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Tuesday, November 27, 2007

Internet addiction an epidemic in Korea

Compulsive Internet use has been identified as a mental health issue in other countries, including the United States. However, it has reached epidemic levels in South Korea because of the country’s nearly universal Internet access.

According to an article that appeared in the New York Times, itt has become a national issue in recent years, as users started dropping dead from exhaustion after playing online games for days on end. A growing number of students have skipped school to stay online, shockingly self-destructive behavior in this intensely competitive society.

Up to 30 percent of South Koreans under 18, or about 2.4 million people, are at risk of Internet addiction, said Ahn Dong-hyun, a child psychiatrist at Hanyang University in Seoul who just completed a three-year government-financed survey of the problem.

They spend at least two hours a day online, usually playing games or chatting. Of those, up to a quarter million probably show signs of actual addiction, like an inability to stop themselves from using computers, rising levels of tolerance that drive them to seek ever longer sessions online, and withdrawal symptoms like anger and craving when prevented from logging on.

To address the problem, the government has built a network of 140 Internet-addiction counseling centers, in addition to treatment programs at almost 100 hospitals and, most recently, the Internet Rescue camp, which started this summer. Researchers have developed a checklist for diagnosing the addiction and determining its severity, the K-Scale. (The K is for Korea.)

In the US, the prevalence of Internet addiction appears less than Korea with estimates of 5 to 10 percent of the population who suffer from the problem. The issue of Internet addiction continues to raise significant concern as more therapists see clients who suffer from Internet-related problems, including online gaming, online affairs, Internet pornography and Internet gambling addictions.

Thursday, November 01, 2007

Treating Internet Addiction

The October issue of the CyberPsychology & Behavior Journal published the first study to examine treatment outcomes with Internet addicts. The study conducted by the Center for Internt Addiction Recovery examined 114 patients over 12-weekly sessions and upon six-month follow-up after termination. Results showed that clients gained symptom management by the 3rd session and were able to maintain complete recovery after 12 sessions and at six months after treatment ended. The main and most successful treatment with Internet addicts is cognitive-behavioral therapy and the study supports that CBT is the primary therapy to use in treating Internet addiction. This is the first study to examine specific treatment variables with Internet-addicted patients and shows long-term potential in treatment recovery.

To learn more please read the full article published by Mary Anne Liebert entitled, "Cognitive-Behavioral Therapy with Internet Addicts: Treatment Outcomes and Implications" is published by CyberPsychology & Behavior, Vol. 10, No. 5, pages 671-679 (October 2007).

Friday, June 22, 2007

AMA considering Video Game Addiction a disorder

In today's headlines, the American Medical Association is considering video game overuse an addiction. While they say a final diagnostic classification for the behavior is a ways off, studies have been conducted and clinical evidence is mounting to support the validity of this new syndrome.

Dr. Martin Wasserman, executive director of MedChi, the Maryland State Medical Society, helped spearhead the new proposal, which has resulted in a 10-page report submitted to the AMA by the group's Council on Science and Public Health.

"The concern came up because one of our psychiatrists here in Maryland was seeing older people who were losing their social contacts," specifically because of their overuse of video games, Wasserman said. "It was ruining their family life. So, it was not unlike gambling addictions or alcohol, where it was having a profound impact on the lives of individuals."

According to the AMA report, one soon-to-be-released British study polled 7,000 "gamers" and found that 12 percent of them met World Health Organization criteria for addictive behaviors.

Statistics released in 2005 by the Entertainment Software Association (ESA), an industry group, estimated that 70 percent to 90 percent of American children play video games. The typical gamer is a 30-year-old male who spends about seven or eight hours a week gaming.

The ESA survey also found that video game overuse was most prevalent among the approximately 9 percent of video game users who play against others online in Internet-based "massive multiplayer online role playing games."

The new AMA report defines "heavy game use" as two or more hours a day, but Wasserman, a pediatrician, said addictions are best defined by their impact on an individual's life and psyche.

We have already discussed in prior blog posts that online gaming has become problematic for many. These new studies bring to light the issues and continue to add to the growing dialogue of how new technologies can clinically impact individuals and families.

Friday, March 09, 2007

Are you an obsessive online gamer?

As a follow-up to my discussion on online gaming addiction, I received this email from a recovered gaming addict that I wanted to share. I wanted to hear from other gamers to see if physical numbing or problems also result from intensive playing.

