Internet addiction and problematic Internet use: A systematic review of clinical research

AIM: To provide a comprehensive overview of clinical studies on the clinical picture of Internet-use related addictions from a holistic perspective. A literature search was conducted using the database Web of Science.METHODS: Over the last 15 years, the number of Internet users has increased by 1000%, and at the same time, research on addictive Internet use has proliferated. Internet addiction has not yet been understood very well, and research on its etiology and natural history is still in its infancy. In 2013, the American Psychiatric Association included Internet Gaming Disorder in the appendix of the updated version of the Diagnostic and Statistical Manual for Mental Disorders(DSM-5) as condition that requires further research prior to official inclusion in the main manual, with important repercussions for research and treatment. To date, reviews have focused on clinical and treatment studies of Internet addiction and Internet Gaming Disorder. This arguably limits the analysis to a specific diagnosis of a potential disorder that has not yet been officially recognised in the Western world, rather than a comprehensive and inclusive investigation of Internet-use related addictions(including problematic Internet use) more generally. RESULTS: The systematic literature review identified a total of 46 relevant studies. The included studies used clinical samples, and focused on characteristics of treatment seekers and online addiction treatment. Four main types of clinical research studies were identified, namely research involving(1) treatment seeker characteristics;(2) psychopharmacotherapy;(3) psychological therapy; and(4) combined treatment. CONCLUSION: A consensus regarding diagnostic criteria and measures is needed to improve reliability across studies and to develop effective and efficient treatment approaches for treatment seekers.

P300 change and cognitive behavioral therapy in subjects with Internet addiction disorder A 3-month follow-up study

Event-related potential studies of cognitive function in addiction behaviors have focused on the P300 event-related potential component. The current study investigated the association between P300 component and Internet addiction disorder. We found that individuals with Internet addiction disorder exhibited significantly longer P300 latencies than controls （N2： P = 0.035; P3a： P = 0.031 P3b： P = 0.043） and similar P300 amplitudes compared to control participants. After 3 months of cognitive behavioral therapy, P300 latencies decreased significantly in the P3a and P3b （P3a： P = 0.045; P3b： P = 0.062）. These results suggest that deficits in cognitive function may be involved in Internet addiction disorder, and that clinical psychological treatment may be effective.

Functional magnetic resonance imaging of internet addiction in young adults

AIM: To report the results of functional magnetic resonance imaging(f MRI) studies pertaining internet addiction disorder(IAD) in young adults.METHODS: We conducted a systematic review on Pub Med, focusing our attention on f MRI studies involving adult IAD patients, free from any comorbid psychiatric condition. The following search words were used, both alone and in combination: f MRI, internet addiction, internet dependence, functional neuroimaging. The search was conducted on April 20^(th), 2015 and yielded 58 records. Inclusion criteria were the following: Articles written in English, patients' age ≥ 18 years, patients affected by IAD, studies providing f MRI results during resting state or cognitive/emotional paradigms. Structural MRI studies, functional imaging techniques other than f MRI, studies involving adolescents, patients with comorbid psychiatric, neurological or medical conditions were excluded. By reading titles and abstracts, we excluded 30 records. By reading the full texts of the 28 remaining articles, we identified 18 papers meeting our inclusion criteria and therefore included in the qualitative synthesis.RESULTS: We found 18 studies fulfilling our inclusion criteria, 17 of them conducted in Asia, and including a total number of 666 tested subjects. The included studies reported data acquired during resting state or different paradigms, such as cue-reactivity, guessing or cognitive control tasks. The enrolled patients were usually males(95.4%) and very young(21-25 years). The most represented IAD subtype, reported in more than 85% of patients, was the internet gaming disorder, or videogame addiction. In the resting state studies, the more relevant abnormalities were localized in the superior temporal gyrus, limbic, medial frontal and parietal regions. When analyzing the task related fmri studies, we found that less than half of the papers reported behavioral differences between patients and normal controls, but all of them found significant differences in cortical and subcortical brain regions involved in cognitive control and reward processing: Orbitofrontal cortex, insula, anterior and posterior cingulate cortex, temporal and parietal regions, brain stem and caudate nucleus.CONCLUSION: IAD may seriously affect young adults' brain functions. It needs to be studied more in depth to provide a clear diagnosis and an adequate treatment.

