|
1
|
Núñez-Rodríguez S, Burgos-González D, Mínguez-Mínguez LA, Menéndez-Vega F, Antoñanzas-Laborda JL, González-Bernal JJ, González-Santos J. Effectiveness of Therapeutic Interventions in the Treatment of Internet Gaming Disorder: A Systematic Review. Eur J Investig Health Psychol Educ 2025; 15:49. [PMID: 40277866 PMCID: PMC12025817 DOI: 10.3390/ejihpe15040049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2025] [Revised: 03/17/2025] [Accepted: 03/22/2025] [Indexed: 04/26/2025] Open
Abstract
Internet Gaming Disorder (IGD) has been recognized by the World Health Organization (WHO) in the International Classification of Diseases (ICD-11) and as an emerging condition in the DSM-5. IGD is increasingly prevalent, with various negative effects on individuals' development and adaptation. To address this issue, different therapeutic interventions, like CBT, virtual reality, mindfulness, or family therapy, have been explored. This systematic review aimed to answer the following research question: What is the effectiveness of therapeutic interventions in reducing IGD symptoms in adolescents and young adults diagnosed with this disorder? Following PRISMA guidelines, 22 studies published between 2014 and 2025 were included. Results show that cognitive behavioral therapy (CBT) is the most effective intervention, significantly reducing IGD severity, anxiety, and depression. Combining CBT with physical exercise or mindfulness further enhanced outcomes. Other promising approaches include virtual reality (VR), transcranial direct current stimulation (tDCS), and family-based interventions. Additionally, treatments involving mindfulness and animal-assisted therapy showed potential in improving emotional regulation and interpersonal relationships. However, further research is needed to evaluate long-term efficacy and explore emerging therapies.
Collapse
Affiliation(s)
- Sandra Núñez-Rodríguez
- Department of Health Sciences, University of Burgos, 09001 Burgos, Spain; (S.N.-R.); (D.B.-G.); (L.A.M.-M.); (J.J.G.-B.); (J.G.-S.)
| | - David Burgos-González
- Department of Health Sciences, University of Burgos, 09001 Burgos, Spain; (S.N.-R.); (D.B.-G.); (L.A.M.-M.); (J.J.G.-B.); (J.G.-S.)
| | - Luis Alberto Mínguez-Mínguez
- Department of Health Sciences, University of Burgos, 09001 Burgos, Spain; (S.N.-R.); (D.B.-G.); (L.A.M.-M.); (J.J.G.-B.); (J.G.-S.)
| | - Félix Menéndez-Vega
- Department of Health Sciences, University of Burgos, 09001 Burgos, Spain; (S.N.-R.); (D.B.-G.); (L.A.M.-M.); (J.J.G.-B.); (J.G.-S.)
| | | | - Jerónimo Javier González-Bernal
- Department of Health Sciences, University of Burgos, 09001 Burgos, Spain; (S.N.-R.); (D.B.-G.); (L.A.M.-M.); (J.J.G.-B.); (J.G.-S.)
| | - Josefa González-Santos
- Department of Health Sciences, University of Burgos, 09001 Burgos, Spain; (S.N.-R.); (D.B.-G.); (L.A.M.-M.); (J.J.G.-B.); (J.G.-S.)
| |
Collapse
|
|
2
|
Skok K, Waszkiewicz N. Biomarkers of Internet Gaming Disorder-A Narrative Review. J Clin Med 2024; 13:5110. [PMID: 39274323 PMCID: PMC11396063 DOI: 10.3390/jcm13175110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2024] [Revised: 08/14/2024] [Accepted: 08/22/2024] [Indexed: 09/16/2024] Open
Abstract
Since game mechanics and their visual aspects have become more and more addictive, there is concern about the growing prevalence of Internet gaming disorder (IGD). In the current narrative review, we searched PubMed and Google Scholar databases for the keywords "igd biomarker gaming" and terms related to biomarker modalities. The biomarkers we found are grouped into several categories based on a measurement method and are discussed in the light of theoretical addiction models (tripartite neurocognitive model, I-PACE). Both theories point to gaming-related problems with salience and inhibition. The first dysfunction makes an individual more susceptible to game stimuli (raised reward seeking), and the second negatively impacts resistance to these stimuli (decreased cognitive control). The IGD patients' hypersensitivity to reward manifests mostly in ventral striatum (VS) measurements. However, there is also empirical support for a ventral-to-dorsal striatal shift and transition from goal-directed to habitual behaviors. The deficits in executive control are demonstrated in parameters related to the prefrontal cortex (PFC), especially the dorsolateral prefrontal cortex (DLPFC). In general, the connection of PFC with reward under cortex nuclei seems to be dysregulated. Other biomarkers include reduced P3 amplitudes, high-frequency heart rate variability (HRV), and the number of eye blinks and saccadic eye movements during the non-resting state. A few studies propose a diagnostic (multimodal) model of IGD. The current review also comments on inconsistencies in findings in the nucleus accumbens (NAcc), anterior cingulate cortex (ACC), and precuneus and makes suggestions for future IGD studies.
Collapse
Affiliation(s)
- Katarzyna Skok
- Faculty of Education, University of Bialystok, ul. Świerkowa 20, 15-328 Bialystok, Poland
| | - Napoleon Waszkiewicz
- Department of Psychiatry, Medical University of Bialystok, pl. Wołodyjowskiego 2, 15-272 Bialystok, Poland
| |
Collapse
|
|
3
|
Sharma R, Weinstein AM. Recent treatment and novel imaging studies evaluating treatment of internet gaming disorder: a narrative review. Front Psychiatry 2024; 15:1408560. [PMID: 38938461 PMCID: PMC11210348 DOI: 10.3389/fpsyt.2024.1408560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 05/03/2024] [Indexed: 06/29/2024] Open
Abstract
Internet Gaming Disorder (IGD) is an emerging public health concern; effective treatments are still under development. This mini-review focuses on summarizing the main scientific evidence from psychological, pharmacological, brain imaging, and emerging treatment approaches for IGD. We searched PubMed and Scopus databases using keywords related to IGD and treatment. Cognitive behavioral therapy (CBT) is the most extensively researched psychological treatment for IGD, supported by several randomized controlled trials (RCTs). Other promising approaches include mindfulness, relapse prevention, abstinence protocols, and family therapy. Pharmacological treatments like bupropion and escitalopram have shown benefits, especially when IGD is comorbid with conditions like major depressive disorder. However, the quality of evidence is moderate for psychological interventions but low to moderate for pharmacological approaches. Emerging treatments such as transcranial direct current stimulation (tDCS), repetitive transcranial magnetic stimulation (rTMS), and electro-acupuncture have demonstrated efficacy in reducing IGD symptoms and modulating brain activity. Brain imaging techniques like functional magnetic resonance imaging (fMRI) have provided insights into the neural mechanisms underlying IGD and treatment effects, although these studies lack randomized controlled designs. While multimodal approaches show promise, larger, well-designed RCTs are needed to establish effective IGD treatments.
Collapse
Affiliation(s)
- Rishi Sharma
- Department of Psychology, Ariel University, Ariel, Israel
| | | |
Collapse
|
|
4
|
Mestre-Bach G, Potenza MN. Neural mechanisms linked to treatment outcomes and recovery in substance-related and addictive disorders. DIALOGUES IN CLINICAL NEUROSCIENCE 2023; 25:75-91. [PMID: 37594217 PMCID: PMC10444012 DOI: 10.1080/19585969.2023.2242359] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 07/24/2023] [Accepted: 07/24/2023] [Indexed: 08/19/2023]
Abstract
The present review focuses on potential neural mechanisms underlying recovery from psychiatric conditions characterised by impaired impulse control, specifically substance use disorders, gambling disorder, and internet gaming disorder. Existing treatments (both pharmacological and psychological) for these addictions may impact brain processes, and these have been evaluated in neuroimaging studies. Medication challenge and short-term intervention administration will be considered with respect to treatment utility. Main models of addiction (e.g., dual process, reward deficiency syndrome) will be considered in the context of extant data. Additionally, advanced analytic approaches (e.g., machine-learning approaches) will be considered with respect to guiding treatment development efforts. Thus, this narrative review aims to provide directions for treatment development for addictive disorders.
