Clinical Psychology
and Psychotherapy

Clinical Psychology and Psychotherapy

Internet Use Disorder: Treatment

Even though Internet Use Disorder has been extensively discussed in the media, there have been only a few double-blind, controlled trials on the treatment of Internet Use Disorder. Most of the previous treatment studies either used inconsistent criteria to define Internet Use Disorder or lacked an adequate methodological quality in assessing the therapeutic outcome, or both.

As far as is known, psychotherapy, especially Cognitive Behavioral Therapy (CBT), and self-help programs seem to be effective.

Based on the experience of the treatment of other addicitive or compulsive disorders, Psychoeducation and Family Counseling might be helpful.

So far, there are no sufficient data on the pharmacotherapy of Internet Use Disorder. The use of antidepressants, mood stabilizers, anxiolytics, and of Naltrexone has been proposed.

Psychotherapy

Psychotherapy is the proclaimed “sine qua non” in treating  Internet Use Disorder. In complete disregard of the high prevalence rates and the impact of Internet Use Disorder on the persons affected, only a handful of studies have been conducted on the causes and treatment options of this disorder.

Psychoeducation

In accordance to the findings on other disorders of obsssive-compulsive- or addictive nature, psychoeducation seems to be an important tool in the treatment of Internet Use Disorder. Clinical studies on this subject have yet to be published.

Cognitive Behavioral Therapy (CBT)

As mentionend above, only few studies on the treatment of Internet Use Disorder have been published. Young reports on positive effects of Cognitive Behavioral Therapy (CBT) in the treatment of patients with Internet Use Disorder (cf. Young 2007).

Du et al. reported on the therapeutic effectiveness of school-based  group cognitive behavioral therapy (CBT) for Internet addiction in adolescents. In a randomized, controlled trial including 56 patients, aged 12-17 years,  group cognitive behavioral therapy for Internet addiction in adolescent students proved to be effective, particularly in improving emotional state and regulation ability, behavioral and self-management style (cf. Du 2010).

There are several more clinical studies on CBT for Internet Use Disorder from China (cf. Bai 2007, Cao 2007, Fang-ru 2005, Lanjun 2009, Li 2009, Rong 2006, Zhu 2009), who have not been published in English yet.
 

Acceptance and Commitment Therapy (ACT)

Twohig and Crosby treated 6 male adults, who reported symptoms of problematic Internet pornography viewing,  in eight 1.5-hour sessions of Acceptance and Commitment Therapy (ACT). The treatment resulted in an 85% reduction in viewing at posttreatment with results being maintained at 3-month follow-up (83% reduction) (cf. Twohig 2010).
 

Familiy Counseling and Teacher Education

There are some reports, that familiy counseling and teacher education could be helpful in treating and preventing Internet Use Disorder (cf. Du 2010, Orzack 2006).

© Sandra Elze, M.D. & Michael Elze, M.D.
Prien am Chiemsee / Rosenheim, www.Dr-Elze.com
 

 

Pharmacotherapy

Few studies on the pharmacotherapy of Internet Use Disorder have been published, and most of these studies do not meet criteria of a a double-blind, placebo-controlled design.

Escitalopram

Dell'Osso et al. treated a small group of patients with Internet Use Disorder (19 adults, 14 completers) with escitalopram, starting with an initial dose of 10 mg/day and an increase to 20 mg/day. The open-label treatment with escitalopram was associated with an improvement of Internet Use Disorder symptoms (cf. Dell'Osso 2008).
 

Bupropion

Han et al. treated 11 patients who met criteria for Internet video game addiction (IAG) with bupropion SR (bupropion sustained release). After 6 weeks of bupropion-treatment the subjects showed a decrease in craving for Internet video game play, total game play time, and cue-induced brain activity in dorsolateral prefrontal cortex  (cf. Han 2010).

Methylphenidate

Han et al. treated 62 children with attention-deficit/hyperactivity disorder (ADHD) who showed some symptoms of Internet Use Disorder with methylphenidate. After 8 weeks of treatment, the Young's Internet Addiction Scale - Korean version (YIAS-K) scores and Internet usage times were significantly reduced (cf. Han 2009).

Naltrexone

In a case report Bostwick et al. describe the treatment of a patient  who sufffered from compulsive Internet use for sexual gratification with naltrexone (cf. Bostwick 2008).

© Sandra Elze, M.D. & Michael Elze, M.D.
Prien am Chiemsee / Rosenheim, www.Dr-Elze.com
 

 

Multimodal Treatment

As with other mental health disorders, eg. depression or anxiety disorders, multimodal treatment appears to be the most promising way to treat Internet Use Disorder. As mentionend above, further studies are needed.