Problematic Internet use in drug addicts under treatment in public rehab centers

BACKGROUND Problematic Internet use(PIU)or Internet addiction has been recognized to be a behavioral addiction characterized by excessive or poorly controlled preoccupations,urges,or behaviors regarding computer use and Internet access that leads to impairment or distress resembling substance abuse.AIM To investigate the prevalence and characteristics of Internet use and abuse in a group of drug addicts from Southern Italy,by means of a specific questionnaire[“Questionario sull’Utilizzo delle Nuove Tecnologie”(QUNT)].METHODS All subjects(183)were heavy smokers,almost 50%of them used heroin and/or opioid compounds,30%alcohol,10%cannabis,8%cocaine,and 5%were polydrug users.Almost 10%of the individuals were also suffering from gambling disorder.RESULTS The time spent online was more than 4 hours a day in the total sample,with a slight prevalence in male subjects.Cocaine and cannabis users spent more than 6 hours online,significantly more than opioid and alcohol abusers.Distribution of the QUNT factors was not different in both sexes.Cocaine users showed higher scores at the“loss of control”,“pornography addiction”,and“addiction to social networks”factors,for the stimulant effect of this substance.Moreover,15 out of the total 17 cocaine users were pathological gamblers.Positive and statistically significant relationships were observed between some QUNT factors and body mass index.CONCLUSION These findings indicate that PIU is less severe in subjects taking sedative substances,such as heroin/opioids and alcohol,than in subjects taking stimulants.Alternatively,it may be used as a“stimulant”trigger in cocaine and cannabis users.Flattening effect of abuse drugs was noted on possible sex-related differences in QUNT items.We observed a sort of“protective”effect of a love relationship and/or living together with a partner,as those engaged subjects showed lower scores on different items than single subjects or those living alone.The relationship between time spent online(and related sedentary lifestyle)and body mass index would suggest that Internet use might be a contributing factor to increasing weight gain and obesity amongst adolescents and young adults worldwide.Our findings also highlighted the specific vulnerability of drug addicts who use stimulants,rather than sedative compounds,to other kinds of behavioral addictions,such as gambling disorder.

ACT联合rTMS对青少年游戏障碍患者网瘾程度及内隐认知偏倚的影响

目的探讨接受与现实疗法(ACT)联合重复经颅磁刺激(rTMS)在青少年游戏障碍(GD)患者中的应用效果。方法选取2021年1月至2022年1月该院收治的100例青少年GD患者,按随机数字表法分为观察组和对照组,各50例。对照组采取认知行为疗法,观察组采取ACT联合rTMS,比较2组中文网络成瘾量表修订版(CIAS-R)评分、内隐认知偏倚情况和学习倦怠评分。结果2组治疗前CIAS-R各维度评分比较,差异无统计学意义(P>0.05)。观察组治疗后CIAS-R各维度评分低于对照组,差异有统计学意义(P<0.05)。2组治疗前内隐认知偏倚情况比较,差异无统计学意义(P>0.05)。2组治疗后内隐认知偏倚情况比较,差异有统计学意义(P<0.05)。2组治疗前学习倦怠各维度评分比较,差异无统计学意义(P>0.05)。观察组治疗后学习倦怠各维度评分低于对照组,差异有统计学意义(P<0.05)。结论ACT联合rTMS治疗青少年GD患者的效果显著,能降低网瘾程度,改善内隐认知偏倚和学习倦怠情况,有利于其健康成长。

中庸思维与大学生短视频成瘾的关系:链式中介效应分析

目的探讨认知重评和积极应对方式在中庸思维与大学生短视频成瘾之间的中介作用。方法采用中庸思维量表、情绪调节量表、简易应对方式问卷、短视频成瘾量表对693名大学生进行测量。结果①短视频成瘾与中庸思维、认知重评、积极应对方式呈负相关(r=-0.28、-0.34、-0.34,P均<0.01);②中庸思维直接影响大学生短视频成瘾(β=-0.13,P<0.01),同时,通过认知重评(β=-0.10,P<0.01)、积极应对方式(β=-0.05,P<0.01)和认知重评一积极应对方式(β=-0.06,P<0.01)3条中介路径间接影响短视频成瘾。结论认知重评与积极应对方式在中庸思维和大学生短视频成瘾之间起链式中介作用。

