Clinical psychology of Internet addiction: a review of its conceptualization, prevalence, neuronal processes, and implications for treatment

Research into Internet addiction (IA) has grown rapidly over the last decade. The topic has generated a great deal of debate, particularly in relation to how IA can be defined conceptually as well as the many methodological limitations. The present review aims to further elaborate and clarify issues that are relevant to IA research in a number of areas including: definition and characterization, incidence and prevalence rates, associated neuronal processes, and implications for treatment, prevention, and patient-specific considerations. It is concluded that there is no consensual definition for IA. Prevalence rates among nationally representative samples across several countries vary greatly (from 1% to 18.7%), most likely reflecting the lack of methodological consistency and conceptual rigor of the studies. The overlaps between IA and other more traditional substance-based addictions and the possible neural substrates implicated in IA are also highlighted. In terms of treatment and prevention, both psychological and pharmacological treatments are examined in light of existing evidence alongside particular aspects inherent to the patient perspective. Based on the evidence analyzed, it is concluded that IA may pose a serious health hazard to a minority of people

Models of collaboration between psychologist and family doctor: a systematic review of primary care psychology

open2noThe prevalence of psychological suffering is greater than the actual request for clinical consultation in Europe (Alonso et al., 2004). In Italy, no more than 5.5% of the population requested psychological assistance during lifetime (Miglioretti et al., 2008). There are different obstacles that prevent the access to mental health services, such as economic restrictions (Mulder et al., 2011), cultural prejudice (Kim et al., 2010), and lack of knowledge about the service providers that can answer to the patient’s psychological needs (Molinari et al., 2012). Therefore, the psychologist is often consulted as a last resort, only after everything else has failed, when problems have become severe, and thus requiring longer, more intensive, and expensive treatments. The introduction of the Primary Care Psychologist, a professional who works together with the family doctor, allows to overcome the above-mentioned problems and intercept unexpressed needs for psychological assistance. This professional role is operating in many countries since several years. In this study, current literature concerning different models of collaboration between physician and psychologist, in Europe and in Italy, was reviewed. A systematic search of Web of Science (ISI), Pubmed, Scopus, and PsychINFO was conducted using the initial search terms Primary Care Psychologist, Family Doctor, Primary Care, Collaborative Practice, and several relevant papers were identified. The review has shown the improved quality of care when mental health care is integrated into primary. Analyzing how different programs are implemented, results indicated that the more efficacious models of Primary Care Psychology are those tailored on the environment’s needs.The results of our systematic review stress the importance of the Primary Care Psychologist implementation also in Italy, to intercept unexpressed psychological needs and enhance clients’ quality of life.openFrancesca, Bianco; Enrico, BenelliBianco, Francesca; Benelli, Enric

Schema therapy for emotional dysregulation: Theoretical implication and clinical applications

The term emotional dysregulation refers to an impaired ability to regulate unwanted emotional states. Scientific evidence supports the idea that emotional dysregulation underlies several psychological disorders as, for example: personality disorders, bipolar disorder type II, interpersonal trauma, anxiety disorders, mood disorders and posttraumatic stress disorder. Emotional dysregulation may derive from early interpersonal traumas in childhood. These early traumatic events create a persistent sensitization of the central nervous system in relation to early life stressing events. For this reason, some authors suggest a common endophenotypical origin across psychopathologies. In the last 20 years, cognitive behavioral therapy has increasingly adopted an interactiveontogenetic view to explain the development of disorders associated to emotional dysregulation. Unfortunately, standard Cognitive Behavior Therapy (CBT) methods are not useful in treating emotional dysregulation. A CBT-derived new approach called Schema Therapy (ST), that integrates theory and techniques from psychodynamic and emotion focused therapy, holds the promise to fill this gap in cognitive literature. In this model, psychopathology is viewed as the interaction between the innate temperament of the child and the early experiences of deprivation or frustration of the subject\u2019s basic needs. This deprivation may lead to develop early maladaptive schemas (EMS), and maladaptive Modes. In the present paper we point out that EMSs and Modes are associated with either dysregulated emotions or with dysregulatory strategies that produce and maintain problematic emotional responses. Thanks to a special focus on the therapeutic relationship and emotion focused-experiential techniques, this approach successfully treats severe emotional dysregulation. In this paper, we make several comparisons between the main ideas of ST and the science of emotion regulation, and we present how to conceptualize pathological phenomena in terms of failed regulation and some of the ST strategies and techniques to foster successful regulation in patients

