Efficacy of Short-term Treatment of Internet and Computer Game Addiction

Abstract

Internet and computer game addiction represent a growing mental health concern, acknowledged by the World Health Organization.OBJECTIVE To determine whether manualized cognitive behavioral therapy (CBT), using short-term treatment for internet and computer game addiction (STICA), is efficient in individuals experiencing internet and computer game addiction. DESIGN, SETTING, AND PARTICIPANTSA multicenter randomized clinical trial was conducted in 4 outpatient clinics in Germany and Austria from January 24, 2012, to June 14, 2017, including follow-ups. Blinded measurements were conducted. A consecutive sample of 143 men was randomized to the treatment group (STICA; n = 72) or wait-list control (WLC) group (n = 71). Main inclusion criteria were male sex and internet addiction as the primary diagnosis. The STICA group had an additional 6-month follow-up (n = 36). Data were analyzed from November 2018 to March 2019. INTERVENTIONSThe manualized CBT program aimed to recover functional internet use. The program consisted of 15 weekly group and up to 8 two-week individual sessions. MAIN OUTCOMES AND MEASURESThe predefined primary outcome was the Assessment of Internet and Computer Game Addiction Self-report (AICA-S). Secondary outcomes were self-reported internet addiction symptoms, time spent online on weekdays, psychosocial functioning, and depression.RESULTS A total of 143 men (mean [SD] age, 26.2 [7.8] years) were analyzed based on intent-to-treat analyses. Of these participants, 50 of 72 men (69.4%) in the STICA group showed remission vs 17 of 71 men (23.9%) in the WLC group. In logistic regression analysis, remission in the STICA vs WLC group was higher (odds ratio, 10.10; 95% CI, 3.69-27.65), taking into account internet addiction baseline severity, comorbidity, treatment center, and age. Compared with the WLC groups, effect sizes at treatment termination of STICA were d = 1.19 for AICA-S, d = 0.88 for time spent online on weekdays, d = 0.64 for psychosocial functioning, and d = 0.67 for depression. Fourteen adverse events and 8 serious adverse events occurred. A causal relationship with treatment was considered likely in 2 AEs, one in each group.CONCLUSIONS AND RELEVANCE Short-term treatment for internet and computer game addiction is a promising, manualized, short-term CBT for a broad range of internet addictions in multiple treatment centers. Further trials investigating the long-term efficacy of STICA and addressing specific groups and subgroups compared with active control conditions are required.

Excessive Spending in a “Free‐to‐Play” Smartphone Game

“…Treatment options for gaming disorder previously had been limited, 12 but a randomized controlled trial published after our treatment of the patient found that cognitive behavioral therapy (CBT) increased remission of internet and computer game addiction in men relative to a waitlist control at treatment end (69.4% vs 23.9%) 13 . CBT has also been found to be effective at treating symptoms of gambling disorder 14 .…”

Access to health care for gaming disorder: A patient-centred approach to address the continuum of need

“…However, there are currently few RCTs for GD suggesting that the development of an evidence-based treatment model is some way in the future (26,49). The lag between clinical practice and the development of evidence is not unusual in addictions research.…”

“…In terms of treatment, the most common approach has been cognitive-behavioural therapy (CBT), usually delivered in brief individual and group-based formats, and other non-CBT psychotherapeutic interventions (14-16, 24, 25). CBT for GD may be an effective shortterm intervention for reducing GD and depressive symptoms, but more studies with follow-up are needed to assess longer-term gains (24,26). Pharmacological interventions have predominantly employed antidepressants (i.e., bupropion and escitalopram), but their effectiveness is currently unclear due to lack of controlled trials (14).…”

Das I-PACE Modell zur Beschreibung der Entstehung und Aufrechterhaltung von internetbezogenen Störungen und anderen Verhaltenssüchten

“…Dennoch können Vorschläge für die klinische Praxis vor dem Hintergrund des aktuellen Kenntnisstandes (auch aus dem Kontext der Forschung und Therapie von substanzgebundenen Süchten) abgeleitet werden [37]. Auch kann konstatiert werden, dass bereits vorhandene standardisierte Manuale zur kognitiven Verhaltenstherapie von Computerspiel-und Internetsucht, die sich als wirksam erwiesen haben [38], an verschiedenen im I-PACE Modell zusammengefassten Mechanismen ansetzen. Zusätzlich könnte es sinnvoll sein, die im Verlauf des Suchtprozesses häufig entstehenden Aufsuchtendenzen durch ein Training zur Modifikation des kognitiven Bias zu reduzieren [39].…”