Update 7/9/19

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Behavioral addictions are well known to our society and on the rise. We are all familiar with alcohol, gambling, kleptomania and drugs but people can also have compulsive habits of exercise, shopping or eating disorders. Internet related behavioral additions are now commonly recognized as well.  Behavioral addictions produce short-term rewards that trigger persistent behavior with loss of impulse control, despite the persons’s knowledge of adverse consequences  Engagement in these repetitive behaviors can ultimately interfere with individuals health, finances and/or relationships. This is especially dangerous for middle schoolers and teens whose brains are not developed. They are also more susceptible to development of negative habits due to peer pressure and manipulative exploitive marketing. Students become unable or unwilling to read books or effectively verbally communicate.

Do Not Disturb: Confessions of a Writer

In “Do Not Disturb, New York Times writer Kevin Rosse compellingly describes his unhealthy relationship with technology and the point when he slipped across the line into “problem territory”.  He states, “I don’t love referring to what we have as an “addiction.” That seems too sterile and clinical to describe what’s happening to our brains in the smartphone era. Unlike alcohol or opioids, phones aren’t an addictive substance so much as a species-level environmental shock.” He took measures into his own hands with the aide of Catherine Price, author of Do You Need to Break Up With Your Phone? As he started taking breaks and stopped using his phone he became aware of how uncomfortable he was with stillness. He was advised by to have periods of doing nothing but observing his surroundings. He was alone with is own thoughts. He realized how many people are also constantly on their phones to cope with.

Behavioral Disorders Officially Classified as a Mental Disorder

The American Psychiatric Association in 2013 officially classified behavioral addictions as a mental disorder. (2)  According to Jon Grant in his Introduction to Behavioral Addictions,  “evidence suggests that behavioral addictions resemble substance addictions in many domains, including natural history, phenomenology, tolerance, comorbidity, overlapping genetic contribution, neurobiological mechanisms, and response to treatment,” (1)

WHO Announces Internet Gaming Addiction as a Mental Disorder

The World Health Organization, after reviewing the breadth of scientific research  listed Internet Gaming Addiction (IGA) in the 11th International Classification of Diseases (ICD-11) as a mental health disorder in 2018.

This has been considered for many years by the WHO. With consistent evidence that this form of compulsive addiction can develop with or without predisposing factors and can contribute to depression, anxiety, personality changes, social phobia and poor grades, causing serious life consequences, they have finally added this classification to the psychiatric disease code.  It is estimated that about 70% of households play video games with an average video game play time of 20 hours per week.

Symptoms of Addiction

1) Excessive use of video games, even at night, with the person only experiencing happiness if on a video game

2) It takes precedence over work, school or friendships

3) Increased use of video games over time (tolerance), despite negative consequences

4) Withdrawal symptoms of irritability, anger anxiety or social withdrawal if not allowed to play or the technology malfunctions

Recommendations for Parents Include:

  • Limit video games to one hour per day or on weekends only
  • Monitor carefully video play time
  • Be sensitive to personality or mood changes in your child after playing video games
  • If your child becomes angry, aggressive or depressed after the allotted time limit for the game, you may need stricter controls or eliminate video games all together

The Children and Screens Institute for Digital Media and Child Development has developed Guidelines for parents.

A special 2017 supplemental issue of the American Academy of Pediatrics journal  Pediatrics discusses 3 broad areas with scientific findings listed here. A full list of articles is also listed below near the end of this page.

Cognitive, Psychosocial, and Physical Effects: Topic areas include how screen time and media affect learning, attention, obesity, sleep, youths’ sense of self, youth well-being, and risky behaviors such as addiction and screen use while driving.

Effects on Family, Society, and Culture: Topic areas include how screen time and media affect the parent–child relationship, privacy in the era of “Big Data,” digital media literacy, youth civic engagement, and digital inequality.

