Lecture: Media Addiction
Lecture: Media Addiction CAMHS-UA 150
Popular in Child and Adolescent Mental Health Studies: Children and the Media
Popular in Child Development
George Maxwell Miller
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This 9 page Class Notes was uploaded by Brianda Hickey on Wednesday March 9, 2016. The Class Notes belongs to CAMHS-UA 150 at NYU School of Medicine taught by Andrea Vazzana in Spring 2016. Since its upload, it has received 19 views. For similar materials see Child and Adolescent Mental Health Studies: Children and the Media in Child Development at NYU School of Medicine.
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Date Created: 03/09/16
Lecture: Media Addiction Addiction not deﬁned by DSM DSM IV TR Diagnostic Criteria for Substance Abuse A. A maladaptive pattern of substance use leading to clinically signiﬁcant impairment or distress, as manifested by one (or more) of the following, occurring within a 12- month period: 1. recurrent substance use resulting in a failure to fulﬁll major role obligations at work, school, or home 2. recurrent substance use in situations in which it is physically hazardous ex. driving 3. recurrent substance - related legal problems ex. arrests for substance 4. Continued substance use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the eﬀects of the substance ex. arguments, physical ﬁghts B. The symptoms have never met criteria for Substance Dependence for this class of substance DSM IV Diagnostic Criteria for Substance Dependence A maladaptive pattern of substance use, leading to clinically signiﬁcant impairment or distress as manifested by three (or more) of the following, occurring at any time in the same 12-month period: 1. tolerance, as deﬁned by either of the following: a need for markedly increased amounts of the substance to achieve intoxication or desired eﬀect markedly diminished eﬀect with continued use of the same amount of the substance 2. Withdrawal, as manifested by either of the following: the characteristic withdrawal syndrome for the substance the same substance (or closely related) is taken to relieve or avoid withdrawal symptoms 3. .The substance is often taken in larger amounts or over a longer period than was intended 4. There is a persistent desire or unsuccessful eﬀorts to cut down or control substance use 5. A great deal of time is spent in activities necessary to obtain substance, use the substance, or recover from its eﬀects 6. Important social, occupational or recreational activités are given up or reduced because of substance use 7. The substance use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance Specify if: With psychological Dependence evidence of tolerance or withdrawal Without Psychological Dependence: no evidence of tolerance or withdrawal Deﬁnition of Terms Tolerance: A need for markedly increased amounts of the substance to achieve intoxication or desired eﬀect. Markedly diminished eﬀects with continued use of the same amount of the substance Substance Dependence: When an individual persists in use of alcohol or other drugs despite problems related to use of the substance Behavioral Addiction: Does not rely on alcohol or other drugs (i.e. gambling addiction) Pathological gambling and substance use disorders are very similar in the way they aﬀect the brain and neurological rewards system. Both are related to poor impulse control and the brain’s system of reward and aggression Pathological Gambling is in the DSM ( 4 & 5) Epidemiology of Internet Use According to the January 2010 Kaiser Family Foundation study, 8-18-year-olds spend an average of 1 hour and 29 minutes on the computer in a typical day 93% of teens ages 12-17 go online 69% of teens have their own computer 63% of teen Internet users go online every day 27% of teens use their phone to get online 24% of teens with a game console use it to go online History of Internet Addiction 1998: Anecdotal reports indicated that some on-line users were becoming addicted to the Internet in the same way that others became addicted to drugs or alcohol, which resulted in academic, social, and occupational impairment Internet Addiction 1998:The Emergence of a New Clinical Disorder suggested by Kimberly S. Young Young used Pathological Gambling as a model to deﬁne Internet addiction By using it as a model, addictive Internet use can be deﬁned as an impulse- control disorder that does not involve an intoxicant Impulse Control Disorders Intermitten Explosive Disorder Abrupt anger Kleptomania Pathological stealing Pathological Gambling Pyromania ﬁre setting Trichotillomania compulsive hair pulling Pathological Gambling A. Persistent and recurrent maladaptive gambling behavior as indicated by ﬁve (or more) of the following: 1. is preoccupied with gambling (e.g., preoccupied with reliving past gambling experiences, handicapping or planning the next venture, or thinking of ways to get money with which to gamble) 2. needs to gamble with increasing amounts of money in order to achieve the desired excitement a person who used to be able to get an excitement from 50 dollar bill, now needs 1,000 3. has repeated unsuccessful efforts to control, cut back, or stop gambling 4. is restless or irritable when attempting to cut down or stop gambling 5. gambles as a way of escaping from problems or of relieving a dysphoric mood (e.g., feelings of helplessness, guilt, anxiety, depression) 6. after losing money gambling, often returns another day to get even ("chasing" one's losses) 7. lies to family members, therapist, or others to conceal the extent of