Negative self-talk and addiction recovery

January 29th, 2012

Everyone has internal beliefs about what they are, or aren’t, good at. For many these have become an implicit reality – facts about life that are rarely examined and never questioned. The “gravity” of our lives.

When I review these internal beliefs with clients, especially those in early recovery but also others who don’t have trouble with addiction per se, we often find that they are packed full of negative self-beliefs and self-talk. Phrases like “I’m impatient/rude/stupid,” “I’m not good at doing _____,” or “I can’t handle _____” are so commonplace in psychotherapy circles that restructuring them can often become the focus of many sessions. And negative self-beliefs are a huge source of shame, and you know how I feel about that.

Inevitably these negative self-beliefs and the associated shame are often the remnants of past experience, whether personal or “other” inflicted. Poor performance in some childhood activity, ridicule by peers, or harsh words from misguided parents can lead to seemingly permanent imprints on the world-view of the young, and then the older. Ironically, even seemingly self-assured views like “I am in control of my life” can become defeating when they turn into “I am a failure because I can’t handle this on my own.” We get that one a lot in addiction treatment from clients who think that they are weak because they’ve found themselves needing help. Again, this thought pattern leads to shame and often resistance to receiving the necessary addiction help.

As usual, a big part of dealing with these issues, from both a cognitive behavioral therapy (CBT) point of view and a humanistic one, is to examine their sources and test their appropriateness. It’s rare that these statements prove universally true and it’s even more infrequent that they turn out to have no connection to a small set of past hurts that happened long ago. In recovery from addiction, I often have clients look at how many other things in life they’ve needed help with – learning how to read, how to play sports, or how to do well at their job. We’re constantly relying on others for help, but when it comes to our psychological functioning we believe that we should be masters regardless of our level of training – a belief that I see as having no basis. But then again, I am a psychologist…

How to break negative self-talk and self-belief cycles

For readers who want to test their own beliefs and the existence of their own negative self-talks it helps to keep a written journal. Make a list of such negative self-beliefs that you are already aware of and try to be as aware as possible of negative self-talk as it happens over the course of one whole day. Write those down too. Now, using a whole line on a piece of paper (or a spread-sheet if you want to be super organized about this) create little spaces (columns) to write down a single situation in which those thoughts and beliefs come up for you in everyday life. In the nest column put down an objective assessment of what actually happened. In the last column write a short assessment of how close your initial internal dialog was to the “truth.”

Let’s use an example – Imagine getting an upset email from your boss that brings up your good old “I’m never going to succeed” negative self-belief. When you go to your journal and find the line for that specific negative belief you write “got upset email from boss” in column one and “boss was upset that I forgot to send out update email yesterday as expected” in column two. Now examine your current level of functioning at work in light of this specific mistake, past work occurrences, and the very near future.

If you’ve been held back from advancement repeatedly and been scolded, fired, or nearly fired for forgetting these sorts of things in the past, the belief might be a sign that you need to become active about finding ways to improve on this sort of forgetfulness in the future. But if such occurrences are relatively rare and haven’t caused negative consequences at work or other environments, then it sounds like the belief is an exaggeration of a much less frightening reality along the lines of “I don’t always perform perfectly at work.” I don’t know about you, but that sort of internal belief I can live with.

Now go on and do your homework – or are you a slacker?!

Posted in:  Education, For addicts, For others, Tips Tags: addiction, belief, beliefs, negative, negative self, negative self beliefs, negative self talk, self, self beliefs

Naltrexone the addiction cure?

January 23rd, 2012

CNN released a news article a little while back titled “With anti-addiction pill, ‘no urge, no craving‘” that seems to suggest that a cure for addiction has been found. As usual, news reporting on these sort of topics revolves around a kernel of truth, with nice window dressing an a serving of embellishment.

While naltrexone, and topiramate, have been shown to improve outcomes in addiction treatment, they have by no means revealed anything that would warrant giving them the title “anti-addiction pills.”

Indeed, there are now a few different preparations of Naltrexone, including a long acting version called Vivitrol that while relatively expensive, has been shown to be relatively effective at cutting relapse rates for both alcoholics AND heroin (or opiate addicts). Note the difference though here between my language and that used by CNN; Naltrexone has been shown to reduce relapse rates, not eliminate them, and current research seems to show that it is most effective only for specific groups of alcoholics who have a specific type of Mu opioid receptor.

As the article points out, a combination of therapies, including behavioral therapies, medications, and social-support, are still the best option when it comes to addiction treatment.