Media Content: Topic areas include how screen time and media affect aggressive behavior, sexuality and sexual behavior, cyberbullying, children’s perceptions of advertising and marketing, and children’s views of themselves and others via media stereotypes

 

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Internet Addiction Changes Brain Similar to Cocaine

This study examines the physiologic and structural brain changes in those with internet addiction. Researchers find there are similar changes in those with compulsive eating and substance addiction such as cocaine, opiates and methamphetamine. Internet Addiction Brain Changes   Abnormal White Matter Integrity in Adolescents with Internet Addiction Disorder: A Tract-Based Spatial Statistics Study (2012) Lin et al.   A Tract-Based Spatial Statistics Study

 

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The Hacking of the American Mind: The Science Behind the Corporate Takeover of Our Bodies and Brains

Dr. Robert Lustig in his new book The Hacking of the American Mind: The Science Behind the Corporate Takeover of Our Bodies and Brains (2017) describes in detail the neuroscience behind addiction and contentment. He underscores deliberate industry tactics to addict us to unhealthy lifestyles.  As a pediatric endocrinologist and UCSF Professor Emeritus, Dr. Lustig is best known for his work on identifying and preventing obesity in children by examining their addiction to sugary beverages. He now puts cell phones in the same category as sodas in their addictive nature. His book helps define the difference between pleasure with short term rewards and happiness with long term contentment. Dr. Lustig adds much needed enlightenment to the growing problem of addiction.

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Hooked: Internet, Gaming and Social Media Addictions

Researchers are showing similar pathophysiologic changes in those with internet related behavioral addictions and substance addictions. Studies show that Internet addiction symptoms include loss of interests, decreased psychosocial functioning, social retreat, and heightened psychosocial distress.  It is estimated that in 2012, more than one billion individuals played computer games. Online gaming is lucrative creating a market of about $12 billion in China alone in 2013. These games include the popular “World of Warcraft”.

The prevalence of Internet gaming addiction varies from 0.2% in Germany to 50% of Korean teenagers depending on how the studies are performed. Tech Addiction Statistics A 2006 Stanford study showed that one in eight Americans had at least one sign of “problematic internet use”. The lead author, Elias Aboujaoude, MD. states, “We often focus on how wonderful the Internet is – how simple and efficient it can make things, but we need to consider the fact that it creates real problems for a subset of people.” (5) 1 in 8 Americans with Problematic Internet Use

 

Digital Detox: Rehabilitation for Internet Related Addictions

Because of the rise in internet related addictions many countries have established both inpatient and outpatient treatment centers with professional guidance and cognitive-behavioral therapy programs; these include South-East Asia, the United States and Europe. (4)   Japan and China have “fasting camps” where individuals are cut off completely from technology.  “Electronic Heroin” China’s Boot Camps for Internet Addicts   In the United states the reSTART program in Seattle  treats those with addiction to internet, virtual reality, social media and video gaming. They state that one should “Connect With Life, Not Your Device”.

At the Bradford Regional Medical Center in Pennsylvania Psychologist Kimberly Young runs an inpatient  “10 day Digital Detox” program. Using cognitive therapy with educational classes they teach people new coping mechanisms when they enter the “real world”, understanding that it is difficult for people to have total abstinence from the internet.   Bradford Regional Medical Center Internet Rehabilitation Center

In San Francisco the Paradigm San Francisco has been operating since 2006 treating teens for a variety of mental health issues including teen addiction which has risen dramatically in the last several years. It is a 30 day in house program located in Marin County.Paradigm San Francisco

 

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Reset Your Child’s Brain

Child and adult integrative psychiatrist Dr. Victoria Dunckley has written a thorough guidebook, Reset Your Child’s Brain, for parents to help them recognize symptoms of digital overuse and address this issue in their own homes. Dr Dunckley, who practices in Los Angles, has a website and blog with valuable information and articles for parents. http://drdunckley.com Dr. Victoria Dunkley

 

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Irresistible: Addiction by Design

The tech world is aware of the issue of internet related addictions as this is built into their technology. Books such as Irresistible, by Adam Alter, and Screen Schooled, by Joe Clement and Matt Miles, highlight these addictive techniques. Physicians, psychologists and scientists are beginning to consider internet related disorders as public health problem. Below are more references and information.

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Brain Hacked: Tech Insider Tristan Harris Shows How

In an interview with former Google product manager, Tristan Harris, 60 Minutes explores how Silicon Valley has been engineering your phone, apps and social media to get you hooked. Tristan Harris states in the interview “Well every time I check my phone, I’m playing the slot machine to see, “What did I get?” This is one way to hijack people’s minds and create a habit, to form a habit. What you do is you make it so when someone pulls a lever, sometimes they get a reward, an exciting reward. And it turns out that this design technique can be embedded inside of all these products.

