Guideline on Early Interventions for Internet Use Disorders

Introduction: Early interventions targeting individuals with initial symptoms of Internet use disorders have the potential to prevent disorder escalation and reduce first symptoms. Given that Internet use disorders, including gaming disorder and social network use disorder, often emerge during adolescence, early interventions for children and adolescents are crucial from both clinical and public health perspectives. These interventions typically focus on selective or indicated prevention strategies, addressing both individuals at risk and their significant others. Methods: This systematic review was conducted as part of the development of the AWMF S1 guideline on Internet use disorders. A PICO framework guided the formulation of clinical questions. A systematic literature search in Web of Science and PubMed (2011–2021) yielded 1,719 studies, from which 40 were selected for full-text analysis. Nine studies met the inclusion criteria and were evaluated using CONSORT guidelines. Evidence levels and recommendation strengths were assigned according to the Oxford Centre for Evidence-Based Medicine (CEBM) and AWMF guidelines, respectively. Results: Nine studies, primarily focusing on gaming and social network use disorders, supported the development of six recommendations for early interventions. Four randomized controlled trials (RCTs) demonstrated that indicated prevention programs in educational settings significantly reduced Internet use disorder symptoms. Cognitive-behavioral therapy (CBT) was identified as the preferred intervention approach. A longitudinal study supported the use of CBT in counseling centers for adolescents with subclinical Internet use disorder symptoms. Parent-focused interventions and online interventions also showed promising results. Discussion: The evidence supports the implementation of early intervention programs for Internet use disorders in educational, counseling, and family settings. Especially CBT was effective in reducing Internet use disorder symptoms. However, further research is needed to assess long-term outcomes and address gaps in early interventions for adult populations and less-studied forms of Internet use disorders, such as pornography use and compulsive shopping.