involvement with gambling 8. has committed illegal acts such as forgery, fraud, theft, or embezzlement to ﬁnance gambling 9. has jeopardized or lost a signiﬁcant relationship, job, or educational or career opportunity because of gambling 10. relies on others to provide money to relieve a desperate ﬁnancial situation caused by gambling B. The gambling behavior is not better accounted for by a Manic Episode. Internet Addication Young’s Adaptation 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? added in Depression Do you stay on-line longer than originally intended? Have you jeopardized or risked the loss of a signiﬁcant relationship, job, educational, or career opportunity because of the Internet? Have you lied to family members, a therapist, or others to conceal the extent of involvement with the Internet? Do you use the Internet as a way of escaping from problems or of relieving a dysphoricmood (e.g., feelings of helplessness, guilt, anxiety, depression)? Internet Addition: The emergence of a New Clinical Disorder? Participants who answered “yes” to ﬁve or more of the criteria were classiﬁed as dependent Internet users, the remainder were nondependent users 396 Dependents 100 Non dependents Qualitative analyses suggest signiﬁcant behavioral and functional usage differences between the two groups such as: The types of applications utilized The degree of difﬁculty controlling weekly usage The severity of problems noted Internet Addiction, Results 1 Length of time using Internet Among Dependents, 17% had been on-line for more than 1 year Among Non-dependents, 71% had been on-line for more than 1 year Suggests that Internet addiction happens quickly from ﬁrst introduction Hours per week (for non-essential tasks, rather than for academic or employment purposes) Dependents estimated 8.04 hours per week Non-dependents estimated 4.70 hours per week Dependents gradually developed a daily Internet habit of up to 10 times their initial use as their familiarity with the Internet increased (increased tolerance) Internet Addiction, Results II Applications Used Nondependents mostly used the Internet for gathering information and e-mail Dependents predominately used two-way communication functions (i.e., chat rooms, MUDS, newsgroups, or e-mail) Multiuser Dungeons (MUDS): players take on character roles Dependents often preferred their on-line friends over their real-life relationships Internet Addiction, Results III Extent of problems Non-dependents said that time distortion was the major consequence of Internet use, but it did not cause their real-life responsibilities to be neglected Dependents reported that excessive use of the Internet resulted in personal, family, and occupational problems similar to those documented in other established addictions such as pathological gambling, eating disorders, and alcoholism Internet Addiction Should it have been included in the DSM-V? Not enough evidence to include it under Impulse Control Disorder As an Impulse Control Disorder Three subtypes: excessive gaming Sexual preoccupations E-mail/text messaging Internet itself is not addictive, just abused South Korea considers Internet addiction one of its most serious public health issues 2006: 210,000 South Korean children estimated to be afﬂicted and require treatment 80% of those were proposed to need psychotropic medications Average South Korean high school student spends about 23 hours each week online gaming 2007: 1,043 counselors trained in the treatment of Internet addiction China: Tao Ran, Director of Addiction Medicine at Beijing Military Region Central Hospital, reported that 13.7% of Chinese adolescent Internet users meet Internet addiction diagnostic criteria (10 million teenagers) 2007: Began restricting computer game use. Laws discourage more than 3 hours of daily game use United States: Lacks data for prevalence of potential disorder. Internet cafes are not frequently used as they are in Asia In addition, attempts to measure clouded by shame, denial, and minimization (Block, 2007) Comorbidity- co-exhisting problems About 86% of Internet addiction cases have a comorbid DSM-IV diagnosis present Patients generally present only for the comorbid condition(s), thus Internet addiction is unlikely to be detected Adolescents with Internet addiction had higher rates of ADHD symptoms, depression, social phobia, and hostility (Yen et al., 2007) Hostility was associated with Internet addiction for male but not for female students Suggests that Internet addiction is associated with symptoms of ADHD and depressive disorders Internet Addiction Conclusion American Psychiatric Association chose not to include it under Behavioral Addictions in DSM-V because they felt that it did not have sufﬁcient research to support that it is an actual disorder Video Game Addiction Excessive or compulsive use of computer and video games that interfere with daily life In 2009, video game sales worldwide were estimated at $40 billion Two-thirds of household in the U.S. play computer or video games In 2010, average gamer spent 8 hours a week playing video games 40% of all gamers are female Most researchers have hypothesized that symptoms and criteria would be similar to pathological gambling (like Internet addiction) This parallel seems justiﬁable, because both are proposed to be behavioral addictions that begin as entertainment that can stimulate emotional responses and dopamine release Dopamine: a neurotransmitter that is responsible for transmitting signals in between the nerve cells (neurons) of the brain Affects your emotions, movements, and