Adolescents’ psychological functioning and unintentional injuries: motor vehicles and sports accidents

Adolescence represents a crucial period for psychological development. Adolescents have been shown more prone to injuries than adults have and they are frequently involved in motor vehicle and sports accident. Although adolescents’ injuries have been widely investigated in international literature, victims’ psychological profiles associated with different types of accidents have been scarcely addressed. The present study aimed to identify adolescents’ psychological functioning associated with different types of injuries among a population of Italian adolescents who visited an emergency department. Moreover, the present paper intended to compare psychological profiles of adolescents who have had road and sports accidents. The sample was composed by N= 60 adolescents who attended an emergency department in central Italy. Subjects completed self-report measures assessing emotional and behavioural functioning and the use of defence mechanisms. Both road and sport accidents were associated with adolescents’ maladaptive psychological functioning. Adolescents involved in motor vehicle accidents showed a problematic emotional and behavioural functioning in general and a massive use of defense strategies; their peers who had sport accidents also show various difficulties in internalizing and externalizing functioning. Several adolescents’ emotional-behavioural variables are associated with injuries rates. Risk taking behaviours and other victims’ psychological profiles should be considered to have an exhaustive picture of individual factors that can impair a healthy development

Internet addiction and problematic Internet use: A systematic review of clinical research

AIM: To provide a comprehensive overview of clinical studies on the clinical picture of Internet-use related addictions from a holistic perspective. A literature search was conducted using the database Web of Science. METHODS: Over the last 15 years, the number of Internet users has increased by 1000%, and at the same time, research on addictive Internet use has proliferated. Internet addiction has not yet been understood very well, and research on its etiology and natural history is still in its infancy. In 2013, the American Psychiatric Association included Internet Gaming Disorder in the appendix of the updated version of the Diagnostic and Statistical Manual for Mental Disorders (DSM-5) as condition that requires further research prior to official inclusion in the main manual, with important repercussions for research and treatment. To date, reviews have focused on clinical and treatment studies of Internet addiction and Internet Gaming Disorder. This arguably limits the analysis to a specific diagnosis of a potential disorder that has not yet been officially recognised in the Western world, rather than a comprehensive and inclusive investigation of Internet-use related addictions (including problematic Internet use) more generally. RESULTS: The systematic literature review identified a total of 46 relevant studies. The included studies used clinical samples, and focused on characteristics of treatment seekers and online addiction treatment. Four main types of clinical research studies were identified, namely research involving (1) treatment seeker characteristics; (2) psychopharmacotherapy; (3) psychological therapy; and (4) combined treatment. CONCLUSION: A consensus regarding diagnostic criteria and measures is needed to improve reliability across studies and to develop effective and efficient treatment approaches for treatment seekers

The Use of Mobile Social Technology as Transitional Objects Impact on Personality Functioning

The purpose of this dissertation is to examine the impact unlimited connectivity and unlimited access to voice, text, and video communication as well as multimedia content consumption through mobile social technology has on personality integration. The increased use of mobile social technology has changed how the user engages social relationships. Through mobile social technology, the user places importance in an inanimate object for engagement of social relationships. A reliance on the inanimate object as a social relationship is thought to compromise the ability to internalize integrated object relations and develop stable personality organization. This theoretical research uses hermeneutic analysis of Kernberg’s Object Relations theory, Winnicott’s theory on Transitional Objects, Anthropomorphism, and Kohut’s Self Psychology as it pertains to the relationship with mobile social technology. Through the hermeneutic process of understanding the presented experience of each of these theories the aim is to form a clearer picture of how our relationship with mobile social technology impacts personality functioning. Further research is needed to continue to expand our understanding of the impact of our relationship with social technologies. This Dissertation is available in Open Access at AURA: Antioch University Repository and Archive, http://aura.antioch.edu and OhioLink ETD Center, http://www.ohiolink.edu/etd

