Internet sex addiction: a review of empirical research

The advent of the internet has added another medium in which people can engage in sexual behaviour. This ranges from the passive consumption of online pornography to the interactive exchange of sexual content in cybersex chat rooms. It is believed that access, affordability and anonymity are critical factors that make the Internet viable for the acquisition, development and maintenance of online sexuality. For some, sexual behaviours online are fulfilling, whereas for others, they may take on addictive qualities. Internet sex addiction can be conceptualized as the intersection between Internet addiction and sex addiction and the current literature suggests that there does not appear a clear dividing line between these psychopathologies. The aim of this paper was to provide a comprehensive overview of the empirical studies that have investigated Internet sex addiction in adults. Based on these, it was concluded that engaging in sexual behaviours on the Internet can go awry and result in Internet sex addiction, as it can lead to a wide variety of negative consequences for the individuals affected. Particular attention is drawn to the implications for future research in order to establish the pathological status of Internet sex addiction as a sub-form of Internet addiction, that shares characteristics of real life sex addiction, but which is not to be equated with it. Accordingly, the need for a clear diagnostic framework to clinically assess Internet sex addiction is emphasized as the first step towards understanding the potentially psychopathological qualities and repercussions of sexual behaviours on the Internet

Cannabis use and anxiety: is stress the missing piece of the puzzle?

OBJECTIVE Comorbidity between anxiety and cannabis use is common yet the nature of the association between these conditions is not clear. Four theories were assessed, and a fifth hypothesis tested to determine if the misattribution of stress symptomology plays a role in the association between state-anxiety and cannabis. METHODS Three-hundred-sixteen participants ranging in age from 18 to 71 years completed a short online questionnaire asking about their history of cannabis use and symptoms of stress and anxiety. RESULTS Past and current cannabis users reported higher incidence of lifetime anxiety than participants who had never used cannabis; however, these groups did not differ in state-anxiety, stress, or age of onset of anxiety. State-anxiety and stress were not associated with frequency of cannabis use, but reported use to self-medicate for anxiety was positively associated with all three. Path analyses indicated two different associations between anxiety and cannabis use, pre-existing and high state-anxiety was associated with (i) higher average levels of intoxication and, in turn, acute anxiety responses to cannabis use; (ii) frequency of cannabis use via the mediating effects of stress and self-medication. CONCLUSION None of the theories was fully supported by the findings. However, as cannabis users reporting self-medication for anxiety were found to be self-medicating stress symptomology, there was some support for the stress-misattribution hypothesis. With reported self-medication for anxiety being the strongest predictor of frequency of use, it is suggested that researchers, clinicians, and cannabis users pay greater attention to the overlap between stress and anxiety symptomology and the possible misinterpretation of these related but distinct conditions

Is Cyberchondria a New Transdiagnostic Digital Compulsive Syndrome? A Systematic Review of the Evidence

© 2020 The Author(s). Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).Background. Cyberchondria (CYB) has been described relatively recently as a behaviour characterized by excessive online searching for medical information that is associated with increasing levels of health anxiety. Although CYB has received some attention from researchers, there is no consensus about many of its aspects. Aims. We describe one of the first reported cases of a treatment-seeking patient with CYB. We review the published literature on the definition of CYB, its assessment, epidemiology, cost and burden, psychological models and mechanisms associated with CYB, relationships between CYB and mental disorders and prevention and treatment strategies. Methods: Systematic review of all peer-reviewed papers published within the PubMed, PsycINFO, and Cochrane Library databases. Results. 61 articles were selected. Nearly all the studies were descriptive and cross-sectional recruiting sample mainly from the general/university student population and collecting self-report data via online surveys. Data on epidemiology, clinical features, course, comorbidity and therapeutic interventions were scarce. CYB showed a self-reported association with health anxiety, hypochondriasis and obsessive-compulsive disorder (OCD) as well as other forms of problematic usage of the internet (PUI) The psychological mechanisms associated with CYB include low self-esteem, anxiety sensitivity, intolerance of uncertainty, pain catastrophizing and certain meta-cognitive beliefs. Conclusion: A working definition of CYB includes excessive online health searches that are compulsive and may serve the purpose of seeking reassurance, whilst leading to a worsening of anxiety or distress and further negative consequences. CYB represents a clinically relevant transdiagnostic compulsive behavioural syndrome, closely related to PUI and usually presenting in association with health anxiety, hypochondriasis and/or OCD. CYB is clearly in need of further study and we identify key areas for future research.Peer reviewe

Screening and assessment tools for gaming disorder: A comprehensive systematic review