We’re a long way off from finding anything that can be considered a cure for addiction, no matter what some treatment centers like to claim, but these pills should help us stem the tide while we keep looking…

Posted in:  Education, Medications, Opinions, Treatment Tags: addiction, addiction cure, addiction pill, alcoholics, anti addiction, CNN, cure, cure addiction, heroin, mu, naltrexone, news, opiate, opioid receptor, pill, relapse rates, topiramate, treatment, vivitrol

Rubber-band addiction recovery – No shame

January 15th, 2012

There’s a specific issue that keeps coming up with nearly every addiction client I work with who is in early recovery. Regardless of whether they’re trying to stop unhealthy alcohol or drug use, sex or gambling behavior, or anything else, this issue keeps returning. It doesn’t even seem to matter if this is their first attempt at addiction recovery or if they’ve already been here many times before.

The issue: Shame about a desire to return to old behaviors and stopping their recovery.

At the Matrix Institute on Addiction where I see some clients, they call this “The Wall” suggesting that it usually comes right after a relatively easy period of recovery in which clients are self-assured and confident that they’ve got their addiction beat. “The Wall” is supposed to be marked by anhedonia, depression, severe cravings, irritability, and more fun stuff like that. After the wall is the promised land of long-term recovery. By identifying the specific stages of recovery addicts are supposed to gain more understanding of their process and experience less shame. I love the Matrix method, but I see things a little differently.  The way I see it, “The Wall” is far from a single point in time, but is instead part of a larger pattern I like to call Rubber-band Recovery.

Rubber-band Recovery in Addiction

I’m sure everyone reading this has at some point played with a rubber band, stretching it and letting it snap back to its original state or pulling it between two fingers and playing it like a string (another name for this approach could be String Recovery, but that might get confused with theoretical physics and we don’t want that). When pulling the rubber-band one way, its internal structure pulls back, trying to get back to its natural state. The body can be thought to do the same when placed under chronic alcohol and drug use in addiction – it has a slew of internal processes that work hard to keep the body in its natural state, at homeostasis. Naturally, due to the pharmacological mechanisms of alcohol, cocaine, methamphetamine, marijuana, and many other drugs, these systems usually fail at setting everything back to normal especially during the use itself, which is why we get high. However, their work in a body that consumes drugs on a regular basis is obvious – reductions in the production of specific chemicals (like relevant neurotransmitters), changes in the structure of the brain itself (like producing less receptors or even removing some from the brain’s cells), and production of chemicals that combat the drugs’ actions.

All in all, the body and brain of a long-time, chronic, heavy user of alcohol and drugs are different from the body and brain they started with in important ways that specifically relate to their alcohol and drug use. They are like the stretched rubber band, similar but obviously not the same as it was in its relaxed state.

Individuals in early recovery from addiction essentially experience what happens when that taut, stretched, rubber band is let loose. Hurrying up to get back to its natural state, to homeostasis, it releases all that pent up energy and rushes through its original state, overcompensating and stretching a bit in the other direction. For the addict in early recovery, this is the process of withdrawal. As we’ve spoken about numerous times before when discussing withdrawal, a brain that has reduced its own production of dopamine because of large amounts of methamphetamine that flood its dopamine reserves will still be left with very low dopamine when the crystal meth stops coming in. Low dopamine will bring about many effects that look exactly like the opposite of a methamphetamine high – a large appetite, low energy, and reduced movement and motivation. For heroin addicts, the drug that’s caused them to feel no pain and become constipated will cause their bodies severe pain, diarrhea, and trembling when it’s removed from the equation. Some withdrawal is actually life threatening due to the extreme changes in body chemistry and structure that happen after long term use. In addition to all of the direct effects of the drugs and alcohol, those internal processes that have been working hard to counteract the effects of the drugs (they’re called “opponent processes” by some addiction researcher like Dr. Christopher Evans from UCLA) are still turned up to 10 and are going to take a little time to get back to their original state as well. All in all, that leaves addicts feeling pretty crappy to say the least during withdrawal, the worst part of early recovery from addiction.

But like that good old rubber-band addiction recovery than quickly turns around. Having overcome the worst part of withdrawal, addicts in early recovery often experience joy, confidence, energy, and clarity they probably haven’t felt in a long time. That along with the environmental influence of loved ones who are extremely happy to see an addict quit (especially the first time around) give those in very early recovery a feeling of great well being and happiness, like a nice pink-cloud they get to ride on for a bit. Remember, the rubber band is moving back in the direction it came from during active addiction and it’s likely that brain processes are doing a little overcompensating the other way now too, turning down those opponent processes and flooding the brain with the chemicals it’s been missing.

