Efficacy of Cognitive Behavioral Therapy for Internet, Video Game Addiction


A clinical trial of 147 individuals found that a 15-week treatment program using cognitive behavioral therapy may be a promising treatment for internet and video game addictions.

Video game addiction

An ever-growing mental health issue, many in the medical community have been seeking options for treating internet and computer game.

A recent clinical trial is shining light onto the efficacy of short-term treatment for internet and computer game treatment through a manualized, short-term cognitive behavioral therapy program (CBT).

In order to assess the efficacy of the short-term CBT treatment, investigators carried out a randomized clinical trial among a group of 187 individuals. The trial was conducted in 4 outpatient clinics from Jan. 24, 2012 to June 14, 2017 and data was analyzed from Nov. 2018 to March 2019.

The patient population was limited to men, who represent 90% of patients treated or diagnosed for behavioral addictions. After application of inclusion criteria, 149 participants were randomized to receive either treatment through the CBT therapy program or into a control group. At conclusion of the study, 72 participants were in the CBT group were analyzed and 71 participants were analyzed in a wait-list control group.

The treatment group received short-term treatment via a 15-week, CBT-based, manualized treatment. Participants underwent 15 group session lasting 100 minutes each and 8 individual session lasting 60 minutes each as part of the treatment program. Patients in the treatment group also underwent an additional 6-month follow-up.

The main outcome measure of the study was the Assessment of Internet and Computer Game Addiction Self-report (AICA-S) and secondary outcomes included self-reported internet addiction symptoms, time spent online on weekdays, psychosocial functioning, and depression. Of the 143 participants included in the analysis, the mean age was 26.2 years.

Investigators found that 69.4% (50 of 72) of participants in the treatment group showed remission, which is more than double the rate (23.9%) among the wait-list control group. In their logistic regression analysis, remission was higher in the treatment group than in the control arm (OR, 10.10; 95% CI, 3.69-27.65) when taking age, baseline severity, comorbidity, and treatment center. 

When comparing the two groups, investigators found that effect sizes at treatment termination of the treatment group were d=1.19 for AICA-S, d=0.88 for time spent online on weekdays, d=0.64 for functioning, and d=0.67 for depression. Investigators observed a total of 14 adverse events and 8 serious adverse events within the study. 

In an audio interview on JAMA Network, study author Klaus Wölfling, PhD, of the University Medical Center of the Johannes Gutenberg-University Mainz, Germany, commented on the growing issue and awareness around gaming and internet addiction. 

“The World Health Organization decided last month about the inclusion of gaming disorder. This official approval as a disorder is important for subjects suffering from gaming disorder to receive treatment,” Wölfing said. 

This study, titled “Efficacy of Short-term Treatment of Internet and Computer Game Addiction,” is published in JAMA Psychiatry.

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