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Community Seminar on Youth Health - Internet Addiction and Crime: Health and Safety for the Youth (30 June 2007) Dr. Ben K L CHEUNG Specialist in Psychiatry.

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Presentation on theme: "Community Seminar on Youth Health - Internet Addiction and Crime: Health and Safety for the Youth (30 June 2007) Dr. Ben K L CHEUNG Specialist in Psychiatry."— Presentation transcript:

1 Community Seminar on Youth Health - Internet Addiction and Crime: Health and Safety for the Youth (30 June 2007) Dr. Ben K L CHEUNG Specialist in Psychiatry Clinical Experience on Internet Addiction. Copyright reserved. Please quote source at citation.

2 Internet Addiction Dr Ben Cheung

3 WHAT'S NORMAL INTERNET USE? Not easy to define normality by time – 1997: average 7-19 hours online per week in US Increase in games and FTP? Interfering with normal functioning Harmful effects

4 Internet Addiction Internet addiction is defined as any online- related, compulsive behavior which interferes with normal living and causes severe stress on family, friends, loved ones, and one's work environment.

5 DSM As yet, there is no official psychological or psychiatric diagnosis of an "Internet" or "Computer" addiction. The most recent Statistical Manual of Mental Disorders (DSM-IV) - which sets the standards for classifying types of mental illness - does not include any such category.

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

7 1. 2. 3. 4. 5. 6. 7. 8. 4 4

8 Other suggested features drastic lifestyle changes in order to spend more time on the net general decrease in physical activity a disregard for one's health as a result of internet activity avoiding important life activities in order to spend time on the net sleep deprivation or a change in sleep patterns in order to spend time on the net a decrease in socializing, resulting in loss of friends neglecting family and friends refusing to spend any extended time off the net a craving for more time at the computer neglecting job and personal obligations

9 INTERNET ADDICTION: THE EMERGENCE OF A NEW CLINICAL DISORDER Dependent sample Non-dependent Sample Internet use >1 Yr17%71% Female23936 Mean age for male 2925 Mean age for female 4328 Years of education 15.514 Hours per week38.54.9 (Young 1966)

10 Internet Applications Most Utilized by Dependents and Non-Dependents Application DependentsNon-Dependents Chat Rooms 35%7% Multi-User Dungeons 28%5% News groups 15%10% E-mail 13% (but more intimate) 30% WWW 7%25% Information Protocols (electronic libraries or software database) 2%24%

11 Comparison of Type of Impairment to Severity Level Indicated Impairment NoneMildModerateSevere Academic 0%2%40%58% Relationship 0%2%45%53% Financial 0%10%38%52% Occupational 0%15%34%51% Physical 75%15%10%0% *Despite the negative consequences reported among Dependents, 54% had no desire to cut down the amount of time they spent on-line

12 Assessment of Internet Use Nature of internet use What need is addressed by internet? –Psychological, social, knowledge, spiritual? Effects on functioning Subjective feelings of distress – depression, frustration, disillusionment, alienation, guilt, and anger may be warning signs The balance and integration of in-person and cyberspace living –Integration of the 2 worlds

13 Assessment of Internet Addiction loss of control Lying: the extent of the time or nature of internet activities Harmful effects Improper Behavior: concealing identity Misplaced priorities Emotional response when being limited on internet use Excessive spending on internet related matters

14 What causes Internet addiction? High Virtual relationship and support –temporary pleasure rather than the deeper qualities of "normal" intimate relationships –You can conceal your real name, age, occupation, appearance, and your physical responses Sexual fulfillment –Erotic fantasies –the ultimate safe sex method to fulfill sexual urges without fear of disease such as AIDS –explore the mental and subsequent physical stimulation of acting out forbidden erotic fantasies such as S&M, incest, or urination. –allow those who felt unattractive or maintained few dating opportunities to put up relationships more easily Creating a Persona –creates a virtual "stage" where a person can "act" in a new role through the creation of fictitious handles which alter physical characteristics such as gender, age, or race that cultivate a persona or false image of oneself. Recognition and Power –Personas allow individuals to virtually obtain recognition and achieve power most saliently through the creation of MUD characters

