Efficacy of cognitive behavioural therapy for internet gaming disorder – Article Summary

Jiwon Han, Yesul Seo, Hyunchan Hwang, Sun Mi Kim, Doug Hyun Han

First published: 27 December 2019

https://doi.org/10.1002/cpp.2419

Abstract

Cognitive behavioural therapy (CBT) is considered to be an effective treatment for internet gaming disorder (IGD). This study examined the effectiveness of CBT in treating impulsivity, anxiety, avoidance, and family and environmental problems in patients. A total of 101 patients completed the CBT programme, and 104 completed the supportive therapy. The CBT programme consisted of fourteen 90-min sessions with one therapist and four to five patients, once or twice a week. The supportive therapy group visited a psychiatric outpatient department once or twice a week until they completed 14 visits. Outcomes were measured in terms of improvement in IGD, psychological symptoms, and social interaction. The CBT group (improvement: 67 [66.3%] versus non-improvement: 34 [33.7%]) showed more improvement in IGD compared with the supportive therapy group. The CBT group also showed a greater decrease in internet addiction, anxiety, impulsivity, and social avoidance. In the CBT group, among patients who improved, the greatest improvements were in internet addiction, attention, depression, anxiety, impulsivity, social avoidance, and family cohesion. Our CBT programme may be more effective than supportive therapy with regard to improvement in IGD symptoms by controlling anxiety, impulsivity, and social avoidance. In addition, CBT-related improvements in patients with IGD could be enhanced by controlling anxiety, social avoidance, and family cohesion.

Han et al. (2020) set out to empirically test the effectiveness of cognitive behavioral therapy (CBT) in treating impulsivity, anxiety, avoidance, and family and environmental problems in patients. The authors associate these symptoms with internet gaming disorder (IGD). Patients with IGD display a high rate of psychological concerns, such as attention, mood, loneliness, anxiety, and impulsivity. The study used the following criteria for internet addiction: increasing internet use, prolonged use than intended, psychological discomfort when not using the internet, continuous use despite knowing the negative consequences, and failure to reduce use despite attempts. The authors hypothesized that CBT for IGD, which takes into account psychological and environmental factors, would improve IGD symptoms. Additionally, they expected that psychological and environmental factors would affect the results of CBT for IGD.

Patients were sampled from 332 adults who visited OO University Hospital between September 2014 and August 2018. Out of these, 205 completed the 8-week treatment course and were required to select either CBT for IGD or supportive psychotherapy. Patients on medications for deficit hyperactivity disorder (ADHD), major depressive disorder (MDD), and anxiety disorders were allowed to participate. In the end, 101 participants completed the CBT program, and 104 completed the supportive therapy. The CBT program consisted of 14 sessions. The supportive therapy group visited a psychiatric outpatient department once or twice a week until the completion of 14 visits. The trial outcomes for CBT or supportive therapy were assessed in terms of improvement in IGD, psychological symptoms (attention, mood, anxiety, and impulsivity), and social interaction (self-avoidance and family cohesion).

The study found that more patients showed improvement in the CBT group than observed in the supportive group. Out of the 101 patients who completed the CBT therapy, 67 were improved. On the supportive therapy, only 51 out of the 104 IGD patients were improved. The patients in the CBT group recorded a decrease in internet addiction, anxiety, impulsivity, and social avoidance. Still, significant improvements were in internet addiction, attention, impulsivity, depression, anxiety, family cohesion, and social avoidance. Based on these results, the authors conclude that CBT for IGD was more effective than supportive therapy in terms of the number of areas that showed improvement. For instance, there was a reduction in the severity of IGD, impulsivity, and social avoidance. They suggest that the findings indicate the significance of CBT for IGD in tackling internet addiction compared to supportive therapy. It could help improve IGD symptoms by controlling anxiety, impulsivity, and social avoidance.

However, the authors identified several limitations in the study. For instance, it was difficult to control covariate data because the results were analyzed using clinical information. The study couldn’t demonstrate the pure effects of CBT without medication effects. Another critical limitation in the study was the lack of randomization in its design. It could have exposed the results to selection bias. The authors propose that future studies should focus on IGD without medication and co-morbidities combined with long-term follow-ups.