Clicks Final

Internet Addiction (IA)

Internet Addiction (IA)

is broadly defined as a non-chemical, behavioral addiction, which involves human-machine interaction (Griffiths, 2000) Varying terms such as 'compulsive internet use', 'pathological internet use', and 'problematic internet use' have been introduced as alternative ways to categorize Internet misuse.

Classically, an addiction has been defined as a chronic neurobiological disease characterized by:

1) impaired control over drug use

2) compulsive use, continued use despite harm

3) craving

The only behavioral addiction, i.e., an addiction not related to a substance, which is recognized by DSM-5 is ______________

gambling disorder

One type of problematic internet use is _____________ Disorder, which was included in Section III of the DSM-5 as an emerging area that requires further research before being considered for inclusion as a formal disorder. However, ________ Disorder has been added to ICD-11R (International Classification of Diseases by WHO) in 2018

Internet Gaming; gaming

Ingredients of Behavioral Addictions

1. Compelling goals that are just beyond reach (or seemingly so)

2. Unpredictable positive feedbacks

3. Incremental progress and improvement

4. Tasks that become slowly more difficult over time

5. Unresolved tensions which demand resolution

6. Strong social connections

Nomophobia (No-Mobile-Phobia)

anxiety or discomfort caused by being out of contact with a cellphone or computer, or a fear of remaining out of touch with technology, especially among those who exhibit social phobias (King et al., 2013). High-use individuals, when separated from their smartphones, demonstrate physiological withdrawal-like symptoms, such as increased heart rate and blood pressure, (Clayton et al. 2015) and experience mounting anxiety (Cheever et al., 2014)

Fear of Missing Out (FOMO)

a psychological construct defined by an apprehension of being absent from other people's rewarding experiences and the desire to stay connected with others' experiences (Przybylski, 2013; Elhai, 2018).

Textaphrenia & Ringxiety

the false sensation of having received a text message or call that leads to constantly checking the device. High-use individuals experience phantom cell phone vibrations even in the absence of incoming phone notifications.

Textiety

the anxiety of receiving and responding immediately to text messages accompanied by anxiety and loneliness when unable to send a message or receive an immediate response; stress and changes in mood due to the need to respond immediately to messages.

smartphone use statistics

As of 2018, 94% of individuals ages 18-29 in the U.S. owned a smartphone (Pew Research Center).

On average, young adults in the U.S. spend approximately 4 hours per day on their smartphones; amounts to 28 hours of smartphone use (more than a full day) each week.

However, 26% of adults and 39% of young adults are online “almost constantly”

Adolescents and young adults at _______ risk for cellphone addiction

higher

Research suggests that young adults meeting criteria for internet-related addictions are predominantly _______ but this may reflect focus on internet gaming.

male

Epidemiology of Internet-Related Addictions Among College Students

8067 college students (age 18 -30) were recruited from Singapore, Hong Kong/Macau, China, South Korea, Taiwan and Japan and compared with students in the United States Asian students showed higher risks of internet addiction and online social networking addiction but displayed lower risks of online gaming addiction In general, addicted Asian students were at higher risks of depression than addicted US students

One of the most widely used scales for measuring internet addiction is the _______________ developed by Young in 1996. It is structured on the basis of DSM-IV criteria for pathological gambling and comprises 20 items rated on a five-point Likert scale, from 0 (not applicable) to 5 (always)

Internet Addiction Test (IAT)

Addiction

is a chronic neurobiological disease characterized by behaviors that include one or more of the following: impaired control over drug use, compulsive use, continued use despite harm, and craving

features of addiction (DSM-5)

1. Impaired control over the behavior/substance

2. Functional impairment related to behavior/substance (family, work, social impairment)

3. Risky use of the substance

4. Tolerance and withdrawal (pharmacological criteria)

Many theories of addiction have been proposed to identifying the mechanism(s) that best explains the behaviors observed in addicts. These include:

Negative Reinforcement ("Pain Avoidance")→ boredom or anxiety

Positive Reinforcement ("Pleasure Seeking") → entertainment, bingewatching

Incentive Salience ("Craving") → salience of online activities

Stimulus Response Learning ("Habits")→ notifications, other stimuli

Inhibitory Control Dysfunction ("Impulsivity")

Impaired control & compulsive use

a. using substance for longer or higher amount than planned

b. inability to cut down use

c. spending significant time obtaining, using, or recovering from substance

d. craving i.e., intense desire or urge for the substance (the person cannot think about anything else)

Functional impairment related to behavior/substance

a. failure to fulfill major role obligations at work, school, or home

b. continuing use despite having persistent or recurrent social or interpersonal problems

c. withdrawal from social activities and hobbies to use

Risky use of the substance

a. Physically dangerous (e.g. DWI)

b. Physical consequences (e.g. liver pathology, risk of IV transmitted diseases)

Tolerance and withdrawal (pharmacological criteria)

At least two of the following for 12-month period:

• Alcohol is often taken in larger amounts or over a longer period than was intended.