Collapse
Affiliation(s)
- Gemma Mestre-Bach
- Centro de Investigación, Transferencia e Innovación (CITEI), Universidad Internacional de La Rioja, La Rioja, Spain
| | - Marc N. Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
- Connecticut Council on Problem Gambling, Wethersfield, CT, USA
- Wu Tsai Institute, Yale University, New Haven, CT, USA
- Yale Child Study Center, Yale University School of Medicine, New Haven, CT, USA
- Department of Neuroscience, Yale University School of Medicine, New Haven, CT, USA
| |
Collapse
|
|
5
|
Wang Y, Qin Y, Li H, Yao D, Sun B, Gong J, Dai Y, Wen C, Zhang L, Zhang C, Luo C, Zhu T. Acupuncture modulates the functional connectivity among the subcortical nucleus and fronto-parietal network in adolescents with internet addiction. Brain Behav 2023; 13:e3241. [PMID: 37721727 PMCID: PMC10636388 DOI: 10.1002/brb3.3241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 08/18/2023] [Accepted: 08/22/2023] [Indexed: 09/19/2023] Open
Abstract
BACKGROUND Internet addiction (IA), recognized as a behavioral addiction, is emerging as a global public health problem. Acupuncture has been demonstrated to be effective in alleviating IA; however, the mechanism is not yet clear. To fill this knowledge gap, our study aimed to investigate the modulatory effects of acupuncture on the functional interactions among the addiction-related networks in adolescents with IA. METHODS Thirty individuals with IA and thirty age- and sex-matched healthy control subjects (HCs) were recruited. Subjects with IA were given a 40-day acupuncture treatment, and resting-state functional magnetic resonance imaging (fMRI) data were collected before and after acupuncture sessions. HCs received no treatment and underwent one fMRI scan after enrollment. The intergroup differences in functional connectivity (FC) among the subcortical nucleus (SN) and fronto-parietal network (FPN) were compared between HCs and subjects with IA at baseline. Then, the intragroup FC differences between the pre- and post-treatment were analyzed in the IA group. A multiple linear regression model was further employed to fit the FC changes to symptom relief in the IA group. RESULTS In comparison to HCs, subjects with IA exhibited significantly heightened FC within and between the SN and FPN at baseline. After 40 days of acupuncture treatment, the FC within the FPN and between the SN and FPN were significantly decreased in individuals with IA. Symptom improvement in subjects with IA was well fitted by the decrease in FC between the left midbrain and ventral prefrontal cortex and between the left thalamus and ventral anterior prefrontal cortex. CONCLUSION These findings confirmed the modulatory effects of acupuncture on the aberrant functional interactions among the SN and FPN, which may partly reflect the neurophysiological mechanism of acupuncture for IA.
Collapse
Affiliation(s)
- Yang Wang
- School of Sports Medicine and HealthChengdu Sport UniversityChengduChina
- Postdoctoral Workstation, Affiliated Sport Hospital of Chengdu Sport UniversityChengduChina
- School of Rehabilitation and Health PreservationChengdu University of TCMChengduChina
- College of Traditional Chinese MedicineChongqing Medical UniversityShapingbaChina
| | - Yun Qin
- Key Laboratory for NeuroInformation of Ministry of EducationUniversity of Electronic Science and Technology of ChinaChengduChina
| | - Hui Li
- School of MedicineChengdu UniversityChengduChina
| | - Dezhong Yao
- Key Laboratory for NeuroInformation of Ministry of EducationUniversity of Electronic Science and Technology of ChinaChengduChina
| | - Bo Sun
- Key Laboratory for NeuroInformation of Ministry of EducationUniversity of Electronic Science and Technology of ChinaChengduChina
| | - Jinnan Gong
- Key Laboratory for NeuroInformation of Ministry of EducationUniversity of Electronic Science and Technology of ChinaChengduChina
- School of Computer ScienceChengdu University of Information TechnologyChengduChina
| | - Yu Dai
- Department of Chinese MedicineChengdu Eighth People's HospitalChengduChina
| | - Chao Wen
- Department of RehabilitationZigong Fifth People's HospitalZigongChina
| | - Lingrui Zhang
- Department of MedicineLeshan Vocational and Technical CollegeLeshanChina
| | - Chenchen Zhang
- Department of RehabilitationTCM Hospital of Longquanyi DistrictChengduChina
| | - Cheng Luo
- Key Laboratory for NeuroInformation of Ministry of EducationUniversity of Electronic Science and Technology of ChinaChengduChina
- Research Unit of NeuroInformationChinese Academy of Medical SciencesBeijingChina
| | - Tianmin Zhu
- School of Rehabilitation and Health PreservationChengdu University of TCMChengduChina
- Library, Chengdu University of TCMChengduChina
| |
Collapse
|
|
6
|
Mestre-Bach G, Potenza MN. Neuroimaging correlates of internet gaming disorder: Can we achieve the promise of translating understandings of brain functioning into clinical advances? CANADIAN JOURNAL OF ADDICTION 2023; 14:7-17. [PMID: 38371925 PMCID: PMC10871672 DOI: 10.1097/cxa.0000000000000178] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2024]
Abstract
Objectives Here we aimed to consider the neural factors associated with internet gaming disorder (IGD), as well as the associations between these factors and existing treatments for the disorder. Methods A narrative review was conducted. Results Pharmacological as well as psychological treatments for IGD may be associated with specific changes in multiple brain areas and circuits. In particular, fronto-striatal and subcortical regions and pathways appear relevant to IGD and its treatment. Conclusions Neuroimaging holds promise for identifying specific mechanisms underlying IGD interventions. However, to date, firm conclusions are difficult to draw and more research examining neural mechanisms of empirically supported treatments for IGD is needed.
Collapse
Affiliation(s)
| | - Marc N. Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
- Connecticut Council on Problem Gambling, Wethersfield, CT, USA
- Wu Tsai Institute, Yale University, New Haven, CT, USA
- Yale Child Study Center, Yale University School of Medicine, New Haven, CT, USA
- Department of Neuroscience, Yale University School of Medicine, New Haven, CT, USA
| |
Collapse
|
|
7
|
Gavriel-Fried B, Serry M, Katz D, Hidvégi D, Demetrovics Z, Király O. The concept of recovery in gaming disorder: A scoping review. J Behav Addict 2023; 12:26-52. [PMID: 36917469 PMCID: PMC10260226 DOI: 10.1556/2006.2023.00002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 12/05/2022] [Accepted: 02/03/2023] [Indexed: 03/16/2023] Open
Abstract
Background Recovery from mental health and behavioral disorders is classically defined as a reduction in symptoms. More recent definitions see it as a process in which individuals improve their health, wellness and other life domains. The inclusion of gaming disorder (GD) in the 11th International Classification of Diseases in 2019 prompted growing interest in GD. However, relatively little is known about recovery from GD, and there is scant literature describing or assessing its course. Objectives This scoping review was designed to explore the state of the art on recovery from GD (e.g., terminology and measures used to assess recovery, main topics in studies about recovery from GD). Methods PubMed, Web of Science, and Scopus databases were searched and critically reviewed according to PRISMA guidelines. We included empirical studies in English covering individuals across all age groups who met the diagnostic criteria of GD/internet gaming disorder (IGD) according to valid scales that relate to recovery or any change, and were published before February 2022. Results A total of 47 out of 966 studies met the inclusion criteria. Recovery as a concept is not explicitly mentioned in GD studies. Rather, changes in subjects' disorders are described in terms of decreases/reductions in symptom severity, or improvement/increases. These changes are primarily measured by scales that evaluate symptom reduction and/or improvement in GD and other psychopathologies. Conclusions The concept of recovery is included in the GD field but is not clearly mentioned or used. Therapists and researchers should aim to promote and integrate the notion of recovery in GD.
Collapse
Affiliation(s)
| | - Meytal Serry
- The Bob Shapell School of Social Work, Tel Aviv University, Israel
| | - Dana Katz
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Dorottya Hidvégi
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Zsolt Demetrovics
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
- Centre of Excellence in Responsible Gaming, University of Gibraltar, Gibraltar, Gibraltar
| | - Orsolya Király
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| |
Collapse
|
|
8
|
Hökby S, Westerlund J, Alvarsson J, Carli V, Hadlaczky G. Longitudinal Effects of Screen Time on Depressive Symptoms among Swedish Adolescents: The Moderating and Mediating Role of Coping Engagement Behavior. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3771. [PMID: 36834466 PMCID: PMC9963273 DOI: 10.3390/ijerph20043771] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 02/12/2023] [Accepted: 02/15/2023] [Indexed: 06/18/2023]
Abstract
Studies suggest that hourly digital screen time increases adolescents' depressive symptoms and emotional regulation difficulties. However, causal mechanisms behind such associations remain unclear. We hypothesized that problem-focused and/or emotion-focused engagement coping moderates and possibly mediates this association over time. Questionnaire data were collected in three waves from a representative sample of Swedish adolescents (0, 3 and 12 months; n = 4793; 51% boys; 99% aged 13-15). Generalized Estimating Equations estimated the main effects and moderation effects, and structural regression estimated the mediation pathways. The results showed that problem-focused coping had a main effect on future depression (b = 0.030; p < 0.001) and moderated the effect of screen time (b = 0.009; p < 0.01). The effect size of this moderation was maximum 3.4 BDI-II scores. The mediation results corroborated the finding that future depression was only indirectly correlated with baseline screen time, conditional upon intermittent problem-coping interference (C'-path: Std. beta = 0.001; p = 0.018). The data did not support direct effects, emotion-focused coping effects, or reversed causality. We conclude that hourly screen time can increase depressive symptoms in adolescent populations through interferences with problem-focused coping and other emotional regulation behaviors. Preventive programs could target coping interferences to improve public health. We discuss psychological models of why screen time may interfere with coping, including displacement effects and echo chamber phenomena.
