Internet Addiction: diagnosis, comorbidity and treatment
Weinstein A. (Ariel, Israel)
Текст на русском
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Aviv Weinstein
– Professor, Department of Behavioral Sciences, Faculty
of Social Sciences and Humanities, Ariel University, Israel.
Phone: +972 1-800-660-660.
E-mail: avivweinstein@yahoo.com
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Abstract.
Problematic internet Use (PIU) or excessive internet use is
characterized by excessive or poorly controlled preoccupations,
urges or behaviors regarding computer use and internet access
that lead to impairment or distress. Surveys in the US and Europe
have indicated prevalence of between 1.5% and 8.2%, with varying
diagnostic methods between countries. Cross-sectional studies on
samples of patients report high co-morbidity of internet addiction
with psychiatric disorders. This paper will describe Internet
Addiction in terms of diagnosis as well as co-morbidity with
other psychiatric disorders and treatment.
Key words:
internet addiction; problematic internet use; behavioral addiction.
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Received: June 24, 2015
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Accepted: July 10, 2015
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Publisher: July 23, 2015
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For citation
Introduction: Internet addiction and its treatment
Problematic internet use, or internet addiction, is characterized by
excessive or poorly controlled preoccupations, urges or behaviors
regarding internet use that lead to impairment or distress. Early
studies by Young (1998) Griffiths (1998; 2000) and Aboujaoude (2010)
defined this disorder and have done extensive research on it. The
condition has attracted increasing attention in the popular media and
among researchers, and this attention has paralleled the growth in
computer use and internet access (Shaw et al., 2008).
Phenomenologically, there appear to be at least three subtypes:
excessive gaming-gambling, sexual preoccupations (cybersex), and
socializing or social networking including e-mail/text messaging.
Internet addicts may use the internet for extended periods, isolating
themselves from other forms of social contact, and focus almost
entirely on the internet rather than broader life events. Adolescents
with problematic internet use showed dysfunctional coping strategies
with problems in school and home and showed worse interpersonal
relations (Milani et al., 2009). Internet addiction can be also
explained by a need to escape from oneself and that may account for the
excessive playing of internet games (Kwon et al., 2011).
There are three different models have been proposed for PIU
(Grant et
al., 2010; Weinstein and Lejoyeux, 2010, 2013; Weinstein et al., 2014).
Some researchers have considered the impulse-control disorders as part
of the obsessive-compulsive disorder spectrum a model. This model is
supported by brain-imaging and pharmacological treatment studies with
SSRIs (Dell’Osso et al., 2006), although other treatments and
brain-imaging studies may challenge it. PIU has also been
conceptualized as an impulse control disorder, characterized by the
urge to repeatedly engage in a behavior—going
online—that is pleasurable in the moment but can lead to
negative downstream effects (Aboujaoude, 2010). Third, internet
addiction was suggested to be included in the behavioral addiction
spectrum since it shows the features of excessive use, despite adverse
consequences, withdrawal phenomena, and tolerance that characterize
many substance use disorders. The frequent appearance of internet
addiction in the context of numerous co-morbid conditions raises
complex questions of causality.
Diagnosis and clinical criteria
Four components were originally suggested as essential to the
diagnosis of internet addiction for DSM-V inclusion (Block, 2008):
1) excessive internet use, often associated with a loss of sense
of time or a neglect of basic drives, 2) withdrawal, including
feelings of anger, tension, and/or depression when the computer
is inaccessible, 3) tolerance, including the need for better computer
equipment, more software, or more hours of use, and 4) adverse
consequences, including arguments, lying, poor school or vocational
achievement, social isolation, and fatigue.
A major survey was conducted to develop diagnostic criteria for
internet addiction disorder (IAD) and to evaluate its validity and
reliability in the general population (Tao et al., 2010). The
diagnostic criteria consisted of a symptom criterion (seven clinical
symptoms of IAD), a clinically significant impairment criterion
(functional and psychosocial impairments), a course criterion
(duration of addiction lasting at least 3 months, with at least 6
hours of non-essential internet usage per day) and an exclusion criterion
(exclusion of dependency attributed to psychotic disorders). Internet
addiction was listed as a condition for further study in the DSM-V from
2013 but it is not recognized as a disorder. Internet Gaming Disorder,
however, was included in the appendix of the DSM-V, published in May
2013. Thus, the DSM-5 still does not offer sufficient guidance on how
to approach individuals with suspected Internet-related psychopathology
or how to design or interpret research studies into this topic.
Instead, clinicians and researchers have to rely on proposed
definitions, along with several screening and assessment instruments
developed for PIU and problematic video game use.
Assessment of internet addiction
The questionnaires for diagnosis of internet addiction have used
items from substance dependence questionnaires, as well as new items
related to internet addiction. The most commonly used questionnaire
is Young's Internet Addiction Scale (IAT) which has been validated
(Widyanto et al., 2004; Bernardi and Pallanti, 2009; Korkeila
et al., 2009; Han et al., 2009; Chong Guan et al., 2012; Barke et al.,
2012; Ghamari et al., 2011; Jelenchick et al., 2012). The Internet
Addiction Scale (IAS) was developed by Griffiths (1998) and was
validated by Nichols and Nicki (2004) and Canan et al., (2010). Other
questionnaires include the Chen Internet Addiction Scale (CIAS) (Yen et
al., 2012), the Questionnaire of Experiences Related to Internet
(Beranuy Fargues et al., 2009) the Compulsive Internet Use Scale (CIUS)
(Meerkerk et al., 2009; Khazaal et al., 2012), the Problematic Internet
Use Questionnaire (PIUQ) (Demetrovics et al., 2008), and the
Internet-Related Problem Scale (IRPS) (Widyanto et al., 2011).
Prevalence rates
International prevalence rates for internet addiction range from 1.5 %
to 8.2 % (Petersen et al., 2009), and in the US 6% (Greenfield, 1999)
0.3—0.7% (Shaw and Black, 2008) and 4% (Christakis et al.,
2011) and 25% among Southern US university students (Forston
et al., 2007) see Moreno et al., (2011) for evaluation. In Europe,
rates vary between 3% in Germany (Woelfling et al., 2009), 5.4% and 5%
in Italy (Poli and Agrimi; Pallanti et al., 2006), 10.4% in Greece
(Tsitsika et al., 2009) and 18.3% in the UK. A major survey of 11
European countries found a prevalence rate of 4.4% (Durkee et al.,
2012).
Internet addiction has been most studied in the Far East. In China,
prevalence rates vary between 10.2% of moderate users and 0.6% of
severely addicted (Lam et al., 2009), 6.44% in Shaanxi Province (Ni et
al., 2009) between 2.4% and 5.52% in Hunan province (Deng et al., 2007;
Cao et al., 2007). In Shanghai, 8.8% (Xu et al., 2012) and in Hong Kong
6.7% (Fu et al., 2010). In Taiwan 17.9% of students were addicted (Tsai
et al., 2009) and in South Korean middle school students 16% were
potential at-risk users and 3.1% were high-risk users (Seo et al.,
2009). Other studies in South Korea have found 4.3% (Jang et al.,
2008), 10.7% (Park et al., 2008) 20.3% (Ha et al., 2007) 1.6% (Kim et
al., 2006), and 3.5% (Whang et al., 2003) of adolescents with internet
addiction.
Psychiatric Comorbidity
Cross-sectional studies on samples of patients report high co-morbidity
of internet addiction with psychiatric disorders such as affective
disorders, anxiety disorders (including generalized anxiety disorder,
social anxiety disorder), and attention deficit hyperactivity disorder
(ADHD). See review by Weinstein et al., (2014).
See table 1 for a list of studies showing Internet addiction
comorbidity with other psychiatric disorders and symptoms. The table is
divided between adult and adolescent studies.
Table 1
Internet addiction-comorbidity with other psychiatric disorders
and symptoms (References in brackets)
*In children
Abnormal obsessive-compulsive measures were identified before
participants became addicted to the Internet (Dong et al., 2011). A
relationship between withdrawal and anxiety/depression and future
Internet addiction was also found among South Korean males (Cho et al.,
2012). Finally, a review on 20 studies correlating problematic internet
use and mental disorders found that 75% reported significant
correlations of PIU with depression, 57% with anxiety, 100% with
symptoms of ADHD, 60% with obsessive-compulsive symptoms, and 66% with
hostility/aggression (Carli et al., 2013).
Relationship of internet addiction with drug and alcohol use
Very few studies looked at the relationships between drug and alcohol
use and internet addiction. Subjects with cannabis use had higher mean
score on the IAT in Finland (Korkeila et al., 2009). Parental problem
drinking had a significant direct effect on internet addiction in boys
but not in girls in early adolescence in the US. Significant indirect
effects of parental problem drinking on internet addiction were
evidenced via anxiety-depression and aggression for boys and via family
function and aggression for girls (Jang and Ji., 2012). Problematic
internet use was also associated with substance use experiences among
Greek adolescents on the island of Kos (Fisoun et al., 2012).
Adolescents who have used illicit substances and were abusing the
Internet as well appear to share some common personality
characteristics, such as psychoticism. Finally, internet addiction was
associated with harmful use of alcohol among Taiwanese students (Yen et
al., 2009; Ken et al., 2008). It is unknown whether internet addiction
and these co-morbid disorders could be explained by shared risk factors
or are best considered as secondary disorders.
The phenomenology of internet addiction
There are several reasons that certain individuals are vulnerable
to internet addiction. These include coping with stress
(Grusser et al., 2005), expanding social networks (Campbell et al.,
2006), greater control and social anxiety (Lee and Stapinski 2012; Kuss
and Griffiths (2011), coping with developmental challenges (Ko et al.,
2006; Israelashvili et al., 2012); and creating a virtual
“ideal self” and escapism (Achab et al., 2011;
Zanetta et al., 2011I; Billieux et al., 2011; Li et al., 2011). Other
contributing factors may be sex addiction, leading to people to the
internet to pursue cybersex (Southern, 2008; Ross et al., 2012; Brand
et al., 2011).
Treatment
Cognitive-Behavior Therapy
Treatment for internet addiction is based on interventions and
strategies used in the treatment of substance use disorders.
Psychosocial approaches are the mainstay of current treatment research,
with very little study of pharmacological treatment. There is
preliminary evidence for success of an "initiated abstinence" program
in 12—15 year old students in Austria, Germany, and Italy (Kalke et
al., 2004), and for a counseling program in Hong Kong (Shek et al.,
2009). Preliminary results from a study of 114 patients receiving
cognitive behavior therapy indicated that most clients were able to
manage their presenting complaints by the eighth session, and symptom
management was sustained at 6-month follow-up (Young ,2007).
