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\"Internet addiction is an emergent disorder in the psychiatric and psychological fields. This book provides a theoretical framework to understand how to define and conceptualize compulsive use of the Internet from a clinical perspective. With various theoretical models from the psychiatric, psychological, communication, and sociological fields, it explores the prevalence of the disorder and the most addictive or problematic online applications, such as online pornography, Internet gambling, and online games. Evidenced-based treatment approaches are provided as well. A must-have for every clinician\"--Provided by publisher.

RationaleMinocycline, a tetracycline antibiotic, inhibits activation of microglia. In preclinical studies, minocycline prevented development of opioid tolerance and opioid-induced hyperalgesia (OIH). The goal of this study was to determine if minocycline changes pain threshold and tolerance in individuals with opioid use disorder who are maintained on agonist treatment.MethodsIn this double-blind, randomized human laboratory study, 20 participants were randomized to either minocycline (200 mg/day) or placebo treatment for 15 days. The study had three test sessions (days 1, 8, and 15 of treatment) and one follow-up visit 1 week after the end of treatment. In each test session, participants were assessed on several subjective and cognitive measures, followed by assessment of pain sensitivity using the Cold Pressor Test (CPT). Daily surveys and cognitive measures using Ecological Momentary Assessment (EMA) were also collected four times a day on days 8 through 14 of treatment, and proinflammatory serum cytokines were assessed before and on the last day of treatment.ResultsMinocycline treatment did not change pain threshold or tolerance on the CPT. Similarly, minocycline did not change severity of pain, opioid craving, withdrawal, or serum cytokines. Minocycline treatment increased accuracy on a Go/No-Go task.ConclusionsWhile these findings do not support minocycline’s effects on OIH, minocycline may have a potential use as a cognitive enhancer for individuals with opioid use disorder, a finding that warrants further systematic studies.

Longitudinal studies of prospective predictors for pathological Internet use (PIU) in adolescents as well as its course are lacking. This three-wave longitudinal study was conducted within the framework of the European Union-funded project “Saving and Empowering Young Lives in Europe” over a 2-year period. The sample consisted of 1444 students at the baseline investigation (T0); 1202 students after 1 year (T1); and 515 students after 2 years (T2). Structured self-report questionnaires were administered at all three time points. PIU was assessed using the Young Diagnostic Questionnaire (YDQ). In addition, demographic (i.e., gender), social (i.e., parental involvement), psychological (i.e., emotional problems), and Internet use-related factors (i.e., online activities) were assessed as prospective predictors. The prevalence of PIU was 4.3 % at T0, 2.7 % at T1 and 3.1 % at T2. However, only 3 students (0.58 %) had persistent categorical PIU (YDQ score of ≥5) over the 2-year period. In univariate models, a variety of variables that have been previously identified in cross-sectional investigations predicted PIU at T2. However, multivariate regression demonstrated that only previous PIU symptoms and emotional problems were significant predictors of PIU 2 years later (adjusted R 2 0.23). The stability of categorical PIU in adolescents over 2 years was lower than previously reported. However, current PIU symptoms were the best predictor of later PIU; emotional symptoms also predicted PIU over and above the influence of previous problematic Internet use. Both PIU symptoms and emotional problems may contribute to the vicious cycle that supports the perpetuation of PIU.

Since the inclusion of gaming disorder in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as a condition for further study, there has been an increasing consensus that problematic gaming can be detrimental to mental health, yet efforts in preventing such problems from emerging have been limited. To address this gap, we developed the Game Over Intervention (GOI), a parent-based program designed based on the frameworks of ecological systems theory and self-determination theory. This study aimed to test the efficacy of the new program using the method of a randomized controlled trial, with the control condition being a program for effective learning. Participants were the parents of upper primary school students, with 163 (77% women; Mage = 42.70) and 199 (83% women; Mage = 41.82) partaking in the intervention and the control conditions, respectively. Participants rated their children’s gaming time, exposure to violent video games, and symptoms of gaming disorder at three time points: baseline, one week after intervention, and three months after intervention. The results indicate a general reduction in these three criteria across the three-month period. Our study provides tentative evidence demonstrating the effectiveness of the GOI in mitigating some gaming-related problems.