Relationship between borderline personality symptoms and Internet addiction: The mediating effects of mental health problems

Aim To examine the relationship between borderline personality symptoms and Internet addiction as well as the mediating role of mental health problems between them. Methods A total of 500 college students from Taiwan were recruited and assessed for symptoms of Internet addiction using the Chen Internet Addiction Scale, borderline personality symptoms using the Taiwanese version of the Borderline Symptom List and mental health problems using four subscales from the Symptom Checklist-90-Revised Scale (interpersonal sensitivity, depression, anxiety, and hostility). Structural equation modeling (SEM) was used to test our hypothesis that borderline personality symptoms are associated with the severity of Internet addiction directly and also through the mediation of mental health problems. Results SEM analysis revealed that all paths in the hypothesized model were significant, indicating that borderline personality symptoms were directly related to the severity of Internet addiction as well as indirectly related to the severity of Internet addiction by increasing the severity of mental health problems. Conclusion Borderline personality symptoms and mental health problems should be taken into consideration when designing intervention programs for Internet addiction

A longitudinal study of adolescent Internet addiction: the role of conscientiousness and classroom hostility

Over the last decade, research on Internet Addiction (IA) has increased. However, almost all studies in this area are cross-sectional and do not examine the context in which internet use takes place. Therefore, a longitudinal study examined the role of conscientiousness (as a personality trait) and classroom hostility (as a contextual factor) in the development of IA. The participants comprised 648 adolescents and were assessed over a two-year period (while aged 16–18 years). A three-level hierarchical linear model was carried out on the data collected. Findings revealed that: (i) lower conscientiousness was associated with IA and this did not change over time; and (ii) although being in a more hostile classroom did not initially have a significant effect, it increased girls’ IA vulnerability over time and functioned protectively for boys. Results indicated that the contribution of individual and contextual IA factors may differ across genders and over time. More specifically, although the protective effect of conscientiousness appeared to hold, the over-time effect of classroom hostility increased the risk of IA for girls. These findings are discussed in relation to the psychological literature. The study’s limitations and implications are also discussed

The words of the body: psychophysiological patterns in dissociative narratives

Trauma has severe consequences on both psychological and somatic levels, even affecting the genetic expression and the cell\u2019s DNA repair ability. A key mechanism in the understanding of clinical disorders deriving from trauma is identified in dissociation, as a primitive defense against the fragmentation of the self originated by overwhelming experiences. The dysregulation of the interpersonal patterns due to the traumatic experience and its detrimental effects on the body are supported by influent neuroscientific models such as Damasio\u2019s somatic markers and Porges\u2019 polyvagal theory. On the basis of these premises, and supported by our previous empirical observations on 40 simulated clinical sessions, we will discuss the longitudinal process of a brief psychodynamic psychotherapy (16 sessions, weekly frequency) with a patient who suffered a relational trauma. The research design consists of the collection of self-report and projective tests, pre-post therapy and after each clinical session, in order to assess personality, empathy, clinical alliance and clinical progress, along with the verbatim analysis of the transcripts trough the Psychotherapy Process Q-Set and the Collaborative Interactions Scale. Furthermore, we collected simultaneous psychophysiological measures of the therapeutic dyad: skin conductance and hearth rate. Lastly, we employed a computerized analysis of non-verbal behaviors to assess synchrony in posture and gestures. These automated measures are able to highlight moments of affective concordance and discordance, allowing for a deep understanding of the mutual regulations between the patient and the therapist. Preliminary results showed that psychophysiological changes in dyadic synchrony, observed in body movements, skin conductance and hearth rate, occurred within sessions during the discussion of traumatic experiences, with levels of attunement that changed in both therapist and the patient depending on the quality of the emotional representation of the experience. These results go in the direction of understanding the relational process in trauma therapy, using an integrative language in which both clinical and neurophysiological knowledge may take advantage of each other