Internet Addiction in Adolescents: The PROTECT Program for Evidence-Based Prevention and Treatment

By Katajun Lindenberg, Sophie Kindt and Carolin Szász-Janocha

This book presents a new, evidence-based cognitive behavioral intervention for the prevention and treatment of Internet addiction in adolescents.  It provides a comprehensive overview of the current state of research regarding phenomenology, diagnostics, epidemiology, etiology, and treatment and prevention of Internet addiction as a new behavioral addiction. The book is divided into two sections. The first part of the book explores various bio-psycho-social factors that contribute to the development and maintenance of symptoms in young individuals. Chapters in the second part of the book discuss the PROTECT intervention to reduce Internet addiction in adolescents. PROTECT aims to modify risk factors and maintenance factors, specifically, boredom and motivational problems, procrastination and performance anxiety, social anxiety and maladaptive emotion regulation. The PROTECT intervention is a low-intensity approach which uses comprehensive case examples in order to increase cognitive dissonance and treatment motivation. In addition, PROTECT contains cognitive behavioral intervention techniques such as psychoeducation, behavior activation, cognitive restructuring, problem solving and emotion regulation. 

Topics featured in this book include:

• Adolescence and development-specific features of Internet addiction.
• An overview of modifiable risk factors and maintenance factors of Internet addiction.
• Environmental factors that affect the development of Internet addiction.
• Online and offline video gaming addiction. 
• Social network addiction.
• Strategies that work in prevention and treatment.

Internet Addiction in Adolescents is a must-have resource for researchers, professors, clinicians and related professionals as well as graduate students in clinical child, school, and developmental psychology, educational policy and politics, and social work as well as related disciplines.

• Language: English
• Publisher: Springer
• Release date: Jun 2, 2020
• ISBN: 9783030437848

Book preview

Part IInternet Use Disorders in Adolescents

© Springer Nature Switzerland AG 2020

K. Lindenberg et al.Internet Addiction in Adolescentshttps://doi.org/10.1007/978-3-030-43784-8_1

1. Definition and Diagnostics of Internet Use Disorders

Katajun Lindenberg¹, ² , Sophie Kindt¹, ² and Carolin Szász-Janocha¹, ³

(1)

Institute of Psychology, Goethe-University Frankfurt, Frankfurt, Germany

(2)

Institute for Psychology, University of Education, Heidelberg, Germany

(3)

Institute of Psychology, Heidelberg University, Heidelberg, Germany

Keywords

Internet use disordersDiagnosticsCompulsive Internet useInternet addictionGaming disorderInternet gaming disorderICD-11DSM-5Assessment

1.1 Terms and Concepts

In the early phase of research on pathological video game and Internet use starting in the 1990s, different definitions were used because standard diagnostic criteria were lacking. While some researchers categorized the phenomenon as an impulse control disorder, similar to pathological gambling (Beard & Wolf, 2001; Shapira et al., 2003; Young, 1998b), others defined it as an addictive disorder, i.e. a behavioral addiction (King, Delfabbro, Griffiths, & Gradisar, 2011; Kuss & Griffiths, 2012). In the literature, different terms have been used to describe the maladaptive use of video games and the Internet, such as video game addiction (Fisher, 1994), compulsive Internet use (Greenfield, 1999), pathological Internet use (Davis, 2001), problematic Internet use (Shapira, Goldsmith, Keck, Khosla, & McElroy, 2000), or Internet addiction (Young, 1998b). Another controversy concerns the question whether the Internet itself can be addictive, or whether the addictive or pathological use is related to specific Internet applications, such as social networks, online games, online shopping, or online pornography (Davis, 2001; Griffiths, 2000; Rehbein & Mößle, 2013; Starcevic & Aboujaoude, 2017). Davis (2001) differentiates between specific pathological Internet use, i.e. the use of one specific application and generalized pathological Internet use, a multidimensional use that encompasses a general desire to escape into the virtual world. In this book, the term Internet use disorders (IUD) is used to describe the phenomenon, as it encompasses both the addictive use of video games (gaming addiction) and the addictive use of other Internet applications (e.g., social media addiction).