But alas, this little turn doesn’t last too long and back we go into the darker place of negativity, low energy, anhedonia, and more. But instead of calling this stage “The Wall,” I understand it as one of the inevitable turns in what is sure to be a back and forth, seesaw like trip of recovery ups and downs. Periods of confidence in our ability to overcome our demons are followed by others that make us feel week and irritable. The good news is that just like with a rubber-band, each successive cycle on this seesaw gets a little less intense, which means that confidence, elation, depression, and anger turn into comfort, contentment, and ease – our new homeostasis. After a ride like that most addicts really need a little rest and when we reach this stage (no matter what it looks like specifically for each person), long-term recovery feels like the norm instead of an effort. This is the real end goal of recovery – a state of being that feels normal and that doesn’t involve unhealthy alcohol or drug use, sexual acting out, or gambling.

At the end of the rubber-band game we get back to just a good old unstretched rubber-band, and it feels good. In the process, it makes little sense to feel guilty, or ashamed, at all the intermediate stages. They’re part of the game of recovery and they’re essentially impossible to avoid completely. Intense cravings come during specific parts because of internal, biological, and external, environmental influences. Being ashamed of that would be essentially the same as being ashamed of extreme hunger when you haven’t eaten in 5 hours and see a commercial for your favorite food – silly and useless. I can guarantee that the rubber band doesn’t feel ashamed about they way it behaves when snapping back…

Posted in:  Education Tags: addiction, alcohol drug, alcohol drug use, anhedonia, ashamed, band, biological, cravings, depression, drug use, early recovery, early recovery addiction, long term recovery, recovery, rubber, rubber band, UCLA, unhealthy, withdrawal

Recovery = Abstinence… Or not

December 25th, 2011

The Substance Abuse and Mental Health Services Administration (SAMHSA) just release a new definition of “recovery” from mental health and addiction:

A process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential.

I’ll give you 10 seconds to find a key missing ingredient in this definition of recovery without peeking at our title. Hey! No Looking!!!

The definition calls recovery a process the provides improvements in well-being and that allows people to gain control of their life. It seems that abstinence is simply nowhere to be found in this new SAMHSA definition.

I have no doubt that some people will be upset about the decision not to include abstinence in the definition of recovery, but I won’t be one of them. I’ve been saying that we should be moving to a different definition, one that focuses on improvement in quality of life, as the basis for whether someone is in recovery or not. You see as far as I’m concerned it doesn’t matter whether a person is using any substances – all I care about is the impact of such use on their well being, their “quality of life.”

We’ve already written a few article on All About Addiction making this exact point (see here and here for some examples) and there have been some addiction researchers calling for the same when measuring success in addiction treatment research (see here and here).

Most addiction treatment research simply measures abstinence when individuals finish treatment (especially outpatient treatment) and then maybe 6 or 12 months later. But as the research I linked to earlier shows, there are a whole slew of people who are not abstinent a year after their release from addiction treatment but are without a doubt involved in recovery: Their substance use is either fully under control or is at least producing much less of a problem than it had before. As far as I’m concerned that is a success, and if the use begins being troublesome again, then it is possible that more treatment, and perhaps complete abstinence, is necessary.

This whole thought process can easily lead us right down the harm reduction, substitution therapy, and legalization argument rabbit hole, and I’m all for that discussion. I’m also sure that I will once again get some more hate-mail from readers who think I’m being irresponsible by suggesting that people who have at one point had trouble with substance abuse may be able to use anything (even substances that were not their drug of choice) ever again. They’ll accuse me of being responsible for those who decide to try such methods and fail while taking absolutely no responsibility for the countless who try their approach and relapse. Fortunately for me I’ve learned to ignore those emails.

Posted in:  Education Tags: 12 months, addiction, definition, definition recovery, recovery, SAMHSA, substance abuse and mental health services administration, treatment

Crystal meth addiction and the Miracle of Letting Go

December 12th, 2011

This is a guest post by Cathy Taughinbaugh of Treatment Talk.org.

