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Efficacy of Short-term Treatment of Internet and Computer Game Addiction: A Randomized Clinical Trial.

ABSTRACT: Importance:Internet and computer game addiction represent a growing mental health concern, acknowledged by the World Health Organization. Objective:To determine whether manualized cognitive behavioral therapy (CBT), using short-term treatment for internet and computer game addiction (STICA), is efficient in individuals experiencing internet and computer game addiction. Design, Setting, and Participants:A multicenter randomized clinical trial was conducted in 4 outpatient clinics in Germany and Austria from January 24, 2012, to June 14, 2017, including follow-ups. Blinded measurements were conducted. A consecutive sample of 143 men was randomized to the treatment group (STICA; n?=?72) or wait-list control (WLC) group (n?=?71). Main inclusion criteria were male sex and internet addiction as the primary diagnosis. The STICA group had an additional 6-month follow-up (n?=?36). Data were analyzed from November 2018 to March 2019. Interventions:The manualized CBT program aimed to recover functional internet use. The program consisted of 15 weekly group and up to 8 two-week individual sessions. Main Outcomes and Measures:The predefined primary outcome was the Assessment of Internet and Computer Game Addiction Self-report (AICA-S). Secondary outcomes were self-reported internet addiction symptoms, time spent online on weekdays, psychosocial functioning, and depression. Results:A total of?143 men (mean [SD] age, 26.2 [7.8] years) were analyzed based on intent-to-treat analyses. Of these participants, 50 of 72 men (69.4%) in the STICA group showed remission vs 17 of 71 men (23.9%) in the WLC group. In logistic regression analysis, remission in the STICA vs WLC group was higher (odds ratio, 10.10; 95% CI, 3.69-27.65), taking into account internet addiction baseline severity, comorbidity, treatment center, and age. Compared with the WLC groups, effect sizes at treatment termination of STICA were d?=?1.19 for AICA-S, d?=?0.88 for time spent online on weekdays, d?=?0.64 for psychosocial functioning, and d?=?0.67 for depression. Fourteen adverse events and 8 serious adverse events occurred. A causal relationship with treatment was considered likely in 2 AEs, one in each group. Conclusions and Relevance:Short-term treatment for internet and computer game addiction is a promising, manualized, short-term CBT for a broad range of internet addictions in multiple treatment centers. Further trials investigating the long-term efficacy of STICA and addressing specific groups and subgroups compared with active control conditions are required. Trial Registration:ClinicalTrials.gov identifier: NCT01434589.

SUBMITTER: Wolfling K

PROVIDER: S-EPMC6624826 | biostudies-literature | 2019 Oct

REPOSITORIES: biostudies-literature

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Efficacy of Short-term Treatment of Internet and Computer Game Addiction: A Randomized Clinical Trial.

Wölfling Klaus K Müller Kai W KW Dreier Michael M Ruckes Christian C Deuster Oliver O Batra Anil A Mann Karl K Musalek Michael M Schuster Andreas A Lemenager Tagrid T Hanke Sara S Beutel Manfred E ME

JAMA psychiatry 20191001 10

<h4>Importance</h4>Internet and computer game addiction represent a growing mental health concern, acknowledged by the World Health Organization.<h4>Objective</h4>To determine whether manualized cognitive behavioral therapy (CBT), using short-term treatment for internet and computer game addiction (STICA), is efficient in individuals experiencing internet and computer game addiction.<h4>Design, setting, and participants</h4>A multicenter randomized clinical trial was conducted in 4 outpatient cl ...[more]

PMID: 31290948

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Project description:BACKGROUND:Physical activity (PA) is beneficial in improving negative physical and psychological effects of cancer and cancer treatment, but adherence to PA guidelines is low. Computer-tailored PA interventions can reach large populations with little resources. They match with patients' preference for home-based, unsupervised PA programs and are thus promising for the growing population of cancer survivors. The current study assessed the efficacy of a computer-tailored PA intervention in (four subgroups of) prostate and colorectal cancer survivors. METHODS:Prostate and colorectal cancer patients and survivors were randomized to the OncoActive intervention group (N =?249), or a usual-care waiting-list control group (N =?229). OncoActive participants received a pedometer and computer-tailored PA advice, both Web-based via an interactive website and with printed materials. Minutes moderate-to-vigorous PA (MVPA) and days ?30 min PA were assessed with an accelerometer (ActiGraph) at baseline and 6 months. Further, questionnaires were used to assess self-reported PA, fatigue, distress, and quality of life at baseline, 3 and 6 months. Differences between both groups were assessed using linear regression analyses (complete cases and intention-to-treat). In addition, efficacy in relation to age, gender, education, type of cancer, and time since treatment was examined. RESULTS:Three months after baseline OncoActive participants significantly increased their self-reported PA (PA days: d =?0.46; MVPA: d =?0.23). Physical functioning (d =?0.23) and fatigue (d =?-?0.21) also improved significantly after three months. Six months after baseline, self-reported PA (PA days: d =?0.51; MVPA: d =?0.37) and ActiGraph MVPA (d =?0.27) increased significantly, and ActiGraph days (d =?0.16) increased borderline significantly (p =?.05; d =?0.16). Furthermore, OncoActive participants reported significantly improvements in physical functioning (d =?0.14), fatigue (d =?-?0.23) and depression (d =?-?0.32). Similar results were found for intention-to-treat analyses. Higher increases in PA were found for colorectal cancer participants at 3 months, and for medium and highly educated participants' PA at 6 months. Health outcomes at 6 months were more prominent in colorectal cancer participants and in women. CONCLUSIONS:The OncoActive intervention was effective at increasing PA in prostate and colorectal cancer patients and survivors. Health-related effects were especially apparent in colorectal cancer participants. The intervention provides opportunities to accelerate cancer recovery. Long-term follow-up should examine further sustainability of these effects. TRIAL REGISTRATION:The study was registered in the Dutch Trial Register ( NTR4296 ) on October 17 2018.

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Dataset Information

Efficacy of Short-term Treatment of Internet and Computer Game Addiction: A Randomized Clinical Trial.

Publications

Efficacy of Short-term Treatment of Internet and Computer Game Addiction: A Randomized Clinical Trial.

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