• There are unsuccessful efforts to control alcohol use.

• A great deal of time is spent in activities necessary to obtain alcohol, use alcohol, or recover from its effects.

• Craving, or a strong desire or urge to use alcohol.

• Recurrent alcohol use resulting in a failure to fulfill major role obligations at work, school, or home.

• Continued alcohol use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of alcohol.

• Important social, occupational, or recreational activities are given up or reduced because of alcohol use.

• Recurrent alcohol use in situations in which it is physically hazardous.

• Alcohol use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by alcohol.

Diagnostic Criteria for Gambling Disorder (DSM-5)

At least four of the following for 12-month period:

• Needs to gamble with increasing amounts of money in order to achieve the desired excitement.

• Is restless or irritable when attempting to cut down or stop gambling.

• Has made repeated unsuccessful efforts to control, cut back, or stop gambling.

• Is often preoccupied with gambling (e.g., having persistent thoughts of reliving past gambling experiences, handicapping or planning the next venture, thinking of ways to get money with which to gamble).

• Often gambles when feeling distressed (e.g., helpless, guilty, anxious, depressed).

• After losing money gambling, often returns another day to get even (“chasing” one’s losses).

• Lies to conceal the extent of involvement with gambling.

• Has jeopardized or lost a significant relationship, job, or educational or career opportunity because of gambling.

• Relies on others to provide money to relieve desperate financial situations caused by gambling.

Internet Gaming Disorder in DSM-5

At least five of the following for 12-month period:

1. Preoccupation with video-games. For example, the individual thinks about previous gaming activity or anticipates playing the next game; Internet gaming becomes the dominant activity in daily life.

2. Withdrawal symptoms when Internet gaming is taken away. These symptoms are typically described as irritability, anxiety, or sadness, but there are no physical signs of pharmacologic withdrawal.

3. Tolerance the need to spend increasing amounts of time engaged in Internet games.

4. Unsuccessful attempts to control the participation in Internet games.

5. Loss of interest in previous hobbies and entertainment as a result of, and with the exception of, Internet games.

6. Continued excessive use of Internet games despite knowledge of psychosocial problems.

7. Has deceived family members, therapists, or others regarding the amount of Internet gaming.

8. Use of Internet games to escape or relieve a negative mood (eg, feelings of helplessness, guilt, anxiety).

9. Has jeopardized or lost a significant relationship, job, or educational or career opportunity because of participation in Internet games.

Gaming disorder is defined in the 11th Revision of the International Classification of Diseases (ICD-11) as a pattern of gaming behavior (“video-gaming”) characterized by:

• Impaired control over gaming

• Increasing priority given to gaming over other activities

• Continuation/escalation of gaming despite the occurrence of negative consequences

Compulsive Sexual Behavior or “Porn Addiction”

Persistent pattern of failure to control intense, repetitive sexual impulses or urges, resulting in repetitive sexual behavior over an extended period (e.g., six months or more) that causes marked distress or impairment in personal, family, social, educational, occupational or other important areas of functioning. • It has been included into Impulse Control Disorders, rather than in the disorders due to substance use and addictive behaviors, to highlight that there is an active scientific discussion about whether these behaviors constitute a behavioral addiction, or not

Compulsive Sexual Behavior or “Porn Addiction” is characterized by

The pattern is manifested in one or more of the following:

a) engaging in repetitive sexual activities has become a central focus of the person's life to the point of neglecting health and personal care or other interests, activities and responsibilities;

b) the person has made numerous unsuccessful efforts to control or significantly reduce repetitive sexual behavior;

c) the person continues to engage in repetitive sexual behaviour despite adverse consequences (e.g., repeated relationship disruption, occupational consequences, negative impact on health); or

d) the person continues to engage in repetitive sexual behaviour even when he/she derives little or no satisfaction from it

features of attention

Allows us to tune in relevant stimuli

Allows us to tune out irrelevant stimuli

Very difficult not to pay attention to something

Most information in our environment is ignored, while some is processed fully

Attention allows us to pursue our goals or to react to relevant stimuli, such as dangers/threats.