© Sandra Elze, M.D. & Michael Elze, M.D.
Prien am Chiemsee / Rosenheim, www.Dr-Elze.com
 

 

Ongoing Clinical Trials

Effects of a Manualized Short-term Treatment of Internet and Computer Game Addiction (STICA)

The Johannes Gutenberg University of Mainz (Germany) is conducting a multi-center, randomized,  single blind trial to determine the efficacy of a manualized Short-term Treatment of Internet and Computer game Addiction (STICA) (cf. Jäger 2012).

Further information >>

 

No further ongoing clinical trials have been reported.

© Sandra Elze, M.D. & Michael Elze, M.D.
Prien am Chiemsee / Rosenheim, www.Dr-Elze.com
 

 

Further Reading...

 

“Internet Addiction: A Handbook and Guide to Evaluation and Treatment”

by K.S. Young and C. Nabuco de Abreu (Editors)

Kimberley S. Young, the researcher who first brought clinical attention to the issue of problematic Internet use, and Christiano Nabuco de Abreu, director of the Integrated Impulsive Disorders Outpatient Unit at the University of San Paulo, provide with “Internet Addiction - A Handbook and Guide to Evaluation and Treatment” an up to date overview on Internet addiction, the treatment options and strategies for prevention.

This book on Amazon.com >>

 

References

Internet Use Disorder: Treatment

Textbooks / Guides

Young KS (1998 a). Caught in the net. How to recognize the signs of internet addiction and a winning strategy for recovery. New York: John Wiley & Sons.
This book on Amazon.com >>

Young KS, Nabuco de Abreu C (2011). Internet Addiction: A Handbook and Guide to Evaluation and Treatment. Hoboken: John Wiley & Sons.
Dieses Buch bei Amazon.de >>

 

Meta-Analysis / Reviews

Byun S, Ruffini C, Mills JE, Douglas AC, Niang M, Stepchenkova S, Lee SK, Loutfi J, Lee JK, Atallah M, Blanton M (2009). Internet addiction: metasynthesis of 1996-2006 quantitative research. Cyberpsychol Behav 12(2): 203–7.
Abstract >>

Cash H, Rae CD, Steel AH, Winkler A (2012). Internet Addiction: A Brief Summary of Research and Practice. Curr Psychiatry Rev 8(4): 292–8.
Abstract >>
Full text (pdf) >>

King DL, Delfabbro PH, Griffiths MD, Gradisar M (2011). Assessing clinical trials of internet addiction treatment: A systematic review and CONSORT evaluation. Clinical Psychology Review 31: 1110–6.

Young KS (2009). Internet addiction: Diagnosis and treatment considerations. Journal of Contemporary Psychotherapy 39: 241–46.

Weinstein A, Lejoyeux M (2010). Internet addiction or excessive Internet use. The American Journal of Drug and Alcohol Abuse. 36(5): 277–83.
Abstract >>

Winkler A, Dörsing B, Rief W, Shen Y, Glombiewski JA (2013). Treatment of internet addiction: A meta-analysis. Clinical Psychology Review 33: 317–329.
Abstract >>

Young KS (1998 b). Internet addiction: The emergence of a new clinical disorder. Cyberpsychol Behav 1(3): 237–44.
Abstract >>

 

Original Research Articles / Clinical Trials

Bai Y, Fan FM (2007). The effects of group counseling on internet-dependent college students [Article in Chinese]. Chinese Mental Health Journal 21(4): 247–50.

Bostwick JM, Bucci JA (2008). Internet sex addiction treated with naltrexone. Mayo Clin Proc 83(2):226-30.
Abstract >>

Cao F-L, Su L-Y, Gao X-P (2007). Control study of group psychotherapy on middle school students with internet overuse [Article in Chinese]. Chinese Mental Health Journal 21(5): 346–9.

Dell'Osso B, Hadley S, Allen A, Baker B, Chaplin WF, Hollander E. (2008). Escitalopram in the treatment of impulsive–compulsive Internet usage disorder: an open-label trial followed by a double-blind discontinuation phase. J Clin Psychiatry. 2008 Mar;69(3):452-6.
Abstract >>

Du YS, Jiang W, Vance A (2010). Longer term effect of randomized, controlled group cognitive behavioural therapy for Internet addiction in adolescent students in Shanghai. Aust N Z J Psychiatry 44(2): 129-34.
Abstract >>

Fang-ru Y, Wei H (2005). The effect of integrated psychosocial intervention on 52 adolescents with internet addiction disorder [Article in Chinese]. Chinese Journal of Clinical Psychology 13(3):343–5.

Han DH, Lee YS, Na C, Ahn JY, Chung US, Daniels MA, Haws CA, Renshaw PF. (2009). The effect of methylphenidate on Internet video game play in children with attention-deficit/hyperactivity disorder. Compr Psychiatry 50(3):251-6.
Abstract >>

Han DH, Hwang JW, Renshaw PF (2010). Bupropion sustained release treatment decreases craving for video games and cue-induced brain activity in patients with Internet video game addiction. Exp Clin Psychopharmacol 18(4): 297-304.
Abstract >>

Jäger S, Müller KW, Ruckes C, Wittig T, Batra A, Musalek M, Mann K, Wölfling K, Beutel ME (2012). Effects of a manualized short-term treatment of internet and computer game addiction (STICA): study protocol for a randomized controlled trial. Trials 13: 43.
Full text (pdf) >>

Kim JU (2008). The effect of a R/T group counseling program on the internet addiction level and self-esteem of internet addiction university students. International Journal of Reality Therapy 27: 4–12.

