Wednesday, July 10, 2019

CBT Program Reduces Addictive Internet Behaviors in Men, Study Finds

A 15-week treatment program that incorporates principles of cognitive-behavioral therapy (CBT) is effective at reducing problem gaming and other addictive internet behaviors in men, according to a study published today in JAMA Psychiatry

“Despite the heterogeneity of the treatment group, we found that our CBT program was effective … regardless of age, comorbidity, or treatment center,” wrote Klaus Wölfling, Ph.D., of the University Medical Center of the Johannes Gutenberg-University in Mainz, Germany, and colleagues. “These findings support a unitary concept of [internet addiction] and point to the flexibility of the STICA [short-term treatment for internet and computer game addiction].”

Internet- and gaming-related addiction is an emerging concept: Internet gaming disorder is listed in the DSM-5 under conditions for further study, and gaming disorder is included in the 11th Revision of the International Classification of Diseases (ICD-11).

Wölfling and colleagues recruited 143 men (average age 26) with addictive behaviors related to the internet and gaming from outpatient psychiatry clinics at university medical centers in Germany and Austria. The problem behaviors reported by the men included online gaming (82 men), offline gaming (9 men), online pornography (23 men), and generalized internet addiction (29 men). Participants were evaluated using the Assessment of Internet and Computer Game Addiction (AICA) scale; AICA is derived from the DSM-5’s proposed criteria for internet gaming disorder but expanded to multiple online activities.

Of the participants, 72 received STICA, which teaches patients to be cognizant of why they engage in dysfunctional internet use and provides skills to help them reduce and control their use. The treatment involved 15 weekly group sessions interspersed with eight individual sessions to aid in patient motivation and monitor participants for any emergent distress. The other 71 men were placed on a wait list and received STICA after 15 weeks.

After 15 weeks, 69% of men who received STICA achieved remission of their addiction (defined as an AICA score of 7 or less) compared with 24% of men on the wait list. The STICA group also reported less time spent online on both weekends and weekdays, fewer depression symptoms, and improved social functioning. 

“The study shows that STICA can be effective in treatment of IA [internet addiction],” Wölfling and colleagues concluded. “Further trials investigating the long-term efficacy of STICA and addressing specific groups and subgroups compared with active control conditions are required.”

For related information, see the American Journal of Psychiatry article “Internet Gaming Disorder: Investigating the Clinical Relevance of a New Phenomenon.”

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