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      Problematic Internet Use, Excessive Alcohol Consumption, Their Comorbidity and Cardiovascular and Cortisol Reactions to Acute Psychological Stress in a Student Population

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          Abstract

          Background and Aims

          Problematic Internet use and excessive alcohol consumption have been associated with a host of maladaptive outcomes. Further, low (blunted) cardiovascular and stress hormone (e.g. cortisol) reactions to acute psychological stress are a feature of individuals with a range of adverse health and behavioural characteristics, including dependencies such as tobacco and alcohol addiction. The present study extended this research by examining whether behavioural dependencies, namely problematic Internet use, excessive alcohol consumption, and their comorbidity would also be associated with blunted stress reactivity.

          Methods

          A large sample of university students ( N = 2313) were screened using Internet and alcohol dependency questionnaires to select four groups for laboratory testing: comorbid Internet and alcohol dependence ( N = 17), Internet dependence ( N = 17), alcohol dependence ( N = 28), and non-dependent controls ( N = 26). Cardiovascular activity and salivary cortisol were measured at rest and in response to a psychological stress protocol comprising of mental arithmetic and public speaking tasks.

          Results

          Neither problematic Internet behaviour nor excessive alcohol consumption, either individually or in combination, were associated with blunted cardiovascular or cortisol stress reactions.

          Discussion

          It is possible that problematic Internet behaviour and excessive alcohol consumption in a student population were not related to physiological reactivity as they may not reflect ingrained addictions but rather an impulse control disorder and binging tendency.

          Conclusions

          The present results serve to indicate some of the limits of the developing hypothesis that blunted stress reactivity is a peripheral marker of the central motivational dysregulation in the brain underpinning a wide range of health and behavioural problems.

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          Most cited references84

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          Cognitive and emotional influences in anterior cingulate cortex.

          Bush, Luu, Posner (2000)
          Anterior cingulate cortex (ACC) is a part of the brain's limbic system. Classically, this region has been related to affect, on the basis of lesion studies in humans and in animals. In the late 1980s, neuroimaging research indicated that ACC was active in many studies of cognition. The findings from EEG studies of a focal area of negativity in scalp electrodes following an error response led to the idea that ACC might be the brain's error detection and correction device. In this article, these various findings are reviewed in relation to the idea that ACC is a part of a circuit involved in a form of attention that serves to regulate both cognitive and emotional processing. Neuroimaging studies showing that separate areas of ACC are involved in cognition and emotion are discussed and related to results showing that the error negativity is influenced by affect and motivation. In addition, the development of the emotional and cognitive roles of ACC are discussed, and how the success of this regulation in controlling responses might be correlated with cingulate size. Finally, some theories are considered about how the different subdivisions of ACC might interact with other cortical structures as a part of the circuits involved in the regulation of mental and emotional activity.
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            The psychometric properties of the internet addiction test.

            There is growing concern about excessive Internet use and whether this can amount to an addiction. In researching this topic, a valid and reliable assessment instrument is essential. In her survey of Internet addiction, Young designed the Internet Addiction Test (IAT), which provides a basis for developments. The IAT has high face validity, but it has not been subjected to systematic psychometric testing. This study sought to replicate and expand Young's survey, and to examine the IAT more systematically. A questionnaire that existed as a Web page was devised, consisting of the IAT and 15 other questions regarding the respondents' demographic information and Internet usage. Participants were recruited through the Internet, yielding 86 valid responses (29 males and 57 females). Factor analysis of the IAT revealed six factors--salience, excessive use, neglecting work, anticipation, lack of control, and neglecting social life. These factors showed good internal consistency and concurrent validity, with salience being the most reliable. Younger and more recent users reported more problems, mainly concerning the neglect of work and social life. We expected interactive Internet functions to be more addictive; however, this was not found to be so. Overall, the IAT is a valid and reliable instrument that may be used in further research on Internet addiction.
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              Internet addiction or excessive internet use.

              Problematic Internet addiction or excessive Internet use is characterized by excessive or poorly controlled preoccupations, urges, or behaviors regarding computer use and Internet access that lead to impairment or distress. Currently, there is no recognition of internet addiction within the spectrum of addictive disorders and, therefore, no corresponding diagnosis. It has, however, been proposed for inclusion in the next version of the Diagnostic and Statistical Manual of Mental Disorder (DSM). To review the literature on Internet addiction over the topics of diagnosis, phenomenology, epidemiology, and treatment. Review of published literature between 2000-2009 in Medline and PubMed using the term "internet addiction. Surveys in the United States and Europe have indicated prevalence rate between 1.5% and 8.2%, although the diagnostic criteria and assessment questionnaires used for diagnosis vary between countries. Cross-sectional studies on samples of patients report high comorbidity of Internet addiction with psychiatric disorders, especially affective disorders (including depression), anxiety disorders (generalized anxiety disorder, social anxiety disorder), and attention deficit hyperactivity disorder (ADHD). Several factors are predictive of problematic Internet use, including personality traits, parenting and familial factors, alcohol use, and social anxiety. Although Internet-addicted individuals have difficulty suppressing their excessive online behaviors in real life, little is known about the patho-physiological and cognitive mechanisms responsible for Internet addiction. Due to the lack of methodologically adequate research, it is currently impossible to recommend any evidence-based treatment of Internet addiction.
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                Author and article information

                Journal
                J Behav Addict
                J Behav Addict
                jba
                JBA
                Journal of Behavioral Addictions
                Akadémiai Kiadó
                2062-5871
                2063-5303
                June 2015
                27 May 2015
                : 4
                : 2
                : 44-52
                Affiliations
                [1 ]School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham , Birmingham, United Kingdom
                Author notes
                * Corresponding author: Adam Bibbey; School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, B15 2TT, United Kingdom; Phone: +44 (0)121 414 8956; Fax: +44 (0)121 414 4121; E-mail: bibbeya@ 123456bham.ac.uk
                Article
                10.1556/2006.4.2015.006
                4500884
                26014670
                5ff42fbf-ae09-4457-ba63-ef24a3b38078
                © 2015 Akadémiai Kiadó, Budapest

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium for non-commercial purposes, provided the original author and source are credited.

                History
                : 11 November 2014
                : 23 February 2015
                Page count
                Figures: 2, Tables: 3, References: 87, Pages: 9
                Funding
                No financial support was received for this study. It should be noted that Adam Bibbey is funded by a Doctoral Award from the Economic and Social Research Council, UK. Annie Ginty is funded by an AXA Research Fund Postdoctoral Fellowship.
                Categories
                Full-Length Report

                internet dependence,alcohol,comorbid dependence,cardiovascular reactivity,cortisol reactivity,acute stress

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