İnternet Bağımlılığı
Özet
İnternet, bilgi paylaşımı ve iletişim sağlamanın yanı sıra günlük hayatın birçok alanına nüfuz etmiş önemli bir kaynak haline gelmiş, ancak yaygınlaşmasıyla birlikte internet bağımlılığı riskini de beraberinde getirmiştir. Standart bir klinik tanımı bulunmayan bu davranışsal bağımlılık; interneti aşırı kullanma isteği, uzak kalındığında sinirlilik hali ve sosyal işlevselliğin bozulması ile karakterizedir. Dünya genelinde kullanıcı sayısının hızla artması ve özellikle COVID-19 pandemisi sürecindeki uzaktan eğitim ile izolasyon dönemleri ergenlerde bu bağımlılığın yaygınlaşma oranını ciddi şekilde yükseltmiştir. Etiyolojisinde depresyon, anksiyete, düşük benlik saygısı, dürtüsellik ve işlevsiz aile ilişkileri gibi çok boyutlu psikososyal faktörlerin rol oynadığı saptanmıştır. Tedavi yaklaşımlarında, çağımızda internet kullanımını tamamen kesmek mümkün olmadığından tam bırakma yerine bireysel kontrolü ve zarar azaltmayı hedefleyen yöntemler öne çıkmaktadır. Bu kapsamda dürtüselliği hedefleyen gerçeklik terapisi, bilişsel çarpıtmaları yeniden yapılandıran bilişsel davranışçı terapi (BDT), aşermeye yönelik müdahaleler ve aile işlevlerini güçlendiren aile terapileri kullanılmaktadır. Ayrıca eşlik eden DEHB, depresyon gibi komorbid durumlara yönelik antidepresanlar ve metilfenidat gibi farmakoterapi seçeneklerinden de yararlanılmaktadır.
Internet has become an important resource penetrating many areas of daily life besides providing information sharing and communication, but its widespread use has brought along the risk of internet addiction. This behavioral addiction, which lacks a standardized clinical definition, is characterized by an excessive desire to use the internet, irritability when away from it, and impairment in social functionality. The rapid increase in the number of users worldwide and especially the remote education and isolation periods during the COVID-19 pandemic have significantly raised the prevalence rate of this addiction among adolescents. It has been determined that multidimensional psychosocial factors such as depression, anxiety, low self-esteem, impulsivity, and dysfunctional family relationships play a role in its etiology. In treatment approaches, since it is not possible to completely cut off internet use in our age, methods aiming at increasing individual control and harm reduction come to the fore rather than complete abstinence. In this context, reality therapy targeting impulsivity, cognitive behavioral therapy (CBT) restructuring maladaptive cognitions, craving behavioral interventions, and family therapies strengthening family functions are utilized. In addition, pharmacotherapy options such as antidepressants and methylphenidate are also utilized for comorbid conditions like ADHD and depression.
Referanslar
Wiederhold BK. Beyond Direct Benefits: Indirect Health Benefits of Social Media Use. Cyberpsychology, behavior and Social networking. 2017;20(1):1-2. doi:10.1089/cyber.2016.29059.bkw.
Ostovar S, Allahyar N, Aminpoor H, et al. Internet addiction and its psychosocial risks (depression, anxiety, stress and loneliness) among Iranian adolescents and young adults: A structural equation model in a cross-sectional study. International Journal of Mental Health and Addiction. 2016;14(3):257–267. doi:10.1007/s11469-015-9628-0
Internet World Statistics. World Internet usage and population statistics; 2020. https://www.internetworldstats.com/stats.htm. Accessed 29 July 2022.
Ostovar S, Bagheri R, Griffiths MD, et al. Internet addiction and maladaptive schemas: The potential role of disconnection/rejection and impaired autonomy/performance. Clinical psychology & psychotherapy. 2021;28(6):1509-1524. doi:10.1002/cpp.2581.
Young KS. Internet addiction. American behavioral scientist. 2004; 48:402-441.
Shaw M, Black DW. Internet addiction: definition, assessment, epidemiology and clinical management. CNS Drugs. 2008; 22: 353-365.
Ögel K (2020) internet Bağımlılığı. İnternetin psikolojisini anlamak ve başa çıkmak. İş Bankası Kültür Yayınları (3. Baskı) s: 105.