Collapse
Affiliation(s)
- Sebastian Hökby
- National Centre for Suicide Research and Prevention (NASP), Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, 171 77 Stockholm, Sweden
- National Centre for Suicide Research and Prevention (NASP), Centre for Health Economics, Informatics and Health Services Research (CHIS), Stockholm Health Care Services, 171 77 Stockholm, Sweden
| | - Joakim Westerlund
- National Centre for Suicide Research and Prevention (NASP), Centre for Health Economics, Informatics and Health Services Research (CHIS), Stockholm Health Care Services, 171 77 Stockholm, Sweden
- Department of Psychology, Stockholm University, 106 91 Stockholm, Sweden
| | - Jesper Alvarsson
- National Centre for Suicide Research and Prevention (NASP), Centre for Health Economics, Informatics and Health Services Research (CHIS), Stockholm Health Care Services, 171 77 Stockholm, Sweden
- Stockholm Centre for Health and Social Change (SCOHOST), Department of Psychology, School of Social Sciences, Södertörn University, 141 89 Huddinge, Sweden
| | - Vladimir Carli
- National Centre for Suicide Research and Prevention (NASP), Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, 171 77 Stockholm, Sweden
- National Centre for Suicide Research and Prevention (NASP), Centre for Health Economics, Informatics and Health Services Research (CHIS), Stockholm Health Care Services, 171 77 Stockholm, Sweden
| | - Gergö Hadlaczky
- National Centre for Suicide Research and Prevention (NASP), Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, 171 77 Stockholm, Sweden
- National Centre for Suicide Research and Prevention (NASP), Centre for Health Economics, Informatics and Health Services Research (CHIS), Stockholm Health Care Services, 171 77 Stockholm, Sweden
| |
Collapse
|
|
9
|
Mestre-Bach G, Potenza MN. Potential Biological Markers and Treatment Implications for Binge Eating Disorder and Behavioral Addictions. Nutrients 2023; 15:827. [PMID: 36839185 PMCID: PMC9962023 DOI: 10.3390/nu15040827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 01/28/2023] [Accepted: 02/04/2023] [Indexed: 02/08/2023] Open
Abstract
The reward system is highly relevant to behavioral addictions such as gambling disorder (GD), internet gaming disorder (IGD), and food addiction/binge eating disorder (FA/BED). Among other brain regions, the ventral striatum (VS) has been implicated in reward processing. The main objective of the present state-of-the-art review was to explore in depth the specific role of the VS in GD, IGD and FA/BED, understanding it as a possible biomarker of these conditions. Studies analyzing brain changes following interventions for these disorders, and especially those that had explored possible treatment-related changes in VS, are discussed. More evidence is needed on how existing treatments (both pharmacological and psychobehavioral) for behavioral addictions affect the activation of the VS and related circuitry.
Collapse
Affiliation(s)
- Gemma Mestre-Bach
- Facultad de Ciencias de la Salud, Universidad Internacional de La Rioja, 26006 Logroño, Spain
| | - Marc N. Potenza
- Department of Psychiatry, School of Medicine, Yale University, New Haven, CT 06510, USA
- Connecticut Mental Health Center, New Haven, CT 06519, USA
- Connecticut Council on Problem Gambling, Wethersfield, CT 06109, USA
- Wu Tsai Institute, Yale University, New Haven, CT 06510, USA
- Yale Child Study Center, School of Medicine, Yale University, New Haven, CT 06510, USA
- Department of Neuroscience, School of Medicine, Yale University, New Haven, CT 06510, USA
| |
Collapse
|
|
10
|
Wang ZL, Potenza MN, Song KR, Dong GH, Fang XY, Zhang JT. Subgroups of internet gaming disorder based on addiction-related resting-state functional connectivity. Addiction 2023; 118:327-339. [PMID: 36089824 DOI: 10.1111/add.16047] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 08/31/2022] [Indexed: 01/05/2023]
Abstract
AIMS To identify subgroups of people with internet gaming disorder (IGD) based on addiction-related resting-state functional connectivity and how these subgroups show different clinical correlates and responses to treatment. DESIGN Secondary analysis of two functional magnetic resonance imaging (fMRI) data sets. SETTING Zhejiang province and Beijing, China. PARTICIPANTS One hundred and sixty-nine IGD and 147 control subjects. MEASUREMENTS k-Means algorithmic and support-vector machine-learning approaches were used to identify subgroups of IGD subjects. These groups were examined with respect to assessments of craving, behavioral activation and inhibition, emotional regulation, cue-reactivity and guessing-related measures. FINDINGS Two groups of subjects with IGD were identified and defined by distinct patterns of connectivity in brain networks previously implicated in addictions: subgroup 1 ('craving-related subgroup') and subgroup 2 ('mixed psychological subgroup'). Clustering IGD on this basis enabled the development of diagnostic classifiers with high sensitivity and specificity for IGD subgroups in 10-fold validation (n = 218) and out-of-sample replication (n = 98) data sets. Subgroup 1 is characterized by high craving scores, cue-reactivity during fMRI and responsiveness to a craving behavioral intervention therapy. Subgroup 2 is characterized by high craving, behavioral inhibition and activations scores, non-adaptive emotion-regulation strategies and guessing-task fMRI measures. Subgroups 1 and 2 showed largely opposite functional-connectivity patterns in overlapping networks. CONCLUSIONS There appear to be two subgroups of people with internet gaming disorder, each associated with differing patterns of brain functional connectivity and distinct clinical symptom profiles and gender compositions.
Collapse
Affiliation(s)
- Zi-Liang Wang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China.,IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China.,Center for Cognition and Brain Disorders, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang Province, China
| | - Marc N Potenza
- Department of Psychiatry and Child Study Center, Yale University School of Medicine, New Haven, CT, USA.,Connecticut Council on Problem Gambling, Wethersfield, CT, USA.,Connecticut Mental Health Center, New Haven, CT, USA.,Department of Neuroscience and Wu Tsai Institute, Yale University, New Haven, CT, USA
| | - Kun-Ru Song
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China.,IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Guang-Heng Dong
- Center for Cognition and Brain Disorders, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang Province, China.,Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, Zhejiang Province, China
| | - Xiao-Yi Fang
- Institute of Developmental Psychology, Beijing Normal University, Beijing, China
| | - Jin-Tao Zhang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China.,IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| |
Collapse
|
|
11
|
Feng C, Huang W, Xu K, Stewart JL, Camilleri JA, Yang X, Wei P, Gu R, Luo W, Eickhoff SB. Neural substrates of motivational dysfunction across neuropsychiatric conditions: Evidence from meta-analysis and lesion network mapping. Clin Psychol Rev 2022; 96:102189. [PMID: 35908312 PMCID: PMC9720091 DOI: 10.1016/j.cpr.2022.102189] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 04/13/2022] [Accepted: 07/18/2022] [Indexed: 02/03/2023]
Abstract
Motivational dysfunction constitutes one of the fundamental dimensions of psychopathology cutting across traditional diagnostic boundaries. However, it is unclear whether there is a common neural circuit responsible for motivational dysfunction across neuropsychiatric conditions. To address this issue, the current study combined a meta-analysis on psychiatric neuroimaging studies of reward/loss anticipation and consumption (4308 foci, 438 contrasts, 129 publications) with a lesion network mapping approach (105 lesion cases). Our meta-analysis identified transdiagnostic hypoactivation in the ventral striatum (VS) for clinical/at-risk conditions compared to controls during the anticipation of both reward and loss. Moreover, the VS subserves a key node in a distributed brain network which encompasses heterogeneous lesion locations causing motivation-related symptoms. These findings do not only provide the first meta-analytic evidence of shared neural alternations linked to anticipatory motivation-related deficits, but also shed novel light on the role of VS dysfunction in motivational impairments in terms of both network integration and psychological functions. Particularly, the current findings suggest that motivational dysfunction across neuropsychiatric conditions is rooted in disruptions of a common brain network anchored in the VS, which contributes to motivational salience processing rather than encoding positive incentive values.
