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Abstract
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Technological advancements often present new challenges to mental health and well-being while, at the same time, creating the possibility for new, effective interventions for its preservation, improvement, and recovery (1). In the current commentary, on one hand, we discuss the category of problematic behaviors for which mobile internet technologies have created an outlet. We also consider research challenges related to the conceptualization of these problems, as proposed by the World Health Organization (WHO) for the upcoming 11th revision of International Classification of Disorders (2). On the other hand, we discuss what the development of mobile and online technologies offers for solving or mitigating these problems. Specifically, we focus on ecological momentary assessment (EMA) and intervention (EMI) methodologies (3, 4) and how they can help in overcoming difficulties currently faced in problematic online behavior research, diagnosis, and therapy.
To address clinical concerns on growing societal significance of new behavioral problems related to the development of technology, WHO recently classified some of them as new diagnostic entities in the ICD-11 (2). Pathological gambling, as well as pathological gaming were described in the "Disorders due to substance use and addictive behaviors" category, while Compulsive Sexual Behavior Disorder (CSBD) was deemed a member of "Impulse Control Disorders" (2, 10), although the discussion on the addictive, compulsive, and/or impulsive roots of the disorder is still ongoing (11-13). An alike debate for some of the other problematic behavior types, e.g., gambling (14, 15), gaming (16) or buying (17, 18) is still in progress.
In our opinion, this discussion raises important questions on determinants for the classification of problematic behavior. Why are some of them classified as addiction-type disorders while others as impulse control disorders? It is worth mentioning that in the Diagnostic and Statistical Manual IV-TR (19) gambling disorder was classified as an impulse control disorder and in the 5th edition (20) as an addiction. A similar change occurred between ICD-10 (21) and ICD-11 (3) for pathological gambling. It raises further important questions: what are the main mechanisms underlying problematic gaming, gambling, or CSBD, and are they homogeneous within each unit? Recognizing these pathological behaviors as psychiatric conditions naturally require further research on their accurate conceptualization and development of effective treatments. Here, another significant question emerges: how do we examine the effectiveness of the treatment? In the case of substance use disorders, there is plenty of objective measures of abstinence such as urinal, saliva, or blood tests (22, 23). In contrast, there is no such objective and retrospective method of assessment for problematic behaviors. However, if the behavior is engaged in online, reliable tracking of activity can be made possible by using EMA...
Language: en |