Intervening in Problematic Internet Use

Study Overview
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Brief Summary
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The present study examines the efficacy of a brief intervention for problematic Internet use based on Motivational Interviewing (MI) and Cognitive Behavioral Therapy (CBT) in a sample of students screened proactively in vocational schools in Northern Germany. Participants will be randomized in an intervention and a control group. It is hypothesized that after 12 months, participants of the intervention group fulfill less DSM-5 criteria for Internet use disorders, spend less time in the Internet, and suffer from less negative consequences caused by the problematic Internet use, compared to the control group.

Detailed Description
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Problematic Internet use is an increasing problem, especially in younger age groups. A population-based study revealed elevated prevalences in adolescents and young adults. The present study aims to provide an intervention for this vulnerable group to change the problematic Internet use. This is suggested to prevent the development of more severe forms of dependence. Brief interventions using MI and elements of CBT have shown to be an adequate method to change addictive behaviors. For the recruitment, students of vocational schools in the states of Schleswig-Holstein and Hamburg in Northern Germany are screened proactively in classes. Participants fulfilling at least 21 points on the Compulsive Internet Use Scale (CIUS) receive a diagnostic telephone interview. If fulfilling at least 2 DSM-5 criteria, participants will be randomly allocated to two conditions: (1) Intervention group with up to three telephone counseling sessions based on MI, (2) Control group receiving a booklet on problematic Internet use. Outcome measures are a reduction of DSM-5 criteria for Internet use disorders, a reduction of time spent on the Internet, and a reduction of negative consequences caused by the problematic Internet use. The efficacy of the intervention will be examined after 6 and 12 months in follow-up interviews.

Official Title
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Intervening in Problematic Internet Use - Preventive Measures for Risk Groups

Conditions
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Internet Use Disorders

Intervention / Treatment
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* Behavioral: Motivational Interviewing


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: CIUS score of 21 and at least 2 DSM-criteria At least 16 years old Exclusion Criteria: Current treatment for mental disorders

Ages Eligible for Study
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Minimum Age: 16 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Intervention group<br>Counseling based on Motivational Interviewing and elements of Cognitive Behavioral Therapy | Behavioral: Motivational Interviewing<br>* Up to three counseling sessions on telephone based on Motivational Interviewing and elements of Cognitive Behavioral Therapy. Counselings are within 12 weeks after the baseline diagnostic interview and follow the stepped care approach.<br>|
| No Intervention: Control group<br>Control group receiving a booklet on problematic Internet use | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change of DSM-5 criteria | Criteria for Internet Use Disorders according to the Internet Gaming Disorder in the DSM-5, but for all Internet Applications are assessed with a diagnostic clinical interview based on the Composite International Diagnostic Interview (CIDI) | Assessment of criteria at baseline and at 6- and 12-month follow ups | 
| Change of time spent on the Internet | Average time of private Internet use on a weekday and on weekends and maximum use are assessed at baseline and at 6- and 12-month follow ups. Change of time is measured by the difference between the follow up assessments and the baseline. | Assessment of time on the Internet at baseline and at 6- and 12-month follow ups | 
| Change of disabilities caused by the problematic Internet use | World Health Organization Disability Assessment Schedule 2.0 (WHODAS) 2.0 (Adapted Version for problematic Internet use): 4 items ranging from 0 (no impairment) to 10 (strong impairment) 2 items estimating the days of impairment in the past 12 months (time frame will be adapted to the time frame in the assessment) For change of disabilities, the difference between follow up assessments and baseline will be measured for the single items. | Assessment of disabilities at baseline and at 6- and 12-month follow ups | 
| Change of negative consequences caused by the problematic Internet use | Negative Consequences-Questionnaire from the Criminological Research Institute of Lower Saxony: 8 items ranging from 1 (much worse) to 5 (much better) Maximum sum score ranges from 8 to 40 The questionnaire is inversely coded, so higher outcomes provide a better outcome For change of negative consequences, the difference between the sum scores in the follow up assessments and baseline will be measured | Assessment of negative consequences at baseline and at 6- and 12-month follow ups | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Readiness to change Internet use | Readiness to change is measured with a single item (How important would it be for you to change your Internet use behavior?) on a 10-point-Likert scale (1=not important at all, 10=very important). A higher value represents a better outcome. | Assessment of readiness to change at baseline and at 6- and 12-month follow ups | 
| Self-efficacy to change Internet use | Self-efficacy is measured with a single item (How confident are you to change your Internet use behavior?) on a 10-point-Likert scale (1=not confident at all, 10=very confident). A higher value represents a better outcome. | Assessment of self-efficacy at baseline and at 6- and 12-month follow ups | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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CBT, Internet Use Disorders, Brief Intervention, Motivational Interviewing, Proactive