具身认知视角下青少年网络成瘾干预:回归身心一体

青少年沉迷网络的现象与网络成瘾低龄化问题日趋严重。基于具身认知理论,可以揭示网络成瘾的形成原因,身心分离导致自我的失控感,身体缺失引发自我的空虚感。具身认知理论将认知系统视为身体与环境互相作用所生成的整体系统;它不是大脑内部的被动信息加工,而是生命体与环境互动过程中的具身和嵌入活动。由此提出青少年网络成瘾的干预思路:在身体与环境的互动中产生“身心一体”感。青少年通过积极参加体育运动和文艺活动可预防网络成瘾,学校可采取的心理干预策略主要有运动疗法、表达性艺术治疗和正念冥想。

Effects of Electroacupuncture Combined Psycho-intervention on Cognitive Function and Event-Related Potentials P300 and Mismatch Negativity in Patients with Internet Addiction

Objective： To observe the effects of comprehensive therapy （CT） with electroacupuncture （EA） in combination with psycho-intervention （PI） on the cognitive function and event-related potentials （ERP）, P300 and mismatch negativity （MMN）, in patients with internet addiction （IA） for a preliminary exploration of the possible mechanism of the therapy. Metheds： One hundred and twenty patients with IA were randomly divided into three groups, and a total of 112 subjects reached the final analysis of the trial, the EA group （39 patients）, the PI group （36 patients） and the CT group （37 patients）. EA was applied at acupoints Baihui （GV20）, Sishencong （EX-HN1）, Hegu （LI4）, Neiguan （PC6）, Taichong （LR3） and Sanyinjiao （SP6）, once every other day; PI with the cognition- behavior mode was implemented every 4 days; both EA and PI were used in the CT group. The treatment course for all patients was 40 days. Changes before and after treatment in terms of scoring by the IA self-rating scale, short-term memory capacity, short-term memory span, and the latency and amplitude of P300 and MMN in patients were observed. Results： After treatment, in all groups, the IA score was lowered significantly （P〈0.05） and scores of short-term memory capacity and short-term memory span increased significantly （P〈0.05）, while the decreased IA score in the CT group was more significant than that in the other two groups （P〈0.05）. ERP measurements showed that P300 latency was depressed and its amplitude raised in the EA group; MMN amplitude increased in the CT group （all P〈0.05）. Cenclusien： The EA in combination with PI could improve the cognitive function of IA patients, and its mechanism might be related to the speedup of cerebral discrimination on external stimulus and the enhancement of effective resource mobilization during information processing of the brain.

自我效能感与高中生网络成瘾的关系:一个有调节的中介模型

基于认知行为模型探究自我效能感与高中生网络成瘾的关系,构建了一个有调节的中介模型。采用一般自我效能感量表、非适应性认知问卷、认知灵活性量表和网络成瘾量表对521名高中生进行测查。结果显示(:1)自我效能感显著负向预测网络成瘾,与非适应性认知显著负相关,非适应性认知与网络成瘾显著正相关(;2)自我效能感对网络成瘾有直接负向预测作用,同时也通过非适应性认知的中介作用影响高中生网络成瘾(;3)认知灵活性在非适应性认知影响网络成瘾中具有调节作用。相对于认知灵活的高中生,认知不灵活的高中生非适应性认知对网络成瘾的正向预测作用更显著。揭示了非适应性认知在自我效能感对网络成瘾的影响中起中介作用,认知灵活性在其中发挥保护作用,这对改善高中生网络成瘾具有重要指导意义。

Neuroimaging the effects of smartphone(over-)use on brain function and structure-a review on the current state of MRI-based findings and a roadmap for future research

The smartphone represents a transformative device that dramatically changed our daily lives,including how we communicate,work,entertain ourselves,and navigate through unknown territory.Given its ubiquitous availability and impact on nearly every aspect of our lives,debates on the potential impact of smartphone(over-)use on the brain and whether smartphone use can be“addictive”have increased over the last years.Several studies have used magnetic resonance imaging to characterize associations between individual differences in excessive smartphone use and variations in brain structure or function.Therefore,it is an opportune time to summarize and critically reflect on the available studies.Following this overview,we present a roadmap for future research to improve our understanding of how excessive smartphone use can affect the brain,mental health,and cognitive and affective functions.

