Attentional bias in excessive Internet gamers: Experimental investigations using an addiction Stroop and a visual probe.

Background and aims Internet Gaming Disorder is included in the Diagnostic and statistical manual of mental disorders (5th edition) as a disorder that merits further research. The diagnostic criteria are based on those for Substance Use Disorder and Gambling Disorder. Excessive gamblers and persons with Substance Use Disorder show attentional biases towards stimuli related to their addictions. We investigated whether excessive Internet gamers show a similar attentional bias, by using two established experimental paradigms. Methods We measured reaction times of excessive Internet gamers and non-gamers (N = 51, 23.7 ± 2.7 years) by using an addiction Stroop with computer-related and neutral words, as well as a visual probe with computer-related and neutral pictures. Mixed design analyses of variance with the between-subjects factor group (gamer/non-gamer) and the within-subjects factor stimulus type (computer-related/neutral) were calculated for the reaction times as well as for valence and familiarity ratings of the stimulus material. Results In the addiction Stroop, an interaction for group × word type was found: Only gamers showed longer reaction times to computer-related words compared to neutral words, thus exhibiting an attentional bias. In the visual probe, no differences in reaction time between computer-related and neutral pictures were found in either group, but the gamers were faster overall. Conclusions An attentional bias towards computer-related stimuli was found in excessive Internet gamers, by using an addiction Stroop but not by using a visual probe. A possible explanation for the discrepancy could lie in the fact that the visual probe may have been too easy for the gamers.

The German version of the Generalized Pathological Internet Use Scale 2: a validation study.

The Generalized Pathological Internet Use Scale (GPIUS2) assesses cognitive behavioral aspects of problematic Internet use. To date, the 15-item scale has only been available in English, and the aim of this study was to translate and validate a German version. An online sample (ON, n=1,041, age 24.2±7.2 years, 46.7% men) completed an Internet version of the translated GPIUS2, and a student sample (OF, n=841, age 23.5±3.0 years, 46.8% men) filled in a pencil and paper version. A third sample of 108 students (21.5±2.0 years, 25.7% men) completed the questionnaire twice to determine the 14-day retest reliability. Participants also answered questions regarding their Internet use habits (OF, ON) and depression, loneliness, and social anxiety (ON). The internal consistencies were α=0.91 (ON) and α=0.86 (OF). Item-whole correlations ranged from r=0.53 to r=0.69 (ON) and from r=0.39 to r=0.63 (OF). The 2 week retest reliability was rtt=0.85. Confirmatory factor analyses found a satisfactory fit for the factorial model proposed by Caplan for the original version. The GPIUS2 score correlated moderately with time spent on the Internet for private purposes in a typical week (ON: r=0.40; OF: r=0.36). Loneliness, depression, and social anxiety explained 46% of the variance in GPIUS2 scores. The German version of the GPIUS2 has good psychometric properties in a pencil and paper version as well as in a web-based format, and the observations regarding loneliness, depression, and social anxiety support the underlying model.

A systematic review and meta-analysis on the efficacy of self-help interventions in tinnitus.

This study is a review and meta-analysis on the efficacy of cognitive-behavioural therapy (CBT) self-help interventions for tinnitus. Randomized controlled trials were identified by searching in databases (e.g. ISI Web of Knowledge, PubMed, Cochrane Library, and PSYNDEX) and by manual search. Ten studies with 1188 participants in total were included in the meta-analysis. Participants were 49.2 years old and had tinnitus for 5.2 years. Self-help interventions significantly reduced tinnitus distress (d = 0.48) and depressiveness (d = 0.25) when compared with a passive control (e.g. information only and discussion forums) at post-assessment. There was no difference to the face-to-face controls (group treatment). The presence of therapists and the methodological quality of the studies did not influence the results. Sensitivity analysis revealed that there might be a publication bias regarding the comparison to the face-to-face control. However, the results suggest that CBT self-help interventions are an effective treatment for tinnitus distress. Since few studies were identified, this conclusion must be supported by future meta-analyses.

The role of catastrophizing in recent onset tinnitus: its nature and association with tinnitus distress and medical utilization.