A treatment study using group cognitive behavioral therapy (CBT)
for Internet addiction in adolescents is reported by Du et al. (2010).
A total of 56 patients, who met Beard's (2005) diagnostic criteria for
internet addiction, aged 12—17 years, were divided randomly into an
active treatment group (n = 32) and a clinical control group (n = 24).
Participants in the active treatment group were treated with an
eight-session multimodal school-based group CBT while participants in
the clinical control group received no intervention. Internet use, time
management, emotional, cognitive and behavioral measures were assessed
for both groups at baseline, immediately after the intervention and at
6 month follow up by investigators blind to the participants' group
status. Results showed that internet use decreased in both groups while
only the multimodal school-based group CBT evidenced improved time
management skills and better emotional, cognitive and behavioral
symptoms. The authors suggested that multimodal school-based group CBT
is effective for adolescents with internet addiction, particularly in
improving emotional state and regulation ability, behavioral and
self-management style. Marital and family therapy may also help in
selected cases, and online self-help books and tapes are available.
Lastly, self-imposed abstinence from computer use and Internet access
may be necessary in some situations (Shaw and Black, 2008).
Pharmacological treatment
Pharmacological studies used agents that were previously used
for treatment of disorders such as ADHD and OCD. A pharmacological
open-label treatment study using extended release methylphenidate in
Korean children with internet video game addiction and co-morbid ADHD
found that, after 8 weeks of treatment, measures of internet use and
internet use duration were significantly reduced, and this improvement
was positively correlated with improvement in measures of attention.
Another study has identified the co-morbidity of impulsive-compulsive
internet use with OCD to examine whether selective serotonin reuptake
inhibitors (SSRIs) such as escitalopram can be useful for treatment of
internet addiction (Dell' Osso et al., 2007). A pharmacological
open-label treatment study using escitalopram with impulsive-compulsive
internet users showed significant decrease in the number of hours spent
on the internet during the first phase of treatment but not later.
Finally, bupropion, a dopamine and norepinephrine inhibitor medication
used for treatment of nicotine and substance dependence was used for
treatment of internet videogame addiction in patients with Internet
video game addiction (IAG) (Han et al., 2010). After a 6 week
period of bupropion SR, craving for internet video game play, total
game play time, and cue-induced brain activity were decreased in
the Internet videogame addiction players. A following study by Han
and Renshaw (2012) has shown that bupropion reduced internet addiction
scores and mean time of online game playing in a group with co-morbid
excessive online videogame playing (EOP) and Major Depressive Disorder
(MDD) as well as Beck Depression Inventory (BDI).For review on existing
pharmacological treatment see Camardese et al. (2012).
Other Treatments
A treatment study combining comprehensive therapy (CT) with
electro-acupuncture (EA) in combination with psycho-intervention (PI)
on cognitive function and event-related potentials (ERP), in patients
with internet addiction (IA) was described by Zhu et al., (2012). After
treatment, in all groups, the IA score was lowered significantly and
scores of short-term memory capacity and short-term memory span
increased significantly while the decreased IA score in the
comprehensive therapy group was more significant than that in the other
two groups.
Evaluation of treatment
For an evaluation of treatment of internet addiction see King
et al. (2012).
A meta-analysis of pharmacological and psychological treatment
studies of internet addiction by Winkler et al., (2013) based on
16 studies, suggested that psychological and pharmacological interventions were
highly effective for improving IA time spent online, depression and
anxiety.
Conclusions
At least three subtypes of internet addiction have been identified:
excessive gaming, sexual preoccupations, and e-mail/text messaging. All
of the variants share the following four components: 1) excessive use,
often associated with a loss of sense of time or a neglect of basic
drives, 2) withdrawal, including feelings of anger, tension, and/or
depression when the computer is inaccessible, 3) tolerance, including
the need for better computer equipment, more software, or more hours of
use, and 4) adverse consequences, including arguments, lying, poor
achievement, social isolation, and fatigue. There is debate as to
whether internet addiction stands as its own diagnosis or is more a
product of other, existing disorders such as anxiety, depression, ADHD
or impulse control disorders. There is growing evidence that internet
addiction is a behavioral addiction but the patho-physiological
mechanisms underlying internet addiction are still under investigation.
The few published treatment studies for internet addiction are based on
interventions and strategies used in the treatment of substance use
disorders adapted to this population. Thus, it is premature to
recommend any evidence-based treatment of internet addiction although
preliminary results of psychological such as cognitive-behavior therapy
and pharmacological interventions such as with Bupropion seem promising
and the field of behavioral addictions will benefit from current and
future research in this area.
Declaration of interest:
The authors report no conflicts of interest. The authors alone are
responsible for the content and writing of the paper.
Acknowledgements
Prof. Weinstein is supported by grants from the National Institute
for Psychobiology in Israel and the Israeli anti-drug authority.
References
Aboujaoude, E. (2010). Problematic Internet use: an overview. World
Psychiatry, 9, 85–90.
Achab, S., Nicolier, M., Mauny, F., Monnin, J., Trojak, B., Vandel, P.,
Sechter, D., Gorwood, P., Haffen, E. (2011). Massively multiplayer
online role-playing games: comparing characteristics of addict vs
non-addict online recruited gamers in a French adult population. BMC
Psychiatry, 11, 144.
Alavi, S.S., Alaghemandan, H., Maracy, M.R., Jannatifard, F.,
Eslami, M., Ferdosi, M. (2012). Impact of addiction to internet on
a number of psychiatric symptoms in students of isfahan universities,
Iran, 2010. International Journal of Preventive Medicine, 3(2),
122–7.
Barke, A., Nyenhuis, N., Kröner-Herwig, B. (2012). The german
version of the internet addiction test: a validation study.
Cyberpsychology Behavior and Social Networking, 15(10), 534–42.
Beard, K.W. (2005). Internet Addiction: A Review of Current
Assessment Techniques and Potential Assessment Questions. Cyberpsychology
and Behavior, 8(1), 7–14.
Beranuy, F.M., Chamarro, L.A., Graner, J.C., Carbonell, S.X. (2009).
Validation of two brief scales for Internet addiction and mobile phone
problem use. Psicothema, 21(3), 480–5 [Article in Spanish].
Bernardi, S., Pallanti, S. (2009). Internet addiction: a descriptive
clinical study focusing on comorbidities and dissociative symptoms.
Comprehensive Psychiatry, 50(6), 510–6.
Billieux, J., Chanal, J., Khazaal, Y., Rochat, L., Gay, P.,
Zullino, D., Van der Linden, M. (2011). Psychological predictors of
problematic involvement in massively multiplayer online role-playing
games: illustration in a sample of male cybercafé players.
Psychopathology, 44(3), 165–71.
Block, J.J. (2008). Issues for DSM-V: Internet Addiction. American
Journal of Psychiatry, 165, 306–307.
Brand, M., Laier, C., Pawlikowski, M., Schächtle, U.,
Schöler, T., Altstötter-Gleich, C. (2011). Watching
pornographic pictures on the Internet: role of sexual arousal ratings
and psychological-psychiatric symptoms for using Internet sex sites
excessively. Cyberpsychology Behavior and Social Networking, 14(6),
371–7.
Camardese, G., De Risio, L., Di Nicola, M., Pizi, G., Janiri, L.
(2012). A role for pharmacotherapy in the treatment of "internet
addiction". Clinical Neuropharmacology, 35(6), 283–9.
Campbell, A.J., Cumming, S.R., Hughes, I. (2006). Internet use by
the socially fearful: addiction or therapy? Cyberpsychology and
Behavior, 9(1), 69–81.
Canan, F., Ataoglu, A., Ozcetin, A., Icmeli, C. (2012). The association
between Internet addiction and dissociation among Turkish college
students. Comprehensive Psychiatry, 53(5), 422–6.
Cao, H., Sun, Y., Wan, Y., Hao, J., Tao, F. (2011). Problematic
Internet use in Chinese adolescents and its relation to psychosomatic
symptoms and life satisfaction. BMC Public Health, 11, 802.
Cao, F., Su, L., Liu, T., Gao, X. (2007). The relationship between
impulsivity and Internet addiction in a sample of Chinese adolescents.
European Psychiatry, 22(7), 466–71.
Carli, V., Durkee, T., Wasserman, D., Hadlaczky, G., Despalins, R.,
Kramarz, E., Wasserman, C., Sarchiapone, M., Hoven, C.W., Brunner, R.,
Kaess, M. (2013). The association between pathological internet use and
comorbid psychopathology: a systematic review. Psychopathology, 46(1),
1–13. doi: 10.1159/000337971.
Cheung, L.M., Wong, W.S. (2011).The effects of insomnia and internet
addiction on depression in Hong Kong Chinese adolescents: an exploratory
cross-sectional analysis. Journal of Sleep Research, 20(2),
311–7.
Cho, S.M., Sung, M.J., Shin, K.M., Lim, K.Y., Shin, Y.M. (2012).
Does Psychopathology in Childhood Predict Internet Addiction in Male
Adolescents? Child Psychiatry and Human Development [Epub
ahead of print].
Chong, G.N., Isa, S.M., Hashim, A.H., Pillai, S.K., Harbajan Singh,
M.K. (2012). Validity of the Malay Version of the Internet Addiction
Test: A Study on a Group of Medical Students in Malaysia. Asia Pacific
Journal of Public Health [Epub ahead of print].
Christakis, D.A., Moreno, M.M., Jelenchick, L., Myaing, M.T., Zhou, C.
(2011). Problematic internet usage in US college students: a pilot
study. BMC Medicine, 22, 9, 77.
Dalbudak, E., Evren, C., Aldemir, S., Coskun, K.S., Ugurlu, H.,
Yildirim, F.G. (2013). Relationship of Internet Addiction Severity with
Depression, Anxiety, and Alexithymia, Temperament and Character in
University Students. Cyberpsychology Behavior and Social Networking
[Epub ahead of print].
De Berardis, D., D'Albenzio, A., Gambi, F., Sepede, G., Valchera, A.,
Conti, C.M., Fulcheri, M., Cavuto, M., Ortolani, C., Salerno, R.M.,
Serroni, N., Ferro, F.M. (2009). Alexithymia and its relationships with
dissociative experiences and Internet addiction in a nonclinical
sample. Cyberpsychology and Behavior, 12(1), 67–9.
Dell' Osso, B., Altamura, A.C., Hadley, S.J., Baker, B.R., Hollander,
E. (2007). An open-label trial of escitalopram in the treatment of
impulsive-compulsive internet usage disorder. European
Neuropsychopharmacology, 16, S82–S83.