Background Reconsolidation-based interventions have been suggested to be a promising treatment strategy for substance use disorders. In this study, we aimed to investigate the effectiveness of a working memory intervention to interfere with the reconsolidation of alcohol-related memories in a sample of non-treatment seeking heavy drinkers. Methods Participants were randomized to one of the two conditions that underwent a 3-day intervention: in the experimental condition, a 30-min working memory training was performed immediately after a 15-min memory retrieval session (i.e., within the memory reconsolidation time-window), whereas in the control condition, the working memory training was performed prior to a memory retrieval session. Results In contrast to our original hypothesis, a high working memory load after memory retrieval did not interfere with the reconsolidation of those memories while a high working memory load prior to memory retrieval (the original control condition) strongly reduced retrieval-induced craving and craving for alcohol at follow-up. Conclusion Whereas the neurocognitive mechanism behind this effect needs to be further investigated, the current findings suggest that, if replicated, working memory training prior to addiction-related memory retrieval has the potential to become an effective (adjunctive) intervention in the treatment of substance use disorders.

Rationale Individuals with depression smoke more than smokers without depression. Research has shown that cigarette demand is a useful tool for quantifying tobacco reinforcement and supposes a clinical predictor of treatment outcomes. Despite previous studies examining the relative reinforcing efficacy of nicotine among different populations of smokers, to date, no study has assessed cigarette demand among individuals with elevated depressive symptoms. Objective The aim of this study was to compare cigarette demand among samples of smokers with low and elevated depressive symptoms. Further, it also sought to examine the relationship between depressive symptomatology and the individual CPT demand indices. Methods Participants (80 non-depressed smokers and 85 depressed smokers) completed the 19-item version of the Cigarette Purchase Task (CPT). Depression symptomatology was assessed using the Beck Depression Inventory-Second Edition (BDI-II). Depressed smokers needed to present at least moderate depressive symptoms as indicated by scoring ≥ 20 on the BDI-II. Results Depressive symptomatology and nicotine dependence were significantly associated with elasticity of demand ( R 2  = 0.112; F (2, 155) = 9.756, p  = ≤ 0.001). Depressive symptoms, cigarettes per day, and years of regular smoking also predicted breakpoint scores ( R 2  = 0.088; F (4, 153) = 3.697, p  = 0.007). Conclusion As smokers with elevated depressive symptoms are less sensitive to increases in cigarette prices than those with low depressive symptomatology, future studies should consider these cigarette demand indices when designing depression-focused smoking cessation treatments. Providing this difficult-to-treat population with interventions that promote both pleasurable and alternative reinforcing activities is highly encouraged.

RationaleOne risk factor for alcohol and substance misuse is hypomanic experiences, or periods of mood elevation. Young people who report hypomanic states are more likely to develop bipolar disorder (BP), and BP and other mood disorders increase the risk of addiction. We recently reported that young adults with a history of mood elevation experience less subjective effects from a low dose of alcohol, which may be predictive of future alcohol use. The finding with alcohol raised the question of whether this dampened response to a drug also applies to other drugs, such as amphetamine.ObjectiveThis study assessed responses of d-amphetamine in healthy young adults with varying experiences of mood elevation, as measured by the Mood Disorders Questionnaire (MDQ).MethodsHealthy 18–19-year-olds (N = 30) with a range of MDQ scores participated in three 4-h laboratory sessions in which they received placebo, 10 mg, or 20 mg d-amphetamine. They completed mood questionnaires and cardiovascular measures.ResultsIndividuals with higher MDQ scores reported less stimulation and euphoria after 10 mg, but not 20 mg, d-amphetamine, than individuals with lower scores. MDQ scores were not related to cardiovascular responses to the drug.ConclusionsA history of mood elevation experiences or hypomania states is related to dampened response to a low dose of a psychostimulant drug, extending previous findings with dampened response to alcohol. This phenotype for mood disorders of dampened responses to drugs may contribute to risk for subsequent drug use or misuse.