Collapse
Affiliation(s)
- Chunliang Feng
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education (South China Normal University), Guangzhou, China,Guangdong Provincial Key Laboratory of Mental Health and Cognitive Science, Center for Studies of Psychological Application, School of Psychology, South China Normal University, Guangzhou, China,Corresponding authors at: Guangdong Provincial Key Laboratory of Mental Health and Cognitive Science, Center for Studies of Psychological Application, School of Psychology, South China Normal University, Guangzhou 510631, China; Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China. (C. Feng), (R. Gu)
| | - Wenhao Huang
- Beijing Key Laboratory of Learning and Cognition, and School of Psychology, Capital Normal University, Beijing, China,Department of Decision Neuroscience and Nutrition, German Institute of Human Nutrition (DIfE), Potsdam-Rehbrücke, Germany
| | - Kangli Xu
- The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | | | - Julia A. Camilleri
- Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany,Institute of Neuroscience and Medicine, Brain & Behaviour (INM-7), Research Centre Jülich, Jülich, Germany
| | - Xiaofeng Yang
- The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Ping Wei
- Beijing Key Laboratory of Learning and Cognition, and School of Psychology, Capital Normal University, Beijing, China
| | - Ruolei Gu
- Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, China,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China,Corresponding authors at: Guangdong Provincial Key Laboratory of Mental Health and Cognitive Science, Center for Studies of Psychological Application, School of Psychology, South China Normal University, Guangzhou 510631, China; Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China. (C. Feng), (R. Gu)
| | - Wenbo Luo
- Research Center of Brain and Cognitive Neuroscience, Liaoning Normal University, Dalian, China
| | - Simon B. Eickhoff
- Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany,Institute of Neuroscience and Medicine, Brain & Behaviour (INM-7), Research Centre Jülich, Jülich, Germany
| |
Collapse
|
|
12
|
Brand M, Potenza MN, Stark R. Theoretical models of types of problematic usage of the Internet: when theorists meet therapists. Curr Opin Behav Sci 2022. [DOI: 10.1016/j.cobeha.2022.101119] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
|
|
13
|
An empirical investigation of the externalizing and internalizing pathways to disordered gaming behavior: A longitudinal study across childhood and adolescence. COMPUTERS IN HUMAN BEHAVIOR 2022. [DOI: 10.1016/j.chb.2021.107096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
|
|
14
|
Altered dynamic interactions within frontostriatal circuits reflect disturbed craving processing in internet gaming disorder. CNS Spectr 2022; 27:109-117. [PMID: 32951628 DOI: 10.1017/s1092852920001832] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Individuals with internet gaming disorder (IGD) are generally characterized by impaired executive control, persistent game-craving, and excessive reward-seeking behaviors. However, the causal interactions within the frontostriatal circuits underlying these problematic behaviors remain unclear. Here, spectral dynamic causal modeling (spDCM) was implemented to explore this issue. METHODS Resting-state functional magnetic resonance imaging data from 317 online game players (148 IGD subjects and 169 recreational game users (RGUs)) were collected. Using independent component analysis, we determined six region of interests within frontostriatal circuits for further spDCM analysis, and further statistical analyses based on the parametric empirical Bayes framework were performed. RESULTS Compared with RGUs, IGD subjects showed inhibitory effective connectivity from the right orbitofrontal cortex (OFC) to the right caudate and from the right dorsolateral prefrontal cortex to the left OFC; at the same time, excitatory effective connectivity was observed from the thalamus to the left OFC. Correlation analyses results showed that the directional connection from the right OFC to the right caudate was negatively associated with addiction severity. CONCLUSIONS These results suggest that the disrupted causal interactions between specific regions might contribute to dysfunctions within frontostriatal circuits in IGD, and the pathway from the right OFC to the right caudate could serve as a target for brain modulation in future IGD interventions.
Collapse
|
|
15
|
Dong X, Zhang R, Zhornitsky S, Le TM, Wang W, Li CSR, Zhang S. Depression Mediates the Relationship between Childhood Trauma and Internet Addiction in Female but Not Male Chinese Adolescents and Young Adults. J Clin Med 2021; 10:jcm10215015. [PMID: 34768534 PMCID: PMC8584624 DOI: 10.3390/jcm10215015] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 10/18/2021] [Accepted: 10/26/2021] [Indexed: 01/04/2023] Open
Abstract
Internet addiction is associated with a range of psychological risk factors such as childhood trauma and depression. Studies have also suggested sex differences in internet and other behavioral addictions. However, it remains unclear how childhood trauma, depression and internet addiction inter-relate differently between the sexes. A total of 1749 adolescents and young adults aged 12–27 participated in a survey of sociodemographic characteristics and standardized assessments to evaluate internet addiction (Internet Addiction Test), childhood trauma (Childhood Trauma Questionnaire) and depression (Beck Depression Inventory). Mediation and path analyses were used to examine the relationship between childhood trauma, depression and internet addiction. Internet-addicted females relative to males showed more severe depression but the control participants showed the opposite. Childhood trauma was associated with depression for both internet-addicted males and females; however, internet-addicted females but not males showed significant associations between depression and the severity of internet addiction as well as between childhood trauma and the severity of internet addiction. Further, in females, depression mediated the correlations between all types of childhood trauma and the severity of internet addiction. A path analysis suggested that sexual abuse and emotional neglect contributed most significantly to internet addiction when all types of childhood trauma were examined in one model. The findings suggest sex differences in the relationship between childhood trauma, depression and internet addiction. Childhood trauma contributes to internet addiction through depression only in females. The findings may guide future prevention and intervention strategies of internet addiction.
Collapse
Affiliation(s)
- Xue Dong
- Youth Mental Health Education Center, Department of Psychology, Shaanxi University of Science & Technology, Xi’an 710021, China
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06519-1109, USA; (S.Z.); (T.M.L.); (W.W.); (C.-S.R.L.)
- Correspondence: (X.D.); (S.Z.); Tel.: +86-159-2990-5919 (X.D.); +86-120-3974-7310 (S.Z.)
| | - Ruxin Zhang
- Department of Economics and Management, Xi’an University of Technology, Xi’an 710054, China;
| | - Simon Zhornitsky
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06519-1109, USA; (S.Z.); (T.M.L.); (W.W.); (C.-S.R.L.)
| | - Thang M. Le
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06519-1109, USA; (S.Z.); (T.M.L.); (W.W.); (C.-S.R.L.)
| | - Wuyi Wang
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06519-1109, USA; (S.Z.); (T.M.L.); (W.W.); (C.-S.R.L.)
| | - Chiang-Shan R. Li
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06519-1109, USA; (S.Z.); (T.M.L.); (W.W.); (C.-S.R.L.)
- Department of Neuroscience, Yale University School of Medicine, New Haven, CT 06519-1109, USA
- Interdepartmental Neuroscience Program, Yale University, New Haven, CT 06519-1109, USA
| | - Sheng Zhang
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06519-1109, USA; (S.Z.); (T.M.L.); (W.W.); (C.-S.R.L.)
- Correspondence: (X.D.); (S.Z.); Tel.: +86-159-2990-5919 (X.D.); +86-120-3974-7310 (S.Z.)
| |
Collapse
|
|
16
|
Zhang J, Chen S, Jiang Q, Dong H, Zhao Z, Du X, Dong GH. Disturbed craving regulation to gaming cues in internet gaming disorder: Implications for uncontrolled gaming behaviors. J Psychiatr Res 2021; 140:250-259. [PMID: 34119910 DOI: 10.1016/j.jpsychires.2021.05.051] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Revised: 03/03/2021] [Accepted: 05/21/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND The ability to control craving for games is very important to abstain from Internet gaming disorder (IGD) and abundant clinical evidence has suggested that craving dysregulation is the essential pathogenesis for IGD. However, the neural mechanism underlying this feature remains unclear. METHODS Subjective evaluation and fMRI data from 44 participants (IGD participants: 21; recreational Internet game users (RGUs): 23) were collected while they were performing a regulation of craving task. We analyzed and compared their brain features while they regulated cravings to gaming stimuli. RESULTS Compared to RGUs, IGD participants showed enhanced brain activation in the right anterior cingulate cortex, posterior cingulate cortex (PCC), orbitofrontal cortex and middle temporal gyrus and in the left dorsolateral prefrontal cortex and thalamus during the regulation of craving task. Generalized psychophysiological interaction (gPPI) analysis revealed that IGD participants showed decreased functional connectivity between the right PCC and right inferior parietal lobule compared to that in RGU participants. CONCLUSIONS The results suggested that deficits of craving regulation in IGD participant were associated with the imbalanced coordination between the reward network and the executive network. Enhanced game-seeking motivation and disturbed executive control are responsible for craving dysregulation in IGD participants. These findings suggest a biological mechanism for IGD that may help in finding potential interventions.
Collapse
Affiliation(s)
- Jialin Zhang
- Center for Cognition and Brain Disorders, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang Province, China; State Key Laboratory of Cognitive Neuroscience and Learning, Bejing Normal University, Beijing, China
| | - Shuaiyu Chen
- Center for Cognition and Brain Disorders, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang Province, China
| | - Qing Jiang
- Department of Psychology, Zhejiang Normal University, Jinhua, China
| | - Haohao Dong
- Department of Psychology, Zhejiang Normal University, Jinhua, China
| | - Zhen Zhao
- Department of Psychology, Zhejiang Normal University, Jinhua, China
| | - Xiaoxia Du
- School of Psychology, Shanghai University of Sport, Shanghai, China
| | - Guang-Heng Dong
- Center for Cognition and Brain Disorders, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang Province, China; Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, Zhejiang Province, China.
| |
Collapse
|
|
17
|
Xu LX, Wu LL, Geng XM, Wang ZL, Guo XY, Song KR, Liu GQ, Deng LY, Zhang JT, Potenza MN. A review of psychological interventions for internet addiction. Psychiatry Res 2021; 302:114016. [PMID: 34087672 DOI: 10.1016/j.psychres.2021.114016] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Accepted: 05/16/2021] [Indexed: 12/20/2022]
Abstract
Internet addiction (IA) may constitute a widespread and serious mental problem. Previous reviews have not fully considered potential factors that may contribute to therapeutic outcomes or predict behavioral changes. Such information is relevant to understand the active ingredients of interventions and to develop more efficacious treatments that target features of IA. This systematic review was designed to relate theories of IA to treatments, describe studies of psychotherapies for IA, and propose a model of addiction and interventions based on extant studies. A computer database search of PubMed, PsychINFO, ScienceDirect, China National Knowledge Infrastructure, and Google Scholar was conducted to identify all available research evidence on psychological treatments for IA (N = 31 studies). Among these psychological interventions, the targeted reduction of addiction-related impulsivity and craving, improvement of cognitive maladjustment, and alleviation of family problems have been investigated in IA interventions. The targeted domains and intervention methods are not mutually exclusive, and further research is needed to demonstrate the effective components and mechanisms of action for treatments of IA. Such research will help generate more efficacious evidence-based interventions.