Dell’Osso, B., Altamura, C., Allen, A., Marazziti, D.,
Hollander, E. (2006). Epidemiological and clinical updates on impulse
control disorders: a critical review. European Archives of Psychiatry
and Clinical Neurosciences, 256, 464–475.
Deng, Y.X., Hu, M., Hu, G.Q., Wang, L.S., Sun, Z.Q. (2007). An
investigation on the prevalence of internet addiction disorder in
middle school students of Hunan province. Zhonghua Liu Xing Bing
Xue Za Zhi, 28(5), 445–8 [Article in Chinese].
Demetrovics, Z., Szeredi, B., Rózsa, S. (2008). The
three-factor model of Internet addiction: the development of the
Problematic Internet Use Questionnaire. Behavior Research Methods,
40(2), 563–74.
Du, Y.S., Jiang, W., Vance, A. (2010). Longer term effect of
randomized, controlled group cognitive behavioural therapy for Internet
addiction in adolescent students in Shanghai. Australia and New Zealand
Journal of Psychiatry, 44(2), 129–34.
Durkee, T., Kaess, M., Carli, V., Parzer, P., Wasserman, C., Floderus,
B., Apter, A., Balazs, J., Barzilay, S., Bobes, J., Brunner, R., Corcoran,
P., Cosman, D., Cotter, P., Despalins, R., Graber, N., Guillemin, F.,
Haring, C., Kahn, J.P., Mandelli, L., Marusic, D., Mészáros,
G., Musa, G.J., Postuvan, V., Resch, F., Saiz, P.A., Sisask, M.,
Varnik, A., Sarchiapone, M., Hoven, C.W., Wasserman, D. (2012). Prevalence
of pathological internet use among adolescents in Europe: demographic and
social factors. Addiction, 107(12), 2210–22.
Fisoun, V., Floros, G., Siomos, K., Geroukalis, D., Navridis, K.
(2012). Internet addiction as an important predictor in early detection
of adolescent drug use experience-implications for research and
practice. Journal of Addiction Medicine, 6(1), 77–84.
Fortson, B.L., Scotti, J.R., Chen, Y.C., Malone, J., Del Ben, K.S.
(2007). Internet use, abuse, and dependence among students at a
southeastern regional university. Journal of American College Health,
56(2), 137–44.
Fu, K.W., Chan, W.S., Wong, P.W., Yip, P.S. (2010). Internet addiction:
prevalence, discriminant validity and correlates among adolescents in
Hong Kong. British Journal of Psychiatry, 196(6), 486–92.
Ghamari, F., Mohammadbeigi, A., Mohammadsalehi, N., Hashiani, A.A.
(2011). Internet addiction and modeling its risk factors in medical
students, Iran. Indian Journal of Psychological Medicine, 33(2),
158–62.
Grant, J.E., Potenza, M.N., Weinstein, A., Gorelick, D.A (2010).
Introduction to Behavioral Addictions. American Journal of Drug and
Alcohol Abuse, 36(5), 233–241.
Griffiths, M. (1998). Internet addiction: Does it really exist?
In J. Gackenbach (Ed.), Psychology and the internet: Intrapersonal,
interpersonal and transpersonal applications, pp. 61–75.
New York: Academic Press.
Griffiths, M. (2000). Internet addiction – Time to be taken
seriously? Addiction Research, 8, 413–418.
Guo, J., Chen, L., Wang, X., Liu, Y., Chui, C.H., He, H., Qu, Z.,
Tian, D. (2012). The relationship between internet addiction and
depression among migrant children and left-behind children in China.
Cyberpsychology Behavior and Social Networking, 15(11),
585–90.
Greenfield, D.N. (1999). Psychological characteristics of compulsive
internet use: a preliminary analysis. Cyberpsychology and
Behavior, 2(5), 403–12.
Grusser, S.M., Thalemann, R., Albrecht, U., Thalemann, C.N. (2005).
Excessive computer usage in adolescents-results of a psychometric
evaluation. Wien Klin Wochenschr, 117(5–6), 188–195
[Article in German].
Ha, J.H., Kim, S.Y., Bae, S.C., Bae, S., Kim, H., Sim, M., Lyoo, I.K.,
Cho, S.C. (2007). Depression and Internet addiction in adolescents.
Psychopathology, 40(6), 424–30.
Han, D.H., Renshaw, P.F. (2012). Bupropion in the treatment of
problematic online game play in patients
with major depressive disorder. Journal of
Psychopharmacology, 26(5), 689–96.
Han, D.H., Hwang, J.W., Renshaw, P.F. (2010). Bupropion sustained
release treatment decreases craving for video games and cue-induced
brain activity in patients with Internet video game addiction.
Experimental and Clinical Psychopharmacology, 18(4),
297–304.
Han, D., Lee, Y., Na, C., Ahn, J., Chung, U., Daniels, M., Haws, C.,
Renshaw, P. (2009). The effect of methylphenidate on Internet video
game play in children with attention-deficit/hyperactivity disorder.
Comprehensive Psychiatry, 50(3), 251–6.
Israelashvili, M., Kim, T., Bukobza, G. (2012). Adolescents' over-use
of the cyber world – Internet addiction or identity exploration?
Journal of Adolescence, 35(2), 417–24.
Jang, M.H., Ji, E.S. (2012). Gender differences in associations
between parental problem drinking and early adolescents' internet
addiction. Journal of Specialists in Pediatric Nursing, 17(4),
288–300.
Jang, K.S., Hwang, S.Y., Choi, J.Y. (2008). Internet addiction
and psychiatric symptoms among Korean adolescents. Journal of
School Health, 78(3), 165–71.
Jelenchick, L.A., Becker, T., Moreno, M.A. (2012). Assessing
the psychometric properties of the Internet Addiction Test (IAT)
in US college students. Psychiatry Research, 30, 196(2–3),
296–301.
Kalke, J., Raschke, P. (2004). Learning by doing: "initiated
abstinence", a school-based programme for the prevention of addiction.
Results of an evaluation study. European Addiction Research,
10(2), 88–94.
Khazaal, Y., Chatton, A., Horn, A., Achab, S., Thorens, G.,
Zullino, D., Billieux, J. French validation of the compulsive Internet
use scale (CIUS). (2012). Psychiatric Quarterly, 83(4),
397–405.
Kim, K., Ryu, E., Chon, M.Y., Yeun, E.J., Choi, S.Y., Seo, J.S., Nam,
B.W. (2006). Internet addiction in Korean adolescents and its relation
to depression and suicidal ideation: a questionnaire survey.
International Journal of Nursing Studies, 43(2), 185–92.
Kim, S.J., Park, D.H., Ryu, S.H., Yu, J., Ha, J.H. (2012).
Usefulness of Young's Internet Addiction Test for clinical populations.
Nordic Journal of Psychiatry, Dec 18 [Epub ahead of print].
King, D.L., Delfabbro, P.H., Griffiths, M.D., Gradisar, M. (2012).
Cognitive-behavioral approaches to outpatient treatment of internet
addiction in children and adolescents. Journal of Clinical Psychology,
68(11), 1185–95.
King, D.L., Delfabbro, P.H., Griffiths, M.D., Gradisar, M. (2011).
Assessing clinical trials of Internet addiction treatment: a systematic
review and CONSORT evaluation. Clinical Psychology Review, 31(7),
1110–6.
Kittinger, R., Correia, C.J., Irons, J.G. (2012). Relationship
between Facebook use and problematic Internet use among college students.
Cyberpsychology Behavior and Social Networking, 15(6), 324–7.
Ko, C.H., Yen, J.Y., Yen, C.F., Chen, C.S., Weng, C.C., Chen, C.C.
(2008). The association between Internet addiction and problematic
alcohol use in adolescents: the problem behavior model. Cyberpsychology
and Behavior, 11(5), 571–6.
Korkeila, J., Kaarlas, S., Jaaskelainen, M., Vahlberg, T.,
Taiminen, T. (2009). Attached to the web – harmful use of
the Internet and its correlates. European Psychiatry, 25,
236–41.
Kormas, G., Critselis, E., Janikian, M., Kafetzis, D., Tsitsika, A.
(2011). Risk factors and psychosocial characteristics of potential
problematic and problematic internet use among adolescents: a
cross-sectional study. BMC Public Health, 11, 595.
Kratzer, S., Hegerl, U. (2008). Is "Internet Addiction" a disorder
of its own? – a study on subjects with excessive internet use.
Psychiatriche Praxis, 35(2), 80–3 [Article in German].
Kuss, D.J., Griffiths, M.D. (2011). Online social networking and
addiction – a review of the psychological literature. International
Journal of Environmental Research in Public Health, 8(9), 3528–52.
Kwon, J.H., Chung, C.S., Lee, J. (2011). The Effects of Escape from
Self and Interpersonal Relationship on the Pathological Use of Internet
Games. Community Mental Health Journal, 47, 113–121.
Lam, L.T., Peng, Z.W., Mai, J.C., Jing, J. (2009). Factors
associated with Internet addiction among adolescents. Cyberpsychology
and Behavior, 12(5), 551–5.
Lee, B.W., Stapinski, L.A. (2012). Seeking safety on the internet:
relationship between social anxiety and problematic internet use.
Journal of Anxiety Disorders, 26(1), 197–205.
Li, D., Liau, A., Khoo, A. (2011). Examining the influence of
actual-ideal self-discrepancies, depression, and escapism, on
pathological gaming among massively multiplayer online adolescent
gamers. Cyberpsychology Behavior and Social Networking,
14(9), 535–9.
Liberatore, K.A., Rosario, K., Colón-De Martí,
L.N., Martínez, K.G. (2011). Prevalence of Internet addiction
in Latino adolescents with psychiatric diagnosis. Cyberpsychology
Behavior and Social Networking, 14(6), 399–402.
Mazhari, S. (2012). Association between problematic Internet use
and impulse control disorders among Iranian university students.
Cyberpsychology Behavior and Social Networking, 15(5),
270–3.
Meerkerk, G.J., Van Den Eijnden, R.J., Vermulst, A.A., Garretsen, H.F.
(2009). The Compulsive Internet Use Scale (CIUS): some psychometric
properties. Cyberpsychology and Behavior, 12(1), 1–6.
Milani, L., Osualdella, D., Di Blasio, P. (2009). Quality of
Interpersonal Relationships and Problematic Internet
Use in Adolescence. Cyberpsychology and Behavior,
12(6), 681–4.
Moreno, M.A., Jelenchick, L., Cox, E., Young, H., Christakis, D.A.
(2011). Problematic internet use among US youth: a systematic review.
