Adapting Dialectical Behavior Therapy for Treating Problematic Interactive Media Use

Abstract

Over the past decade, clinicians have observed an increase in adolescents overusing interactive media, resulting in detrimental consequences such as disrupted sleep, inattention to academic tasks, and deterioration of social relationships. The recognition of problematic interactive media use (PIMU), the excessive and dysregulated use of interactive electronic media that affects mental and physical health, resulting in difficulty meeting developmentally appropriate functional capacity, has led to a call for therapeutic interventions. To date, there has been limited research on treatments for adolescents with PIMU. This article documents the therapeutic benefit of dialectical behavior therapy (DBT) adapted to treat PIMU and applied to a 15-year-old male individual with a history of dysregulated use of the Internet in the categories of gaming, pornography, information-bingeing, and social media. Outcomes were measured by diary cards, documenting the patient’s affective states, urges to engage in PIMU, the number of times he acted upon these urges, and collateral information provided by both parents and teachers from his school. Over the course of a 7-module DBT intervention covered during 14 sessions, the patient showed improvement in his targeted self-regulation behaviors of reducing nighttime screen use and decreasing frequency of pornography use. The patient showed academic improvement, as he was able to complete homework more effectively without being distracted by devices. We concluded that the application of this adapted DBT is potentially helpful in treating adolescents’ excessive and dysregulated use of interactive media and electronic devices, and that this treatment approach deserves further study.

The Effect of Distress Tolerance Training on Problematic Internet Use and Psychological Wellbeing Among Faculty Nursing Students: A Randomized Control Trial

“…DBT has been demonstrated to improve outcomes in patients with substance use disorders. 18,20,21 The main results of this study are as follows: the study group, who received distress tolerance skills training, demonstrated an increase in their tolerance toward distress levels at post-treatment and at the 3-month follow-up. The study group exhibited a significant decrease in problematic internet use scores across all subscales (obsession, neglect, control disorders) post-treatment, and this reduction was sustained for three months.…”

“…DBT has been demonstrated to improve outcomes in patients with substance use disorders. 18 , 20 , 21 …”

“…This finding is concordant with evidence that has shown improvement in addiction symptoms and craving, as well as induced remission in patients with substance addiction. 18 , 20 , 21 …”

“…Another study also highlighted the benefits of adapting DBT to treat problematic internet use in adolescents, as it was found to be helpful in addressing their excessive and dysregulated use of interactive media and electronic devices. 20 , 21 …”

Exploring Use Patterns and Racial and Ethnic Differences in Real Time Affective States During Social Media Use Among a Clinical Sample of Adolescents With Depression: Prospective Cohort Study (Preprint)

“…Although there are reasons to hypothesize a contributory link between certain types of SMU and declining mental health (eg, SMU that displaces face-to-face social interactions and leads to increased social isolation and loneliness), underlying mental or behavioral health issues may actually drive high-frequency SMU. In fact, young people with certain behavioral health conditions-especially attention-deficit/hyperactivity disorder, social anxiety disorder, autism spectrum disorder, and depression-use screen media more and are predisposed to problematic interactive media use, characterized by a clinically relevant decline in one's functional status [34][35][36][37][38][39][40][41][42]. Underlying mental health conditions may also amplify or otherwise alter the effects of SMU.…”