Attention

a cognitive function which filters internal and external stimuli

top-down attention

Sustained Attention

Higher-level goals

Complex functions

Executive functions- monitoring & planning, active ignoring

Bottom-Up Attention

Perception-Based

Fast

Involuntary/Reactive

“Primitive”

Less affected by fatigue

Bottom-Up Attention Responds to:

Colors, Sounds, Movements àmemes & Survival stimuli (sex, food, threats)

Top-down attention has evolved from mechanisms related to food foraging. As our brains became more complex, they have progressively evolved to _________________ as this guaranteed survival advantages.

forage information

top-down attention is controlled in the _______ while bottom-up attention is controlled in the _______ of the brain

prefrontal cortex, parietal lobe

Interferences on Attention

Internal- Intrusions (mind-wandering) Diversions (multi-tasking)

External- Distractions (irrelevant stimuli) Diversions (multi-tasking)

Our capacity to ignore is limited by the fact that …..

we are always paying attention to something.

The New York Sun

The New York Sun debuted on September 3, 1833, becoming the first successful penny daily.Advertisements, notably help-wanted ads, were plentiful.

Its instant popularity was due to coverage of sensational and sometimes fabricated stories and scandals. Its success was also the result of ubiquitous newsboys, who the innovative Day had hired to hawk the paper.

By 1834, the Sun had the largest circulation in New York City.

Among the many fabricated stories The New York Sun covered: “The Great Moon Hoax” in 1835

Early Attention Merchants of America

In 1917, as Woodrow Wilson prepared to declare war against the German Empire, newspaperman and campaign aide George Creel suggested to Wilson his administration should use modern scientific advertising techniques to "arouse ardor and enthusiasm" for the war.

Like British war propaganda, Creel and his CPI committee employed every medium of appeal possible (printed word, spoken word, motion picture, telegraphs, cable, posters, magazines, county fairs, classrooms etc.). Soon, virtually every physical interface in America contained wartime propaganda.

In 2018, ____% of Facebook's global revenue came from advertising revenue (Statista, 2018).

98%

_______________ can use the wealth of personal data about users from Facebook/Social Media's product ecosystem for ads. They can serve up custom ads to Facebook and Instagram users from specific income groups or religions, and target users based on other categories, such as sexual orientation, age, or political affiliation.

Advertisers

how do advertisers keep up engaged?

They use strategies to engage both our bottom-up system via lights, colors, sounds, movements, strong (negative or survival) emotions and our top-down system via social rewards and information access among others

fake news

News articles that are intentionally and verifiably false and could mislead readers

Includes intentionally fabricated news stories as well as articles that originate on satirical websites but could be misunderstood as factual

Social Media and Fake News

Social media platforms collect and present news from a wide variety of outlets, regardless of quality, reliability,political leanings of original source, and without clarity on reputation of the original publishers.

If readers can’t quickly identify who wrote/provided information for a story, it’s hard to judge its honesty without elaborate fact-checking, which most people don’t do

On social media, news get conveyed to a person via friends or people they follow, and your friends’ endorsement of the story (through a share, like, retweet, etc.) usually occurs alongside the story, making people more accepting of the information presented

Articles are automatically tagged with indications of their popularity

This makes people more likely to tune in to a story when counts are high

Barriers to creating media dropped with increased ease of creating content/websites, making it easier to author fake news articles

features of traditional news

Business model involves researching and reporting accurate news for the benefit of paying consumers

Legal pressure exists (avoiding libel charges)

Consumers have expectations about the news from these sources

On account of their size, visibility, and public nature, they are largely held accountable for any blatant misinformation publishes

features of fake news

Reporting fake news motivated by financial or ideological motivations

Low accountability (not held to the same legal standard)

Lack of accountability decreases pressure to report accurately

Accurate research and factchecking is time and resource intensive, fake news firms can produce their output for cheap

Many consumers still consume and/or enjoy the output

Social Media and Fake News in the 2016 Election

Using placebo headlines as a control, estimated that the average American adult saw and remembered 1.14 fake stories in the lead to the election, indicating wide dissemination of fake news content

Higher education, older age, and increased media consumption were associated with more accurate conclusions about headlines.