Archives of Pediatric and Adolescent Medicine, 165(9),
797–805.
Morrison, C.M., Gore, H. (2010). The relationship between excessive
Internet use and depression: a questionnaire-based study of 1,319 young
people and adults. Psychopathology, 43(2), 121–6.
Ni, X., Yan, H., Chen, S., Liu, Z. (2009). Factors influencing
internet addiction in a sample of freshmen university students in China.
Cyberpsychology and Behavior, 12(3), 327–30.
Nichols, L.A., Nicki, R. (2004). Development of a psychometrically
sound internet addiction scale: a preliminary step. Psychology of
Addictive Behaviors, 18(4), 381–4.
Niemz, K., Griffiths, M., Banyard, P. (2005). Prevalence of
pathological Internet use among university students and correlations
with self-esteem, the General Health Questionnaire (GHQ) and
disinhibition. Cyberpsychology and Behavior, 8(6), 562–70.
Pallanti, S., Bernardi, S., Quercioli, L. (2006). The Shorter PROMIS
Questionnaire and the Internet Addiction Scale in the assessment of
multiple addictions in a high-school population: prevalence and related
disability. CNS Spectrum, 11(12), 966–74.
Park, J.W., Park, K.H., Lee, I.J., Kwon, M., Kim, D.J. (2012).
Standardization study of internet addiction improvement motivation
scale. Psychiatry Investigations, 9(4), 373–8.
Park, S.K., Kim, J.Y., Cho, C.B. (2008). Prevalence of Internet
addiction and correlations with family factors among South Korean
adolescents. Adolescence, 43(172), 895–909.
Poli, R., Agrimi, E. (2012). Internet addiction disorder:
prevalence in an Italian student population. Nordic Journal of
Psychiatry, 66(1), 55–9.
Ross, M.W., Månsson, S.A., Daneback, K. (2012). Prevalence,
severity, and correlates of problematic sexual Internet use in Swedish
men and women. Archives of Sexual Behavior, 41(2), 459–66.
Shaw, M., Black, D.W. (2008). Internet addiction: definition,
assessment, epidemiology and clinical management. CNS Drugs, 22(5),
353–65.
Shek, D.T., Tang, V.M., Lo, C.Y. (2009). Evaluation of an Internet
addiction treatment program for Chinese adolescents in Hong Kong.
Adolescence, 44(174), 359–73.
Smahel, D., Brown, B.B., Blinka, L. (2012). Associations between
online friendship and Internet addiction among adolescents and
emerging adults. Developmental Psychology, 48(2), 381–8.
Southern, S. (2008). Treatment of compulsive cybersex behavior.
Psychiatric Clinics of North America, 31(4), 697–712.
Tao, R., Huang, X., Wang, J., Zhang, H., Zhang, Y., Li, M. (2010).
Proposed diagnostic criteria for Internet addiction. Addiction,
105, 556–564.
te Wildt, B.T., Putzig, I., Zedler, M., Ohlmeier, M.D. (2007).
Internet dependency as a symptom of depressive mood disorders.
Psychiatrische Praxis, 34 Suppl 3, S318–22 [Article in German].
Tsai, H.F., Cheng, S.H., Yeh, T.L., Shih, C.C., Chen, K.C.,
Yang, Y.C., Yang, Y.K. (2009). The risk factors of Internet addiction
– a survey of university freshmen. Psychiatry Research,
167(3), 294–9.
Tsitsika, A., Critselis, E., Louizou, A., Janikian, M., Freskou, A.,
Marangou, E., Kormas, G., Kafetzis, D. (2011). Determinants of Internet
addiction among adolescents: a case-control study. Scientific World
Journal, 11, 866–74.
Tsitsika, A., Critselis, E., Kormas, G., Filippopoulou, A.,
Tounissidou, D., Freskou, A., Spiliopoulou, T., Louizou, A.,
Konstantoulaki. E., Kafetzis, D. (2009). Internet use and misuse: a
multivariate regression analysis of the predictive factors of internet
use among Greek adolescents. European Journal of Pediatrics,
168(6), 655–65.
Wang, H., Zhou, X., Lu, C., Wu, J., Deng, X., Hong L. (2011).
Problematic Internet Use in high school students in Guangdong Province,
China. PLoS One, 6(5), e19660.
Wei, H.T., Chen, M.H., Huang, P.C., Bai, Y.M. (2012). The
association between online gaming, social phobia, and depression:
an internet survey. BMC Psychiatry, 12, 92.
Weinstein, A., Dorani, D., Elhadif, R., Bukovza Y, Yarmulnik, A.,
Dannon, P. (2015). Internet addiction is associated with social anxiety
in young adults. Annals of Clinical Psychiatry, 27(1), 4–9.
Weinstein, A.M., Feder, K., Rosenberg, K., Dannon, P (2014).
Internet addiction – criteria evidence and treatment.
Chapter 5 (pp. 99–117) in Kenneth Paul Rosenberg and Laura
Curtiss Feder (Eds.) “Behavioral Addictions: Criteria,
Evidence and Treatment”. Burlington Elsevier Science USA.
Weinstein, A., Lejoyeux, M. (2010). Internet addiction or
Excessive Internet Use. American Journal of Drug and Alcohol Abuse,
36(5), 277–283.
Weinstein, A., Lejoyeux, M. (2013). New developments in the
psychobiology of internet and videogame addiction. The American
Journal on Addiction, 20, 1–9.
Weinstein A., Yaacov Y., Manning M., Danon P., Weizman A. Internet
addiction and Attention Deficit Hyperactivity Disorder (ADHD) among
school children. Israeli Medical Association Journal (in press).
Whang, L.S., Lee, S., Chang, G. (2003). Internet over-users'
psychological profiles: a behavior sampling analysis on internet
addiction. Cyberpsychology and Behavior, 6(2), 143–50.
Widyanto, L., Griffiths, M.D., Brunsden, V. (2011). A psychometric
comparison of the Internet Addiction Test, the Internet-Related Problem
Scale, and self-diagnosis. Cyberpsychology Behavior and Social
Networking, 14(3), 141–9.
Widyanto, L., McMurran, M. (2004). The psychometric properties of
the internet addiction test. Cyberpsychology and Behavior, 7(4),
443–50.
Winkler A., Dörsing B., Rief W., Shen Y., Glombiewski J.A.
(2013). Treatment of internet addiction: A meta-analysis. Clinical
Psychology Review, 33(2), 317–329.
Woelfling, K., Buhler, M., Lemenager, T., Mairsen, C., Mann, K.
(2009). Gambling and internet addiction: review and research agenda.
Der Nervenarzt, 80(9), 1030–9 [Article in German].
Xiuqin, H., Huimin, Z., Mengchen, L., Jinan, W., Ying, Z., Ran, T.
(2010). Mental health, personality, and parental rearing styles of
adolescents with Internet addiction disorder. Cyberpsychology
Behavior and Social Networking, 13(4), 401–6.
Xu, J., Shen, L.X., Yan, C.H., Hu, H., Yang, F., Wang, L.,
Kotha, S.R., Zhang, L.N., Liao, X.P., Zhang, J., Ouyang, F.X.,
Zhang, J.S., Shen, X.M. (2012). Personal characteristics related to
the risk of adolescent internet addiction: a survey in Shanghai, China.
BMC Public Health, 12(1), 1106.
Yates, T.M., Gregor, M.A., Haviland, M.G. (2012). Child
maltreatment, alexithymia, and problematic internet use in young
adulthood. Cyberpsychology Behavior and Social Networking, 15(4),
219–25.
Yen, J.Y., Ko, C.H., Yen, C.F., Chen, C.S., Chen, C.C. (2009).
The association between harmful alcohol use and Internet addiction
among college students: comparison of personality. Psychiatry and
Clinical Neurosciences, 63(2), 218–24.
Yen, C.F., Ko, C.H., Yen, J.Y., Chang, Y.P., Cheng, C.P. (2009).
Multi-dimensional discriminative factors for Internet addiction among
adolescents regarding gender and age. Psychiatry and Clinical
Neurosciences, 63(3), 357–64.
Yen, J.Y., Ko, C.H., Yen, C.F., Wu, H.Y., Yang, M.J. (2007). The
comorbid psychiatric symptoms of Internet addiction: attention deficit
and hyperactivity disorder (ADHD), depression, social phobia, and
hostility. Journal of Adolescent Health, 41(1), 93–8.
Yen, J.Y., Yen, C.F., Chen, C.S., Tang, T.C., Ko, C.H. (2009).
The association between adult ADHD symptoms and internet addiction
among college students: the gender difference. Cyberpsychology
Behavior, 12(2), 187–91.
Yen, J.Y., Yen, C.F., Wu, H.Y., Huang, C.J., Ko, C.H. (2011).
Hostility in the real world and online: the effect of internet addiction,
depression, and online activity. Cyberpsychology Behavior and Social
Networking, 14(11), 649–55.
Young, K.S. (2007). Cognitive behavior therapy with Internet
addicts: treatment outcomes and implications. Cyberpsychology
Behavior, 10(5), 671–9.
Young, K.S. (1998). Caught in the Net. New York: John Wiley
& Sons.
Zanetta Dauriat, F., Zermatten, A., Billieux, J., Thorens, G.,
Bondolfi, G., Zullino, D., Khazaal, Y. (2011). Motivations to play
specifically predict excessive involvement in massively multiplayer
online role-playing games: evidence from an online survey. European
Addiction Research, 17(4), 185–9.
Zhu, T.M., Li, H., Jin, R.J., Zheng, Z., Luo, Y., Ye, H., Zhu, H.M.
(2012). Effects of electroacupuncture combined psycho-intervention on
cognitive function and event-related potentials P300 and mismatch
negativity in patients with internet addiction. Chinese Journal of
Integrative Medicine, 18(2), 146–51.
For citation
Weinstein A. Internet Addiction: diagnosis, comorbidity and treatment.
Med. psihol. Ross., 2015, no. 4(33), p. 3 [in English, in Russian].
Available at: http://mprj.ru ↑
Интернет-зависимость: диагностика, коморбидность и лечение
Вайнштейн А. (Ариэль, Израиль)
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Вайнштейн Авив
– профессор, кафедра поведенческих наук,
факультет социальных и гуманитарных наук, Ариэльский
университет, Ариэль, Израиль. Тел.: +972 1-800-660-660.
E-mail: avivweinstein@yahoo.com
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Аннотация.
