Tishara Rajagopal
‘My Strange Addiction’ is a TLC reality television series that showcases some of the most bizarre behaviours compulsively indulged in. A possible guilty pleasure in itself, the show portrays fascinating cases of rare conditions — some whimsical and humorous, others potentially life-threatening. Moving past Lori, who is addicted to sleeping with her hairdryer (on), and Josh, who cannot resist the warm feeling of eating glass, this article addresses a contemporary odd addiction: the internet. Through this discussion, I will critically review the findings that explore diagnoses, causes, and treatments of internet addiction.
Internet gaming addiction, while not fully classified as a unique mental disorder, is included in DSM-5. Similar to the criteria illustrated for gaming, Beard (2005) proposed diagnostic criteria for internet addiction. They are along the lines of preoccupation and anticipation, inability to control usage, and irritability when it is stopped or cut back. Further, the person must either have risked the loss of a relationship, career or educational opportunity, lied to conceal the extent of usage, or used the internet as a means of escaping problems or dysphoric moods. A scarcely investigated area of this idea is the use of smartphones as a channel for internet addiction. Studies have shown that through symptoms of withdrawal and preoccupation, smartphone overuse can be characterised as an addiction as well (Lin et al., 2017). The irony and brilliance in this line of research is that it increasingly relies on applications and smartphone technology to understand ‘cyber behaviourism’.
This question has been examined from multiple perspectives. A behaviourist approach describes internet use as one that is on a variable ratio reinforcement schedule. Similar to gambling, the rewards — messages, notifications, social media posts, pornography, or games — are hinged on unpredictable reward structures. The intensity is greater when coupled with stimulating or mood enhancing content (Cash, Rae, Steel, & Winkler 2012). This not an entirely foreign phenomenon to a generation that derives entertainment from surfing the infinite internet. The mechanism of refreshing a feed is eerily, possibly purposefully, similar to that upon which slot machines are based. When a text comes through, one is not guaranteed a hilarious Whatsapp forward, but the anticipation and unpredictability reinforces the behaviour. As with other addictions, potential predispositions have been identified, that cause individuals to be more vulnerable. They include depression, social anxiety, ADHD symptoms, impulsivity, low perceived social support, and low self-esteem (Brand, 2017).
These evaluations are standard for addictive behaviour. The discussion around the internet is ambivalent in that it must be contextualized within the boundaries of regular use, given its embeddedness in certain cultures. Additionally, the lack of clarity lies in considering the invaluable services it provides. Is it an addiction to the internet itself, or the feeling of connectivity to a virtual social structure? Until thorough examinations are made into this inquiry, treatment options are restrained. A general understanding is that total abstinence is not a viable goal. Young (1999) suggests some cognitive-behavioural options such as disrupting patterns of usage, external inhibitors (which promote the person to go offline), setting goals with respect to time spent, or abstaining from applications which are difficult to regulate the use of.
Psychopharmacological interventions have been tested as well. Prescriptions for the observed comorbid psychiatric symptoms associated with internet addiction have been found to decrease the target behaviour. For instance, escitalopram saw a significant decline among subjects characterised by an impulsive-compulsive behaviour towards the internet (Dell'Osso et al., 2009). Similar results were observed for treatments with bupropion (an antidepressant), and with methylphenidate (a psychostimulant) for those with attention-deficit disorder (Han, Hwang, & Renshaw, 2010; Han et al., 2009). The comorbidity observed with these disorders makes the treatment of internet addiction particularly complex; more attention ought to be diverted towards understanding predispositions and the possible mediators that internet usage engages, such as self-esteem and social connectedness.
The continuous development of technology in human lives means that research is outpaced by newer conceptualizations of the problem. Gambling addiction was introduced as a disorder after decades of literature. It is only expected that the same will follow for internet overuse. Taking it back a few steps from a clinical perspective to a layman’s point of view: we kind of just need our fix of the world wide web. As an exercise, try going internet-free for a day and see how many assignments you don’t complete, catch-ups you miss out on, and songs are unplayble on your mundane commute. It is a starling but true proposition that an instance of internet addiction wouldn’t be in the realm of what TLC considers ‘strange’. While the realization of our dependency on technology can be a crippling finding, the need for classifying behaviour as addictive and ‘modern’ is paramount.
