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Background and aims
Although first treatment approaches for Internet Use Disorders (IUDs) have proven to be effective, health care utilization remained low. New service models focus on integrated health care systems, which facilitate access and reduce burdens of health care utilization, and stepped-care interventions, which efficiently provide individualized therapy.
An integrated health care approach for IUD intended to (a) be easily accessible and comprehensive, (b) cover a variety of comorbid syndromes, and (c) take heterogeneous levels of impairment into account was investigated in a one-armed prospective intervention study on n = 81 patients, who were treated from 2012 to 2016.
First, patients showed significant improvement in Compulsive Internet Use over time, as measured by hierarchical linear modeling. Effect sizes of outcome change from baseline to 6-month follow-up ranged from d = 0.48 to d = 1.46. Second, differential effects were found depending on patients’ compliance, demonstrating that high compliance resulted in significantly higher rates of change. Third, patients referred to minimal interventions did not differ significantly in amount of change from patients referred to intensive psychotherapy.
Tailored interventions result in higher efficiency through optimized resource allocation and equal amounts of symptom change in all treatment conditions. Moreover, comprehensive, low-threshold interventions seem to increase health service utilization.
Background and aims
Instances of Internet use disorders (IUD) including Internet gaming disorder (IGD) and non-gaming pathological Internet use (ng-PIU) have the extent that they are now a growing mental health issue. Individuals suffering from IUD show a large range of symptoms, high comorbidities and impairments in different areas of life. To date there is a lack of efficient and evidence-based treatment programs for such adolescents. The present registered single-arm trial (ClinicalTrials.gov: NCT03582839) aimed to investigate the long-term effects of a brief manualized cognitive behavioral therapy (CBT) program for adolescents with IUD.
N = 54 patients (16.7% female), aged 9–19 years (M = 13.48, SD = 1.72) received the CBT group program PROTECT+. IUD symptom severity (primary outcome variable) as well as comorbid symptoms, risk-related variables and potentially protective skills (secondary outcome variables) were assessed at pretest, posttest, as well as 4 and 12 months after admission.
Patients showed a significant reduction in IUD symptom severity at the 12-month follow-up. Effect sizes were medium to large depending on the measure. Beyond the statistical significance, the clinical significance was confirmed using the reliable change index. Secondary outcome variables showed a significant reduction in self-reported depression, social anxiety, performance anxiety and school anxiety as well as in parental-reported general psychopathology.
Discussion and conclusions
The present study shows long-term effects of a manual-based CBT treatment for adolescents suffering from IUD. The results indicate that even a 4-session brief intervention can achieve a medium to large effect over 12 months. Future work is needed to confirm the efficacy within a randomized controlled trial (RCT).
Background and aims
Limited research has investigated how individuals' problem gaming affects significant others. The present study investigated the extent to which partners and parents were personally affected by their partner or child's problematic gaming behavior and what steps, if any, were taken in relation to treatment and other help-seeking by the gamers and the respondents themselves.
Two targeted samples (parents, n = 104; partners, n = 264) in Australia were recruited and administered an online survey. The survey assessed gaming-related harm across multiple domains, including financial, relationship, emotional wellbeing, physical health and work/study. Treatment and help-seeking questions referred to seeking psychological assistance, self-help, and community support. Non-parametric tests compared groups on harm measures based on GD status.
Parents and partners of individuals rated in the ‘problem gaming’ range reported significantly greater harms compared to those in the at-risk and non-problem categories. The most frequently endorsed harms were in the relationship domain, including neglected household responsibilities, withdrawal from social events, and relationship conflict. Some parents consult with friends and family (15%) to resolve their child's gaming-related problems. Partners reported to seek outside support and assistance for themselves, including 30% who sought a psychologist. No partners reported having consulted a psychologist for their gaming partner.
Problem gaming affects significant others across multiple life areas, but few seek outside help or support, suggesting there may be significant unmet needs.
Further research should examine factors that influence acceptance and engagement with problem gaming help options. Harm indicators may be useful for evaluating targeted interventions and other measures to reduce problem gaming.