Collapse
Affiliation(s)
- Lin-Xuan Xu
- State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Lu-Lu Wu
- State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Xiao-Min Geng
- State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Zi-Liang Wang
- State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | | | - Kun-Ru Song
- State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Guan-Qun Liu
- State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Lin-Yuan Deng
- Faculty of Education, Beijing Normal University, Beijing 100875, China
| | - Jin-Tao Zhang
- State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China.
| | - Marc N Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; Child Study Center, Yale University School of Medicine, New Haven, CT, USA; Department of Neuroscience, Yale University School of Medicine, Connecticut Mental Health Center, New Haven, Connecticut Council on Problem Gambling, Wethersfield, CT, USA; Connecticut Council on Problem Gambling, Wethersfield, CT, USA; Connecticut Mental Health Center, New Haven, CT, USA
| |
Collapse
|
|
18
|
Gao XJ, Sun JJ, Xiang M. Positive psychological intervention for anxiety, depression and coping in subjects addicted to online games. World J Clin Cases 2021; 9:3287-3293. [PMID: 34002137 PMCID: PMC8107890 DOI: 10.12998/wjcc.v9.i14.3287] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 02/05/2021] [Accepted: 03/10/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Addiction to online games is not uncommon. The patients usually refuse to take medications and present with affective symptoms such as anxiety, depression and negative coping styles. Psychological intervention based on positive psychology is a promising treatment for such patients.
AIM To evaluate the effect of positive psychological intervention on anxiety, depression and coping in people addicted to online games.
METHODS This self-controlled study included 89 people addicted to online games, who received treatment at Hangzhou Seventh People’s Hospital, Hangzhou, China in 2019. The Hamilton Anxiety Scale, Hamilton Depression Scale and Trait Coping Style Questionnaire were administered to evaluate the anxiety, depression and coping style among these people. Psychological intervention based on positive psychology was provided for 6 wk followed by another evaluation. The results were compared against those from the previous evaluation.
RESULTS After 6 wk of psychological intervention, 89 people achieved a significant improvement in the Hamilton Anxiety Scale and Hamilton Depression Scale-24 scales. The score for positive coping style in Trait Coping Style Questionnaire was significantly improved, while that of the negative coping style decreased significantly (P < 0.05).
CONCLUSION Psychological intervention based on positive psychology alleviated affective symptoms, such as anxiety and depression, in subjects addicted to online games. Psychological intervention corrected negative coping style, thereby improving mental health.
Collapse
Affiliation(s)
- Xiu-Jun Gao
- Department of Psychiatry, Hangzhou Seventh People’s Hospital, Hangzhou 310013, Zhejiang Province, China
| | - Ji-Jun Sun
- Department of Psychiatry, Hangzhou Seventh People’s Hospital, Hangzhou 310013, Zhejiang Province, China
| | - Mei Xiang
- Department of Elderly Psychiatry, Hangzhou Seventh People’s Hospital, Hangzhou 310013, Zhejiang Province, China
| |
Collapse
|
|
19
|
Abstract
Abstract
Purpose of Review
Gaming disorder (GD), meanwhile classified as a mental disorder in both DSM-5 and ICD-11, is a current public health issue. Theoretical models assume core psychological processes, such as cue reactivity, craving, reward processing, decision-making, cognitive biases, inhibitory control, and stress relief, to be crucially involved in the development and maintenance of GD. This review summarizes neuroscientific findings on these processes in the context of GD as well as treatments and intervention programs addressing these processes.
Recent Findings
We identified overlaps regarding the involvement of neural structures and networks related to psychological processes which may be targeted by public health programs. Complex interactions between executive control, salience, reward, and habit networks are crucially linked to processes involved in GD and public health programs respectively.
Summary
We point at the difficulties of making one to one assignments of neural networks to psychological processes or interventions. Furthermore, new treatment and prevention programs of GD are discussed pointing at possible future directions for neuroscientific research and treatment programs for GD.
Collapse
|
|
20
|
Goslar M, Leibetseder M, Muench HM, Hofmann SG, Laireiter AR. Treatments for internet addiction, sex addiction and compulsive buying: A meta-analysis. J Behav Addict 2020; 9:14-43. [PMID: 32359229 PMCID: PMC8935188 DOI: 10.1556/2006.2020.00005] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND AND AIMS Internet addiction, sex addiction and compulsive buying are common behavioral problems, which share similarities with gambling disorder and substance use disorders. However, little is known about the efficacy of their treatments. The objective of this meta-analysis was to examine the efficacy of the treatments of such problem behaviors, and to draw parallels to gambling disorder and substance use disorders in terms of treatment response. METHODS Literature search yielded 91 studies totaling 3,531 participants to provide a comprehensive evaluation of the short-term and long-term efficacy of psychological, pharmacological and combined treatments for internet addiction, sex addiction, and compulsive buying. RESULTS Psychological, pharmacological, and combined treatments were associated with robust pre-post improvements in the global severity of internet addiction (Hedges's g: 1.51, 1.13, and 2.51, respectively) and sex addiction (Hedges's g: 1.09, 1.21, and 1.91, respectively). For compulsive buying, psychological and pharmacological treatments were also associated with a large-sized pre-post reduction in global severity (Hedges's g: 1.00 and 1.52, respectively). The controlled pre-post and within-group pre-follow-up effect sizes were in the similar range, with few exceptions. Moderator analyses suggest that psychological interventions are effective for reducing compulsive behaviors, especially when delivered face-to-face and conducted over extended periods of time. Combinations of cognitive-behavioral approaches with medications showed an advantage over monotherapies. DISCUSSION AND CONCLUSIONS The results suggest that treatments for common behavioral addictions are effective in the short term, similar to those implemented for gambling disorder and substance use disorders, but more rigorous clinical trials are needed.
Collapse
Affiliation(s)
- Martina Goslar
- Department of Psychology, University of Salzburg, Hellbrunnerstrasse 34, 5020, Salzburg, Austria,Corresponding author. Department of Psychology, University of Salzburg, Hellbrunnerstrasse 34, 5020, Salzburg, Austria. Fax: +43/(0)662/8044 5126. E-mail:
| | - Max Leibetseder
- Department of Psychology, University of Salzburg, Hellbrunnerstrasse 34, 5020, Salzburg, Austria
| | - Hannah M. Muench
- Psychosomatisches Zentrum Waldviertel (PSZW), Universitätsklinik für Psychosomatische Medizin der Karl Landsteiner Privat-Universität, Grafenbergerstraße 2, 3730, Eggenburg, Austria
| | - Stefan G. Hofmann
- Department of Psychological and Brain Sciences, Boston University, 900 Commonwealth Avenue, 2nd Fl., Boston, MA, 02215, USA
| | - Anton-Rupert Laireiter
- Department of Psychology, University of Salzburg, Hellbrunnerstrasse 34, 5020, Salzburg, Austria,Faculty of Psychology, University of Vienna, Liebiggasse 5, 1010, Wien, Austria
| |
Collapse
|
|
21
|
Gansner M, Belfort E, Leahy C, Mirda D, Carson N. An Assessment of Digital Media-related Admissions in Psychiatrically Hospitalized Adolescents. ADOLESCENT PSYCHIATRY 2020. [DOI: 10.2174/2210676609666190221152018] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Background:
Prevalent adolescent digital media use has brought clinical attention
to its potential associated risks. While excessive digital media use has been connected to adolescent
difficulties with mood and impulsivity, no study has examined digital media’s role in
precipitating adolescent psychiatric admissions.
Objective:
Our study aims were to identify and characterize digital media-related admissions
in a sample of psychiatrically hospitalized adolescents, and to recognize unique patterns of
digital media use within this sample. We hypothesized that adolescents with digital mediarelated
admissions would endorse higher amounts of digital media use and problematic online
behaviors.
Methods:
We administered a cross-sectional survey of psychiatrically hospitalized adolescents
between 2012 and 2016. Admissions were considered related to digital media use either
by adolescent report or documentation in the medical record. Unadjusted comparisons
were used to examine relationships between digital media-related psychiatric admissions, online
behaviors and suicide-related risk factors.
Results:
68 of 218 participants (31.2%) had digital media-related admissions. The most frequent
cause of digital media-related admission was cyberbullying (31.9%). Teens with digital-
media related admissions were significantly more likely to sext, use social media, and be
cyberbullied; these adolescents were also at increased risk of suicide planning and hopelessness.
