE AS A
REACTION OF THE
GAMER TO THE
GAME (I.E
REPEATED
FRUSTRATION OF
NOT WINNING) AND
IN THE CASE OF
THE DRUG ADDICT
THE THOUGHT
THAT HE WILL BE
CAUGHT) CREATE
THE EVENTUALITY
HEIGHTENED
STRESS LEADS TO
DYSAUTONOMIA
DEATH

39. DEATH ON INTERNET ADDICTION

40. PROMOTING INTERNET
WELLNES

42. LAWS ENACTED ROAD
HEALTH
INFORMATION
CAMPAIGN
ROAD

43. CREATIONS OF
NATIONAL LAWS,
BILLS AND
RESOLUTIONS INSTITUTIONAL
INITIATIVES i.e.
universities
COMMUNITY
SYNERGISTIC
EFFORTS

45. The Cybercrime Prevention Act of 2012 is the first law in the Philippines which
specifically criminalizes computer crime, which prior to the passage of the law had no
strong legal precedent in Philippine jurisprudence.
While laws such as the Electronic Commerce Act of 2000 (Republic Act No. 8792[
regulated certain computer-related activities, these laws did not provide a legal basis for
criminalizing crimes committed on a computer in general: for example, Onel de Guzman,
the computer programmer charged with purportedly writing the ILOVEYOU computer
worm, was ultimately not prosecuted by Philippine authorities due to a lack of legal basis
for him to be charged under existing Philippine laws at the time of his arrest

47. Future of internet
addiction study

48. Epigenetic
research
WHY IS EPIGENETIC RESEARCH APT IN OUR
CURRENT STATE OF AFFAIRS (I.E INTERNET
ADDICTION)
FILIPINO CHILDREN SHOWED THE
MOST VULNERABILITY

49. FACTS
Unicef showed that there are about three to six million Filipino children
left behind as parents pursue work abroad.The figure of affected
Filipino children casts a huge shadow when compared with Indonesia's
one million and Thailand's half a million.
Feminization” of migration has complicated the situation as it “implies
a redefinition of the economic role of women in society and within the
family as well.”
The absence of parents, creates “displacement, disruptions and
changes in care-giving arrangement.”
Such effects are more felt when it is the mother who works abroad, as
families go through more adjustments, than when it is the father who
goes to work abroad.
This is because men do not easily take up care-giving when they
assume the role of the mother

50. the social costs of labor migration cannot be denied, impacting severely on children,
psychologically and physically.
While children feel the economic benefits of parents working abroad, various studies
however show that children “do not recognize this as a form of care.” Thus, children of
migrants are less socially adjusted.
Those with absent mother “tend to be more angry, confused, pathetic and more afraid
than other children
Absence of the mother could be the most disruptive in the life of the children.”
The feeling of neglect and abandonment is most felt by the eldest daughter who
assumes the mother’s role in the family as the father struggles to take the mother’s
role.
Some report that such communication technologies as the mobile phone and the
internet have been instrumental in easing the anxiety arising from separation (Porio
2007). In Madianou and Miller’s (2011) study of long-distance parenting among Filipina
migrants in the UK, mothers felt empowered by the mobile phone, as it allowed them
to partially reconstruct their roles as parents. Others contend that ICT use can heighten
feelings of anxiety because of increased awareness of how different their family
situation is from the norm (Miller, 2007).

51. Labor migration of parents also skews the values of children as they view it
only in terms of “money equivalent.” With no proper guidance from the
parents, the regular remittances lead to materialistic attitude of children.
Children of migrants are also vulnerable to abuse and violence with the
parent’s absence
Children of OFWs, particularly of migrant mothers, are more ambivalent
about the benefits of transnational communication. Parreñas (2005)
describes young adult children’s feelings of abandonment and longing for
deeper emotional intimacy with their mothers that cannot be appeased
by weekly calls over the mobile phone. Moreover, such connversations
are typically “commodified,” in that the discourse is dominated by the
mothers’ admonitions that the child achieve in school or behave
appropriately in exchange for the mother’s sacrifices and economic
contributions. Negative feelings are allegedly diminished when children
receive support from extended families and communities, enjoy open
communication with their migrant parents, and clearly understand the
limited financial options that led their parents to migrate in the first place
(ibid.).

52. SO WHAT S A MUST TO KNOW
ABOUT
INTERNET ADDICTION?

53. WHEN YOU OPEN YOUR TABLET OR COMPUTER TO
USE IT
EXPECT THE CONSEQUENCES
IT IS NOT ALWAYS THAT YOU ARE THE ONE IN
CONTROL
IF YOU ARE NOT MINDFUL OF THAT ACTIVITY IT CAN
GRIP YOU AND CONTROL YOU
IT CAN EVEN OVERPOWER YOUR EMOTIONS
BE MINDFUL AND USE IT FOR YOUR OWN GOOD
PURPOSE

54. # self regulate
# self preserve
Salamat po