Проблемное использование Интернета (ПИИ), или чрезмерное использование
Интернета, характеризуется непреодолимой тягой к компьютеру и
поглощенностью использованием компьютера и Интернета, приводящими к
дистрессу и ухудшению состояния человека. Различные исследования
показали, что в США и Европе от данного расстройства страдает
1,5—8,2% людей. Результаты исследований методом поперечных
срезов свидетельствуют о высокой коморбидности интернет-зависимости
и разных психических заболеваний. В данной статье рассматриваются
проблемы диагностики, лечения интернет-зависимости и коморбидности
интернет-зависимости и других психических расстройств.
Ключевые слова:
интернет-зависимость; проблемное использование Интернета; поведенческая
зависимость.
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Поступила в редакцию:
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Прошла рецензирование:
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Опубликована:
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24.06.2015
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10.07.2015
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23.07.2015
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Ссылка для цитирования размещена в конце публикации.
Введение: интернет-зависимость и ее лечение
Проблемное использование Интернета (ПИИ), или чрезмерное использование
Интернета, характеризуется непреодолимой тягой к компьютеру и
поглощенностью использованием компьютера и Интернета, приводящими к
дистрессу и ухудшению состояния человека. В предыдущих исследованиях
Янг (1998), Гриффитс (1998; 2000) и Абужаудэ (2010) определили данное
расстройство и получили много информации о нем. Проблему стали освещать
в СМИ, и она привлекла внимание многих исследователей. Вместе с тем
отмечался рост использования компьютера и Интернета [80].
Феноменологически выделяется как минимум три подтипа интернет-зависимости:
зависимость от компьютерных игр (гэмблинг), киберсексуальная зависимость
и зависимость от общения в социальных сетях или по электронной
почте/посредством текстовых сообщений. Люди, зависимые от Интернета,
используют его в течение длительных периодов времени, изолируют себя
от других форм социальных контактов и отдают предпочтение Интернету,
а не другим жизненным событиям. Подростки с интернет-зависимостью
пользуются неэффективными стратегиями совладания с проблемами в школе
и дома. Кроме того, у них часто бывают проблемы в сфере межличностных
отношений [59]. Интернет-зависимость также может рассматриваться как
попытка сбежать от самого себя. То же самое касается зависимости от
онлайн-игр [53].
Для ПИИ было предложено три разных модели [44; 102; 103; 37]. Так,
некоторые исследователи относят расстройства привычек и влечений к
расстройствам обсессивно-компульсивного спектра. Доказательствами могут
служить данные сканирования мозга и результаты исследований, в которых
лечение интернет-зависимости проводилось с использованием селективных
ингибиторов обратного захвата серотонина (СИОЗС) [21]. Однако другие
исследования способны опровергнуть данную теорию. Также ПИИ называли
расстройством привычек и влечений, характеризующимся сильным желанием
часто выходить в Сеть. Такое поведение сначала доставляет удовольствие,
но в итоге может привести к негативным последствиям [1]. Наконец,
некоторые авторы предлагают считать интернет-зависимость поведенческой
зависимостью. Они уверены, что для нее характерны злоупотребление,
несмотря на негативные последствия, синдром отмены, развитие
толерантности. Все это имеет место в случае зависимости от ПАВ.
Интернет-зависимость часто сопровождается другими расстройствами.
Из-за этого возникает вопрос о том, что первично.
Диагностика и клинические критерии
Для включения интернет-зависимости в DSM-V было предложено 4
критерия [11]: 1) чрезмерное использование Интернета, часто —
с потерей чувства времени или пренебрежением базовыми потребностями,
2) синдром отмены, включая злость, напряжение и/или депрессию, когда
компьютер недоступен, 3) толерантность, включая потребность в лучшем
компьютерном оборудовании, большем количестве компьютерных программ,
увеличении периода времени, проводимого за компьютером и 4) негативные
последствия, включая споры, ложь, проблемы с учебой и отдыхом,
социальную изоляцию и утомление.
Для разработки диагностических критериев интернет-зависимости и
оценки их валидности и надежности в общей популяции было проведено
масштабное исследование [75]. Диагностические критерии включают
симптоматические критерии (семь клинических симптомов
интернет-зависимости), критерии клинически значимых нарушений
(функциональных и психосоциальных), критерии течения (длительность
зависимости не менее трех месяцев и использование Интернета в течение
как минимум 6 часов в день при том, что человек вполне мог бы без этого
обойтись) и критерии исключения (исключение зависимости, вызванной
психическими расстройствами). Интернет-зависимость в 2013 году была
упомянута в DSM-V как состояние, требующее дальнейшего изучения, но она
не считается психическим расстройством. Между тем зависимость от
онлайн-игр была включена в приложение к DSM-V, опубликованное в мае
2013 года. Так, до сих пор в DSM-V не прописан подход к людям, которые,
вероятно, зависимы от Интернета. К тому же там не прописано, как
организовывать и интерпретировать результаты исследований
интернет-зависимости. Однако определения разрабатываются, а
диагностические инструменты создаются врачами и исследователями ПИИ и
зависимости от онлайн-игр.
Оценка интернет-зависимости
Опросники для диагностики интернет-зависимости — это
модифицированные опросники для диагностики зависимости от психоактивных
веществ, включающие вопросы по интернет-зависимости. Наиболее часто
используемый опросник — это валидизированный тест Кимберли —
Янг на интернет-зависимость (IAT) [106; 10; 7; 93; 100; 8; 35; 48].
Шкала интернет-зависимости (IAS) была создана Гриффитсом (1998) и
валидизирована (Nichols and Nicki (2004) [63] и Canan et al. (2010)).
Другие опросники: «Шкала интернет-зависимости Чен» (CIAS)
(Yen et al., 2012), Опросник «Опыт, связанный с Интернетом»
[99], шкала компульсивного использования Интернета (CIUS) [92; 25],
опросник проблематичного использования Интернета (PIUQ) [16] и шкала
проблем, связанных с Интернетом (IRPS) [105].
Коэффициент распространенности
Коэффициент распространенности интернет-зависимости во всем мире
варьируется между 1,5% и 8,2% (Petersen et al., 2009). В США он
составляет 6% [27], 0,3—0,7% [80] и 4% [71], а также 25% среди
студентов университетов Северной Америки [42; 72]. В Европе коэффициент
варьируется между 3% в Германии [26], 5,4% и 5% в Италии [68; 65],
10,4% в Греции [43] и 18,3% в Великобритании. Согласно крупному
исследованию, проведенному в 11 европейских странах, коэффициент
равен 4,4% [70].
Больше всего исследований на тему интернет-зависимости было проведено
на Дальнем Востоке. В Китае коэффициент распространенности варьируется
между 10,2% для интернет-зависимости средней степени тяжести и 0,6% для
тяжелой зависимости [23]. Он составляет 6,44% в провинции Шэньси [24],
от 2,4% до 5,52% в провинции Хунань [3; 94]. В Шанхае коэффициент равен
8,8% [67], в Гонконге — 6,7% [40]. В Тайване зависимы 17,9%
студентов [96]. В Южной Корее в группе риска оказались 16% учащихся
средней школы. Среди них 3,1% были подвержены высокому риску
(Seo et al., 2009). Другие исследователи из Южной Кореи обнаружили 4,3%
[46], 10,7% [66], 20,3% [16], 1,6% [38] и 3,5% [104] подростков с
интернет-зависимостью.
Коморбидность с психическими расстройствами
Поперечные исследования свидетельствуют о высокой коморбидности
интернет-зависимости и психических расстройств, таких как аффективные
расстройства, тревожные расстройства (включая генерализованное
тревожное расстройство, социальное тревожное расстройство) и синдром
дефицита внимания и гиперактивности (СДВГ) [37].
В таблице 1 представлены данные о коморбидности интернет-зависимости
и других психических расстройств/симптомов. В таблице разделены
исследования, проведенные в среде взрослых и подростков.
Таблица 1
Коморбидность интернет-зависимости и других психических
расстройств/симптомов
Примечание: * — у детей.
Симптомы обсессивно-компульсивного расстройства наблюдались у
участников исследования до того, как они стали зависимыми от Интернета
(Dong et al., 2011). Связь между синдромом отмены, тревожным
расстройством/депрессией и будущей интернет-зависимостью была
обнаружена среди мужчин из Южной Кореи [18]. Наконец, обзор 20
исследований, в которых изучались корреляции между проблематичным
использованием Интернета и психическими заболеваниями, показал:
у 75% участников интернет-зависимость коррелировала с депрессией,
у 57% — с тревожным расстройством, у 100% — с
симптомами СДВГ, у 60% — с симптомами обсессивно-компульсивного
синдрома и у 66% — с враждебностью/агрессивностью [90].
Связь интернет-зависимости с употреблением алкоголя и наркотиков
Проблема связи интернет-зависимости с употреблением наркотиков и
алкоголя мало изучена. Исследование, проведенное в Финляндии [7],
показало, что у субъектов, употреблявших каннабис, средний балл в
тесте Кимберли — Янг на интернет-зависимость превышал норму.
В США злоупотребление родителей алкоголем влияло на интернет-зависимость
у мальчиков, но не у девочек младшего подросткового возраста.
Злоупотребление родителей алкоголем косвенно влияет на риск
интернет-зависимости через тревожность/депрессию и агрессивность среди
мальчиков и функции семьи и агрессивность среди девочек [47]. ПИИ
также было связано с употреблением психоактивных веществ греческими
подростками с острова Кос [36]. Подростки, употреблявшие ПАВ и
зависевшие от Интернета, имели схожие личностные черты, например
психотизм. Наконец, интернет-зависимость оказалась связана с
чрезмерным употреблением алкоголя учащимися с Тайваня ([86];
Ken et al., 2008). Не известно, имеют ли эти расстройства
общие факторы риска или же одно влечет за собой другое.
Феноменология интернет-зависимости
Существует несколько факторов, повышающих риск интернет-зависимости.
Это желание справиться со стрессом [22], расширить круг общения [12],
повысить уровень контроля, социальная тревожность [54; 52], нарушения
развития (Ko et al., 2006; Israelashvili et al., 2012 [45]), создание
виртуального «идеального Я» и эскапизм [56; 61; 76; 55].
К другим факторам относится сексуальная зависимость, которая становится
причиной возникновения киберсексуальной зависимости.
Лечение
Когнитивно-бихевиоральная терапия
Для лечения интернет-зависимости применяются вмешательства и
стратегии, используемые при лечении расстройств, вызванных
употреблением психоактивных веществ. Психосоциальные подходы являются
основным направлением современных исследований методов лечения.
