Financial Disclosure IN INTERNET ADDICTION ACROSS THE LIFESPAN - - PDF document

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BRAIN FUNCTION AND TREATMENT RESPONSE IN INTERNET ADDICTION ACROSS THE LIFESPAN

David R. Rosenberg, M.D., Paul Arnold, M.D., Vaibhav Diwadkar, Ph.D., Gregory Hanna, M.D., James Kennedy, M.D., Donald Kuhn, Ph.D., Frank MacMaster, Ph.D., Jeffrey Stanley, Ph.D., Philip Szeszko, Ph.D., Ronald Thomas, Ph.D., Gregory Baldwin, B.A., Michael Butkus , Ph.D., Michelle Caton, B.A., Phillip Easter, B.A., Pamela Falzarano, M.A., Georgia Michalopoulou, Ph.D., Rebecca Neill, M.S., Arthur Robin, Ph.D., Preeya Taormina, Ph.D., Joel Williams, B.A.

Financial Disclosure

I have financial relationships to disclose: Employee of: Consultant for: Stockholder in: Research support from: NIMH R01 MH059299 Honoraria from:

“I’m Going to Take a Chance

• n You, David.”

John Sweeney, Ph.D.

“The Great Tragedy of Science – the Slaying of a Beautiful Hypothesis by an Ugly Fact.”

• Thomas Huxley

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10/27/2019 2 “Chance Favors the Prepared Mind.”

• Louis Pasteur

THE INTERNET IS A WONDERFUL SERVANT BUT A CRUEL AND CRIPPLING MASTER

Internet Use Disorder

• Typically Devote 8-10 Hours or More

per Day and at Least 30 Hours per Week

• Can Go for Long Periods without Food or

Sleep

• Medical Complications

e.g. Back/Eye Pain, Obesity/Weight Gain

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Internet Gaming Disorder (IGD)

• Condition Proposed for Further Study DSM-5

Proposed Criteria for IGD

• Persistent and Recurrent Use of the Internet Leading to

Clinically Significant Impairment in a 12 Month Period

• Preoccupation with Internet Game
• Withdrawal Symptoms when Taken Away
• Tolerance - Need to Spend Increasing Amount of Time
• Unsuccessful Attempts to Control Participation
• Loss of Interest in Previous Hobbies and Entertainment
• Continued Use Despite Psychosocial Problems
• Use of Internet to Escape or Relieve Negative Mood
• Jeopardized or Lost a Significant Relationship, Job,

Educational or Career Opportunity

RELATED DISORDERS

• Excessive Gambling On Line may Qualify

for a Separate Diagnosis of Gambling Disorder

• Excessive Use of Internet not Involving

Playing Online Games is Not Considered Analogous to Internet Gaming Disorder

SUBTYPES

• Impulse Control Subtype
• Obsessive-Compulsive Subtype
• Depressed/Anxious Subtype
• Combined Impulse Control and

Obsessive-Compulsive Subtype

ALWAYS AN UNDERLYING DISORDER

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PREVALENCE

• Appears to be Highest in Asian

Countries and Male Adolescents, 12-20 Years of Age

• Many Reports from China and South

Korea, Fewer from North America and Europe

• Prevalence Reported to be up to 8.4%

for Males and 4.5% for Females

RISKS AND PROGNOSIS

• Access and Availability
• Adolescent Males at Greatest Risk

but Increasing Across the Lifespan

• Speculated that Asian

Environmental and/or Genetic Background may be Risk Factor

CONSEQUENCES OF INTERNET ADDICTION

• School Failure
• Loss of Jobs
• Marriage and Relationship Failure
• Adverse Impact on Healthy Social,

Educational, and Family Activities

INTERNET ADDICTION TEST (IAT)

*SCORES 40 OR HIGHER ARE PROBLEMATIC*

Brain Structures Central to Internet Addiction

Thalamus Anterior Cingulate Dorsolateral Prefrontal Cortex Anterior Cingulate Thalamus Parietal Cortex Dorsolateral Prefrontal Cortex Striatum: Putamen Caudate Nucleus Accumbens

• Right and Left Hand Finger Tapping
• Number Matching
• 1n-back Letter Matching
• 2n-back Letter Matching

Functional MRI Tasks

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Internet Addiction – Baseline fMRI Healthy Control – Baseline fMRI Internet Addiction – Baseline fMRI Internet Addiction – Follow-Up fMRI Internet Addiction – Follow-Up fMRI Internet Addiction – Post-Relapse fMRI

PRELIMINARY CONCLUSIONS

• Internet Use Disorder has Significant

Public Health Importance

• May be Harder to "Unplug" and Escape

the Internet than Other Addictions

• Critical Brain Alterations may be

Associated with Internet Addiction

• Growing Public Health Concern Requiring

Societal Attention and Intervention

THANK YOU!

QUESTIONS AND COMMENTS

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