OBJECTIVE: Persistent tinnitus affects 10 to 15% of adults. Little is understood about why only a small percentage of patients become severely affected. Catastrophic thinking has been suggested as one potentially relevant factor that might influence a patient's coping behavior, and thus tinnitus habituation. The current study investigates the concept of tinnitus catastrophizing and its relation with distress and medical utilization in recent onset tinnitus. DESIGN: Participants were administered a survey assessing catastrophizing, tinnitus distress, medical utilization, coping, and mood disturbance. Regression analyses investigated the nature of tinnitus catastrophizing and its contributions to distress and health care utilization. STUDY SAMPLE: 278 subjects with tinnitus for less than six months were recruited from Ear-Nose-Throat units, through the internet, and newspaper articles. RESULTS: Controlling for background variables, high subjective tinnitus loudness, low behavioral coping, and depressive symptoms were significantly associated with tinnitus catastrophizing. Furthermore, greater tinnitus catastrophizing was related to higher distress and more frequent medical visits. CONCLUSIONS: Tinnitus catastrophizing appears to be pivotal already at an early stage of tinnitus experience. Addressing catastrophizing by specific prevention and intervention programs might reduce the development of distress and medical utilization in the long term. Longitudinal studies are required to clarify cause-effect relations.

The efficacy of minimal contact interventions for acute tinnitus: a randomised controlled study.

Acute tinnitus can lead to substantial distress and eventually result in long-lasting impairment. The aim of this study was to compare the efficacy of a cognitive-behavioural intervention (delivered as Internet self-management, bibliotherapy or group training) to the information-only control condition. Applicants suffered from subjective tinnitus for up to six months, were between 18 and 75 years old and received no other tinnitus-related psychological treatment. A total of 304 participants were randomly assigned to one of the four study arms. Tinnitus distress, depressive symptoms, psychosomatic discomfort and treatment satisfaction were assessed. At the post-assessment tinnitus distress was significantly lower in the Internet and the group training conditions compared to the control condition. Inter-group effect sizes were moderate to large. At follow-up, all active training conditions showed significantly reduced tinnitus distress compared to the control condition (intention-to-treat analysis). An additional completer analysis showed a significant reduction in tinnitus distress only for the group condition. All effect sizes were moderate. There were no differences regarding psychosomatic discomfort, but depressive symptoms were reduced in the group condition at the post-assessment (intention-to-treat analysis). Treatment satisfaction was significantly higher in the training conditions. The dropout rate was 39%. The present study shows that distress can be reduced as early as the acute stadium and that minimal-contact interventions are a promising way to do this. In particular, the Internet and group conditions led to a large, immediate decrease in distress, and the participants were highly satisfied with the training.

An internet-based cognitive-behavioural training for acute tinnitus: secondary analysis of acceptance in terms of satisfaction, trial attrition and non-usage attrition.

OBJECTIVES: Recent studies on tinnitus have focused on the efficacy of Internet-based interventions. Other core features of the quality of service, e.g. acceptance and attrition, have often been overlooked. This study analyses Internet-based training regarding acceptance and attrition in a trial on minimal-contact interventions for acute tinnitus. Whenever possible, we give information on other forms of training for comparison. METHODS: In a randomised controlled trial with 337 participants, 87 persons took part in the Internet training. RESULTS: The participants were as satisfied with the Internet-based training as with a face-to-face group training. There was a 34.48% dropout from the Internet-based training (dropout attrition). The training attrition from the Internet-based training was even higher at 64.4%. CONCLUSIONS: Two out of three indicators for acceptance-satisfaction and dropout attrition-provide comparable results between the Internet-based training and a face-to-face group training. The third indicator, training attrition, shows a better result for the group training. Future research should focus on attrition in order to enhance the overall effectiveness of training.

The German version of the internet addiction test: a validation study.

Reports about excessive Internet use, possibly amounting to an addiction, have increased. Progress with research and treatment of this phenomenon requires valid standardized assessment instruments. A frequently used questionnaire is the Internet Addiction Test (IAT) by Kimberly Young. The 20-item questionnaire is well established in a number of languages, but a German validation was lacking so far. An online (ON) sample (n=1,041, age 24.2±7.2 years, 46.7 percent men) completed an Internet version of the IAT and a student sample (offline [OF] sample, n=841, age: 23.5±3.0 years, 46.8 percent men) filled in a paper/pencil version. The participants also answered questions regarding their Internet use habits. A further sample of 108 students (21.5±2.0 years, 25.7 percent men) completed the questionnaire twice to determine the 14-day retest reliability. The internal consistencies were α=0.91 (ON) and α=0.89 (OF). Item-whole correlations ranged from r=0.23 to r=0.65 (ON) and from r=0.30 to r=0.64 (OF). Two-week retest reliability was r(tt)=0.83. Factor analyses with Varimax rotation yielded the same two factors in both samples, which explained 46.7 percent (ON) and 42.0 percent (OF) of the variance. The IAT score correlated with the time spent in the Internet in a typical week (ON: r=0.44; OF: r=0.38). The German version of the IAT was shown to have good psychometric properties and a stable two-factorial structure. Correlations with online time were in line with those reported for the IAT in other languages.