Фармакологическое лечение мало изучено. Существуют предварительные
доказательства эффективности программы Initiated abstinence для
12—15-летних учащихся из Австрии, Германии и Италии [49] и
программы консультирования в Гонконге [81]. Предварительные результаты
исследования 114 пациентов, проходивших когнитивно-поведенческую
терапию, показали, что большинство клиентов смогли справиться с
первоначальными симптомами к восьмой сессии. Положительный эффект
сохранялся в течение последующего 6-месячного наблюдения [109].
Также существует исследование эффективности метода групповой
когнитивно-поведенческой терапии (КПТ) для интернет-зависимых
подростков [19]. 56 интернет-зависимых пациентов в возрасте
12—17 лет разделили на группы. Первая группа активно лечилась
(n = 32), а вторая была контрольной (n = 24). Участники из первой
группы посещали сеансы мультимодальной групповой КПТ в школе, а
добровольцы из второй группы не лечились. В начале, в конце
исследования и спустя 6 месяцев после начала лечения ученые оценили
особенности эмоциональной, когнитивной, поведенческой сфер участников и
то, как те распоряжались своим временем и использовали Интернет.
Добровольцы из обеих групп стали реже пользоваться Интернетом. Однако
только подростки из первой группы стали лучше управлять своим временем,
и у них уменьшилось число эмоциональных, когнитивных и поведенческих
симптомов зависимости. Авторы предположили, что школьные сеансы
мультимодальной групповой КПТ эффективны для подростков с
интернет-зависимостью. В частности, они улучшают эмоциональное
состояние и способность к контролю, развивают навыки управления
поведением и самоуправления. Супружеская и семейная терапия тоже может
помочь в отдельных случаях. Доступны онлайн книги и аудиозаписи для
самопомощи. Наконец, в некоторых ситуациях необходимо добровольное
воздержание от использования компьютера и Интернета [80].
Фармакологическое лечение
В фармакологических исследованиях использовались препараты, которые
ранее применялись для лечения таких расстройств, как СДВГ и ОКР.
Открытое исследование фармакологического лечения корейских детей с
интернет-зависимостью и СДВГ с использованием метилфенидата
пролонгированного действия показало: через 8 недель лечения частота и
продолжительность использования Интернета значительно снизились. Это
положительно коррелировало с повышением уровня внимания у детей. В
другом исследовании, показавшем, что импульсивно-компульсивное
использование Интернета коморбидно с ОКР, изучалось, можно ли вылечить
интернет-зависимость с помощью селективных ингибиторов обратного
захвата серотонина (СИОЗС), таких как эсциталопрам [21]. Согласно
данным проведенного открытого исследования, в первой фазе лечения
эсциталопрамом участники с интернет-зависимостью стали проводить в
Интернете гораздо меньше времени. Потом эффект исчез. Наконец, для
лечения зависимости от онлайн-игр использовался бупропион, ингибитор
дофамина и норэпинефрина. Его обычно назначают при зависимости от
ПАВ [30]. Спустя 6 недель лечения у участников исследования ослабла
тяга к онлайн-видеоиграм. Они стали проводить за видеоиграми меньше
времени. Кроме того, у них снизился уровень соответствующей мозговой
активности. Следующее исследование, которое провели Хань и Реншоу,
показало, что лечение бупропионом приводило к снижению средних баллов
в тесте для диагностики интернет-зависимости. Помимо этого, участники
исследования, также зависимые от онлайн-игр и страдавшие от клинической
депрессии, после лечения стали меньше играть в видеоигры [5].
Другие методы лечения
Проводилось сравнительное исследование комплексной терапии
интернет-зависимости, электроакупунктуры в сочетании с психологическим
вмешательством в когнитивную сферу и метода вызванных потенциалов [20].
После лечения во всех группах уровень интернет-зависимости значительно
снизился. Кроме того, у участников исследования улучшилась
кратковременная память и увеличился ее объем. Сильнее всего уровень
интернет-зависимости снизился в группе комплексной терапии по сравнению
с двумя другими группами.
Оценка лечения
Оценку лечения интернет-зависимости можно найти у King et al. [14].
На основании метаанализа 16 исследований фармакологического и
психологического лечения интернет-зависимости [97] можно предположить,
что психологическое и фармакологическое вмешательство весьма эффективно.
Оно помогает уменьшить время, проводимое интернет-зависимыми в Сети,
снижает уровни тревоги и депрессии.
Выводы
Были определены, по крайней мере, три подтипа интернет-зависимости:
зависимость от видеоигр, киберсексуальная зависимость и зависимость от
электронной почты/текстовых сообщений. Для всех вариантов характерны
следующие составляющие: 1) чрезмерное использование Интернета, часто
— с потерей чувства времени или пренебрежением базовыми
потребностями, 2) синдром отмены, включая злость, напряжение и/или
депрессию, когда компьютер недоступен, 3) толерантность, включая
потребность в лучшем компьютерном оборудовании, большем количестве
компьютерных программ, увеличении периода времени, проводимого за
компьютером и 4) негативные последствия, включая споры, ложь, проблемы
с учебой и отдыхом, социальную изоляцию и утомление.
Не существует единого мнения по поводу того, является ли
интернет-зависимость отдельным расстройством или же это компонент
других расстройств, таких как тревожное расстройство, депрессия, СДВГ
или расстройства привычек и влечений. Появляется все больше
доказательств того, что интернет-зависимость можно отнести к
поведенческим зависимостям. При этом патофизиологические механизмы
данного расстройства пока неясны. Некоторые исследования показали, что
интернет-зависимость можно лечить так же, как зависимость от ПАВ.
Однако пока рано рекомендовать какие-то определенные методы лечения
интернет-зависимости, хотя когнитивно-бихевиоральная терапия и
фармакологическое лечение с использованием бупропиона могут оказаться
эффективными. Дальнейшие исследования на данную тему помогут узнать
больше.
Декларация интересов
Автор сообщает об отсутствии конфликта интересов. Только автор несет
ответственность за содержание и написание статьи.
Благодарности
Проф. А. Вайнштейн поддержан грантами от Национального Института
Психобиологии в Израиле и израильским управлением по борьбе с
наркотиками.
Литература
1. Aboujaoude E. Problematic Internet use: an
overview // World Psychiatry. – 2010. – Vol. 9.
– P. 85–90.
2. Alexithymia and its relationships with
dissociative experiences and Internet addiction in a nonclinical sample
/ D. De Berardis, A. D'Albenzio, F. Gambi [et al.] //
Cyberpsychology and Behavior. – 2009. – Vol. 12(1).
– P. 67–69.
3. An investigation on the prevalence of internet
addiction disorder in middle school students of Hunan province
/ Y.X. Deng, M. Hu, G.Q. Hu [et al.] // Zhonghua Liu
Xing Bing Xue Za Zhi. – 2007. – Vol. 28(5). –
P. 445–448 [Article in Chinese].
4. An open-label trial of escitalopram in
the treatment of impulsive-compulsive internet usage disorder /
B. Dell' Osso, A.C. Altamura, S.J. Hadley [et al.] //
European Neuropsychopharmacology. – 2007. – Vol. 16.
– P. 82–83.
5. A role for pharmacotherapy in the treatment
of "internet addiction" / G. Camardese, L. De Risio,
M. Di Nicola [et al.] // Clinical
Neuropharmacology. – 2012. – Vol. 35(6). –
P. 283–289.
6. Assessing clinical trials of Internet addiction
treatment: a systematic review and CONSORT evaluation / D.L. King,
P.H. Delfabbro, M.D. Griffiths [et al.] // Clinical Psychology
Review. – 2011. – Vol. 31(7). –
P. 1110–1116.
7. Attached to the web – harmful use of
the Internet and its correlates / J. Korkeila, S. Kaarlas,
M. Jaaskelainen [et al.] // European Psychiatry. – 2009. –
Vol. 25. – P. 236–241.
8. Barke A., Nyenhuis N., Kröner-Herwig B.
The german version of the internet addiction test: a validation study
// Cyberpsychology Behavior and Social Networking. – 2012.
– Vol. 15(10). – P. 534–542.
9. Beard K.W. Internet Addiction: A Review of
Current Assessment Techniques and Potential Assessment Questions //
Cyberpsychology and Behavior. – 2005. – Vol. 8(1).
– P. 7–14.
10. Bernardi S., Pallanti S. Internet addiction:
a descriptive clinical study focusing on comorbidities and dissociative
symptoms // Comprehensive Psychiatry. – 2009. –
Vol. 50(6). – P. 510–516.
11. Block J.J. Issues for DSM-V: Internet
Addiction // American Journal of Psychiatry. – 2008.
– Vol. 165. – P. 306–307.
12. Campbell A.J., Cumming S.R., Hughes I.
Internet use by the socially fearful: addiction or therapy? //
Cyberpsychology and Behavior. – 2006. – Vol. 9(1).
– P. 69–81.
13. Cheung L.M., Wong W.S. The effects of
insomnia and internet addiction on depression in Hong Kong Chinese
adolescents: an exploratory cross-sectional analysis // Journal
of Sleep Research. – 2011. – Vol. 20(2).
– P. 311–317.
14. Cognitive-behavioral approaches to outpatient
treatment of internet addiction in children and adolescents
/ D.L. King, P.H. Delfabbro, M.D. Griffiths [et al.]
// Journal of Clinical Psychology. – 2012. – Vol. 68(11).
– P. 1185–1195.
15. Demetrovics Z., Szeredi B., Rózsa S.
The three-factor model of Internet addiction: the development of
the Problematic Internet Use Questionnaire // Behavior Research
Methods. – 2008. – Vol. 40(2). –
P. 563–574.
16. Depression and Internet addiction in
adolescents / J.H. Ha, S.Y. Kim, S.C. Bae [et al.]
// Psychopathology. – 2007. – Vol. 40(6). –
P. 424–430.
17. Determinants of Internet addiction among
adolescents: a case-control study / A. Tsitsika,
E. Critselis, A. Louizou [et al.] // Scientific World
Journal. – 2011. – Vol. 11. –
P. 866–874.
18. Does Psychopathology in Childhood Predict
Internet Addiction in Male Adolescents? / S.M. Cho,
M.J. Sung, K.M. Shin [et al.] // Child Psychiatry and
Human Development. – 2012.
19. Du Y.S., Jiang W., Vance A. Longer term
effect of randomized, controlled group cognitive behavioural
therapy for Internet addiction in adolescent students in Shanghai
// Australia and New Zealand Journal of Psychiatry. – 2010.
– Vol. 44(2). – P. 129–134.
20. Effects of electroacupuncture combined
psycho-intervention on cognitive function and event-related
potentials P300 and mismatch negativity in patients withinternet
addiction / T.M. Zhu, H. Li, R.J. Jin [et al.] // Chinese Journal of
Integrative Medicine. – 2012. – Vol. 18(2).