I am a parent of an addict. I would say looking back, that I was naive and in denial about the drug use in my home. The last two years of high school for my daughter were challenging. One day of her senior year, I found what looked like drugs in her back pack. We were divorced, but I showed them to her father who decided to take them to the police station to find out what they were. When we were told the drugs were crystal meth, we were both shocked and frightened. Two nephews of my daughter’s dad had become addicted to crystal meth. One is now serving a long term sentence in a California prison and the other was killed, so as you can imagine he was concerned about this drug use in particular. We came together, sat our daughter down and she told us she didn’t use drugs, but was carrying them for a friend. She said she knew that it was wrong to be doing that for someone else, burst into tears, and yes, we believed her. Looking back I realize how much in denial we really were.

She went away to college in Colorado. We sent her off, and she went away with the best of intentions. Her grades that freshman year were abysmal. She was on probation her first semester, flunked out the second semester and then went to summer school at the local junior college. She managed to get herself back in for the fall of her sophomore year. Things did not improve, and her grades went from bad to worse. She decided to quit school for the next semester and work. Her dad and I needed to let go of the college dream because we finally realized she was wasting our money, and wasting her life. She did find a part time job at a local pet store, but it seemed her hours were getting less and less. For some reason she had trouble getting to work, and finally could not keep her job. By June we were emotionally exhausted. We agreed to one more month’s rent. We sent it, but both of us felt, that this was the last bit of help we could give her. Yet, I still wasn’t clear what the problem was.

The idea of having my 19 year old daughter living on the streets, was terrorizing. I went back in late June to see what I could do and to find out more. In addition, to not having a job or any obvious means of support, to my surprise, she had bought a Rottweiler puppy, named Bella. We decided one day during my visit to take the dog on a walk in the hills on a hot 80+ degree day. She had on a long sleeve t-shirt which surprised me for such a hot day and during the walk, I made several comments about how hot she must be.

Finally, walking behind her, it became clear to me that she was deliberately covering her arms. I began to panic. I went up to her, touched her arm, and said, “You should at least pull your sleeves up.” She sharply pulled her arm away and I knew.  I was really numb for quite awhile as we continued down the hill, I didn’t know what to say, and prayed that this was some kind of mistake.  Finally, I confronted her in the parking lot. She would not show me her arms, and we both just burst into tears. I began naming off drugs. Of course starting with heroin, but when I mentioned crystal meth, she nodded. I could not believe my daughter who had been a girl scout, and a member of the high school water polo team among other things, was shooting up crystal meth.

I told her I was not going to leave her in Colorado, and she said the only way she would come home was if we brought her dog, Bella. So we did. Luckily, for all of us, she was willing to get into drug treatment.  She went to an outdoor wilderness program in Utah for five weeks and then on to Safe Harbor Residential Drug Treatment Center for Women in Costa Mesa for three months. She lived for about six months in a Safe Harbor Sober Living home. Her dad found a loving home for her dog. Bella.

We have been very lucky with our daughter, because she finally did decide to make some good choices. Her recovery has not been perfect, but I have been forever grateful that she did not have the dramatic relapses that so many addicts and  parents have had to go through.

After six years, she continues to do well, earning her college degree in southern California in June of 2009, and now works at a job in her field that she enjoys. She has moved on with her life, but what she has learned, in treatment is still close to her heart. She is indeed a changed person, and would not be the person she is today, had addiction not entered her life.

What I have learned is this. Addiction comes into your life for a reason. I was most likely living in a fog until drug addiction entered my life, and it was the wake up call I needed to pay attention, look at my life choices and seek inner peace and serenity. There is no finish line for addiction, not for the addict nor for the addict’s parents. We both continue on, the addict hopefully managing their disease and their parents hoping that their child manages their disease.

The greatest gift I have learned from this whole experience is that addiction does not discriminate as well as the importance of letting go. Addiction can enter any family, regardless of their race, economic situation or upbringing. Letting go does not mean I lose interest in my child or their struggles. Letting go means I love and respect my child, but I let them follow their path and find their own way to recovery if that is their choice. I will offer them resources if I am able, but I will let go of trying to control their disease.

For most of us parents, that is the hardest lesson, that lesson of letting go. We want to fix our children’s problems and make everything better. It breaks our hearts, and goes against what the word “parent” stands for. It is however necessary, not only when our child is an addict, but when any of our children reach adulthood and are ready to spread their wings. We need to let go and let our children fly alone.