15 Addition without the drug We can get high from what we do Concept of behavioural addiction Reward system involved The Internet is simply the most recent addition to a long list of behaviors that we may find addictive

16 Types of Internet Addiction Cyber-relationship Addiction: –over-involvement in online relationships. Cybersexual Addiction –compulsive use of adult web sites Online gambling Online shopping, eBay Information Overload - compulsive web surfing or database searches. Online games

17 Cyberporn and cybersexual addiction Most common forms of Internet addiction. The widespread availability of sexual content online Almost 60% of the cases of online sexual compulsivity seen result exclusively from Internet use. Interactive aspects of the Internet: chat rooms, instant messaging, and online gaming.

18 Epidemiology survey of nearly 18,000 people: –nearly 6% of those surveyed met the strict criteria for Compulsive Internet use, with –another 4-6 % abusing the Net on a regular basis. –over 29% of those I studies report using the Internet to " alter their mood or escape on a regular basis.

19 2004

20 Young (1996) initiated telephone surveys to formally study pathological Internet use (PIU): Internet users using an average of 38 hours per week for non-academic or non-employment related purposes which caused detrimental effects Brenner (1996) received 185 responses in one month to his on-line survey regarding behavior patterns associated with the Internet. His survey showed that 17% used the Internet more than 40 hours per week, 58% said that others had complained about their excessive net usage, and 46% indicated getting less than 4 hours of sleep per night due to late night log ins. Steve Thompson (1996) developed the "McSurvey" which yielded 104 valid responses. Among respondents to his on-line survey, 72% felt addicted and 33% felt their Internet usage had a negative effect on their lives. Surveys conducted on college campuses (Morhan- Martin, 1997; Scherer, 1997) also supported that students suffered significant academic and relationships impairment due to excessive and uncontrolled Internet usage.

21 Internet addiction and MI Associated with depression (02)

22 Other research: 6% are being negatively impacted by their Internet use. 37.5% reported masturbating while online! For these Internet users, the Net offered a high degree of stimulation and sexual excitement.

23 Negative Consequences Of Addictive Use Of The Internet Time: 40-80 hrs per week, or single session >20 hours Sleep loss, late for school or work, use of caffeine Lack of exercise, carpal tunnel syndrome, back strain, eye strain Familial Problems Academic Problems Occupational Problems

24 Assessment Of Pathological Internet Use Triggers or high risk situations –environment, relationships, life events Applications: use pattern (typical day) Emotions: online vs offline, before log in Cognitions: catastrophic thinking, cognitive distortions, self-esteem Psychosocial aspect: the need for escape, level of role fulfillment

25 Aim of treatment Control use Self discipline developing effective coping strategies in order to change the addictive behavior through personal empowerment and proper support systems

26 Important points in Management Re-use of the computer: –may trigger feelings of suspicion and jealousy for the spouse Deal with rationalization: –that cybersex isnt cheating because of the lack of physical contact. Issue of forgiveness must be work through Renew Commitment –first evaluate how the cyberaffair has hurt the relationship –help formulate relationship-enhancing goals that will renew commitment and improve intimacy between the couple –evaluate the types of activities the couple used to enjoy before the Internet and encourage them to engage in those events once again –Issue of transparency vs protection of esteem and respect –Implement a contract of regular review and monitoring –Work out partnership to give trust / win trust. Emphasize the need to be in phase

27 Support Network find an appropriate support group that best addresses his or her situation may join a local interpersonal growth group, a singles group, ceramics class, a bowling league, or church group to help meet new people. internet addiction support groups.

28 A symptom of an underlying Problems Poor Communication, Sexual Dissatisfaction, Lack of from support from family and friends Financial Problems Work/study pressure

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