Lanjun Z (2009). The applications of group mental therapy and sports exercise prescriptions in the intervention of internet addiction disorder [Article in Chinese]. Psychological Science (China), 32, 738–41.

Li G, Dai X-Y (2009). Control study of cognitive–behavior therapy in adolescents with internet addiction disorder [Article in Chinese]. Chinese Mental Health Journal 23(7 ):457–70.

Orzack MH, Voluse AC, Wolf D, Hennen J (2006). An ongoing study of group treatment for men involved in problematic internet-enabled sexual behavior. Cyberpsych Behav 9(3) 348–60
Abstract >>

Rong Y, Zhi S, Yong Z (2006). Comprehensive intervention on internet addiction of middle school students [Article in Chinese]. Chinese Mental Health Journal 19(7): 457–9.

Shek, D. T. L., Tang, V.M. Y., & Lo, C. Y. (2009). Evaluation of an internet addiction treatment program for Chinese adolescents in Hong Kong. Adolescence, 44, 359–373.

Twohig MP, Crosby JM (2010). Acceptance and commitment therapy as a treatment for problematic internet pornography viewing. Behav Ther 41(3): 285–295.
Abstract >>

Young KS (2007). Cognitive behavior therapy with internet addicts: Treatment outcomes and implications. Cyberpsychol Behav 10(5): 671–9.
Abstract >>

Zhu TM, Jin RJ, Zhong XM (2009). Clinical effect of electroacupuncture combined with psychologic interference on patient with internet addiction disorder [Article in Chinese]. Chinese Journal of Integrated Traditional and Western Medicine 29(3): 212–214.
Abstract >>

Internet Use Disorder: Reviews
 

Cash H, Rae CD, Steel AH, Winkler A (2012). Internet Addiction: A Brief Summary of Research and Practice. Curr Psychiatry Rev 8(4): 292–8.
Abstract >>
Full text (pdf) >>

Chakraborty K, Basu D, Vijaya Kumar KG (2010). Internet addiction: consensus, controversies, and the way ahead. East Asian Arch Psychiatry 20(3): 123-32.
Abstract >>
Full text (pdf) >>

Huang XQ, Li MC, Tao R (2010). Treatment of Internet Addiction. Current Psychiatry Reports 12(5): 462-70.
Abstract >>

Petersen KU, Weymann N, Schelb Y, Thiel R, Thomasius R (2009). Pathologischer Internetgebrauch - Epidemiologie, Diagnostik, komorbide Störungen und Behandlungsansätze. Fortschr Neurol Psychiatr 77(5):263-71.
Abstract >>

Peukert P, Sieslack S, Barth G, Batra A (2010). Internet- and computer game addiction: Phenomenology, comorbidity, etiology, diagnostics and therapeutic implications for the addictives and their relatives. Psychiatr Prax 37(5): 219-24.
Abstract >>

Shaw M, Black DW (2008). Internet addiction: definition, assessment, epidemiology and clinical management. CNS Drugs 22(5): 353-65.
Abstract >>

van Rooij AJ, Zinn MF, Schoenmakers TM, van de Mheen D (2012). Treating Internet Addiction With Cognitive-Behavioral Therapy: A Thematic Analysis of the Experiences of Therapists. Int J Ment Health Addiction 10(1): 69-82.
Abstract >>

Winkler A, Dörsing B, Rief W, Shen Y, Glombiewski JA (2013). Treatment of internet addiction: A meta-analysis. Clinical Psychology Review 33: 317–329.
Abstract >>

Wölfling K, Bühler M, Leménager T, Mörsen C, Mann K (2009). Gambling and internet addiction. Review and research agenda [Article in German]. Nervenarzt 80(9): 1030–9.
Abstract >>

Young KS (1998 a). Caught in the net. How to recognize the signs of internet addiction and a winning strategy for recovery. New York: John Wiley & Sons.
This book on Amazon.com >>

Young KS (1998 b). Internet addiction: The emergence of a new clinical disorder. Cyberpsychol Behav 1(3): 237–44.
Abstract >>

 


© Sandra Elze, M.D. & Michael Elze, M.D.
Prien am Chiemsee / Rosenheim, www.Dr-Elze.com
 

 




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© Sandra Elze, M.D. & Michael Elze, M.D.
Prien am Chiemsee / Rosenheim, www.Dr-Elze.org
Last updated: 03-24-2016
 

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