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Internet Addiction to Cybersex and Gambling: Etiology, Prevention and Treatment 8 CE Hours

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Internet Addiction to Cybersex and Gambling: Etiology, Prevention and Treatment 8 CE Hours Chapter 2: Internet Addiction to Cybersex and Gambling: Etiology, Prevention and Treatment 8 CE Hours By: Deborah Converse, MA, NBCT, Clinical Ed. Learning objectives This workshop is designed to help you: Assess negative aspects of social networking; Discuss the behavioral and psychological impact of Internet addiction; Identify prevalence rates of Internet addiction by age, gender and Apply criteria necessary for a DSM-5 diagnosis of gambling disorder; socioeconomic variables; Analyze similarities between Internet addiction and obsessive/ Discuss biological, social and environmental factors that may compulsive disorders; predispose an individual to an Internet sexual addiction; Identify factors that may lead to the development of an Internet Explain biological, social and environmental influences on the addiction; development of an Internet gambling addiction; Explain examples of inappropriate thought patterns that may lead Analyze unique factors of Internet sexual addictions as compared to Internet sexual and gambling addictions; to other forms of addiction; Discuss pharmacological and psychotherapy treatments that Discuss federal laws and sanctions on Internet child pornography; and have proven effective for treating Internet sexual and gambling Apply prevention strategies for Internet addiction. addictions; Introduction Many individuals today are drawn by the power of the Internet to life personalities. Reality may reinforce responsibilities, obligations, expand their world. The Internet can be a positive tool in business, personal weaknesses and failures. By going online, these realities can education, research and communication, and has revolutionized quickly disappear into an exciting virtual life based on imagination, opportunities to establish social networks worldwide. However, desires and grandiose thinking, all in the privacy of cyberspace. this unlimited access can also lead to self-destructive behaviors and Aboujaoude (2011) studied heavy Internet users and found that they addictions in many areas. Some individuals like to escape into novel experienced dissociation phenomenon as demonstrated by high scores experiences, and they develop alternative personalities that are more on dissociation questionnaires. Other scientific studies noted biological aggressive, less inhibited, more sensual, and more likely to take risks. changes that occurred in the brain during excessive online use. The Internet may lead to dramatic changes in behavior and identity in PET scans have been used to measure the level of the neurotransmitter some individuals. Excessive use of the Internet can lead to addiction dopamine during excessive Internet use (Renshaw, 2007). Dopamine is with characteristics similar to obsessive-compulsive disorders and the released in the brain during pleasurable and rewarding experiences such as same type of euphoria reported during impulse control disorders. sex, eating or gambling, as well as during use of addictive substances like Internet addiction is a relatively new phenomenon, and research studies alcohol and drugs. The euphoric state that occurs during the use of cocaine into problematic Internet use are in the beginning stages. One study by and other addictive substances correlates with the level of dopamine Elias Aboujaoude (2011) reviewed Internet habits of more than 2,500 released in several pleasure centers in the brain. Studies of the brain during U.S. adults and found significant rates of online pathological behavior online gambling or during sexual encounters have shown effects on the across all geographic, socioeconomic, age and gender groups. brain’s reward system that is similar to those of substance abuse. The data from this study indicated that Internet use often interfered A study by Dr. John Suler (2004) identified dynamics of Internet with the individual’s personal relationships, career goals and family use that enhance its appeal and may lead to addiction. These factors responsibilities, and altered the self-concepts and personalities of many include disinhibition, anonymity, accessibility, the loss of balance or individuals. This study showed that in the virtual world, individuals control, and the lack of any real hierarchy in cyberspace. Suler notes developed an exaggerated sense of their abilities, a superior attitude that “People have the opportunity to separate their actions online from toward others, new moral codes, increased impulsive behavior, and a their in-person lifestyle and identity; they feel less vulnerable about tendency to develop a totally different persona. These characteristics self disclosing and acting out.” may lead individuals to indulge in activities online that they would Anonymity allows individuals to believe their online behavior is separate never consider in real life. from who they really are and thus does not reflect on their character The Internet has been described as a gateway drug, which has opened and absolves them of responsibility for their actions. These fallacies the door to many addictions. With the development of video games, of thinking allow them to abandon moral and societal boundaries and smart phones, iPads, personal daily planners and wireless computers, behave in ways they would never have considered in real life. some individuals spend more time and are more preoccupied with The invisibility and anonymity online leads to disinhibition because online experiences than real-world ones. Their communications and the individual is able to be alone to engage in risky online activity interactions in every aspect of life are linked to the online virtual world. without judgment or censorship. The person or activity they choose Described by some researchers as the “e-personality,” many individuals is easily accessible 24 hours a day and is often designed to the find themselves in a daily battle between their virtual life and their real- individual’s specific requirements or desires. SocialWork.EliteCME.com Page 1 Addition to cybersex and gambling from a diagnosis standpoint Internet sex addiction is not listed in the latest DSM manual, the DSM-5 an “official” disorder in the DSM, but one on which the American (APA, 2013) which is commonly used by psychiatrists in the United States Psychiatric Association request additional research. Upon further and several other countries to provide diagnoses of mental health disorders research, the APA may or may not decide to make the disorder that are recognized by the American Psychological Association. Therefore, “official” in future editions of the DSM. it is not considered a mental health disorder by APA standards. The DSM-5 states that Internet Gaming Disorder is most common Gambling disorder is the only behavioral (non-substance related) in male adolescents 12 to 20 years of age. According to studies it is addiction included in the category of Addictive Disorders of the DSM-5. thought that Internet Gaming Disorder is more prevalent in Asian An important departure from past diagnostic manuals is that the substance- countries than in North America and Europe (APA, 2013). related disorders chapter has been expanded to include gambling disorder. “Internet-based gambling” is not included in the diagnostic criteria for This change reflects the increasing and consistent evidence that some Internet Gaming Disorder. This is because Internet-based gambling is behaviors, such as gambling, activate the brain reward system with effects already included in the Gambling Disorder diagnostic criteria. similar to those of drugs of abuse and that gambling disorder symptoms The diagnostic criteria for Internet Gaming Disorder include: resemble substance use disorders to a certain extent. 1. Repetitive use of Internet-based games, often with other players, Previously, the DSM-IV listed pathological gambling but in a different that leads to significant issues with functioning. Five of the chapter. This new term and its location in the new manual reflect following criteria must be met within one year: research findings that gambling disorder is similar to substance-related ○ Preoccupation or obsession with Internet games. disorders in clinical expression, brain origin, comorbidity, physiology, ○ Withdrawal symptoms when not playing Internet games. and treatment. ○ A build-up of tolerance–more time needs to be spent playing Recognition of these commonalities will help people with gambling the games. disorder get the treatment and services they need, and others may better ○ The person has tried to stop or curb playing Internet games, understand the challenges that individuals face in overcoming this disorder. but has failed to do so. ○ The person has had a loss of interest in other life activities, While gambling disorder is the only addictive disorder included such as hobbies. in DSM-5 as a diagnosable condition, Internet gaming disorder is ○ A person has had continued overuse of Internet games even included in Section III of the manual. Disorders listed there require with the knowledge of how much they impact a person’s life. further research before their consideration as formal disorders. This ○ The person lied to others about his or her Internet game usage. condition is included to reflect the scientific literature on persistent and ○ The person uses Internet games to relieve anxiety or guilt–it’s recurrent use of Internet games, and a preoccupation with them, can a way to escape. result in clinically significant impairment or distress. ○ The person has lost or put at risk and opportunity or Additionally,
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