Posted in:  Education Tags: addict, addiction, crystal meth, daughter, Family of addict, life, meth, Parents of addict

Evolution of Addiction Treatment – California learning

December 1st, 2011

Addiction conferences are getting more and more common, and quite a few nowadays showcase the talents of some very knowledgeable, and renowned, addiction experts. Coming from the academic side of things, I’ve been to conferences held by the American Psychological Association, the American Public Health Association, the Society for Neuroscience, and the College on Problems of Drug Dependence.

When it comes to more clinical, or addiction treatment oriented, conferences, I think our readers would be hard pressed to find a better conference than the Evolution of Addiction Treatment conference about to take place at the Westin Hotel by the Los Angeles airport in just over a week (December 8th-11th). Some of the biggest names in addiction research and addiction treatment will be there including Drs Allen Berger and David Mee-Lee who have both contributed greatly to the field of addiction during their decades of work. The conference would be worth it even if they were the only ones speaking.

But they’re not. There are literally dozes of speakers and 3.5 full days of amazing talks. If you decide to go, we even arranged for a discount for you by entering the code “AAA10″ before you pay. We’ll have a little booth set up in the hall if you want to come by and say “hi” but more than anything, we’d love for you to have the opportunity to learn as much as you can about addiction and addiction treatment options so that you can continue to carry the message that there is more than hope, there’s treatment that works!

See you there!

Posted in:  Education, Links, Treatment Tags: addiction, conference, conferences, evolution of addiction treatment, treatment, Treatment

Internet addiction – Epidemic or fad?

November 24th, 2011

By Adi Jaffe, Ph.D., and Yalda Uhls, MA, MBA

1 in 3 people consider the Internet to be as important as air, water, food and shelter. Given how intensely people feel about this technology, is it any wonder that some psychologists are convinced that Internet addiction is a real pathology?  True, claiming that people are as dependent on the Internet as they are on air, food, or water is obviously a non-starter; it’s pretty clear that the actual role of technology is far less compulsory in terms of human survival.

But does this kind of dependence, compulsory or otherwise, qualify as an addiction?

While the DSM only currently recognizes specific dependence on substances as an addiction, it is apparent that a subset of people who overuse the Internet and digital media tools also display behaviors exhibited by substance abusers.  In the last decade, as the problem became more widely acknowledged, a few psychological measures have been developed to identify Internet addiction. While none of these are perfect, certain measures are becoming more accepted in the field (like Young’s Internet Addiction Test).  Using these scales, studies have identified correlates of Internet addiction and found that ADHD, depression, social phobia and hostility were all linked to excessive Internet use, a pattern reminiscent of correlates of alcohol and drug addictions as well.

The internet is just a tool, why should people who overuse it be considered addicts?

Some of the most compelling evidence comes from Asia.  In Korea, a country where technology is deeply enmeshed in the culture and Internet cafes abound, Internet addiction is considered one of the country’s most serious problems.  In the last decade, many people have died after marathon sessions of playing online video games, presumably from exhaustion and lack of nutrition, as they ignored their basic needs so they could continue to play a game. It’s a bit reminiscent of animal studies in which rats with electrodes implanted in their dopamine “pleasure centers” forgo food for lever presses to their own demise.  China has struggled with similar issues and in 2007 the country restricted game use to less than three hours a day (it’s important to note that there’s some loose consensus that more than 38 hours of recreational internet use a week is problematic).  In Korea, where they may be ahead of the curve in terms of dealing with the issue, more than 1,000 counselors have been trained in the treatment of Internet addiction and nearly 200 hospitals enlisted in the effort.  Moreover, preventive measures were recently introduced in schools and free Internet rescue camps are offered throughout the country.

In America, current estimates are that a child between the ages of 8-18 uses digital media nearly eight hours a day, while extreme users spend up to 12 hours a day with media, every day of the week.  Children are spending more time with screens than with their parents or at school; are we doing enough to protect vulnerable children from developing an addiction to the Internet?  No laws currently exist to protect children from excessive internet use. Doesn’t society have a responsibility to protect children, in the way we attempt to protect them from drugs and alcohol? If so, what would such protection look like and how would it be enforced?

You might be asking yourself whether people are actually addicted to the Internet itself or whether the Internet is simply a tool where other more basic pathologies, such as poor impulse control or social phobias, or fetishes are played out?

