Effects of retrieval-extinction training on internet gaming disorder

Abstract

Background and aims Internet gaming disorder (IGD) leads to serious impairments in cognitive functions, and lacks of effective treatments. Cue-induced craving is a hallmark feature of this disease and is associated with addictive memory elements. Memory retrieval-extinction manipulations could interfere with addictive memories and attenuate addictive syndromes, which might be a promising intervention for IGD. The aims of this study were to explore the effect of a memory retrieval-extinction manipulation on gaming cue-induced craving and reward processing in individuals with IGD. Methods A total of 49 individuals (mean age: 20.52 ± 1.58) with IGD underwent a memory retrieval-extinction training (RET) with a 10-min interval (R-10min-E, n = 24) or a RET with a 6-h interval (R-6h-E, n = 25) for two consecutive days. We assessed cue-induced craving pre- and post-RET, and at the 1- and 3-month follow-ups. The neural activities during reward processing were also assessed pre- and post-RET. Results Compared with the R-6h-E group, gaming cravings in individuals with IGD were significantly reduced after R-10min-E training at the 3-month follow-up (P < 0.05). Moreover, neural activities in the individuals with IGD were also altered after R-10min-E training, which was corroborated by enhanced reward processing, such as faster responses (P < 0.05) and stronger frontoparietal functional connectivity to monetary reward cues, while the R-6h-E training had no effects. Discussion and Conclusions The two-day R-10min-E training reduced addicts’ craving for Internet games, restored monetary reward processing in IGD individuals, and maintained long-term efficacy.

A proposal for the unification of psychotherapeutic action understood as memory modification processes.

“…Laboratory studies of more complex design indicate the ecological validity of the unlearning sequence, as noted earlier. The fact that the unlearning sequence is defined as certain subjective experiences, rather than particular procedures, has allowed it to be fulfilled in creative ways in various empirical studies of its therapeutic application: Gray et al (2017, 2020) and Iyadurai et al (2018) report the successful use of specialized protocols designed for posttraumatic stress disorder rooted in a single event, and various protocols have been developed and applied for particular addictions (e.g., alcohol addiction: Gale et al, 2021; cocaine seeking: Luo et al, 2015; heroin craving: Xue et al, 2012; nicotine addiction: Germeroth et al, 2017; internet gaming addiction: Zhao et al, 2022). The protocol developed by Högberg et al (2011) for suicidal adolescents eliminated their posttraumatic symptomology in a small number of therapy sessions, and an analysis of that protocol by Ecker (2018, pp.…”

Ten years of research on the treatments of internet gaming disorder: A scoping review and directions for future research

“…However, earlier reviews have included studies with relatively loose inclusion criteria or ones lacking control groups (for example ( Zhao et al., 2022 )) or randomized controlled structures, limiting conclusions that could be drawn. Given advances in this area, the current review focuses on treatment studies with control groups and considers directions for future research.…”