– P. 146–151.
21. Epidemiological and clinical updates on
impulse control disorders: a critical review / B. Dell’Osso,
C. Altamura, A. Allen [et al.] // European Archives of Psychiatry
and Clinical Neurosciences. – 2006. – Vol. 256.
– P. 464–475.
22. Excessive computer usage in adolescents
– results of a psychometric evaluation / S.M. Grusser,
R. Thalemann, U. Albrecht [et al.] // Wien Klin Wochenschr.
– 2005. – Vol. 117(5–6). –
P. 188–195 [Article in German].
23. Factors associated with Internet addiction
among adolescents / L.T. Lam, Z.W. Peng, J.C. Mai
[et al.] // Cyberpsychology and Behavior. – 2009. –
Vol. 12(5). – P. 551–555.
24. Factors influencing internet addiction in a
sample of freshmen university students in China / X. Ni, H. Yan,
S. Chen [et al.] // Cyberpsychology and Behavior. – 2009.
– Vol. 12(3). – P. 327–330.
25. French validation of the compulsive Internet
use scale (CIUS) / Y. Khazaal, A. Chatton, A. Horn
[et al.] // Psychiatric Quarterly. – 2012. – Vol. 83(4).
– P. 397–405.
26. Gambling and internet addiction: review and
research agenda Der Nervenarzt / K. Woelfling, M. Buhler, T.
Lemenager [et al.]. – 2009. – Vol. 80(9).
– P. 1030–1039 [Article in German].
27. Greenfield D.N. Psychological characteristics
of compulsive internet use: a preliminary analysis // Cyberpsychology
and Behavior. – 1999. – Vol. 2(5). –
P. 403–412.
28. Griffiths M. Internet addiction: Does it
really exist? // Psychology and the internet: Intrapersonal,
interpersonal and transpersonal applications / Ed. by J. Gackenbach.
– New York: Academic Press. – 1998. –
P. 61–75.
29. Griffiths M. Internet addiction – Time
to be taken seriously? // Addiction Research. – 2000. –
Vol. 8. – P. 413–418.
30. Han D.H., Hwang J.W., Renshaw P.F. Bupropion
sustained release treatment decreases craving for video games and
cue-induced brain activity in patients with Internet video game
addiction // Experimental and Clinical Psychopharmacology.
– 2010. – Vol. 18(4). – P. 297–304.
31. Han D.H., Renshaw P.F. Bupropion in
the treatment of problematic online game play in patients with
major depressive disorder // Journal of Psychopharmacology. –
2012. – Vol. 26(5). – P. 689–696.
32. Hostility in the real world and online:
the effect of internet addiction, depression, and online activity /
J.Y. Yen, C.E. Yen, H.Y. Wu [et al.] // Cyberpsychology Behavior and
Social Networking. – 2011. – Vol. 14(11). –
P. 649–655.
33. Impact of addiction to internet on a number
of psychiatric symptoms in students of isfahan universities, Iran,
2010 / S.S. Alavi, H. Alaghemandan, M.R. Maracy [et al.] //
International Journal of Preventive Medicine. – 2012. –
Vol. 3(2). – P. 122–127.
34. Internet addiction and Attention Deficit
Hyperactivity Disorder (ADHD) among school children / A.
Weinstein, Y. Yaacov, M. Manning [et al.] // Israeli Medical
Association Journal (in press).
35. Internet addiction and modeling its
risk factors in medical students, Iran / F. Ghamari, A.
Mohammadbeigi, N. Mohammadsalehi [et al.] // Indian Journal of
Psychological Medicine. – 2011. – Vol. 33(2).
– P. 158–162.
36. Internet addiction as an important predictor
in early detection of adolescent drug use experience-implications for
research and practice / V. Fisoun, G. Floros, K. Siomos [et al.] //
Journal of Addiction Medicine .– 2012. – Vol. 6(1).
– P. 77–84.
37. Internet addiction – criteria evidence
and treatment. Chapter 5 / A.M. Weinstein, K. Feder, K. Rosenberg
[et al.] // Behavioral Addictions: Criteria, Evidence and Treatment /
Ed. by K.P. Rosenberg, L.C. Feder. – USA, Burlington:
Elsevier Science. – 2014. – P. 99–117.
38. Internet addiction in Korean adolescents and
its relation to depression and suicidal ideation: a questionnaire
survey / K. Kim, E. Ryu, M.Y. Chon [et al.] // International Journal
of Nursing Studies. – 2006. – Vol. 43(2). –
P. 185–192.
39. Internet addiction is associated with social
anxiety in young adults / A. Weinstein, D. Dorani, R. Elhadif
[et al.] // Annals of Clinical Psychiatry.
– 2015. – Vol. 27(1). – P. 4–9.
40. Internet addiction: prevalence, discriminant
validity and correlates among adolescents in Hong Kong / K.W. Fu,
W.S. Chan, P.W. Wong [et al.] // British Journal of Psychiatry.
– 2010. – Vol. 196(6). – P. 486–492.
41. Internet dependency as a symptom of depressive
mood disorders / B.T. te Wildt, I. Putzig, M. Zedler [et
al.] // Psychiatrische Praxis. – 2007. – Vol. 34,
Suppl 3. – P. 318–322 [Article in German].
42. Internet use, abuse, and dependence among
students at a southeastern regional university / B.L. Fortson,
J.R. Scotti,,Y.C. Chen [et al.] // Journal of American College Health.
– 2007. – Vol. 56(2). – P. 137–144.
43. Internet use and misuse: a multivariate
regression analysis of the predictive factors of internet use among
Greek adolescents / A. Tsitsika, E. Critselis, G. Kormas [et al.]
// European Journal of Pediatrics. – 2009. – Vol. 168(6).
– P. 655–665.
44. Introduction to Behavioral Addictions
/ J.E. Grant, M.N. Potenza, A. Weinstein [et al.] // American Journal
of Drug and Alcohol Abuse. – 2010. – Vol. 36(5).
– P. 233–241.
45. Israelashvili M., Kim T., Bukobza G.
Adolescents' over-use of the cyber world – Internet addiction
or identity exploration? // Journal of Adolescence. – 2012.
– Vol. 35(2). – P. 417–424.
46. Jang K.S., Hwang S.Y., Choi J.Y. Internet
addiction and psychiatric symptoms among Korean adolescents //
Journal of School Health. – 2008. – Vol. 78(3).
– P. 165–171.
47. Jang M.H., Ji E.S. Gender differences in
associations between parental problem drinking and early adolescents'
internet addiction // Journal of Specialists in Pediatric Nursing.
– 2012. – Vol. 17(4). – P. 288–300.
48. Jelenchick L.A., Becker T., Moreno M.A.
Assessing the psychometric properties of the Internet Addiction
Test (IAT) in US college students // Psychiatry Research. –
2012. – Vol. 30, № 196(2–3). –
P. 296–301.
49. Kalke J., Raschke P. Learning by doing:
"initiated abstinence", a school-based programme for the prevention
of addiction: Results of an evaluation study // European Addiction
Research. – 2004. – Vol. 10(2). –
P. 88–94.
50. Kittinger R., Correia C.J., Irons J.G.
Relationship between Facebook use and problematic Internet use
among college students // Cyberpsychology Behavior and Social
Networking. – 2012. – Vol. 15(6). –
P. 324–327.
51. Kratzer S., Hegerl U. Is "Internet Addiction"
a disorder of its own? – a study on subjects with
excessive internet use // Psychiatriche Praxis.
– 2008. – Vol. 35(2). – P. 80–33
[Article in German].
52. Kuss D.J., Griffiths M.D. Online social
networking and addiction – a review of the psychological
literature // International Journal of Environmental Research in
Public Health. – 2011. – Vol. 8(9). –
P. 3528–3552.
53. Kwon J.H., Chung C.S., Lee J. The Effects of
Escape from Self and Interpersonal Relationship on the Pathological
Use of Internet Games // Community Mental Health Journal. –
2011. – Vol. 47. – P. 113–121.
54. Lee B.W., Stapinski L.A. Seeking safety on
the internet: relationship between social anxiety and problematic
internet use // Journal of Anxiety Disorders. – 2012. –
Vol. 26(1). – P. 197–205.
55. Li D., Liau A., Khoo A. Examining the influence
of actual-ideal self-discrepancies, depression, and escapism, on
pathological gaming among massively multiplayer online adolescent
gamers // Cyberpsychology Behavior and Social Networking. –
2011. – Vol. 14(9). – P. 535–539.
56. Massively multiplayer online role-playing
games: comparing characteristics of addict vs non-addict online
recruited gamers in a French adult population / S. Achab,
M. Nicolie, F. Mauny [et al.] // BMC Psychiatry. – 2011.
– Vol. 11. – P. 144.
57. Mazhari S. Association between problematic
Internet use and impulse control disorders among Iranian university
students // Cyberpsychology Behavior and Social Networking. –
2012. – Vol. 15(5). – P. 270–273.
58. Mental health, personality, and parental
rearing styles of adolescents with Internet addiction disorder
/ H. Xiuqin, Z. Huimin, L. Mengchen [et al.] // Cyberpsychology
Behavior and Social Networking. – 2010. – Vol. 13(4).
– P. 401–406.
59. Milani L., Osualdella D., Di Blasio P.
Quality of Interpersonal Relationships and Problematic Internet
Use in Adolescence // Cyberpsychology and Behavior. – 2009.
– Vol. 12(6). – P. 681–684.
60. Morrison C.M., Gore H. The relationship
between excessive Internet use and depression: a questionnaire-based
study of 1,319 young people and adults // Psychopathology. –
2010. – Vol. 43(2). – P. 121–126.
61. Motivations to play specifically predict
excessive involvement in massively multiplayer online role-playing
games: evidence from an online survey / F. Zanetta Dauriat,
A. Zermatten, J. Billieux [et al.] // J European Addiction
Research. – 2011. – Vol. 17(4). –
P. 185–189.
62. Multi-dimensional discriminative factors
for Internet addiction among adolescents regarding gender and age /
C.F. Yen, C.H. Ko, J.Y. Yen [et al.] // Psychiatry and Clinical
Neurosciences. – 2009. – Vol. 63(3). –
P. 357–364.
63. Nichols L.A., Nicki R. Development of a
psychometrically sound internet addiction scale: a
preliminary step // Psychology of Addictive Behaviors. –
2004. – Vol. 18(4). – P. 381–384.
64. Niemz K., Griffiths M., Banyard P. Prevalence
of pathological Internet use among university students and correlations
with self-esteem, the General Health Questionnaire (GHQ) and
disinhibition // Cyberpsychology and Behavior.