In the case of certain online behaviors, it may be simple to define the behavior as problematic because similar behavior offline has long been established as socially unacceptable when performed to excess.  For example, well established addictive behaviors such as gambling or sexual activity are easily played out online.   Even respected public leaders such as former congressman Anthony Weiner admit they have problems that are beyond their own control and that they need professional treatment.  In case you haven’t heard about Weiner, he was the Congressman who resigned after being exposed for texting sexually explicit photos of himself to constituents he had never met. Sounds like something an ignorant teenager might do right?  So when does this kind of behavior cross the threshold to compulsion or addiction when performed repeatedly?

Examples such as Weiners’ may be relatively easy to identify as a problematic compulsion but when online behavior is sanctioned by society as in the case of sending non-sexual texts, emails, or surfing the Internet for hours on end, it is more difficult to determine exactly when the line between normal and dysfunctional is crossed. Indeed, when one considers the “crackberry” nickname given to certain smart phones, a direct comparison to addiction seems relevant. Nevertheless, those who constantly check emails at the dinner table, on vacations, and while driving, are often extremely successful executives whose business culture demands this level of connectedness.  Indeed, some schools even promote the use of digital media as an exciting learning tool; for example, the curriculum for one elementary school in New York is designed entirely around video games. Given the potential for harmful behavior, how do we reconcile overuse of the Internet when our culture often validates and supports its use?

With all of these difficult issues still to be resolved, the answer to the question of whether or not Internet addiction is the same as substance abuse is obviously not yet, and may never be, crystal clear.  However, according to everything we know right now, there’s no question that for at least a subset of Internet users, online life can become disruptive to normal functioning. The question is how to minimize that sort of risk as our society becomes more and more globally dependent on technology.

If you think you might have a problem with the Internet, ask yourself the following questions – if you answer yes to more than 5 of these problems, you may need to seek treatment.

1. Do you often feel preoccupied with the Internet (think about previous online activity or anticipate next online session)?
2. Do you feel the need to use the Internet with increasing amounts of time in order to achieve satisfaction?
3. Have you repeatedly made unsuccessful efforts to control, cut back, or stop your Internet use?
4. Do you feel restless, moody, depressed, or irritable when attempting to cut down or stop Internet use?
5. Do you stay online longer than originally intended?
6. Have you jeopardized or risked the loss of significant relationship, job, educational or career opportunity because of the Internet?
7. Have you lied to family members, therapist, or others to conceal the extent of your involvement with the Internet?
8. Do you use the Internet as a way of escaping from problems or of relieving a dysphoric mood (e.g., feelings of helplessness, guilt, anxiety, depression)?

As with other compulsive or addictive behavioral patterns, the key to combating internet-addiction-like symptoms is to intervene early. Since many addicts start out using their respective drug/behavior of choice as a coping mechanism, realizing early on that unhealthy patterns of behavior are developing is crucial. If a child draws his or her self-esteem from retreat into the online world, it would be extremely helpful to find additional activities that could similarly boost confidence. If compulsive use patterns do develop, it is likely going to take a concerted effort to break them without bringing up serious resistance. Techniques such as Motivational Interviewing (MI) will likely prove as useful in this domain as they have with substance abuse and addiction – gentle guidance is often more effective than cornering a troubled individual and forcing them to act.

The good news? Internet withdrawal is not likely to cause much in terms of physiological withdrawal symptoms, so if cutting off access does become necessary, at least there’s no risk of going into shock, cardiac arrest, or DT-like symptoms. Still, expect that psychological withdrawal-like symptoms will be similar to those experienced with many drugs: Depression, anhedonia, anxiety, irritableness, sleep disturbances, and more are all likely to be part of the picture. If we’re talking about cutting off a child, expect screaming… lot’s of screaming.

 

For more information about technology and its effects on human development, visit Yalda T. Uhls’ website:  Inthedigitalage.com

 

Citations:

Cisco Survey on Internet, 2011: http://www.cisco.com/en/US/netsol/ns1120/index.html

American Psychiatric Association. (2008). Issues for DSM-V: Internet addiction.

Byun, S., Ruffini, C. R., Mills, J. E., Douglas, A. C., Niang, M., Stephchenkova, S., Lee, S. K., et al. (2009). Internet addiction: Metasynthesis of 1996-2006 quantitative research. Cyberpsychology and Behavior, 12(2), 203-207.

Christakis, D. A. (2010). Internet addiction: A 21st century epidemic? BMC Medicine, 8.

Young, K.S. (1998). Internet addiction: The emergence of a new clinical disorder. CyberPsychology & Behavior 1:237-244.

Posted in:  Education Tags: addiction, anthony weiner, behavior, internet, internet addiction, internet use, online, use, Weiner