Conclusion:
Efforts should be made by mental health clinicians to identify and address online
relational conflict, as well as to screen for cyberbullying and sexting. Clinicians should
consider that adolescents with digital media-related presentations may be at elevated risk of
self-harm, with higher rates of suicide planning and hopelessness compared to hospitalized
peers with admissions unrelated to digital media.
Collapse
Affiliation(s)
- Meredith Gansner
- Department of Psychiatry, Cambridge Health Alliance, Cambridge, MA, 02139, United States
| | - Erin Belfort
- Department of Psychiatry, Cambridge Health Alliance, Cambridge, MA, 02139, United States
| | - Caroline Leahy
- Department of Psychiatry, Cambridge Health Alliance, Cambridge, MA, 02139, United States
| | - Danielle Mirda
- Department of Psychiatry, Cambridge Health Alliance, Cambridge, MA, 02139, United States
| | - Nicholas Carson
- Department of Psychiatry, Cambridge Health Alliance, Cambridge, MA, 02139, United States
| |
Collapse
|
|
22
|
Zajac K, Ginley MK, Chang R. Treatments of internet gaming disorder: a systematic review of the evidence. Expert Rev Neurother 2019; 20:85-93. [PMID: 31544539 DOI: 10.1080/14737175.2020.1671824] [Citation(s) in RCA: 81] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Introduction: The American Psychiatric Association included Internet gaming disorder (IGD) in the 5th Edition of the Diagnostic and Statistical Manual of Mental Disorders, and the World Health Organization included gaming disorder in the 11th revision of the International Classification of Diseases. These recent updates suggest significant concern related to the harms of excessive gaming.Areas covered: This systematic review provides an updated summary of the scientific literature on treatments for IGD. Inclusion criteria were that studies: 1) evaluate the effectiveness of an intervention for IGD or excessive gaming; 2) use an experimental design (i.e. multi-armed [randomized or nonrandomized] or pretest-posttest); 3) include at least 10 participants per group; and 4) include an outcome measure of IGD symptoms or gaming duration. The review identified 22 studies evaluating treatments for IGD: 8 evaluating medication, 7 evaluating cognitive behavioral psychotherapy, and 7 evaluating other interventions and psychosocial treatments.Expert opinion: Even with the recent uptick in publication of such clinical trials, methodological flaws prevent strong conclusions about the efficacy of any treatment for IGD. Additional well-designed clinical trials using common metrics for assessing IGD symptoms are needed to advance the field.
Collapse
Affiliation(s)
- Kristyn Zajac
- Calhoun Cardiology Center, Department of Medicine, University of Connecticut School of Medicine, Farmington, CT, USA
| | - Meredith K Ginley
- Department of Psychology, East Tennessee State University, Johnson City, TN, USA
| | - Rocio Chang
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, CT, USA
| |
Collapse
|
|
23
|
Abstract
AbstractAs the use of digital technology has increased, abuse and addiction to technology have been identified among a minority of users. In the mid-1990s, the concept of internet addiction was first used. Today, almost every digital technology use has been claimed to have a minority of disordered users. One key aspect of addictive substance behaviors is craving. Craving is also an important component of behavioral addictions including digital technology disorders such as Internet Gaming Disorder. The aim of the present study was to develop the Turkish version of the Craving for Internet Gaming Scale (CIGS) via an adaptation of the Penn Alcohol Craving Scale (PACS). The present study comprised 368 adolescents from four different samples. The measures used included the Craving for Internet Gaming Scale, Digital Game Addiction Scale, and Brief Self-Control Scale. The structural validity of CIGS was investigated with Exploratory Factor Analysis (EFA), Confirmatory Factor Analysis (CFA), and criterion validity. The reliability of CIGS was evaluated using Cronbach α internal consistency reliability coefficient and corrected item total correlation coefficients. As a result of EFA, it was found that the five-item CIGS had a single-factor structure. The unidimensional CIGS obtained as a result of EFA was tested with CFA. As a result of CFA, the unidimensional structure of CIGS was confirmed in two different samples. Criterion validity of CIGS was assessed via digital gaming addiction, self-discipline, impulsiveness, daily internet gaming duration, and internet gaming history. As a result of criterion analysis, CIGS was associated with these variables in the expected direction. Finally, according to reliability analysis, the CIGS was found to be a reliable scale. When validity and reliability analysis of the CIGS are considered as a whole, it is concluded that the CIGS is a valid and reliable scale that assesses craving for internet gaming.
Collapse
|
|
24
|
Sun Y, Wang H, Bo S. Altered topological connectivity of internet addiction in resting-state EEG through network analysis. Addict Behav 2019; 95:49-57. [PMID: 30844604 DOI: 10.1016/j.addbeh.2019.02.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2018] [Revised: 01/17/2019] [Accepted: 02/14/2019] [Indexed: 10/27/2022]
Abstract
The results of some neuroimaging studies have revealed that people with internet addiction (IA) exhibit structural and functional changes in specific brain areas and connections. However, the understanding about global topological organization of IA may also require a more integrative and holistic view of brain function. In the present study, we used synchronization likelihood combined with graph theory analysis to investigate the functional connectivity (FC) and topological differences between 25 participants with IA and 27 healthy controls (HCs) based on their spontaneous EEG activities in the eye-closed resting state. There were no significant differences in FC (total network or sub-networks) between groups (p > .05 for all). Graph analysis showed significantly lower characteristic path length and clustering coefficient in the IA group than in the HC group in the beta and gamma bands, respectively. Altered nodal centralities of the frontal (FP1, FPz) and parietal (CP1, CP5, PO3, PO7, P5, P6, TP8) lobes in the IA group were also observed. Correlation analysis demonstrated that the observed regional alterations were significantly correlated with the severity of IA. Collectively, our findings showed that IA group demonstrated altered topological organization, shifting towards a more random state. Moreover, this study revealed the important role of altered brain areas in the neuropathological mechanism of IA and provided further supportive evidence for the diagnosis of IA.
Collapse
|
|
25
|
Ma SS, Worhunsky PD, Xu JS, Yip SW, Zhou N, Zhang JT, Liu L, Wang LJ, Liu B, Yao YW, Zhang S, Fang XY. Alterations in functional networks during cue-reactivity in Internet gaming disorder. J Behav Addict 2019; 8:277-287. [PMID: 31146550 PMCID: PMC7044545 DOI: 10.1556/2006.8.2019.25] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Cue-induced brain reactivity has been suggested to be a fundamental and important mechanism explaining the development, maintenance, and relapse of addiction, including Internet gaming disorder (IGD). Altered activity in addiction-related brain regions has been found during cue-reactivity in IGD using functional magnetic resonance imaging (fMRI), but less is known regarding the alterations of coordinated whole brain activity patterns in IGD. METHODS To investigate the activity of temporally coherent, large-scale functional brain networks (FNs) during cue-reactivity in IGD, independent component analysis was applied to fMRI data from 29 male subjects with IGD and 23 matched healthy controls (HC) performing a cue-reactivity task involving Internet gaming stimuli (i.e., game cues) and general Internet surfing-related stimuli (i.e., control cues). RESULTS Four FNs were identified that were related to the response to game cues relative to control cues and that showed altered engagement/disengagement in IGD compared with HC. These FNs included temporo-occipital and temporo-insula networks associated with sensory processing, a frontoparietal network involved in memory and executive functioning, and a dorsal-limbic network implicated in reward and motivation processing. Within IGD, game versus control engagement of the temporo-occipital and frontoparietal networks were positively correlated with IGD severity. Similarly, disengagement of temporo-insula network was negatively correlated with higher game-craving. DISCUSSION These findings are consistent with altered cue-reactivity brain regions reported in substance-related addictions, providing evidence that IGD may represent a type of addiction. The identification of the networks might shed light on the mechanisms of the cue-induced craving and addictive Internet gaming behaviors.