References
Beard, K. W. (2005). Internet addiction: a review of current assessment techniques and potential assessment questions. CyberPsychology & Behavior, 8(1): 7-14.
Brand, Matthias. (2017). Theoretical Models of the Development and Maintenance of Internet Addiction. 10.1007/978-3-319-46276-9_2.
Dell'Osso, B., Hadley, S., Allen, A., Baker, B., Chaplin, W. F., Hollander, E. (2008). Escitalopram in the treatment of impulsive-compulsive Internet usage disorder: an open-label trial followed by a double-blind discontinuation phase. Journal of Clinical Psychiatry, 69(3): 452-6
Cash, H., D. Rae, C., H. Steel, A., & Winkler, A. (2012). Internet Addiction: A Brief Summary of Research and Practice. Current Psychiatry Reviews, 8(4), 292–298.doi:10.2174/157340012803520513
Han, D. H., Hwang, J.W., Renshaw, P. F. (2010). Bupropion sustained release treatment decreases craving for video games and cue-induced brain activity in patients with Internet video game addiction. Experimental and Clinical Psychopharmacology, 18(4): 297-304.
Han, D.H., Lee, Y. S., Na, C., Ahn, J. Y., Chung, U. S., Daniels, M. A., et al. (2009). The effect of methylphenidate on Internet video game play in children with attention-deficit/hyperactivity disorder. Comprehensive Psychiatry, 50(3): 251-6.
Lin, Yu-Hsuan & Lin, Sheng-Hsuan & C. H. Yang, Cheryl & Kuo, Terry. (2017). Psychopathology of Everyday Life in the 21st Century: Smartphone Addiction. 10.1007/978-3-319-46276-9_20.
Young, K.S. (1999). Internet Addiction: Symptoms, Evaluation, And Treatment. Innovations in Clinical Practice, 17.
Tishara Rajagopal
‘My Strange Addiction’ is a TLC reality television series that showcases some of the most bizarre behaviours compulsively indulged in. A possible guilty pleasure in itself, the show portrays fascinating cases of rare conditions — some whimsical and humorous, others potentially life-threatening. Moving past Lori, who is addicted to sleeping with her hairdryer (on), and Josh, who cannot resist the warm feeling of eating glass, this article addresses a contemporary odd addiction: the internet. Through this discussion, I will critically review the findings that explore diagnoses, causes, and treatments of internet addiction.
Internet gaming addiction, while not fully classified as a unique mental disorder, is included in DSM-5. Similar to the criteria illustrated for gaming, Beard (2005) proposed diagnostic criteria for internet addiction. They are along the lines of preoccupation and anticipation, inability to control usage, and irritability when it is stopped or cut back. Further, the person must either have risked the loss of a relationship, career or educational opportunity, lied to conceal the extent of usage, or used the internet as a means of escaping problems or dysphoric moods. A scarcely investigated area of this idea is the use of smartphones as a channel for internet addiction. Studies have shown that through symptoms of withdrawal and preoccupation, smartphone overuse can be characterised as an addiction as well (Lin et al., 2017). The irony and brilliance in this line of research is that it increasingly relies on applications and smartphone technology to understand ‘cyber behaviourism’.
This question has been examined from multiple perspectives. A behaviourist approach describes internet use as one that is on a variable ratio reinforcement schedule. Similar to gambling, the rewards — messages, notifications, social media posts, pornography, or games — are hinged on unpredictable reward structures. The intensity is greater when coupled with stimulating or mood enhancing content (Cash, Rae, Steel, & Winkler 2012). This not an entirely foreign phenomenon to a generation that derives entertainment from surfing the infinite internet. The mechanism of refreshing a feed is eerily, possibly purposefully, similar to that upon which slot machines are based. When a text comes through, one is not guaranteed a hilarious Whatsapp forward, but the anticipation and unpredictability reinforces the behaviour. As with other addictions, potential predispositions have been identified, that cause individuals to be more vulnerable. They include depression, social anxiety, ADHD symptoms, impulsivity, low perceived social support, and low self-esteem (Brand, 2017).