The inclusion of gaming disorder (GD) as an official diagnosis in the ICD-11 was a significant milestone for the field. However, the optimal measurement approaches for GD are currently unclear. This comprehensive systematic review aimed to identify and evaluate all available English-language GD tools and their corresponding evidence. A search of PsychINFO, PsychArticles, ScienceDirect, Scopus, Web of Science, and Google Scholar identified 32 tools employed in 320 studies (N = 462,249 participants). The evaluation framework examined tools in relation to: (1) conceptual and practical considerations; (2) alignment with DSM-5 and ICD-11 criteria; (3) type and quantity of studies and samples; and (4) psychometric properties. The evaluation showed that GD instrumentation has proliferated, with 2.5 tools, on average, published annually since 2013. Coverage of DSM-5 and ICD-11 criteria was inconsistent, especially for the criterion of continued use despite harm. Tools converge on the importance of screening for impaired control over gaming and functional impairment. Overall, no single tool was found to be clearly superior, but the AICA-Sgaming, GAS-7, IGDT-10, IGDS9-SF, and Lemmens IGD-9 scales had greater evidential support for their psychometric properties. The GD field would benefit from a standard international tool to identify gaming-related harms across the spectrum of maladaptive gaming behaviors.Peer reviewedFinal Accepted Versio

Relationships between online gambling, mental health and substance use: A review

This review deals with the published literature to date while examining the relationship between online gambling, mental health problems, and substance use. Online gambling, particularly problematic gambling online, was found to be associated with poor mental health and use of various substances. Recent preliminary evidence also suggests that online gamblers may be at a greater risk of some substance use and mental health problems, relative to nononline gamblers. However, many of the reviewed studies were limited by investigation of online gambling behaviors only; these samples may have inadvertently comprised individuals who engage in both online and nononline gambling. Future research is required to address these limitations

Developing e-health applications to promote a patient-centered approach to medically unexplained symptoms

Medically unexplained symptoms (MUS) are physical symptoms that cannot be (fully) explained by organic pathology despite adequate diagnostic testing. MUS are highly prevalent and range from single, self-limiting complaints to constellations of chronic and disabling symptoms. Apart from the suffering and impairments MUS impose on patients, they are very costly for society due to the associated productivity losses and burden on healthcare. Anne van Gils’ PhD research aimed to develop e-health applications, offering solutions to three obstacles in the treatment of MUS. Communication problems between patients and healthcare providers are the first obstacle. Since many healthcare providers find it difficult to manage patients with MUS, an online course (‘e-learning’) was developed to improve their knowledge, skills, and attitude. Healthcare providers found this an effective and satisfying way to learn about MUS. The second obstacle are the limited availability of and stigma surrounding psychological treatment. Even though psychotherapy is one of few evidence-based treatments for MUS, only a small proportion of patients benefits from this type of treatment. Online self-help can form a widely available and acceptable alternative. Self-help reduces physical symptoms and improves quality of life. This led to the development of Grip: an online, guided self-help intervention, offered in general practice. Grip also addresses the third obstacle: the large variation in symptom characteristics and etiological factors of MUS. Personalizing the contents of psychological treatments may thus improve their effectiveness. Grip uses algorithms, based on results of online questionnaires and diaries to personalize treatment

Internet addiction in adolescents: prevalence and risk factors

As new media are becoming daily fare, Internet addiction appears as a potential problem in adolescents. From the reported negative consequences, it appears that Internet addiction can have a variety of detrimental outcomes for young people that may require professional intervention. Researchers have now identified a number of activities and personality traits associated with Internet addiction. This study aimed to synthesise previous findings by (i) assessing the prevalence of potential Internet addiction in a large sample of adolescents, and (ii) investigating the interactions between personality traits and the usage of particular Internet applications as risk factors for Internet addiction. A total of 3,105 adolescents in the Netherlands filled out a self-report questionnaire including the Compulsive Internet Use Scale and the Quick Big Five Scale. Results indicate that 3.7% of the sample were classified as potentially being addicted to the Internet. The use of online gaming and social applications (online social networking sites and Twitter) increased the 2 risk for Internet addiction, whereas extraversion and conscientiousness appeared as protective factors in high frequency online gamers. The findings support the inclusion of 'Internet addiction' in the DSM-V. Vulnerability and resilience appear as significant aspects that require consideration in further studies

Mental health literacy: a cross-cultural approach to knowledge and beliefs about depression, schizophrenia and generalized anxiety disorder

Many families worldwide have at least one member with a behavioral or mental disorder, and yet the majority of the public fails to correctly recognize symptoms of mental illness. Previous research has found that Mental Health Literacy (MHL)—the knowledge and positive beliefs about mental disorders—tends to be higher in European and North American cultures, compared to Asian and African cultures. Nonetheless quantitative research examining the variables that explain this cultural difference remains limited. The purpose of our study was fourfold: (a) to validate measures of MHL cross-culturally, (b) to examine the MHL model quantitatively, (c) to investigate cultural differences in the MHL model, and (d) to examine collectivism as a predictor of MHL. We validated measures of MHL in European American and Indian samples. The results lend strong quantitative support to the MHL model. Recognition of symptoms of mental illness was a central variable: greater recognition predicted greater endorsement of social causes of mental illness and endorsement of professional help-seeking as well as lesser endorsement of lay help-seeking. The MHL model also showed an overwhelming cultural difference; namely, lay help-seeking beliefs played a central role in the Indian sample, and a negligible role in the European American sample. Further, collectivism was positively associated with causal beliefs of mental illness in the European American sample, and with lay help-seeking beliefs in the Indian sample. These findings demonstrate the importance of understanding cultural differences in beliefs about mental illness, particularly in relation to help-seeking beliefs