Collapse
Affiliation(s)
- Shan-Shan Ma
- Institute of Developmental Psychology, Beijing Normal University, Beijing, China,State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Patrick D. Worhunsky
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Jian-song Xu
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Sarah W. Yip
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Nan Zhou
- Faculty of Education, Beijing Normal University, Beijing, China
| | - Jin-Tao Zhang
- State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China,Beijing Key Lab of Applied Experimental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, China,Corresponding authors: Jin-Tao Zhang; State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Normal University, No. 19, Xinjiekouwai street, Haidian District, Beijing 100875, China; Phone/Fax: +86 10 58800728; E-mail: ; Xiao-Yi Fang; Institute of Developmental Psychology, Beijing Normal University, No. 19, Xinjiekouwai street, Haidian District, Beijing 100875, China; Phone/Fax: +86 10 58808232; E-mail:
| | - Lu Liu
- Institute of Developmental Psychology, Beijing Normal University, Beijing, China
| | - Ling-Jiao Wang
- State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Ben Liu
- State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Yuan-Wei Yao
- State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Sheng Zhang
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Xiao-Yi Fang
- Institute of Developmental Psychology, Beijing Normal University, Beijing, China,Corresponding authors: Jin-Tao Zhang; State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Normal University, No. 19, Xinjiekouwai street, Haidian District, Beijing 100875, China; Phone/Fax: +86 10 58800728; E-mail: ; Xiao-Yi Fang; Institute of Developmental Psychology, Beijing Normal University, No. 19, Xinjiekouwai street, Haidian District, Beijing 100875, China; Phone/Fax: +86 10 58808232; E-mail:
| |
Collapse
|
|
26
|
Costa S, Kuss DJ. Current diagnostic procedures and interventions for Gaming Disorders: A Systematic Review. Front Psychol 2019; 10:578. [PMID: 30971971 PMCID: PMC6445881 DOI: 10.3389/fpsyg.2019.00578] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 03/01/2019] [Indexed: 12/24/2022] Open
Abstract
Background: Despite the growth in the number of studies on Gaming Disorders (GD), assessing the characteristics of clinical subjects is still limited. Driven by the need to overcome this limitation, a broad systematic review is essential to cover the studies that have already assessed the clinical characteristics of individuals diagnosed with GD. Objectives: The aim of this systematic review is to provide a broad cross-cultural picture of the current diagnostic procedures and interventions used for GDs in clinical practice. Methods: A total of 28 studies met the inclusion criteria, and data were synthesized in these categories: (1) the cultural background of the country where the research took place; (2) the instruments used to measure GD; (3) the diagnostic criteria for GD; (4) the diagnostic procedures used; and (5) the treatment protocol applied. Results: Results of this systematic review suggest that in GD clinical practice, there is a great deal of heterogeneity in the choice of instruments, the diagnostic and intervention processes for GD. Conclusions: This systematic review indicates that a validation process of standard procedures in clinical populations with GD is necessary to create clear shared guidelines for practitioners.
Collapse
Affiliation(s)
- Sebastiano Costa
- Dipartimento di Psicologia, Università degli Studi della Campania Luigi Vanvitelli, Caserta, Italy
| | - Daria J Kuss
- Department of Psychology, Nottingham Trent University, Nottingham, United Kingdom
| |
Collapse
|
|
27
|
Wang M, Zheng H, Du X, Dong G. Mapping Internet gaming disorder using effective connectivity: A spectral dynamic causal modeling study. Addict Behav 2019; 90:62-70. [PMID: 30366150 DOI: 10.1016/j.addbeh.2018.10.019] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2018] [Revised: 09/25/2018] [Accepted: 10/15/2018] [Indexed: 12/13/2022]
Abstract
OBJECTS Understanding the neural basis underlying Internet gaming disorder (IGD) is essential for the diagnosis and treatment of this type of behavioural addiction. Aberrant resting-state functional connectivity (rsFC) of the default mode network (DMN) has been reported in individuals with IGD. Since rsFC is not a directional analysis, the effective connectivity within the DMN in IGD remains unclear. Here, we employed spectral dynamic causal modeling (spDCM) to explore this issue. METHODS Resting state fMRI data were collected from 64 IGD (age: 22.6 ± 2.2) and 63 well-matched recreational Internet game users (RGU, age: 23.1 ± 2.5). Voxel-based mean time series data extracted from the 4 brain regions within the DMN (medial prefrontal cortex, mPFC; posterior cingulate cortex, PCC; bilateral inferior parietal lobule, left IPL/right IPL) of two groups during the resting state were used for the spDCM analysis. RESULTS Compared with RGU, IGD showed reduced effective connectivity from the mPFC to the PCC and from the left IPL to the mPFC, with reduced self-connection in the PCC and the left IPL. CONCLUSIONS The spDCM could distinguish the changes in the functional architecture between two groups more precisely than rsFC. Our findings suggest that the decreased excitatory connectivity from the mPFC to the PCC may be a crucial biomarker for IGD. Future brain-based intervention should pay attention to dysregulation in the IPL-mPFC-PCC circuits.
Collapse
|
|
28
|
Gioia F, Boursier V. Treatment of Internet Addiction and Internet Gaming Disorder in Adolescence. ADVANCES IN PSYCHOLOGY, MENTAL HEALTH, AND BEHAVIORAL STUDIES 2019. [DOI: 10.4018/978-1-5225-8449-0.ch008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Internet use is growing year after year and adolescents represent a large proportion of internet users. There is a scholarly interest in teen internet gaming disorder (IGD) and internet addiction (IA) is constantly increasing, but little is known about the treatments of IA and IGD. This study systematically reviews the literature of the last fifteen years, focusing on two main aspects: adolescence, and IA and IGD intervention programs. The inclusion criteria were (1) contain empirical data, (2) include an analysis relating to IA or IGD, (3) include teen samples aged between 13 and 19 years or with an average age within this range, and (4) provide a full-text article published in English. A total number of 17 papers were included, 7 focused on IA and 10 focused on IGD. Prevalence and different treatment-related outcomes are discussed.
Collapse
|
|
29
|
Mottaz A, Corbet T, Doganci N, Magnin C, Nicolo P, Schnider A, Guggisberg AG. Modulating functional connectivity after stroke with neurofeedback: Effect on motor deficits in a controlled cross-over study. NEUROIMAGE-CLINICAL 2018; 20:336-346. [PMID: 30112275 PMCID: PMC6091229 DOI: 10.1016/j.nicl.2018.07.029] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 07/13/2018] [Accepted: 07/27/2018] [Indexed: 01/03/2023]
Abstract
Synchronization of neural activity as measured with functional connectivity (FC) is increasingly used to study the neural basis of brain disease and to develop new treatment targets. However, solid evidence for a causal role of FC in disease and therapy is lacking. Here, we manipulated FC of the ipsilesional primary motor cortex in ten chronic human stroke patients through brain-computer interface technology with visual neurofeedback. We conducted a double-blind controlled crossover study to test whether manipulation of FC through neurofeedback had a behavioral effect on motor performance. Patients succeeded in increasing FC in the motor cortex. This led to improvement in motor function that was significantly greater than during neurofeedback training of a control brain area and proportional to the degree of FC enhancement. This result provides evidence that FC has a causal role in neurological function and that it can be effectively targeted with therapy.
Stroke patients participated in clinical trial on neurofeedback of functional connectivity. Patients learned to enhance synchrony of neural activity in their motor cortex. This led to reduced motor impairment. Evidence for a causal role of neural synchrony in neurological deficits and recovery.
Collapse
Affiliation(s)
- Anaïs Mottaz
- Division of Neurorehabilitation, Department of Clinical Neurosciences, University Hospitals Geneva, Avenue de Beau-Séjour 26, 1211 Geneva, Switzerland
| | - Tiffany Corbet
- Division of Neurorehabilitation, Department of Clinical Neurosciences, University Hospitals Geneva, Avenue de Beau-Séjour 26, 1211 Geneva, Switzerland
| | - Naz Doganci
- Division of Neurorehabilitation, Department of Clinical Neurosciences, University Hospitals Geneva, Avenue de Beau-Séjour 26, 1211 Geneva, Switzerland
| | - Cécile Magnin
- Division of Neurorehabilitation, Department of Clinical Neurosciences, University Hospitals Geneva, Avenue de Beau-Séjour 26, 1211 Geneva, Switzerland
| | - Pierre Nicolo
- Division of Neurorehabilitation, Department of Clinical Neurosciences, University Hospitals Geneva, Avenue de Beau-Séjour 26, 1211 Geneva, Switzerland
| | - Armin Schnider
- Division of Neurorehabilitation, Department of Clinical Neurosciences, University Hospitals Geneva, Avenue de Beau-Séjour 26, 1211 Geneva, Switzerland
| | - Adrian G Guggisberg
- Division of Neurorehabilitation, Department of Clinical Neurosciences, University Hospitals Geneva, Avenue de Beau-Séjour 26, 1211 Geneva, Switzerland.
| |
Collapse
|
|
30
|
Yip SW, Gross JJ, Chawla M, Ma SS, Shi XH, Liu L, Yao YW, Zhu L, Worhunsky PD, Zhang J. Is Neural Processing of Negative Stimuli Altered in Addiction Independent of Drug Effects? Findings From Drug-Naïve Youth with Internet Gaming Disorder. Neuropsychopharmacology 2018; 43:1364-1372. [PMID: 29154365 PMCID: PMC5916358 DOI: 10.1038/npp.2017.283] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 11/05/2017] [Accepted: 11/08/2017] [Indexed: 12/31/2022]
Abstract
Difficulties in emotion regulation are commonly reported among individuals with alcohol and drug addictions and contribute to the acquisition and maintenance of addictive behaviors. Alterations in neural processing of negative affective stimuli have further been demonstrated among individuals with addictions. However, it is unclear whether these alterations are a general feature of addictions or are a result of prolonged exposure to drugs of abuse. To test the hypothesis of altered negative affect processing independent of drug effects, this study assessed neural function among drug-naïve youth with a behavioral addiction-Internet gaming disorder (IGD). Fifty-six young adults (28 with IGD, 28 matched controls) participated in fMRI scanning during performance of a well-validated emotion regulation task. Between-group differences in neural activity during task performance were assessed using a whole-brain, mixed-effects ANOVA with correction for multiple comparisons at currently recommended thresholds (voxel-level p<0.001, pFWE<0.05). Compared to controls, youth with IGD exhibited significantly blunted neural responses within distributed subcortical and cortical regions including the striatum, insula, lateral prefrontal cortex and anterior cingulate in response to negative affective cues, as well as during emotion regulation. Independent component analysis (ICA) further identified between-group differences in engagement of a fronto-cingulo-parietal network, involving decreased engagement in IGD youth relative to controls. Study findings are largely consistent with those from prior neuroimaging studies in substance-use disorders, thus raising the possibility that neural processing of negative affect may be blunted across drug and behavioral addictions independent of acute or chronic drug effects.