your sensations of pleasure and pain People gamble or play video games for many reasons, including relaxation, competence, autonomy, and escape from daily concerns Playing is hypothesized to produce “ﬂow” states, in which the player is focused, has a sense of control, may lose a sense of time and place, and ﬁnds playing intrinsically rewarding ﬂow = fully participating in the activity Playing is not pathological initially, but becomes pathological for some individuals when the activity becomes dysfunctional, harming the individual’s social, occupational, family, school, and psychological functioning Video Game Addiction research Study of 1,178 children ages 8 to 18 Although only 8.5% of children were classiﬁed as showing pathological levels of video game use, respectively 21% and 65% of children with non-pathological or pathological levels of use reported being addicted to video games (Gentile, 2008 In a study of a self-selected sample of over 5,500 online game players, nearly half considered themselves addicted to their preferred game (Yee, 2006) Perceptions of Video Game Addiction Surveyed 438 players of the online video game, World of Warcraft Respondents reported using computers 8 hours a day and playing video games 5.5 hours a day 73% of video game addiction test scores fell in the range “frequent problems, may be developing an addiction” 40% reported being addicted to video games (although only 6% scored as being at high risk on a video game addiction scale) 40% of players believed in the salience of video game play in their life Including playing or thinking about games a lot, craving games, scheduling around them, and games’ being central in their life 22% thought addiction would involve playing many hours, or “to excess” Two year, longitudinal study in Singapore 3,034 elementary and middle school students Prevalence of pathological gaming was similar to other countries (about 9%) Greater amounts of gaming, lower social competence, and greater impulsivity seemed to act as risk factors for becoming pathological gamers Depression, anxiety, social phobia, and lower school performance seemed to act as outcomes of pathological gaming Suggests that video game “addiction” is similar to other addictive behaviors It can last for years Not solely a symptom of comorbid disorders Social Networking Sites Integrates impersonal communication (i.e. coordinating meetings, events, schedules and other task oriented activities), mass communication(music, news, movie clips and websites) and, most signiﬁcantly, interpersonal communication(direct personal messages, sharing of daily thoughts, ideas, observations and images SNSs’ Statistics 73% of adolescents use SNSs, most commonly Facebook More than half of adolescents log on to a social media site more than once a day 8% of American teens use Twitter 86% of social network - using teens comment o n a friends wall 83% comment on friend’s pictures 66% send private messages to friends 58% send IM or text messages using the site 52% send group messages Facebook Addiction The use of Facebook may contribute to the severity of symptoms associated with Internet addiction (Kittinger, 2012) Bergen Facebook Addiction Scale (BFAS) Developed by Dr. Cecilie Andreassen at the University of Bergen, Norway Psychological scale to measure Facebook addiction In January 2011, they invited 423 students (227 women and 196 men) to complete the draft BFAS questionnaire, along with a battery of other standardized self-report scales of personality, sleep, sociability, attitudes towards Facebook, and addictive tendencies Eventually, Andraessen and colleagues ﬁnalized the BFAS to six basic criteria Six basic criteria, with participants asked to give one the following 5 responses to each one: (1) Very rarely, (2) Rarely, (3) Sometimes, (4) Often, and (5) Very often: You spend a lot of time thinking about Facebook or planning how to use it You feel an urge to use Facebook more and more You use Facebook in order to forget about personal problems You have tried to cut down on the use of Facebook without success You become restless or troubled if you are prohibited from using Facebook You use Facebook so much that it has had a negative impact on your job/studies. Andreassen and colleagues suggest that scoring "often" or "very often" on at least four of the six items may suggest the respondent is addicted to Facebook Critiques against Andreassen’s work The term “Facebookaddiction” may already be obsolete due to the amount of different activities available on theFacebookwebsite (i.e. games, messaging, gambling) TheFacebookAddiction Scale does not address just one online application, rather a whole website More research needs to be done to examine addiction to one aspect of the website Not an actual diagnosis Research suggests that it tends to occur more often among younger than older users People who are anxious and socially insecure use Facebook more than those with lower scores on those traits (hypothesized to occur because those who are anxious ﬁnd it easier to communicate via social media than face-to-face) People who are more organized and ambitious tend not to become addicted to Facebook, and are more likely to use social media as an integral part of work and networking activity Conclusion More research needs to be done for media addictions to be included in the DSM Future research should develop treatment protocols and conduct outcome studies for effective management of symptoms researchers should also focus on the prevalence and the rol
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