Young K. Internet addiction: the emergence of a new clinical disorder. Cyberpsychology & behavior. 1998;3:237-44.
American Psychiatric Association (2000) Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision (DSM-IV-TR). Washington, DC: American Psychiatric Association.
American Psychiatric Association (2013) Diagnostic and Statistical Manual of Mental Disorders, 5 th Edition (DSM-5). Washington, DC: American Psychiatric Publishing.
World Health Organization, 2018. International Classification of Diseases for Mortality and Morbidity Statistics (11th Revision).
Young K, Pistner M, O'Mara J, et al. Cyber disorders: the mental health concern for the new millennium. Cyberpsychology & behavior. 1999;2(5):475-9. doi:10.1089/cpb.1999.2.475.
Davis RA. A cognitive-behavioral model of pathological Internet use. Computer Human Behavior. 2001;17: 187-95.
Salehan M, Negahban A. Social networking on smartphones: When mobile phones become addictive. Computer Human Behavior. 2013;29: 2632-39.
Turel O, He Q, Xue G et al. Examination of neural systems sub-serving facebook “addiction”. Psychological reports. 2014;115: 675-95. doi:10.2466/18.PR0.115c31z8.
Mok JY, Choi SW, Kim DJ. Latent class analysis on internet and smartphone addiction in college students. Neuropsychiatric disease and treatment. 2014;10:817-828. doi:10.2147/NDT.S59293.
Jeong SH, Kim HJ, Yum JY, et al. What type of content are smartphone users addicted to?: SNS vs. games. Computer Human Behavior. 2016;54:10-17.
Pan YC, Chiu YC, Lin YH. Systematic review and meta-analysis of epidemiology of internet addiction. Neuroscience Biobehavior Review.2020;118:612-622. doi:10.1016/j.neubiorev.2020.08.013.
Kuss DJ, Griffiths MD, Karila L, et al. Internet addiction: a systematic review of epidemiological research for the last decade. Current pharmaceutical design.2014;20(25):4026-52.doi: 10.2174/13816128113199990617.
Cheng C, Li AY. Internet addiction prevalence and quality of (real) life: a meta-analysis of 31 nations across seven world regions. Cyberpsychology, behavior and social networking. 2014;17(12):755-60. doi:10.1089/cyber.2014.0317
Fam JY. Prevalence of internet gaming disorder in adolescents: A meta-analysis across three decades. Scandinavian journal of psychology. 2018;59(5):524-531. doi:10.1111/sjop.12459.
Király O, Griffiths MD, Urbán R, et al. Problematic internet use and problematic online gaming are not the same: findings from a large nationally representative adolescent sample. Cyberpsychology, behavior and social networking. 2014;17(12):749-54. doi:10.1089/cyber.2014.0475.
Montag C, Bey K, Sha P, et al. Is it meaningful to distinguish between generalized and specific Internet addiction? Evidence from a cross-cultural study from Germany, Sweden, Taiwan and China. Asia-Pacific psychiatry:official journal of the Pacific Rim College of Psychiatrists. 2015;7(1):20-26. doi: 10.1111/appy.12122.
Li YY, Sun Y, Meng SQ, et al. Internet Addiction Increases in the General Population During COVID-19: Evidence From China. American journal on addictions. 2021;30(4):389-397. doi:10.1111/ajad.13156.
Bener A, Yildirim E, Torun P, et al. Internet addiction, fatigue, and sleep problems among adolescent students: a large-scale study. International Journal Mental Health Addiction. 2018; 17(4):959-969. doi:10.1007/s11469-018-9937-1.
Di Nicola M, Ferri VR, Moccia L, et al. Gender Differences and Psychopathological Features Associated with Addictive Behaviors in Adolescents. Frontiers Psychiatry. 2017;1;8:256. doi:10.3389/fpsyt.2017.00256.
Pan PY, Yeh CB. Internet Addiction among Adolescents May Predict Self-Harm/Suicidal Behavior: A Prospective Study. The Journal of pediatrics. 2018;197:262-267. doi:10.1016/j.jpeds.2018.01.046.
Mihara S, Osaki Y, Nakayama H, et al. Internet use and problematic Internet use among adolescents in Japan: A nationwide representative survey. Addictive behaviors reports. 2016;15(4):58-64. doi:10.1016/j.abrep.2016.10.001.
