1. Internet Addiction: Gaming By: Caroline Duggan Melissa Hatfield Kristen Montour http://www.cartoonstock.com/newscartoon s/cartoonists/mbc/lowres/mbcn381l.jpg

2. What is Addiction? “The state of being enslaved to a habit or practice or to something that is psychologically or physically habit-forming, as narcotics, to such an extent that its cessation causes severe trauma.” (www.dictionary.com)www.dictionary.com Individuals become compulsively dependent upon a particular kind of stimulation. To the point where attaining a steady supply of that stimulation becomes the goals of their lives. Addicts progressively neglect work duties, relationships and ultimately even their own health in order to remain stimulated. http://www.minddisorders.com/Flu- Inv/Internet-addiction-disorder.html

3. Internet Addiction Five Subtypes ◦ Cybersexual: addiction to cybersex and internet pornography. ◦ Cyber-relational: addiction to social networking, Chat Rooms, Instant Messenger, etc. ◦ Net Compulsions: addiction to online gaming, gambling and Ebay ◦ Information Overload: addiction to excessive web surfing and database searches. ◦ Computer Addiction: addiction to pre- programmed computer games (Solitare, Minesweeper). http://www.netaddiction.com/whatis.htm

4. Net-Compulsions Addiction An addiction to online video games, role-playing games, or any interactive gaming environment available through the Internet. ◦ Online games such as: Extensive chat features in these such games offer an aspect missing from offline activities, and the collaborative/competitive nature of working with or against other players can make it hard to take a break. http://www.netaddiction.com/whatis.htm

5. Internet Addiction Disorder Problematic use of the Internet, ◦ Electronic mail (e-mail) ◦ World Wide Web ◦ Gaming Internet addiction disorder is not listed in the mental health professional's handbook, the Diagnostic and Statistical Manual of Mental Disorders (DSM), fourth edition, text revision (2000) Internet addiction has been formally recognized as a disorder by the American Psychological Association http://www.minddisorders.com/Flu- Inv/Internet-addiction-disorder.html

6. Causes to Internet Addiction One theory concerns the mood-altering potential of behaviors related to process addictions (similar to a shopping addiction). Internet use might be reinforced by pleasurable thoughts and feelings that occur while the person is using the Internet. Researchers question the concept of an "addictive personality" as such, it is possible that someone who has one addiction may be prone to become addicted to other substances or activities, including Internet use The interactive aspects of the Internet, such as chat rooms, e-mail, and interactive games, seem to be more likely to lead to Internet addiction than simply web surfing. Social or peer dynamics might prompt excessive Internet use. Some affected persons may lack the social skills that would enable them to meet people in person rather than online. http://www.minddisorders.com/Flu- Inv/Internet-addiction-disorder.html

7. Diagnosis The patient must meet all of the following criteria: ◦ Is preoccupied with the Internet (thinks about previous online activity or is anticipating the next online session). ◦ Needs to spend longer and longer periods of time online in order to feel satisfied. ◦ Has made unsuccessful efforts to control, cut back, or stop Internet use. ◦ Is restless, moody, depressed, or irritable when attempting to cut down or stop Internet use. ◦ Repeatedly stays online longer than he or she originally intended. The person must meet at least one of the following criteria: ◦ Has jeopardized or risked the loss of a significant relationship, job, educational or career opportunity because of Internet use. ◦ Has lied to family members, a therapist, or others to conceal the extent of involvement with the Internet. ◦ Uses the Internet as a way of escaping from problems or of relieving an unpleasant mood (such as feelings of helplessness, guilt, anxiety, or depression). http://www.minddisorders.com/Flu- Inv/Internet-addiction-disorder.html

8. Are YOU Addicted to the Internet? Online Gaming QuizInternet Addiction Quiz

9. Prevalence of Gaming Addiction: North Korea and China North Korea: estimated that 210,000 children ages 6-19 require treatment for online gaming addiction ◦ 20%-24% of those require hospitalization as treatment China: estimated that 10 million teenagers meet addiction criteria ◦ New laws discourage more than 3 hours of daily game use Block, J.J. 2008. Issues for DSM-V: Internet addiction. American Journal of Psychiatry, 165(3)

10. Prevalence of Gaming Addiction: United States Internet cafes rarely used, so attempts to measure online gaming addiction clouded by shame, denial, and minimization. Estimated that 86% of Internet addiction cases are complicated by co-morbidity. Internet addiction unlikely to be found unless the therapist specifically screens for it. Adolescents have been identified as being most at risk for online gaming addiction. Block, J.J. 2008. Issues for DSM-V: Internet addiction. American Journal of Psychiatry, 165(3)