Membership in either party made people 15% more likely to believe fake headlines.

Colorado Spring vs. Boulder by Cass Sustein

Residents in each place, left-leaning Boulder and right-leaning Colorado Springs, were gathered into small groups to discuss their views on controversial topics, like climate change and same-sex marriage. Afterward, they were asked to report on the opinions of their groups as well as their own views on the subjects.

(1) Liberals, in Boulder, became distinctly more liberal on all three issues. Conservatives, in Colorado Springs, become distinctly more conservative on all three issues. The result of deliberation was to produce extremism -- even though deliberation consisted of a brief (15 minute) exchange of facts and opinions!

(2) The division between liberals and conservatives became much more pronounced. Before deliberation, the median view, among Boulder groups, was not always so far apart from the median view among Colorado City groups. After deliberation, the division increased significantly.

(3) Deliberation much decreased diversity among liberals; it also much decreased diversity among conservatives. After deliberation, members of nearly all groups showed, in their post-deliberation statements, far more uniformity than they did before deliberation.

Media Bias

News that confirms a person’s beliefs will be rated as higher quality than news that doesn’t

Asch Conformity Line Experiment

Asch measured the number of times each participant conformed to the majority view. About one third of the participants who were placed in this situation conformed with the clearly incorrect majority on the critical trials.

Over the 12 critical trials, about 75% of participants conformed at least once, and only 25% of participants never conformed.

In the control group, with no pressure to conform to confederates, less than 1% of participants gave the wrong answer.

Social costs of fake news

Fake news leads to less accurate beliefs among citizens

Fake news could reduce the demand for accuracy

fake news could be used to stir up and intensify social conflict or in some cases suppress social conflict

Model of Moral Contagion

fake news can spread so easily because of the ability to engage users and spread moralized content through online networks → MAD (Motivation, Attention and Design) Model of Moral Contagion

Moralized Content

Content is “Moralized” if it references ideas, objects, or events typically construed in terms of the interests or good of a unit larger than the individual (e.g., society, culture, one’s social network).

Online platforms are now one of the primary sources of ________________ people experience in their daily life

morally relevant stimuli

social contagion

the processes through which attitudes, behaviors, and information spread from one person to another, such as through “mimicking”, cognitive appraisal, or information diffusion.

People are _________ times more likely to share content online when they perceive other people are sharing it

seven

Recent work investigating the spread of online content across various domains suggests that ….

emotionally arousing content is robustly associated with increased sharing.

In the case of social media, multiple studies have documented that emotional content is associated with increased sharing on various platforms, including Facebook, Twitter, Google+ and Weibo

Motivation-Attention-Design (MAD Model)

Motivation: people have group identity-based motivations to share moral emotional content

Attention: Moral content tends to capture our attention

Design: the design of social media platforms amplifies our natural motivational and cognitive tendencies to spread such content.

Humans are motivated by groupidentity to share moral-emotional information. Moral-emotional content grabs and sustains our attention due to biological and social advantages. Social media is designed to amplify our group-identities and spread moral emotional content

Group Identity Based Motivations (MAD Model)

When people’s group identities become highly salient, people’s attitudes, emotions, and behaviors are influenced by group rather than individual goals

People view in-group members as more similar and out-group members as more different

People are motivated to maintain positive inter-group image and a positive reputation of themselves in their group (intra-group imagine)

Sharing emotional content functions to increase _________, thus emotional content is highly salient to people

social bonding

Conformity and Influence (MAD Model)

Normative influence is driven by the persons desire to fit in and avoid the social discomfort and potential ostracism that comes from deviance

Informational influence is motivated by the desire to get things right based on the assumption that others are generally good sources of information and that others are just as informed as you are

Moral contagion

the idea that moral-emotional expression is associated with the spread of moralized content in online networks

Moral outrage

a social instinct consisting of emotional displays of anger and disgust

Early human tribes needed to act in collective interest in order to survive requiring a shared code of behavior, which lead to moral outrage

Communities rallying against a dissenter would support their group’s survival

Moral grandstanding

showing off that you are more outraged, and therefore more moral, than others in order to impress peers

Moral-Emotional Content and Attention

Our perceptual systems are naturally tuned to detect moral and emotional stimuli

Moral content provides us with information about people or groups that act in ways which can help or harm us

Emotional stimuli draw our attention because they can threaten or promote well-being and require immediate response

Emotional stimuli has been shown to draw attention away from ongoing visual goals