Li Y, Zhang X, Lu F, et al. Internet addiction among elementary and middle school students in China: a nationally representative sample study. Cyberpsychology, behavior and social networking. 2014;17(2):111-116. doi:10.1089/cyber.2012.0482
Ha YM, Hwang WJ. Gender differences in internet addiction associated with psychological health indicators among adolescents using a national web-based survey. International Journal Mental Health Addiction. 2014;12:660–669. doi:10.1007/s11469-014-9500-7.
Wartberg L, Brunner R, Kriston L, et al. Psychopathological factors associated with problematic alcohol and problematic Internet use in a sample of adolescents in Germany. Psychiatry Research.2016;240:272-277.doi:10.1016/j.psychres.2016.04.057
Dufour M, Brunelle N, Tremblay J, et al. Gender Difference in Internet Use and Internet Problems among Quebec High School Students. Canadian journal of psychiatry.2016;61(10):663-668. doi:10.1177/0706743716640755.
Dong H, Yang F, Lu X, et al. Internet Addiction and Related Psychological Factors Among Children and Adolescents in China During the Coronavirus Disease 2019 (COVID-19) Epidemic. Frontiers Psychiatry. 2020;11:00751. doi:10.3389/fpsyt.2020.00751.
Duan L, Shao X, Wang Y, et al. An investigation of mental health status of children and adolescents in china during the outbreak of COVID-19. Journal of Affective Disorders. 2020;275:112-118. doi:10.1016/j.jad.2020.06.029.
Fumero A, Marrero RJ, Voltes D, et al. Personal and social factors involved in internet addiction among adolescents: A meta-analysis. Computers in Human Behavior, 2018;86:387-400. doi:10.1016/j.chb.2018.05.005.
Lin MP. Prevalence of internet addiction during the COVID-19 outbreak and its risk factors among junior high school students in Taiwan. International Journal of Environmental Research and PublicHealth,2020;17(22):8547. doi:10.3390/ijerph17228547.
Kuss D, Griffiths M. Internet gaming addiction: a systematic review of empirical research. Int J Ment Health Addict 2012;10: 278-96.
Ko CH, Yen JY, Yen CF et al. The association between Internet addiction and psychiatric disorder: A review of the literatüre. European psychiatry. 2012;27: 1-8. doi:10.1016/j.eurpsy.2010.04.011.
Dong G, Hu Y, Lin X. Reward/punishment sensitivities among internet addicts: Implications for their addictive behaviors. Progress in neuro-psychopharmacology & biological psychiatry. 2013;46:139-45. doi:10.1016/j.pnpbp.2013.07.007.
Choi JS, Park SM, Roh MS et al. Dysfunctional inhibitory control and impulsivity in Internet addiction. Psychiatry Research. 2014;215: 424-8. doi:10.1016/j.psychres.2013.12.001.
Hall A, Parsons J. Internet addiction: College student case study using best practices in cognitive behavior therapy. Journal Mental Health Counseling. 2001;23: 312–327.
Tao HK. Teenagers’ Internet addiction and the quality oriented education. Journal High Correspondence Education Philosophy Social Science. 2005;3:70–73.
Li D, Liau A, Khoo A. Examining the influence of actual-ideal self-discrepancies, depression, and escapism, on pathological gaming among massively multiplayer online adolescent gamers. Cyberpsychology, behavior and social networking. 2011;14(9):535-9. doi:10.1089/cyber.2010.0463.
Smahel D, Brown BB, Blinka L. Associations between online friendship and Internet addiction among adolescents and emerging adults. Developmental psychology. 2012;48(2):381-388. doi:10.1037/a0027025.
Lee BW, Stapinski LA. Seeking safety on the internet: relationship between social anxiety and problematic internet use. Journal of Anxiety Disorder. 2012;26(1):197-205.doi:10.1016/j.janxdis.2011.11.001.
Rodgers RF, Melioli T, Laconim S, et al. Internet addiction symptoms, disordered eating, and body image avoidance. Cyberpsychology, behavior and social networking. 2013;16, 56–60. doi:10.1089/cyber.2012.1570.