父母教养方式类型与青少年网络成瘾的关系:认知情绪调节策略的中介作用

为探讨父亲和母亲教养方式的潜在类型与青少年网络成瘾的关系并检验认知情绪调节策略在其中的作用,采用父母教养方式问卷、认知情绪调节策略问卷和网络成瘾问卷对重庆市4091名中学生进行调查。结果表明:(1)父亲和母亲均存在三种潜在教养类型,即积极型、混合型和消极型;(2)与父母混合型教养类型相比,父母积极型教养类型显著负向预测网络成瘾;(3)以父母混合型教养类型作为参照组,适应性和非适应性认知情绪调节策略在父母积极型教养类型与网络成瘾之间存在中介作用,非适应性认知情绪调节策略在父母消极型教养类型与网络成瘾之间存在中介作用。

脑电生物反馈联合团体认知行为治疗对青少年网络成瘾患者的干预效果观察

目的:观察脑电生物反馈联合团体认知行为治疗(GCBT)对青少年网络成瘾患者的干预效果。方法:选择2019年11月—2021年10月于赣州市第三人民医院治疗的80例青少年网络成瘾患者,按随机数字表法分为观察组和对照组,每组40例。对照组采用脑电生物反馈治疗,观察组在对照组基础上采用GCBT。比较两组网络成瘾倾向、生存质量、焦虑情绪及自我和谐度。结果:治疗后观察组网络成瘾诊断量表(IAT)评分、焦虑自评量表(SAS)评分低于对照组,世界卫生组织生存质量简表(WHOQOL-BREF)评分和自我和谐量表(SCCS)的自我刻板性、自我灵活性、自我与经验评分高于对照组,差异有统计学意义(P<0.05)。结论:青少年网络成瘾患者采用脑电生物反馈联合GCBT治疗有利于改善网络成瘾状况及焦虑情绪,提高自我和谐度,改善患者生活质量,可为GCBT的治疗提供理论支持。

压力与中学生网络游戏成瘾:非适应性认知的中介作用

目的基于Davis认知行为模式探讨非适应性认知在压力和网络游戏成瘾(IGD)关系间的中介作用,并分析家庭凝聚力和IGD之间的关系。方法于2021年11月从福州市和厦门市随机选取5所初中,采用青少年生活事件量表、非适应性认知量表、家庭凝聚力量表和网络游戏成瘾量表对850名中学生进行调查,采用Pearson相关分析和中介效应分析进行统计学处理。结果(1)控制人口学变量后,压力能够正向预测IGD(r=0.381,P<0.01);(2)非适应性认知在压力和IGD的关系中起部分中介作用(β=0.67,t=27.54,P<0.01);(3)家庭凝聚力能负向预测IGD(β=0.09,t=-3.48,P<0.01),为预防IGD的保护因素。结论压力直接影响IGD的同时通过非适应性认知影响IGD。

认知行为疗法联合耳穴压豆干预高职院校互联网成瘾综合征大学生的效果观察

目的 观察认知行为疗法联合耳穴压豆干预高职院校互联网成瘾综合征大学生的效果。方法 选择我院的IAD学生共计60例,采用随机数字表法分为对照组和观察组各30例。对照组开展线上+线下结合的认知行为疗法干预。观察组在对照组基础上加用耳穴压豆。观察两组的干预效果、智能手机成瘾量表评分、Barratt冲动量表评分。结果 在疗效方面,观察组总有效率93.33%,显效率66.67%,均高于对照组(P<0.05)。在成瘾情况比较,观察组优于对照组(P<0.05);在冲动情况比较,观察组优于对照组(P<0.05)。结论 认知行为疗法联合耳穴压豆干预高职院校互联网成瘾综合征大学生的效果观察,可以改善学生的相关症状,缓解成瘾性和冲动感。

网络游戏成瘾者认知功能损害的ERP研究

许多研究证明,网络成瘾具有和物质依赖成瘾相同的成瘾症状:不仅有明显的社会功能损害,而且表现出抑郁、强迫、焦虑等精神症状。本研究采用事件相关电位技术,以网络游戏成瘾大学生为被试,探索了网络游戏成瘾者脑认知功能的变化。结果发现:①成瘾者听觉P300的波幅显著低于非成瘾者,说明网络成瘾者可能存在认知功能的损害;②成瘾者听觉N1的波幅显著高于非成瘾者,提示成瘾者可能存在感觉功能的易化,或者受到感觉寻求人格特质的影响。

