Internet addiction is a global and rapidly evolving
disorder. I just returned from the first International Congress on Internet
Addiction Disorders held in Milan, Italy. While the ideas are still fresh, I
wanted to write about the new and exciting programs being started to address
this rapidly evolving problem.
Cultural Approaches
The panel of speakers and attendees were amazing. They showed
the deeply global nature of Internet addiction with each country developing its
own methods representative of what worked best for their own circumstances. For
instance, in Korea, they are a leader in this field as they are the first to
have established a comprehensive Master Plan to prevent and treat Internet
addiction. Developed by multiple Ministries of the Korean Government, they
provide testing for risk of Internet addiction among adolescents, specialized
re-education programs for those at risk, and hundreds of specialized inpatient
treatment programs across the country. In Japan and Germany, they utilize
Internet fasting camps for children identified at risk, also backed by
government support. In China, they utilize military-style boot camps for
re-education as depicted in the new documentary, Web Junkies. In Italy, Milan and Rome developed the first inpatient
programs with alternative treatments in theater therapy to tap into the
emotions of an Internet addict and they explore avatar therapy (in vivo) with
peer group training and support. In France, they do not talk as much about
pathological Internet addiction but in general focus on early education on
technology use for all families. This way, they focus on what parents should do
at home when introducing technology for a child. In the U.S., unfortunately, we
are lagging behind with respect to prevention and treatment. We do no formally
recognize the disorder in the DSM, we only have a handful of specialized
treatment programs, we have some digital detox camps but nothing to the scale
of Korea, and we do not implement policies for early childhood prevention as
they do in France.
This was very enlightening to me, as the only American at
the Congress to see how other cultures were addressing what is seen as a
significant mental health issue. There
was considerable discussion on how to define Internet addiction. Is it its own
disorder? Is it always co-morbidly related to clinical syndromes such as
depression and anxiety? How do social problems influence the development of
this condition as Internet addicts are highly isolated? What is the
relationship with Autism and Asperger’s Syndrome, as these disorders were seen
across cultures as a significant risk factor with Internet addiction disorders?
Age of Onset
There was also significant debate on the age of onset for
the disorder. How young is too young for children to be introduced to
technology? While all the countries represented recognized the benefits of
technology use and adaptation among children and adolescents for careers and
future job performance, it was asked if technology should also come with
warning signs for parents. For instance, in Japan, middle school children were
identified to be the most at risk and this launched a greater discussion on
what parents need to know at home to address potential Internet addiction
disorders.
This is not a new discussion. When I was in Australia this
past summer for a Media Addiction conference at Macquarie University in Sydney,
this debate of how young is too young also was discussed (and again, to no
clear answer). In my own consulting work, throughout the U.S., I have toured
several adolescent clinics seeing a growing number of young people with an
addiction to technology and visited school systems struggling with how to
address the growing problem of students becoming addicted to the very
technology that they are required to use. The
problem hits home domestically too.
Types of Internet
Addicts
The Congress also debated if there were different types of Internet
addicts. Were there differences in terms of addicts related to how much time
they spent online or what applications they were involved with? For instance, a
child who was addicted to video games may be experiencing a developmental phase
the he will grow out of into adulthood, whereas an older adult male who suffers
from sex addiction is now hooked on online pornography and has long-standing
problems with relationships, depression, and substance abuse. Would these two
patients be classified the same or are these different types of addicts, one
being more phased developmentally and the other more chronic and pervasive?
Also, how does what someone becomes addicted to impact the
course of treatment? For instance, in Italy, they use Theater Therapy for young
people to act out their avatars for addicted gamers. This has been very
effective. But, how does this translate to an older adult who may be addicted
to online pornography? Also, how does culture impact treatment? While Korea has a comprehensive Master Plan
(and actually, it was just repurposed as the Master Plan II to address
smartphone use), would this be possible in American to implement? My view at the
Congress was “no” as our U.S. government does view Internet/technology
addiction as a problem. Again, most people did not understand why this is as
many other countries are rapidly addressing what they see as a significant
mental health concern.
The Role of
Government
This led to an important discussion on the role of
government involvement and policy. If the government is not supportive of
initiatives on Internet addiction prevention, education, or treatment, than it
seems that little can be done to properly address the condition. In Korea, they
had statistics that showed the effectiveness of their Master Plan in Prevention
and Treatment but they also were one of the few countries with widespread
government support for the development of their national programs.
Best Practices
In closing, the Congress struggled with the best practices
in this emerging field. The issues involved with Internet Addiction Disorders
were complex. The issues cited were developmental, clinical, social, cultural,
and familial. Developmentally, what was the impact of technology overuse on
children? Clinically, what were the best treatment approaches to resolve
Internet addiction, especially with the reliance of mobile devices in our daily
and work lives? Socially, what were the long-term effects of an over-reliance
on technologies that seem to disconnect us more than connect us, especially
among children who are using this at younger ages? Culturally, did Internet addiction
disorders manifest themselves differently based on ethnic and cultural
backgrounds requiring various forms of treatment and prevention? From the
family perspective, how should parents learn to integrated technology for their
children and what resources were available to help them manage this at home and
at school?
Conclusions
Overall, the Congress was an important step in the field of
Internet and technology addictions. It seems we are all doing something in our
respective countries to address an emerging problem. No matter the terms we
use, although, I agree that terminology is highly important, it is clear that
this has become a global condition and that we are all experiencing problems
with integrating technology into our lives.
Future initiatives based on the Congress are determining: 1]
Defining Internet addiction (be it problematic Internet use, pathological
Internet use, technology addiction, or other terms, we need to define a clear
set of standardized criteria). 2] Consider how co-morbid psychiatric syndromes
and personality traits play a role in the development of Internet addiction
disorders. 3] Consider how age of onset (and age in general with the
introduction of technology) influences childhood development and what parents
and families need to know for prevention and what resources are available to
them as well as to schools. 4] Conduct outcome studies to investigate the best
practices in treating Internet addiction disorders among adolescents and adults.
Finally, 5] Examine the role of culture in the development of Internet
addiction disorders and how public health policies through government and
healthcare systems can enable more effective responses for providing resources,
prevention, education, and treatment.
For more information, please visit the International
Congress on Internet Addiction Disorders website.