Sumanjeet SINGH, Minakshi PALIWAL. Exploring the problem of Internet Addiction: A Review and Analysis of Existing Literature Journal of Wellbeing Management and Applied Psychology 2020; 3(1):11-20
Rehbein F, MöfileT. Video game and Internet addiction: Is there a need for differentiation? Journal of Addicition Research and Practice. 2013;59: 129-42.
Rumpf H, Tao R, Rehbein F et al. (2016) Internet addiction: A future addictive disorder? In NM Petry (Ed.), Behavioral addictions DSM-5® and beyond. Oxford, UK: Oxford University Press, s. 71-100.
Shapira NA, Lessig MC, Goldsmith TD, et al. Problematic internet use: proposed classification and diagnostic criteria. Depression Anxiety. 2003;17(4):207-216.doi: 10.1002/da.10094.
Morahan-Martin J, Schumacher P. Incidence and correlates of pathological Internet use among college students. Computer Human Behavior. 2000;16: 13-29.
Beard KW, Wolf EM. Modification in the proposed diagnostic criteria for internet addiction. Cyberpsychology & behavior. 2001;4: 377-383. doi:10.1089/109493101300210286.
Leung H, Pakpour AH, Strong C, et al. Measurement invariance across young adults from Hong Kong and Taiwan among three internet-related addiction scales: Bergen Social Media Addiction Scale (BSMAS), Smartphone Application-Based Addiction Scale (SABAS), and Internet Gaming Disorder Scale-Short Form (IGDS-SF9) (Study Part A). Addiction Behavior. 2020;101:105969. doi:10.1016/j.addbeh.2019.04.027.
Alimoradi Z, Lin CY, Broström A, Bülow PH, Bajalan Z, Griffiths MD, Ohayon MM, Pakpour AH. Internet addiction and sleep problems: A systematic review and meta-analysis. Sleep medicinereviews.2019;47:51-61.doi:10.1016/j.smrv.2019.06.004.
Young KS. Cognitive behavior therapy with Internet addicts: treatment outcomes and implications. Cyberpsychology & behavior. 2007;10(5):671-679. doi:10.1089/cpb.2007.9971
Gunes H, Tanidir C, Adaletli H, et al. Oppositional defiant disorder/conduct disorder co-occurrence increases the risk of Internet addiction in adolescents with attention-deficit hyperactivity disorder. Journal Behavior Addiction. 2018;7(2):284-291. doi:10.1556/2006.7.2018.46.
Han DH, Kim SM, Bae S, et al. Brain connectivity and psychiatric comorbidity in adolescents with Internet gaming disorder. Addiction biology. 2017;22(3):802-812.doi: 10.1111/adb.12347.
Huang XQ, Li MC, Tao R. Treatment of internet addiction. Current psychiatry reports. 2010;12(5):462-70. doi: 10.1007/s11920-010-0147-1
King DL, Delfabbro PH, Wu AMS, et al. Treatment of Internet gaming disorder: An international systematic review and CONSORT evaluation. Clinical Psychology Reviews. 2017 ;54:123-133. doi:10.1016/j.cpr.2017.04.002
Deng LY, Yong-Xin WU, Kong R, et al. Faculty of Education, University, B.N., Center, P.C., 2014. Interactive influence of impulsiveness and parent-adolescent communication on adolescents. Internet Addict. Psychol. Dev. Educ.
Dong G, Potenza MN. A cognitive-behavioral model of Internet gaming disorder: theoretical underpinnings and clinical implications. Journal of psychiatric research. 2014;58:7-11. doi:10.1016/j.jpsychires.2014.07.005.
Wubbolding RE, 2006. Evolution of psychotherapy: a conference of inner control. Int. J. Real. Ther.
Wubbolding RE, 2000. Reality Therapy for the 21st Century. Reality Therapy for the 21st Century. PA: Brunner-Routledge, Philadelphia.
Kim JU, 2008. The effect of a R/T group counseling program on the Internet addiction level and self-esteem of Internet addiction university students. doi:10.1007/BF02789613
Karimyar Jahromi M, Mosallanejad L. The impact of reality therapy on metacognition, stress and hope in addicts. Global journal of health science. 2014;23;6(6):281-7.doi: 10.5539/gjhs.v6n6p281.