Morality can differ depending on political ideology

The Design of Social Media and Group-Identity Motivations

Online group sizes are much larger than what we can handle face-to-face, which is about 150 people, leading to even more people we aim to impress/maintain positive status

These large group sizes lead to less personalization, causing our group identities to become more salient as the main means of relating to our social network

Large group sizes and indirect communication leads to decreased self-awareness and increased deindividuation, making people more likely to identify with their group and conform to group norms more closely

Social rewards, which may be rare in person, are more common online

Social rewards signal that our peers approve our behavior, receiving rewards for expressing outrage can lead to internalization, whereby a person assumes that expressing outrage is desired or expected by their group

The Design of Social Media and Moral-Emotional Content

Algorithms are designed to show users content that is more likely to draw their attention

Youtube’s algorithm accomplished this by showing users videos loaded with speculation about popular events

The moral-emotional nature of many disinformation videos and articles causes users to stay online longer, creating more profit for companies

Notifications update people about social interactions and demand immediate attention

If someone shares an outrage post and others repost or reply, it draws in and sustains our attention

Algorithms recommends content that aligns with your preexisting views, creating a _____________ effect → you are not exposed to views different from those you have

filter bubble

Loneliness

a complex and usually unpleasant emotional response to isolation.

Loneliness is often defined in terms of one's connectedness to others, or more specifically as "the unpleasant experience that occurs when a person's network of social relations is deficient in some important way".

Loneliness isn't determined by the actual number of friends or social contacts a person has. Social science researchers define loneliness as the emotional state created when people have fewer social contacts and meaningful relationships than they would like — relationships that make them feel known and understood

loneliness statistics

Approximately 20% of the total population in the US feel lonely.

12% of Americans have no one with whom to spend free time or to discuss important matters.These rates have been increasing over time.

In the UK, research by Age UK shows half a million people more than 60 years old spend each day alone without social interaction and almost half a million more see and speak to no one for 5 or 6 days a week.

the Community Life Survey, 2016 to 2017, by the UK's Office for National Statistics, found that young adults in England aged 16 to 24 reported feeling lonely more often than those in older age groups.

loneliness shortens a person's life by 15 years, about the same impact as being obese or smoking 15 cigarettes a day.

oneliness and a wide range of health problems, including increased risk for heart attacks, stroke, and cancer.

Lonely people are more likely to suffer from insomnia, depression, and drug abuse. They are also more likely to suffer from more rapid cognitive decline in old age.

loneliness and social media

Related to frequency of use, the top 25% of social media users were 3x more lonely than the bottom 25% of social media users

Tromholt (2016): assigned ~1000 adults to either continue normal use of Facebook or give it up for a week. Those who gave it up reported more happiness and less depression at the end of the week

Hunt et al. (2018): assigned ~150 college students to either limit social media use to 10 min/day/platform and no more than 30 min/day total or to continue normal use. Those who limited their use were less lonely and less depressed over the course of three weeks

Deters & Mehl (2012) assigned 102 college students to continue normal use or post more status updates on Facebook than usual for one week. Those who posted more often experienced reduced loneliness and felt more connected to friends

Social snacking

a “temporary but illusory fulfillment of social needs”

Scrolling through other people’s Instagram posts or reading other people’s comments without making any of your own feels like social engagement just like eating junk food makes your stomach feel satisfied in the moment

Just as junk food leaves you bloated and empty, social snacking increases isolation and loneliness because it’s not interactive and you are not obtaining important relational resources (e.g., social support)

Default network and social cognition

Default network was originally thought of as “thinking about nothing region” but as it turns out, same parts of the brain that activate when you’re thinking about other people, yourself, or both. When given downtime, our brains default to thinking about our social life

Summer camp study

Researchers tested children’s ability to read facial expressions before the beginning of summer camp and after summer camp and compared their performance with children who did not go to summer camp

Summer camp: 5 days long, no phones

Only the children in the summer camp group showed improvement at post-test

Boundaries and sharing on social media

Is media use making our relationships more superficial? • Does the pressure to make your life look perfect on social media spill over into real life and keeps relationships superficial? • Is knowing when and how to share meaningful information more difficult now that so many of our interactions occur on a smartphone?