"Hello: I play World of Warcraft which I'm sure must be responsible for a great deal of online addiction. I have gone through periods of playing somewhat intensively which I may do for up to 4 hours 4 evenings in a week but then I am suddenly so bored with it that I don't touch it for a month or two then repeat the cycle. So maybe a binge addiction! Anyway, the purpose of this message is to comment on your online survey: Are you an obsessive online gamer? I am a nurse and one thing I have noticed is that frequently people are playing to a point of physical harm. I am in a guild that actually meets every once in a while in San Francisco (so real face time with fellow guildies which I think is unusual) and often they have what seem to me to be tendonitis and other repetitive stress/overuse injuries such as Carpal Tunnel (although as a nurse naturally I would leave diagnosis up to the physicians!). Also I often hear (on Ventrillo which many gamers use for audio) or see (in online comments) remarks that people have tingling or numbness in the nerves of their hands, wrists, forearms, shoulders, or necks, any of which could be the onset of more serious conditions. People seem to accept all this as part of gaming, especially heavy gamers who go on "raids" (something I'd never do) which take hours and hours maybe three times a week to complete. Therefore I think you need to add a question to your online gaming questionnaire: HAVE YOU EVER PLAYED/CONTINUED TO PLAY AN ONLINE GAME AFTER YOUR HANDS OR AMRS BEGIN TO HURT? In this case I am not even addressing lower back pain and possible damage to spine/cartilage, or damage to vision, both of which I suspect as a result of computer use. I think it would be good to see something on your questionnaire about this."

Friday, February 02, 2007

The Rise in Teen Online Gambling

While doing some research on Internet gambling, I came across some amazing statistics. Two days after Congress cracked down on online gambling, new data released from the Annenberg Public Policy Center at the University of Pennsylvania show that more than one million young people currently are using Internet gambling sites on a monthly basis. Among males 18 to 22, Internet gambling doubled in the past year.

The new data are being released by the National Annenberg Risk Survey of Youth, which has tracked gambling among young people ages 14 to 22 since 2002. Based on the survey's most recent estimates, approximately 850,000 males ages 18 to 22 gamble online at least one a month. The corresponding number for males between 14 and 17 is 357,000.

Among the 18- to 22-year-old age group, weekly use of Internet gambling sites increased from 2.3% in 2005 to 5.8% this year, a statistically significant increase.

With a rise in online gambling comes a greater danger of addiction, according to Nancy Petry, a professor of psychiatry at the University of Connecticut’s Center for Gambling Research and Treatment.

In a recent study, Petry found that Internet gamblers were more likely to have a serious gambling than other gamblers. Furthermore, Internet gamblers were more likely to suffer from health and emotional problems such as substance abuse, circulatory disease, depression, and risky sexual behaviors.

As teens and pre-teens go online with greater frequency, the risk for addiction and the form it takes becomes greater. Old favorites such as sports betting and casino games still dominate the Internet but in the future there will be more opportunities that could draw new gamblers into the fold. People can go online and bet about whether Brad Pitt and Angelina Jolie will get married or if Tom Cruise and Katie Holmes’s marriage will last. They can bet on the outcome of the Oscars or who will win on Survivor. These are the new kind of bets that are done by people who might not normally visit a gambling site.

Tuesday, January 09, 2007

What is Internet misuse and what is addiction?

After my last blog entry, I received several emails from therapists, many whom are EAPs who have seen cases like IBM in their practice. They would treat an employee who did something wrong using the computer and was fired, or on the brink of being fired.

They asked me how they could diagnose Internet addiction and differentiate that from general misuse of the computer. This is a very relevant question to ask in our technology-rich society. The symptoms are based upon DSM criteria as follows:

1. Do you feel preoccupied with the Internet (think about previous online activity or anticipate next online session)?
2. Do you feel the need to use the Internet with increasing amounts of time in order to achieve satisfaction?
3. Have you repeatedly made unsuccessful efforts to control, cut back, or stop Internet use?
4. Do you feel restless, moody, depressed, or irritable when attempting to cut down or stop Internet use?
5. Do you stay online longer than originally intended?
6. Have you jeopardized or risked the loss of significant relationship, job, educational or career opportunity because of the Internet?
7. Have you lied to family members, therapist, or others to conceal the extent of involvement with the Internet?
8. Do you use the Internet as a way of escaping from problems or of relieving a dysphoric mood (e.g., feelings of helplessness, guilt, anxiety, depression)?

Answers should evaluate non-essential computer/Internet usage (i.e., non-business or academically related use). Clients are considered addicted when answering “yes” to five (or more) of the questions over a six-month period, when not better accounted for by a manic episode. Associated features among addicted individuals include: (1) ordinarily excessive Internet use, (2) a neglect of routine duties, (3) social isolation from family members and friends, (4) being secretive about online activities or a sudden demand for privacy when online, and (5) significant changes in normal sleep patterns (depravation). While many people may spend too much time online that in itself is not the only criteria to diagnose addiction. Therapists must also evaluate how the Internet is impacting a client’s life and look beyond diagnosis as purely a function of time.