Brand M, Wegmann E, Stark R, et al. The Interaction of Person-Affect-Cognition-Execution (I-PACE) model for addictive behaviors: Update, generalization to addictive behaviors beyond internet-use disorders, and specification of the process character of addictive behaviors. Neuroscience and biobehavioral reviews. 2019;104:1-10. doi:10.1016/j.neubiorev.2019.06.032
Przepiorka AM, Blachnio A, Miziak B, et al. Clinical approaches to treatment of Internet addiction. Pharmacological reports. 2014;66(2):187-91. doi:10.1016/j.pharep.2013.10.001
Young KS. CBT-IA: the first treatment model for Internet addiction. Journal of Cognition Psychotherapy. 2011:25:304–312. doi:10.1891/0889-8391.25.4.304.
Marlatt GA, Blume AW, Parks GA. Integrating harm reduction therapy and traditional substance abuse treatment. Journal of psychoactive drugs. 2001;33:1321. doi:10.1080/02791072.2001.10400463.
Orzack MH, Voluse AC, Wolf D, et al. An ongoing study of group treatment for men involved in problematic Internet-enabled sexual behavior. Cyberpsychology & behavior. 2006;9:348-360. doi:10.1089/cpb.2006.9.348.
Shek DT, Tang VM, Lo CY. Evaluation of an Internet addiction treatment program for Chinese adolescents in Hong Kong. Adolescence 2009;44:359-373
Wölfling K, Müller KW, Dreier M, et al. Efficacy of Short-term Treatment of Internet and Computer Game Addiction: A Randomized Clinical Trial. JAMA Psychiatry. 2019;76(10):1018-1025. doi:10.1001/jamapsychiatry.2019.1676.
Sayette MA. The Role of Craving in Substance Use Disorders: Theoretical and Methodological Issues. Annual review of clinical psychology. 2016;12:407-33. doi:10.1146/annurev-clinpsy-021815-093351.
Tiffany ST, Wray JM, 2012. The clinical significance of drug craving. in: Uhl, G.R. (Ed.). Addiction Reviews. Annals of the New York Academy of Sciences, pp. 1–17.
Suler JR. To get what you need: healthy and pathological internet use. Cyberpsychology & behavior. 1999;2(5):385-93.doi: 10.1089/cpb.1999.2.385.
Zhang JT, Ma SS, Li CR, et al. Craving behavioral intervention for internet gaming disorder: remediation of functional connectivity of the ventral striatum. Addiction biology. 2018;23(1):337-346. doi:10.1111/adb.12474.
Liu QX, Fang XY, Yan N, et al. Multi-family group therapy for adolescent Internet addiction: exploring the underlying mechanisms. Addiction Behavior. 2015;42:1-8. doi:10.1016/j.addbeh.2014.10.021
Yu L, Shek DT. Internet addiction in Hong Kong adolescents: a three-year longitudinal study. Journal of pediatric and adolescent gynecology . 2013;26:S10-7. doi:10.1016/j.jpag.2013.03.010.
Xu LX, Wu LL, Geng XM, et al. A review of psychological interventions for internet addiction. Psychiatry Research. 2021;302:114016. doi:10.1016/j.psychres.2021.114016.
Łukawski K, Rusek M, Czuczwar SJ. Can pharmacotherapy play a role in treating internet addiction disorder? Expert opinion on pharmacotherapy. 2019;20(11):1299-1301. doi: 10.1080/14656566.2019.1612366.
Nakayama H, Mihara S, Higuchi S. Treatment and risk factors of Internet use disorders. Psychiatry and clinical neurosciences. 2017;71:492–505. doi:10.1111/pcn.12493.
Park JH, Lee YS, Sohn JH, et al. Effectiveness of atomoxetine and methylphenidate for problematic online gaming in adolescents with attention deficit hyperactivity disorder. Human Psychopharmacology. 2016;31:427‒432. doi:10.1002/hup.2559.
Gamardese G, Leone B, Walstra C, et al. Pharmacological treatment of Internet addiction. In: Montag C, Reuter M, editors. Internet Addiction. Cham, Switzerland: Springer International Publishing; 2015. p. 151‒165.
Boothby LA, Doering PL. Acamprosate for the treatment of alcohol dependence. Clinical therapeutics. 2005;27:695‒714. doi:10.1016/j.clinthera.2005.06.015.