1.2 Forms of Internet Use Disorders

Internet use disorders can have several forms, with the most commonly used applications among adolescents being video games and social networks.

1.2.1 Gaming Addiction

Video gaming, online and offline, is especially prevalent among male adolescents (see Chap. 2). Especially massively multiplayer online role-playing games (MMORPG) have a high addictive potential. However, other genres such as multiplayer battle arena games (MOBA) also contain features that facilitate the development of a behavioral addiction (Beutel, Hoch, & Wölfling, 2011; Illy & Florack, 2018; Müller & Wölfling, 2017). These games are all played online, together with others, which makes them highly communicative. Gamers join forces in teams or guilds, they explore an infinite fantasy world and solve tasks (quests) together. This causes a sense of social responsibility and belonging, making it hard not to show up online when a quest is to be completed. The opportunity to play against other gamers from anywhere in the world is an attractive challenge for many. Furthermore, these genres often include a nonlinear progress, i.e. quests become more and more difficult as the game progresses, and more and more time needs to be spent on progressing. Players are represented by the game characters, known as avatars, who develop their personal resources and abilities over the course of the game. The avatar allows for an ideal self-representation, which is especially attractive for those who do not experience success in real life. The high level of identification with the avatar leads to an experience of immersion and a strong identification with this virtual self. A functional magnetic resonance imaging (fMRI) study by Leménager et al. (2014) demonstrated that addicted gamers had a stronger emotional identification with their avatar than with a picture of themselves.

Another mechanism that increases the addictive potential of video games is intermittent reinforcement. During intermittent reinforcement, behaviors are not rewarded every time they occur. Rather, the frequency and contingency of rewards is unpredictable. One example of a gaming mechanism with intermittent reinforcement is a loot box—a treasure chest that can be bought for a small amount of money and that contains either valuable items for the avatar or completely useless items. This mechanism is very similar to gambling as it makes loot boxes a game of chance (Griffiths, 2018).

Many modern online games are free-to-play, which means that it does not cost any money to start playing the game. However, some of them include pay-to-win mechanisms that allow the player to spend money for faster progress in the game. These are generally micro-transactions of real money or an in-game currency. This mechanism often tempts gamers to spend large sums in these games, which can be especially problematic for those who are addicted and are no longer in control of their own gaming and spending behavior (Dreier et al., 2017).

To date, most research about online addictions has focused on online gaming behavior. As a consequence, the World Health Organization (WHO) has included gaming disorder as a diagnosis in the ICD-11. Other forms of addictive Internet use have not been included yet.

1.2.2 Social Network Addiction

The excessive use of social networks is another risk behavior that can lead to a behavioral addiction. While boys are more often affected by an addictive consumption of video games, girls spend more time on social networks and thus are more prone to developing a social media addiction (Rehbein & Mößle, 2013). Just like avatars in the world of online games, social network profiles allow for an idealized self-representation. The possibility to communicate with others via online messengers from a safe distance makes it much easier for the introverted person to seek contact. Moreover, the possibility to like and dislike as well as to share and comment leads to social comparison processes that bind the user to the network and increases the risk of an addictive use.

1.2.3 Online Shopping Addiction

Another online activity that can take addictive forms is compulsive online shopping, in which individuals buy items that they do not need and that often remain unpacked. For many, the act of buying is experienced as highly rewarding, not the fact of possessing a new item itself (Müller et al., 2012). Online shopping addiction could merely be an online manifestation of compulsive buying, but in many cases, the online aspect per se is problematic because it increases anonymity. Affected individuals experience a loss of control over their buying behavior, a compulsive preoccupation with special offers, and a continuation of the behavior despite negative consequences, such as financial problems or debt. Risk factors for online shopping addiction are female gender, reduced self-worth, increased impulsivity, and a strong materialistic orientation (Rose & Dhandayudham,