Managing Problematic Usage of the Internet and Related Disorders in an Era of Diagnostic Transition: An Updated Review

Abstract

Introduction: Problematic Usage of the Internet (PUI) refers to a broad and likely heterogeneous group of Internet-related conditions associated with behavioural disturbances and functional impairment. Methods: Within PUI several conditions have been reported, including Gaming Disorder, Shopping Addiction, Cyberchondria, Gambling Disorder, Cyberpornography Addiction and Cyberbullying. While increasing reports in the field try to define the epidemiologic and clinical boundaries of these conditions, the rapid and continuous evolution of Internet related behaviours as well as their problematic/pathological expressions are often difficult to diagnose, assess, approach with treatment interventions and follow-up. Results: In addition, some of the PUI-related conditions show characteristics of addiction to the Internet as a preferential tool to engage in specific behaviours, while some others exclusively manifest on the Internet, making it necessary to find distinct assessment and treatment pathways. Conclusion: The inclusion of Internet Gaming Disorder in Section III by the DSM-5 and the recognition of Gaming Disorder by the ICD-11 opened the way for a systematic clinical investigation of this and other PUI-related conditions, particularly in terms of preventive and therapeutic strategies. The present article is aimed at offering an updated clinical overview on the main expressions of PUI, focussing on the latest acquisitions in this evolving field.

Advances in problematic usage of the internet research – A narrative review by experts from the European network for problematic usage of the internet

“…In addition, a diagnostic specifier of 'online' (as opposed to offline) activity was added. However, PUI describes excessive online activities associated with marked functional impairment and/or distress, which may include not only gaming and gambling but also online buying or shopping, cybersex/pornography use [24], social media use [25], cyberchondria, digital hoarding, cyberstalking, and excessive use of online streaming with addictive, impulsive and/or compulsive features [26]. A further new ICD-11 diagnosis for Other Specified or Unspecified Disorders Due to Addictive Behaviours was created to allow for potential diagnosis of some of these problematic behaviours as disorders, should the extent of the problem meet the specified diagnostic criteria.…”

Cyberchondria: a Growing Concern During the COVID-19 Pandemic and a Possible Addictive Disorder?

“…Studies on clinical populations are scarce. However, it has been suggested that cyberchondria could be a transdiagnostic factor present in several clinical conditions such as PUI, health-related anxiety that may present as generalized anxiety disorder, hypochondriasis, and OC disorder (OCD) [ 15 ]. However, few studies have considered to date cyberchondria as a potentially addictive behavior, although frameworks such as the interaction of person, affect, cognition, and execution (I-PACE) may apply to cyberchondria as it does other addictive disorders [ 9 , 10 ], as might the designation of “other specified disorder due to addictive behaviors” listed in the eleventh revision of the International Classification of Diseases [ 11 ].…”

New challenges in facing cyberchondria during the coronavirus disease pandemic

“…In previous work, our group tentatively proposed a "working" definition of CYB [17] based on existing definitions of CYB -reflecting three key components: 1) the compulsive nature of online health searching; 2) an increase in anxiety or distress during or after the searching; 3) the negative impact on other online and offline activities. This definition reflects a conceptualization J o u r n a l P r e -p r o o f of CYB as a compulsive form of Problematic Usage of the Internet (PUI) [18,19], an emerging group of disorders that are currently conceptualized within a framework of behavioural addiction and in which framework loss of inhibitory cognitive control over impulsive as well as compulsive responding is emphasized. Indeed, CYB and PUI share in common the distressing loss of control over urge-driven online activity, resulting in time-consuming, compulsive behaviour, that is continued despite acknowledgement of negative consequences and that ultimately causes distress or impairs functioning.…”