11. Prevalence of Internet Addiction ◦ 1 out of 8 Americans suffer from Internet Addiction. ◦ 14% said it is hard to abstain from Internet use for several days. ◦ 5.9% said excessive Internet use affected their relationships. ◦ 8.2% said the Internet was a means of escape from the real world. According to the Stanford University School of Medicine Study http://www.netaddiction.com/whatis.htm

12. Effects of Online Gaming Addiction Increase in aggressive behavior Hostile emotions Aggressive thinking Educational issues Grusser, S.M., Thalemann, R. & Griffiths, M.D. (2007). Excessive computer game playing: Evidence for addiction and aggression? CyberPsychology & Behavior, 10(2).

13. Effects of Online Gaming Addiction Isolation from family and friends. Focusing entirely on game achievements rather than on life events. Disrupted sleep patterns. Relationships may suffer. Addicts may gain or lose significant amounts of weight. http://en.wikipedia.org/wiki/Video_game_ad diction

14. Effects of Online Gaming Addiction Attempts were made to survey friends believed to be addicted to online gaming, however only 2 responses were received and both denied overuse of/addiction to online gaming.

15. http://en.wikipedia.org/wiki/Intervention_(T V_series)

16. Online Treatment for Online Addiction? Cyber Treatment for Online Addiction http://farm2.static.flickr.com/1064/5378606 94_481872048d.jpg http://www.netaddiction.com/articles/sympt oms.htm

17. Treatment Abstinence from internet use Support groups and antidepressants or anti-anxiety medications Changing the environment ◦ Decrease reinforcements of internet use Identify and change triggers to internet use Social skills training or family and couples therapy if internet is being used to avoid certain situations Recognizing and being prepared for relapse in order to prevent relapse from occurring http://www.minddisorders.com/Flu- Inv/Internet-addiction-disorder.html

18. Treatment Researchers compared internet addictions to addictive syndromes similar to impulse- control disorders on the Axis 1 Scale in the DSM-IV-TR. Like these impulse-control disorders,(such as, intermittent explosive disorder, pathological gambling, and trichotillimania), cognitive behavioral therapy (CBT) has shown to be effective.

19. CBT cont. In the early stages of treatment therapy is behavioral, focusing on the behaviors related to the disorder that causes the greatest difficulty. As therapy progresses there is a focus is on cognitive distortions that have developed and the effects of these on behavior. Finally, problem solving skills and coping strategies training, modeling, support groups, and tracking progress through journals.

20. CBT Cont. CBT is based on the premise that thoughts determine feelings. Patients are taught to monitor their thoughts and identify the thoughts that trigger the addictive feelings and actions to prevent taking the actions. CBT typically requires 3 months or treatment, or about 12 weekly sessions.

21. Co-morbidities Research has shown that internet addictions are common among people of all ages who have mood disorders, anxiety disorders, impulse control disorders, and substance misuse disorders. Also many people who have an internet addiction suffer from depression, a recent breakdown in a relationship, and social isolation. These conditions need to be treated as well. Pharacological interventions can be used to treat the comorbid psychiatric disorders, such as depression, along with CBT.

22. References Center for Internet Addiction Recovery. (2006). What is Internet Addiction? Retrieved July 24, 2009 from the World Wide Web, http://www.netaddiction.com/whatis.htmhttp://www.netaddiction.com/whatis.htm Encyclopedia of Mental Disorders. (2008). Internet Addiction Disorder. Retrieved July 24, 2009, by Avameg Incorporated Web Site: http://www.minddisorders.com/Flu- Inv/Internet-addiction-disorder.htmlhttp://www.minddisorders.com/Flu- Inv/Internet-addiction-disorder.html Murali, V., Onuba, I. (2009). Management of internet addiction. General Practive Update, 2(5), 32-35. Young, K.S. (2007). Cognitive behavior therapy with internet addicts: Treatment outcomes and implications. Cyberpsychology & Behavior, 10(5), 671-679 Grusser, S.M., Thalemann, R. & Griffiths, M.D. (2007). Excessive computer game playing: Evidence for addiction and aggression? CyberPsychology & Behavior, 10(2). Block, J.J. 2008. Issues for DSM-V: Internet addiction. American Journal of Psychiatry, 165(3)