Text-based communication involves two distinct processes that alter perceptions:

Selective self-presentation: fewer cue systems afford users more control over their message construction, allowing them to create more favorable and intimate messages

Idealization of communicative partner: halo effect when initial message cues, or the context, suggest that a partner may be attractive in some way

online dating

40% of heterosexual couples and over 60% of same-sex couples meet using the internet

Over 30% of marriages begin online In 2014, the average Tinder user logs into the app 11 times and spends 1 hour and 30 minutes on the app per day

In 2017, Bumble reported 800 million matches and 10 billion swipes per mont

benefits of online dating

The ability to meet people outside an individual’s daily routine

Now we can evaluate a potential partner before meeting them Less social stigma in meeting someone “online”

Simple technology

Online dating fits easily into a busy schedule or life • Access anytime, day or night

In a 2013 study researchers from Harvard University and the University of Chicago showed marriages that started online are:

Less likely to end in break-up • Associated with higher levels of satisfaction • Have more satisfaction

Hyperpersonal Model of Text-Based Computer-Mediated Communication study

Antheunis et al. (2019) randomly assigned college students to speed dating over text or over Skype then introduced each pair in person studying social and physical attraction levels before and after the face-toface meeting

Consistent with hypotheses, text-based communication provided greater social attraction. Interestingly, only occurred in participating females but not males

Contrary to hypotheses, no difference in romantic attraction before face-to-face meeting and no difference in decline in romantic attraction after face-to-face meeting, both groups were equally disappointed

addictive qualities of online dating apps

Tinder, Bumble, Grindr, Coffee Meets Bagel and other apps have taken a cue from smartphone gaming and has turned finding companionship into a game

Game like swiping turns the search of finding a potential mate into a simple swipe

Users are searching for a partner using a cost/benefit assessment for achieving their goal. The low expenditure of resources in online dating combined with the high probability of a match makes it an extremely rewarding option

Since users don’t know which swipe will bring the “reward” of a match, the apps encourage users to to keep swiping, just in case the next person is their soul mate

Dating apps like Tinder use a variable reward schedule, the same reward system used in slot machines and video games

Notifications of a match, a message, or even reminders about the people available for swiping on dating apps act as stimuli, reminding and capturing the attention of users through the potential of love or sex

paradox of choice

More choice gives people autonomy and individual freedom

Too much choice produces “choice paralysis”, making it more difficult to choose at all and people end up less satisfied than if the choice was made with fewer options; even a good choice can seem dissatisfying

Internet Addiction and Sedentarism in Youth

Eliack et al. (2016) found that obese adolescents have a higher rate of Internet addiction, poorer physical and psychosocial health, and more daytime sleepiness than non-obese adolescents.

Excessive Internet use and extended period of screen time has been shown to lead to sedentarism (‘sitting-ism”), which refers to decreased energy expenditure or, simply, physical inactivity.

Research reveals that young children have become more enticed to learn via instructional styles (Internet-based instruction) than through other physical activity (i.e., playing with Legos, dolls, etc.)

In 47 preschool-aged children, increased use of screen-based media in the context of the AAP guidelines was associated with:

• Lower microstructural integrity of brain white matter tracts that support language • Lower executive functions • Lower emergent literacy skills • Screen use was also associated with lower scores on corresponding behavioral measures, controlling for age

Relationship between Cell Phone Use, Physical Activity in U.S. College Students

Cell phone use was significantly and negatively related to cardiorespiratory fitness independent of sex, self-efficacy, and percent fat.

low frequency users were more likely to report being connected to active peer groups through their cell phones and to cite this as a motivation for physical activity.

Use of the Mobile Phone and Its Repercussion in the Deficit of Physical Activity

Those who use the smartphone less spend less time sitting than those who have a more continuous use of it (Barkley and Lepp, 2016)

The muscle mass of people with addiction to smartphones was much lower than that of the more moderate users.

The opposite occurs with fat mass, since the more a smartphone is used, the more fat mass users have (Kim et al., 2015)

Furthermore, the misuse of smartphones is associated with a greater proclivity to suffer body aches in the back, neck, wrists, hips and knees

The key to preventing health issues with cell phone and internet usage/sitting disease is to include …..

regular movement throughout the day- take the stairs, walk, get off from subway stop earlier

Cellphone use and motor vehicle accidents

Texting while driving is 6x more likely to cause an accident than driving drunk.

1 out of every 4 car accidents in the United States is caused by texting and driving.

The Illusion of Multitasking

"Fast Switching" happens when attention is shifted rapidly between tasks.This creates the illusion of multitasking

However, there are switching costs: studies on dual-task performance (called dual-task interference) show that performance on the two tasks simultaneously is worse than doing them sequentially, for most tasks.