网络成瘾者认知功能的病例对照研究

目的:研究网络成瘾者与非成瘾者的认知功能是否存在差异。方法:对网络成瘾者(26例)和非成瘾者(26例)进行神经心理测验,包括部分成人韦氏智力测验(WAIS-RC)、修订韦氏智力量表(WMS-R)、Stroop测验、汉诺塔测验、威斯康星卡片分类测验改良版(M-WCST)。结果:网络成瘾者WAIS-RC成绩均较非网瘾组差(如知识:8.8±2.3/12.2±1.8;算术:6.5±1.8/7.8±1.1,t=-4.9,P<0.001;木块图形:11.5±2.8/13.1±1.2,P=0.001;数字符号:57.2±8.9/62.4±5.1,P=0.05)。记忆能力较非网瘾组差(如:逻辑记忆,即刻:10.0±3.4/13.1±1.8,t=-5.8,P<0.01,延迟:7.7±4.0/10.1±2.0,t=-3.4,P=0.002);视觉记忆,即刻:11.7±2.6/13.9±1.6,P<0.01,延迟:11.2±2.3/12.9±1.7,P=0.003)。Stroop测验Stroop-c测验的正确数、完成时间及Stroop-cw测验正确数成绩网瘾组均较非网瘾组差(109.8±2.1/111.0±1.8,P=0.001;68.9±12.3/55.9±5.0;87.1±17.4/97.8±7.8,P<0.001)。网瘾组M-WCST成绩均较非网瘾组差(P<0.05、0.001,如总正确数为34.4±6.1/37.8±2.0)。汉诺塔测验除计划时间分测验网瘾者的成绩均较非网瘾者差(执行时间:20.7±5.7/18.2±3.2,P=0.009,总分59.7±8.1,P<0.001)。结论:网络成瘾者的认知功能较非成瘾者差。

网络成瘾的认知神经科学研究述评

随着研究的深入,认知神经科学的技术和方法被越来越多地应用于网络成瘾的研究中。这些研究主要集中在对网络成瘾者的认知加工功能受损、注意偏向、认知加工倾向、抑制控制和感觉寻求以及网络成瘾的神经通路的研究。在此基础上指出了这些研究结果在探究网络成瘾的机制和实际应用中的价值,并提出未来的研究应该明确网络成瘾与高级认知功能损害的关系,整合现有的研究方法,扩大研究对象和研究指标,突出研究成果在网络成瘾鉴别和干预中的应用价值。

网络成瘾者奖赏系统和认知控制系统的神经机制

网络成瘾作为一种行为成瘾,已成为严重影响人们心理健康的全球性问题.根据大脑发育的神经生物模型,揭示网络成瘾者奖赏和认知控制系统的神经机制是解决网络成瘾问题的关键,也是心理学研究的重大问题.行为研究探讨了网络成瘾具有高奖赏寻求和低认知控制特征;神经机制研究揭示了奖赏和认知控制系统的缺陷是网络成瘾行为的高风险因素;与药物成瘾的比较研究发现,网络成瘾有着独特的奖赏机制.这些研究深化了对网络成瘾心理和神经机制的理解,但仍存在网络成瘾筛查和入组标准不科学、分型笼统、因果研究匮乏、干预和治疗效果具有争议、研究范式存在漏洞等一些急需解决的问题.

病理性互联网使用与情绪、认知需要的模型构建

通过对1030名大学生进行问卷调查,对大学生的情绪、认知需要与网络成瘾的关系进行了探讨。结果发现:消极情绪对网络成瘾有显著而直接的正向作用,消极情绪对网络成瘾具有最强的预测力;认知需要对网络成瘾有显著而直接的负向作用;消极情绪和积极情绪均可通过认知需要间接地影响网络成瘾;男女生的情绪、认知需要对网络成瘾的影响存在差异。

百善孝为先? 大学生双元孝道信念与网络成瘾的关系研究

本研究基于双元孝道模型和病理性互联网使用的认知行为模型,考察双元孝道信念对网络成瘾的影响,并检验非适应性认知的中介作用。以1152名大学生为被试,采用双元孝道信念量表、非适应性认知量表和网络成瘾量表进行测试,结果发现:(1)互惠性孝道和非适应性认知显著负相关,和网络成瘾显著负相关;权威性孝道和非适应性认知显著正相关,和网络成瘾显著正相关;非适应性认知和网络成瘾显著正相关;(2)非适应性认知在孝道信念与网络成瘾之间起中介作用。具体而言,互惠性孝道负向影响非适应性认知,权威性孝道正向影响非适应性认知,非适应性认知正向影响网络成瘾。本研究的结果表明,根植于中国传统文化的孝道信念通过非适应性认知的中介作用影响网络成瘾;而且互惠性孝道和权威性孝道具有相反的作用。