– 2005. – Vol. 8(6). – P. 562–570.
65. Pallanti S., Bernardi S., Quercioli L.
The Shorter PROMIS Questionnaire and the Internet Addiction Scale in
the assessment of multiple addictions in a high-school population:
prevalence and related disability // CNS Spectrum. – 2006.
– Vol. 11(12). – P. 966–974.
66. Park S.K., Kim J.Y., Cho C.B. Prevalence of
Internet addiction and correlations with family factors
among South Korean dolescents //
Adolescence. – 2008. – Vol. 43(172).
– P. 895–909.
67. Personal characteristics related to the risk
of adolescent internet addiction: a survey in Shanghai, China
/ J. Xu, L.X. Shen, C.H. Yan [et al.] // BMC Public Health. –
2012. – Vol. 12(1). – P. 1106.
68. Poli R., Agrimi E. Internet addiction disorder:
prevalence in an Italian student population // Nordic Journal of
Psychiatry. – 2012. – Vol. 66(1). –
P. 55–59.
69. Prevalence of Internet addiction in Latino
adolescents with psychiatric diagnosis / K.A. Liberatore,
K. Rosario, L.N. Colón-De Martí [et al.] //
Cyberpsychology Behavior and Social Networking. – 2011. –
Vol. 14(6). – P. 399–402.
70. Prevalence of pathological internet use among
adolescents in Europe: demographic and social factors / T. Durkee,
M. Kaess, V. Carli [et al.] // Addiction. – 2012. –
Vol. 107(12). – P. 2210–2222.
71. Problematic internet usage in US college
students: a pilot study / D.A. Christakis, M.M. Moreno,
L. Jelenchick [et al.] // BMC Medicine. – 2011. –
Vol. 22. – № 9. – P. 77.
72. Problematic internet use among US youth:
a systematic review / M.A. Moreno, L. Jelenchick, A. Cox
[et al.] // Archives of Pediatric and Adolescent Medicine. –
2011. – Vol. 165(9). – P. 797–805.
73. Problematic Internet use in Chinese
adolescents and its relation to psychosomatic symptoms and life
satisfaction / H. Cao, Y. Sun, Y. Wan [et al.] // BMC Public Health.
– 2011. – Vol. 11. – P. 802.
74. Problematic Internet Use in high school
students in Guangdong Province, China / H. Wang, X. Zhou, C. Lu
[et al.] // PLoS One. – 2011. – Vol. 6(5). –
e19660.
75. Proposed diagnostic criteria for Internet
addiction / R. Tao, X. Huang, J. Wang [et al.] // Addiction. –
2010. – Vol. 105. – P. 556–564.
76. Psychological predictors of problematic
involvement in massively multiplayer online role-playing games:
illustration in a sample of male cybercafé players /
J. Billieux, J. Chanal, Y. Khazaal [et al.] //
Psychopathology. – 2011. – Vol. 44(3). –
P. 165–171.
77. Relationship of Internet Addiction Severity
with Depression, Anxiety, and Alexithymia, Temperament and Character
in University Students / E. Dalbudak, C. Evren, S. Aldemir [et al.]
// Cyberpsychology Behavior and Social Networking. – 2013.
78. Risk factors and psychosocial characteristics
of potential problematic and problematic internet use among adolescents:
a cross-sectional study / G. Kormas, E. Critselis, M. Janikian
[et al.] // BMC Public Health. – 2011. – Vol. 11.
– P. 595.
79. Ross M.W., Månsson S.A., Daneback K.
Prevalence, severity, and correlates of problematic sexual Internet
use in Swedish men and women // Archives of Sexual Behavior. –
2012. – Vol. 41(2). – P. 459–466.
80. Shaw M., Black D.W. Internet addiction:
definition, assessment, epidemiology and clinical management // CNS
Drugs. – 2008. – Vol. 22(5). –
P. 353–365.
81. Shek D.T., Tang V.M., Lo C.Y. Evaluation of
an Internet addiction treatment program for Chinese adolescents in
Hong Kong // Adolescence. – 2009. – Vol. 44(174).
– P. 359–373.
82. Smahel D., Brown B.B., Blinka L. Associations
between online friendship and Internet addiction among adolescents
and emerging adults // Developmental Psychology. – 2012. –
Vol. 48(2). – P. 381–388.
83. Southern S. Treatment of compulsive cybersex
behavior // Psychiatric Clinics of North America. – 2008.
– Vol. 31(4). – P. 697–712.
84. Standardization study of internet addiction
improvement motivation scale / J.W. Park, K.H. Park, I.L. Lee
[et al.] // Psychiatry Investigations. – 2012. –
Vol. 9(4). – P. 373–378.
85. The association between adult ADHD symptoms
and internet addiction among college students: the gender difference
/ J.Y. Yen, C.F. Yen, C.S. Chen [et al.] // Cyberpsychology Behavior.
– 2009. – Vol. 12(2). – P. 187–191.
86. The association between harmful alcohol use
and Internet addiction among college students: comparison of personality
/ J.Y. Yen, C.H. Ko, C.F. Yen [et al.] // Psychiatry and Clinical
Neurosciences. – 2009. – Vol. 63(2). –
P. 218–224.
87. The association between Internet addiction
and dissociation among Turkish college students / F. Canan,
A. Ataoglu, A. Ozcetin [et al] // Comprehensive Psychiatry. –
2012. – Vol. 53(5). – P. 422–426.
88. The association between Internet addiction
and problematic alcohol use in adolescents: the problem behavior
model / C.H. Ko, J.Y. Yen, C.F. Yen // Cyberpsychology and Behavior.
– 2008. – Vol. 11(5). – P. 571–576.
89. The association between online gaming, social
phobia, and depression: an internet survey / H.T. Wei, M.H. Chen,
P.C. Huang [et al.] // BMC Psychiatry. – 2012. –
Vol. 12. – P. 92.
90. The association between pathological internet
use and comorbid psychopathology: a systematic review / V. Carli,
T. Durkee, D. Wasserman [et al.] // Psychopathology. – 2013.
– Vol. 46(1). – P. 1–13.
91. The comorbid psychiatric symptoms of Internet
addiction: attention deficit and hyperactivity disorder (ADHD),
depression, social phobia, and hostility / J.Y. Yen, C.H. Ko, C.E. Yen
[et al.] // Journal of Adolescent Health. – 2007. –
Vol. 41(1). – P. 93–98.
92. The Compulsive Internet Use Scale (CIUS):
some psychometric properties / G.J. Meerkerk, R.J. Van Den Eijnden,
A.A. Vermulst[et al.] // Cyberpsychology and Behavior. – 2009.
– Vol. 12(1). – P. 1–6.
93. The effect of methylphenidate on Internet
video game play in children with attention-deficit/hyperactivity
disorder / D. Han, Y. Lee, C. Na [et al.] // Comprehensive Psychiatry.
– 2009. – Vol. 50(3). – P. 251–256.
94. The relationship between impulsivity and
Internet addiction in a sample of Chinese adolescents / F. Cao,
L. Su, T. Liu [et al.] // European Psychiatry. – 2007. –
Vol. 22(7). – P. 466–471.
95. The relationship between internet addiction
and depression among migrant children and left-behind children in
China / J. Guo, L. Chen, X. Wang // Cyberpsychology Behavior and
Social Networking . – 2012. – Vol. 15(11). –
P. 585–590.
96. The risk factors of Internet addiction
– a survey of university freshmen / H.F. Tsai,
S.H. Cheng, T.L. Yeh [et al.] // Psychiatry Research. –
2009. – Vol. 167(3). – P. 294–299.
97. Treatment of internet addiction: A
meta-analysis / A. Winkler, B. Dörsing, W. Rief [et al.]
// Clinical Psychology Review. – 2013. – Vol. 33(2).
– P. 317–329.
98. Usefulness of Young's Internet Addiction
Test for clinical populations / S.J. Kim, D.H. Park, S.H. Ryu
[et al.] // Nordic Journal of Psychiatry. – 2012. –
Dec 18 [Epub ahead of print].
99. Validation of two brief scales for Internet
addiction and mobile phone problem use / F.M. Beranuy, L.A. Chamarro,
J.C. Graner [et al] // Psicothema. – 2009. – Vol. 21(3).
– P. 480–485 [Article in Spanish].
100. Validity of the Malay Version of the
Internet Addiction Test: A Study on a Group of Medical Students in
Malaysia / G.H. Chong, S.M. Isa, A.H. Hashim [et al.] // Asia Pacific
Journal of Public Health. – 2012.
101. Watching pornographic pictures on the Internet:
role of sexual arousal ratings and psychological-psychiatric symptoms
for using Internet sex sites excessively / M. Brand, C. Laier,
M. Pawlikowski [et al.] // Cyberpsychology Behavior and Social
Networking. – 2011. – Vol. 14(6). –
P. 371–377.
102. Weinstein A., Lejoyeux M. Internet addiction
or Excessive Internet Use // American Journal of Drug and Alcohol
Abuse. – 2010. – Vol. 36(5). – P. 277–283.
103. Weinstein A., Lejoyeux M. New developments
in the psychobiology of internet and videogame addiction
// The American Journal on Addiction. –
2013. – Vol. 20. – P. 1–9.
104. Whang L.S., Lee S., Chang
G.
Internet over-users' psychological profiles: a behavior sampling
analysis on internet addiction // Cyberpsychology and Behavior.
– 2003. – Vol. 6(2). – P. 143–150.
105. Widyanto L., Griffiths M.D., Brunsden V.
A psychometric comparison of the Internet Addiction Test,
the Internet-Related Problem Scale, and self-diagnosis //
Cyberpsychology Behavior and Social Networking. – 2011.
– Vol. 14(3). – P. 141–149.
106. Widyanto L., McMurran M. The psychometric
properties of the internet addiction test // Cyberpsychology and
Behavior. – 2004. – Vol. 7(4). –
P. 443–450.
107. Yates T.M., Gregor M.A., Haviland M.G.
Child maltreatment, alexithymia, and problematic internet use in
young adulthood // Cyberpsychology Behavior and Social Networking.
– 2012. – Vol. 15(4). – P. 219–225.
108. Young K.S. Caught in the Net. –
New York: John Wiley & Sons. – 1998.
109. Young K.S. Cognitive behavior therapy with
Internet addicts: treatment outcomes and implications //
Cyberpsychology Behavior. – 2007.
– Vol. 10(5). – P. 671–679.
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Вайнштейн А. Интернет-зависимость: диагностика, коморбидность и
лечение // Медицинская психология в России: электрон. науч. журн.
– 2015. – N 4(33). – C. 3
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