These evaluations are standard for addictive behaviour. The discussion around the internet is ambivalent in that it must be contextualized within the boundaries of regular use, given its embeddedness in certain cultures. Additionally, the lack of clarity lies in considering the invaluable services it provides. Is it an addiction to the internet itself, or the feeling of connectivity to a virtual social structure? Until thorough examinations are made into this inquiry, treatment options are restrained. A general understanding is that total abstinence is not a viable goal. Young (1999) suggests some cognitive-behavioural options such as disrupting patterns of usage, external inhibitors (which promote the person to go offline), setting goals with respect to time spent, or abstaining from applications which are difficult to regulate the use of.
Psychopharmacological interventions have been tested as well. Prescriptions for the observed comorbid psychiatric symptoms associated with internet addiction have been found to decrease the target behaviour. For instance, escitalopram saw a significant decline among subjects characterised by an impulsive-compulsive behaviour towards the internet (Dell'Osso et al., 2009). Similar results were observed for treatments with bupropion (an antidepressant), and with methylphenidate (a psychostimulant) for those with attention-deficit disorder (Han, Hwang, & Renshaw, 2010; Han et al., 2009). The comorbidity observed with these disorders makes the treatment of internet addiction particularly complex; more attention ought to be diverted towards understanding predispositions and the possible mediators that internet usage engages, such as self-esteem and social connectedness.
The continuous development of technology in human lives means that research is outpaced by newer conceptualizations of the problem. Gambling addiction was introduced as a disorder after decades of literature. It is only expected that the same will follow for internet overuse. Taking it back a few steps from a clinical perspective to a layman’s point of view: we kind of just need our fix of the world wide web. As an exercise, try going internet-free for a day and see how many assignments you don’t complete, catch-ups you miss out on, and songs are unplayble on your mundane commute. It is a starling but true proposition that an instance of internet addiction wouldn’t be in the realm of what TLC considers ‘strange’. While the realization of our dependency on technology can be a crippling finding, the need for classifying behaviour as addictive and ‘modern’ is paramount.
References
Beard, K. W. (2005). Internet addiction: a review of current assessment techniques and potential assessment questions. CyberPsychology & Behavior, 8(1): 7-14.
Brand, Matthias. (2017). Theoretical Models of the Development and Maintenance of Internet Addiction. 10.1007/978-3-319-46276-9_2.
Dell'Osso, B., Hadley, S., Allen, A., Baker, B., Chaplin, W. F., Hollander, E. (2008). Escitalopram in the treatment of impulsive-compulsive Internet usage disorder: an open-label trial followed by a double-blind discontinuation phase. Journal of Clinical Psychiatry, 69(3): 452-6
Cash, H., D. Rae, C., H. Steel, A., & Winkler, A. (2012). Internet Addiction: A Brief Summary of Research and Practice. Current Psychiatry Reviews, 8(4), 292–298.doi:10.2174/157340012803520513
Han, D. H., Hwang, J.W., Renshaw, P. F. (2010). Bupropion sustained release treatment decreases craving for video games and cue-induced brain activity in patients with Internet video game addiction. Experimental and Clinical Psychopharmacology, 18(4): 297-304.
Han, D.H., Lee, Y. S., Na, C., Ahn, J. Y., Chung, U. S., Daniels, M. A., et al. (2009). The effect of methylphenidate on Internet video game play in children with attention-deficit/hyperactivity disorder. Comprehensive Psychiatry, 50(3): 251-6.
Lin, Yu-Hsuan & Lin, Sheng-Hsuan & C. H. Yang, Cheryl & Kuo, Terry. (2017). Psychopathology of Everyday Life in the 21st Century: Smartphone Addiction. 10.1007/978-3-319-46276-9_20.
Young, K.S. (1999). Internet Addiction: Symptoms, Evaluation, And Treatment. Innovations in Clinical Practice, 17.
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