What is Brain Hacking? Tech Insiders on Why You Should Care

 

How Screen Addiction Is Hijacking Our Kids: Glow Kids

Psychotherapist and addiction specialist Nicholas Kardaras explains how digital screens may have a negative effect on children’s heath. He is author of Glow Kids: How Screen Addiction Is Hijacking Our Kids and How to Break the Trance, which highlights an abundance of scientific data on adverse effects of digital technology overuse. As an experienced practitioner he has observed how excessive screen time can lead to ADHD, screen addiction, increased aggression, depression, anxiety and even psychosis. He gives advice to parents and schools alike on when to introduce digital media. He has asked Congress to put a warning label on digital screens stating “WARNING: Excessive Screen Usage By Children Can Lead to Clinical Disorders”

 

Brain Scans of Those With Compulsive Internet Device Use

Dr. David Rosenberg from Wayne State University School of Medicine, Department of Psychiatry and Behavioral Sciences discusses his brain scan research on patients with compulsive internet device use before and after addiction correction. He highlights the loss of cognitive functioning as well as executive functioning with internet use.

 

Electronic Screen Time and the Overstimulated Child

Dr Victoria Dunckley is an experienced Board Certified integrative child psychiatrist and author of “Reset Your Child’s Brain: A Four-Week Plan to End Meltdowns, Raise Grades and Boost Social Skills by Reversing the Effects of Electronic Screen Time”. In this video she discusses the clinical and physiologic effects she has seen from the overuse of digital devices on those with or without a preexisting psychologic dysfunction.

 

Dr. Victoria Dunkley explains clearly and concisely the science behind excessive screen time on interactive devoices such as cell phones, computers and tablets, especially compared to television. She examines, sleep patterns, behavior and aggression.

Screenagers

PBS Special Interview with “Screenagers” documentary creator Dr. Delaney Ruston. She discusses her difficulties controlling  her kids social media and internet gaming and how this led her to make the film. Dr. Ruston explains the parts of the brain that makes use of these devices addictive and how this is similar to substance abuse.

 

American Academy of Pediatrics Digital Media Journal 2017

The American Academy of Pediatrics published a special Pediatrics Supplement Nov 2017. Volume 140.  http://pediatrics.aappublications.org/content/140/Supplement_2 The Articles can be downloaded and are as follows:

Pediatrics Journal Articles in Digital Media and Children Supplement Nov 2017

References for Parents

Web links

 

Books

  • Reset Your Child’s Brain: A 4 Week Plan to End Meltdowns, Raise Grades, and Boost Social Skills by Reversing the Effects of Electronic Screen time.  Victoria Dunckley, MD.

  • The Big Disconnect: Protecting Childhood and Family Relationships in the Digital Age.  Catherine Steiner-Adair.

  • Glow Kids: How Screen Addiction Is Hijacking Our Kids-and How to Break the Trance. Nicholas Kardaras

  • Wired Child: Reclaiming Childhood in a Digital Age. Dr. Richard Freed

  • Cyber Junkie: Escape the Gaming and Internet Trap. Kevin Roberts

 

Animated Entertainment on Cell Phone Addiction

 

This is Our World by Steve Cutts

 

Scientific References

1) Introduction to Behavioral Addictions. Jon E. Grant,  (2010) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3164585/

2) Non-substance addictive behaviors in the context of DSM-5. (2014) Marc N. Potenza, MD, PhD. Addict Behav. 2014 Jan; 39(1): 10. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3858502/

3) Internet gaming addiction: current perspectives. (2013) Daria J Kuss. Psychol Res Behav Manag. 2013; 6: 125–137. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3832462/

4) Treatment outcomes in patients with internet addiction: a clinical pilot study on the effects of a cognitive-behavioral therapy program. (2014) Wölfling K.  Biomed Res Int. 2014;2014:425924

5) Internet addiction: Stanford study seeks to define whether it’s a problem.( 2006) https://med.stanford.edu/news/all-news/2006/10/internet-addiction-stanford-study-seeks-to-define-whether-its-a-problem.html

6) Prevalence and Predictors of Video Game Addiction: A Study Based on a National Representative Sample of Gamers. (2016)  Wittek et al. . Int J Ment Health Addict. 2016; 14(5): 672–686. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5023737/