Collapse
Affiliation(s)
- Sarah W Yip
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - James J Gross
- Department of Psychology, Stanford University, Stanford, CA, USA
| | - Megha Chawla
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Shan-Shan Ma
- State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Xing-Hui Shi
- State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Lu Liu
- State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Yuan-Wei Yao
- State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Lei Zhu
- State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | | | - Jintao Zhang
- State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China,Institute of Developmental Psychology, Beijing Normal University, Beijing, China,State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, No. 19 XieJieKouWai Street, Haidian Strict, Beijing 100875, China, Tel: +861058800728, Fax: +8615010233046, E-mail:
| |
Collapse
|
|
31
|
Kim SN, Kim M, Lee TH, Lee JY, Park S, Park M, Kim DJ, Kwon JS, Choi JS. Increased Attentional Bias Toward Visual Cues in Internet Gaming Disorder and Obsessive-Compulsive Disorder: An Event-Related Potential Study. Front Psychiatry 2018; 9:315. [PMID: 30057559 PMCID: PMC6053507 DOI: 10.3389/fpsyt.2018.00315] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 06/25/2018] [Indexed: 12/24/2022] Open
Abstract
Internet gaming disorder (IGD) is a newly identified potential addiction disorder associated with compulsive internet-game playing behavior and attentional bias toward online gaming- related cues. Attentional bias toward addiction-related cues is the core feature of addiction that is associated with craving, but the pathophysiology of attentional bias in IGD is not well-understood, such as its relationship to compulsivity. In this study, we used the electrophysiological marker of late positive potential (LPP) to compare attentional bias in IGD and obsessive compulsive disorder (OCD). Twenty patients with IGD, 20 patients with OCD, and 23 healthy control (HC) subjects viewed a series of game-related, OCD-related, and neutral pictures while their event-related potentials (ERPs) were recorded. The game-related cues included in-game screen captures of popular internet games. The OCD-related cues included pictures which provokes obsessive and compulsive symptoms of contamination/washing or checking. LPPs were calculated as the mean value of amplitudes between 350 and 750 ms at the centro-parietal (CP1, CPz, CP2) and parietal (P1, Pz, P2) electrode sites. Higher LPP amplitudes were found for game-related cues in the IGD group than in the HCs, and higher LPP amplitudes were observed in the OCD group for OCD-related cues. The IGD group did not exhibit LPP changes in response to OCD-related cues. Subjective scales demonstrated increased arousal to game-related cues and OCD-related cues in both the IGD and OCD groups compared with the HC group. Increased LPPs in response to disorder-specific cues (game-related and OCD-related) were found in both IGD and OCD groups respectively, although the groups showed overlapping arousal on subjective scales. Our results indicate that LPP is a candidate neurophysiological marker for cue-related craving in IGD.
Collapse
Affiliation(s)
- Sung Nyun Kim
- Department of Psychiatry, Seoul Medical Center, Seoul, South Korea
| | - Minah Kim
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, South Korea
| | - Tak Hyung Lee
- Department of Brain and Cognitive Science, Seoul National University College of Natural Science, Seoul, South Korea
| | - Ji-Yoon Lee
- Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul, South Korea
| | - Sunyoung Park
- Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul, South Korea
| | - Minkyung Park
- Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul, South Korea
| | - Dai-Jin Kim
- Department of Psychiatry, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, South Korea
| | - Jun Soo Kwon
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, South Korea.,Department of Brain and Cognitive Science, Seoul National University College of Natural Science, Seoul, South Korea
| | - Jung-Seok Choi
- Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul, South Korea
| |
Collapse
|
|
32
|
Liu L, Yao YW, Li CSR, Zhang JT, Xia CC, Lan J, Ma SS, Zhou N, Fang XY. The Comorbidity Between Internet Gaming Disorder and Depression: Interrelationship and Neural Mechanisms. Front Psychiatry 2018; 9:154. [PMID: 29740358 PMCID: PMC5924965 DOI: 10.3389/fpsyt.2018.00154] [Citation(s) in RCA: 80] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Accepted: 04/04/2018] [Indexed: 12/14/2022] Open
Abstract
Internet gaming disorder (IGD) is characterized by cognitive and emotional deficits. Previous studies have reported the co-occurrence of IGD and depression. However, extant brain imaging research has largely focused on cognitive deficits in IGD. Few studies have addressed the comorbidity between IGD and depression symptoms and underlying neural mechanisms. Here, we systematically investigated this issue by combining a longitudinal survey study, a cross-sectional resting-state functional connectivity (rsFC) study and an intervention study. Autoregressive cross-lagged modeling on a longitudinal dataset of college students showed that IGD severity and depression are reciprocally predictive. At the neural level, individuals with IGD exhibited enhanced rsFC between the left amygdala and right dorsolateral prefrontal cortex (DLPFC), inferior frontal and precentral gyrus, compared with control participants, and the amygdala-frontoparietal connectivity at the baseline negatively predicted reduction in depression symptoms following a psychotherapy intervention. Further, following the intervention, individuals with IGD showed decreased connectivity between the left amygdala and left middle frontal and precentral gyrus, as compared with the non-intervention group. These findings together suggest that IGD may be closely associated with depression; aberrant rsFC between emotion and executive control networks may underlie depression and represent a therapeutic target in individuals with IGD. Registry name: The behavioral and brain mechanism of IGD; URL: https://www.clinicaltrials.gov/ct2/show/NCT02550405; Registration number: NCT02550405.
Collapse
Affiliation(s)
- Lu Liu
- Faculty of Psychology, Institute of Developmental Psychology, Beijing Normal University, Beijing, China.,State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Yuan-Wei Yao
- State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Chiang-Shan R Li
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States.,Beijing Huilongguan Hospital, Beijing, China
| | - Jin-Tao Zhang
- State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Cui-Cui Xia
- Students Counseling Center, Beijing Normal University, Beijing, China
| | - Jing Lan
- Faculty of Psychology, Institute of Developmental Psychology, Beijing Normal University, Beijing, China
| | - Shan-Shan Ma
- Faculty of Psychology, Institute of Developmental Psychology, Beijing Normal University, Beijing, China
| | - Nan Zhou
- Faculty of Psychology, Institute of Developmental Psychology, Beijing Normal University, Beijing, China
| | - Xiao-Yi Fang
- Faculty of Psychology, Institute of Developmental Psychology, Beijing Normal University, Beijing, China
| |
Collapse
|
|
33
|
Zajac K, Ginley MK, Chang R, Petry NM. Treatments for Internet gaming disorder and Internet addiction: A systematic review. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2017; 31:979-994. [PMID: 28921996 PMCID: PMC5714660 DOI: 10.1037/adb0000315] [Citation(s) in RCA: 130] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Problems related to excessive use of the Internet and video games have recently captured the interests of both researchers and clinicians. The goals of this review are to summarize the literature on treatment effectiveness for these problems and to determine whether any treatments meet the minimum requirement of an evidence-based treatment as defined by Chambless et al. (1998). Studies of treatments for Internet gaming disorder (IGD) and Internet addiction were examined separately, as past studies have linked IGD to more severe outcomes. The systematic review identified 26 studies meeting predefined criteria; 13 focused on treatments for IGD and 13 on Internet addiction. The results highlighted a paucity of well-designed treatment outcome studies and limited evidence for the effectiveness of any treatment modality. Studies were limited by methodological flaws, including small sample sizes, lack of control groups, and little information on treatment adherence, among other problems. In addition, the field is beset by a lack of consistent definitions of and established instruments to measure IGD and Internet addiction. The results of this review highlight the need for additional work in the area of treatment development and evaluation for IGD and Internet addiction. Attention to methodological concerns identified within this review should improve subsequent research related to treating these conditions, and ultimately outcomes of patients suffering from them. (PsycINFO Database Record
Collapse
Affiliation(s)
- Kristyn Zajac
- Calhoun Cardiology Center, Department of Medicine, University of Connecticut School of Medicine
| | - Meredith K. Ginley
- Calhoun Cardiology Center, Department of Medicine, University of Connecticut School of Medicine
| | - Rocio Chang
- Department of Psychiatry, University of Connecticut School of Medicine
| | - Nancy M. Petry
- Calhoun Cardiology Center, Department of Medicine, University of Connecticut School of Medicine
| |
Collapse
|