Screen use before bedtime

Evidence shows that screen time close to bedtime is harming the quality and quantity of our sleep.

Screen use decreases our sleep propensity in two ways

1) By increasing arousal (excitement about social medias, movies or games, etc.)

2) By delaying our inner clock

“Text Neck” Epidemic

In a large longitudinal populationbased cohort study in Sweden of over 7,000 young adult subjects (age 20–24) over a 5- year period provided strong evidence that persistent neck pain and upper back pain is associated with time spent text messaging.

There was also an association between reported shoulder pain, numbness, and tingling in the hand or fingers in those subjects who spent the most time texting

Computer Vision Syndrome

More people are experiencing a variety of ocular symptoms related to computer use Symptoms reported by computer users are classified into: • internal ocular symptoms strain and ache • external ocular symptoms→dryness, irritation, burning, visual symptoms→ blur, double vision

Reduced blink rate is consistently reported with computer use, which has been associated with an increase in ocular and visual symptoms. Computer users had reduced blink rate, blink rate is reduced by half within minutes of computer viewing compared to immediately prior to computer use

Electronic Use in Neurodiverse Youth-Autism

Some evidence suggests no differences in total screen time (Montes, 2016)

Based on 2012 study, ~65% of youths with ASD spent most of their free time using non-social media, while only 13.2% spent time on social media

Compared with other disability groups, rates of non-social media use were higher among the ASD group, and rates of social media use were lower (Mazurek et al., 2012)

In another study comparing youth with ASD to TD siblings, children with ASD spent ~1 more hour/day playing video games and had higher levels of problematic video game use (e.g., disengaging from online activity)

Electronic Use in Neurodiverse Youth-ADHD

Estimates as high as 25% of ADHD population said to have IA

Children with ADHD seem to be particularly prone to excessive screen time use

People with ADHD tend to require frequent and immediate rewards, which are needs quickly fed by screen-time activities

Consequences: troubled relationships with families and friends, poor school/work performance, fatigue, and poor sleep (CHADD, 2015)

Also thought to be a potential cause of ADHD symptoms with positive associations found between total screen time and inattention symptoms in preschoolers

theory of planned behavior

Attitude: what you think about a specific behavior

Subjective Norm: what the people around you think about the specific behavior

Perceived Behavioral Control: self-efficacy – will I be able to do it? •

Combination of attitude, subjective norm and behavioral control leads to intention and then to behavior

Motivational Interviewing (MI)

Collaborative strategy used to address ambivalence and elicit motivation to change problematic behavior

Through specific processes, encourages autonomy and leads patients to make their own choices/self-discoveries, after weighting pros and cons of a specific behavior

Motivational Interviewing (MI): Guiding Principles

Express empathy: active listening, reflect patient’s statements back to them

Develop discrepancy: guide patients through questioning and reframing to recognize and acknowledge mismatch between current behavior and future goals

Roll with resistance: avoid confrontations and telling the patient what to do, consider their thoughts, acknowledge ambivalence is natural, recognize resistance as a signal to change your approach •

Support self-efficacy: help patient believe change is possible, plan out change process in small digestible steps

CBT-Internet Addiction (CBT-IA)

Phase 1: Behavior Management • Phase 2: Cognitive Restructuring • Phase 3: Harm Reduction Therapy (& treatment of comorbidities like substance use)

Results support decreased computer use with improved non-computer activities (e.g., performing chores, socializes, communicates better)

Cognitive Behavioral Therapy (CBT)

Structured, short-term, present-oriented therapy focused on solving current problems and modifying dysfunctional thinking/behavior (Beck, 1964)

Operates under assumption that thoughts, feelings, and behaviors interact and influence one another

Stage 1: Behavior Modification • Restructure the environment to encourage positive behavior change

Stage 2: Cognitive Restructuring • Target cognitive distortions to contribute and sustain behavior change

cognitive triangle

CBT Stage 1: Behavior Modification and Changing Habits

How habits form and maintain • Common triggers of problematic phone/internet use • Addressing triggers in the environment to reduce problematic phone/internet use

Habits are formed and maintained through conditioning consisting of 3 parts:

1. A recurring cue/trigger/antecedent (whatever prompts the behavior)

2. A behavior that is repeated contingent on the cue (the behavior itself) •

3. A reward/consequence (the payoff that trains our brains to repeat the habit in the future)