Background The purpose of this study was to compare the effect of 300 mg of bupropion and 8 mg of buprenorphine per day on the treatment of methamphetamine withdrawal cravings over a 2-week treatment interval. Method Sixty-five methamphetamine-dependent men who met the DSM-IV-TR ( Diagnostic and Statistical Manual of Mental Disorders , 4th edition, text revision) criteria for methamphetamine dependence and withdrawal were randomly divided into two groups. Subjects randomly received 300 mg of bupropion or 8 mg of buprenorphine per day in a psychiatric ward. Of the 65 subjects, 35 (53.8%) received buprenorphine and 30 (46.2%) received bupropion. The subjects were assessed by using methamphetamine craving score, interview, and negative urine drug test. Findings There were no statistically significant differences between the two groups in regard to age, education, duration of methamphetamine dependency, marital status, employment, and income. The mean ages were 32.8 years (standard deviation (SD) = 7.26, range = 22 to 59) for the buprenorphine group and 32.21 years (SD = 8.45, range = 17 to 51) for the bupropion group. All 65 patients completed the 2-week study. Both medications were effective in the reduction of methamphetamine cravings. Reduction of craving in the buprenorphine group was significantly more than the bupropion group ( P = 0.011). Overall, a significant main effect of day ( P <0.001) and group ( P = 0.011) and a non-significant group-by-day interaction ( P >0.05) were detected. Conclusions The results support the safety and effectiveness of buprenorphine and bupropion in the treatment of methamphetamine withdrawal craving. Administration of 8 mg of buprenorphine per day can be recommended for the treatment of methamphetamine withdrawal cravings. We should note that it is to be expected that craving decreases over time without any medication. So the conclusion may not be that bupropion and buprenorphine both lower the craving. As the buprenorphine is superior to bupropion, only buprenorphine does so for sure. Trial registration Iranian Registry of Clinical Trials (IRCT) registration number: IRCT2015010320540N1 . Date registered: April 10, 2015.

Background Disordered gamblers have phenotypical and pathological similarities to those with substance use disorders (SUD), including exaggerated automatic cognitive processing of motivationally salient gambling cues in the environment (i.e., attentional and approach bias ). Cognitive bias modification (CBM) is a family of computerised interventions that have proved effective in successfully re-training these automatic cognitive biases in SUD. CBM interventions can, in principle, be administered online, thus showing potential of being a low-cost, low-threshold addition to conventional treatments. This paper presents the design of a pilot randomised controlled trial exploring the effectiveness of two web-based CBM interventions targeting attentional and approach bias towards gambling cues in a sample of Dutch and Belgian problematic and pathological gamblers. Methods/design Participants (N = 182) are community-recruited adults experiencing gambling problems, who have gambled at least twice in the past 6 months and are motivated to change their gambling behaviour. After a baseline assessment session, participants are randomly assigned to one of four experimental conditions (attentional or approach bias training, or the placebo version of the two trainings) and complete six sessions of training. At baseline and before each training session, participants receive automated personalised feedback on their gambling motives and reasons to quit or reduce gambling. The post-intervention, 1-month, and 3-month follow-up assessments will examine changes in gambling behaviour, with frequency and expenditure as primary outcomes, and depressive symptoms and gambling-related attentional and approach biases as secondary outcomes. Secondary analyses will explore possible moderators (interference control capacity and trait impulsivity) and mediators (change in cognitive bias) of training effects on the primary outcomes. Discussion This study is the first to explore the effectiveness of an online CBM intervention for gambling problems. The results of this study can be extremely valuable for developing e-health interventions for gambling problems and further understanding the role of motivational implicit cognitive processes underlying problematic gambling behaviour. Trial registration Netherlands Trial Register, NTR5096 . Registered on 11 March 2015.

Background Current evidence suggests that the addiction on one substance may underpin or affect addiction on another in polysubstance users. However, there is no tool that has been shown to have psychometric validation for assessment of the severity of khat addiction in polysubstance users. Methods Polysubstance users with khat chewing habit ( n  = 178, age = 25.8 ± 3.6, BMI = 23.3 ± 2.8 kg/m 2 ) were recruited from randomly selected houses for a cross-sectional study in Mizan, Ethiopia. The survey including severity of dependence scale for khat (SDS-khat), a brief metacognition questionnaire, and a semi-structured socio-demographics tool were administered by trained interviewers. Results There was no ceiling effect or floor effect in the SDS-Khat scores. Internal consistency was moderate (Cronbach’s alpha = 0.58). Internal homogeneity was adequate (Item-total correlations of the SDS-Khat; r  ≥ 0.55). Significant negative correlations between the SDS-Khat and the metacognition ( r  = −.19 to −.34, p  < 0.05 or p  < 0.01) indicated convergent validity. The findings of exploratory factor analysis were non-unanimous with a suggestion of two models, i.e., a 2-factor and a 1-factor model, while the confirmatory factor analysis favored 1-Factor model. Conclusion The SDS-Khat has adequate psychometric validity for the assessment of psychological severity of khat addiction in the polysubstance users.