Cognitive-behavioral therapy for internet addiction

Internet addiction (IA), which is being debated as a formal diagnosis for the Diagnostic and Statistical Manual (DSM) and elsewhere, has been defined as a pathological, impairing pattern of preoccupation with internet activities such as gaming, gambling, pornography, streaming video, and surfing for random information. These investigators randomised 143 well-educated men with various IA subtypes in Germany and Austria (mean age, 26) to a manual-based cognitive-behavioural therapy (CBT) designed for this condition (short-term treatment for Internet and computer game addiction [STICA]) or to a wait-list control (WLC).

STICA consisted of 15 weekly 100-minute group sessions interspersed with eight 60-minute individual sessions aimed at maintaining motivation for therapy. At the end of treatment, in analyses controlling for factors such as comorbidity and IA severity, remission was 10 times more likely with STICA than WLC.

That a diverse population of well-educated men has significant social and occupational impairment supports the impression of a spectrum of behaviours characterised by craving, loss of control, excessive salience of and over involvement with internet-generated stimulation, and even tolerance and withdrawal leading to escalating involvement, as is seen in substance addiction. Variants of CBT combined with motivational enhancement seem promising for these conditions, as well as perhaps for other syndromes of excessive and irrational engagement with stimuli that provide immediate mental or physical reward.