Elsevier

Journal of Psychiatric Research

Volume 58, November 2014, Pages 7-11
Journal of Psychiatric Research

Review
A cognitive-behavioral model of Internet gaming disorder: Theoretical underpinnings and clinical implications

https://doi.org/10.1016/j.jpsychires.2014.07.005Get rights and content

Highlights

  • Motivational drives related to reward-seeking.

  • Behavioral control relating to executive inhibition.

  • Decision-making that weighs the consequences of engaging in motivated behaviors.

Abstract

Cognitive contributions to the behaviors observed in substance and non-substance addictions have been investigated and characterized. Based on models of drug addictions and the extant literature on Internet gaming disorder (IGD), we propose a cognitive-behavioral model for conceptualizing IGD. The model focuses on three domains and their roles in addictive behaviors. The three domains include motivational drives related to reward-seeking and stress-reduction, behavioral control relating to executive inhibition, and decision-making that involves weighing the pros and cons of engaging in motivated behaviors. Based on this model, we propose how behavioral therapies might target these domains in the treatment of IGD.

Section snippets

Background

Internet addiction disorder (IAD) or problematic Internet use has been proposed as a diagnostic entity and studied for more than a decade; however, there has been debate regarding a standardized definition for such a disorder. Although no formal diagnostic criteria for a psychiatric condition characterized by excessive and interfering patterns of Internet use were included in the fourth edition of the Diagnostic and Statistical Manual (DSM-IV) (Block, 2008, Shaw and Black, 2008, Liu et al., 2011

A cognitive-behavioral model of IGD

A central component of addictions involves reward-seeking (Potenza, 2013). Reward-centric models have focused on pleasurable aspects of drug-taking with the notion that drugs may “hijack” brain reward circuits (Volkow and Li, 2004, Nestler, 2005). The incentive salience model of drug addiction proposes that “liking” a drug may be separated from “wanting” the drug (Berridge, 2007). A “reward deficiency syndrome” model posits that addicted individuals engage in addictive behaviors to compensate

Clinical implications

Several categories of behavioral interventions have demonstrated efficacy in the treatment of gambling and/or drug addictions through randomized controlled trials (Potenza et al., 2011): 1) brief and motivational interventions, which may alter decision-making processes to focus on more future-oriented goals (Burke et al., 2003); 2) contingency management, which provides immediate reinforcement to promote abstinence (Dutra et al., 2008); and, 3) cognitive behavioral therapies, which emphasize

Conclusions

Recent studies suggest neurocognitive differences in individuals with and without IGD. IGD shares multiple features with drug addictions including elevated impulsivity, cognitive inflexibility, and attentional biases. However, the extent to which these may represent pre-existing factors predisposing to IGD or factors that may develop following excessive Internet gaming, or perhaps a combination of both, is not yet known. Although data from studies of substance addictions suggest the last

Role of the funding source

The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Contributors

Guangheng Dong wrote the first draft of the manuscript, Marc Potenza revised and improved the manuscript. All authors contributed to and have approved the final manuscript.

Competing interests

The authors declared that no competing interests exist.

Acknowledgments

This research was supported by National Natural Science Foundation of China (31371023). National Institutes of Health (R01 DA035058, P50 DA09241, P20 DA027844), the Connecticut Department of Mental Health and Addictive Services, and the National Center for Responsible Gaming.

Dr. Potenza has received financial support or compensation for the following: Dr. Potenza has consulted for and advised Lundbeck, Ironwood ad Shire; has received research support from the National Institutes of Health,

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