Article Beyond Information Overload and Stress: A Plea to Acknowledg...

An interesting commentary has come up which appeals to acknowledge the complexity of problematic Internet use and consider individualized intervention strategies. Authors have taken upon a previously published article entitled "

Addictive Influences and Stress Propensity in Heavy Internet Users: A Proposition for Information Overload Mediated Neuropsychiatric Dysfunction" by Kumar et al 2017.

Though, in the title this commentary presents a necessary recommendation which can be principally agreed to any neuropsychiatric disorder, it fails, to realize the scarcity of scientifically designed studies in this field. Though, more of the theoretical discussion may help to identify yet unrecognized aspects of this problem, it doesn't help to identify the components of its complex etiology or suggests any individualized treatment strategy.

Authors also missed to realize that like any other neuropsychiatric disorder ill health effects of problematic internet use may not limit to the vulnerable or predisposed, but may also invlove previously healthy individuals.

Fortunately, this neglected field is getting fast recognition and many studies have been published in recent years which associate a range of mental ill health effects associated with excessive internet use and identify its addictive potentiality. Still, available original studies are not suffient to set the terminologies or definitions, or to suggest individualized treatment strategies. Kumar et al discribed these limitations in detail. They also caution against a prevalent tendency to categorize the mental ill health effects arising problematic use of internet as addiction or substance abuse disorders, and trying any pharmacological treatment for this, in absence of adequate number of scientifically designed studies. Though, in lack of the established treatment strategies, the medical practiceners may help the individuals visiting their OPD with the health complaints with certain non-pharmacological approaches which are already in use to alleviate the stress or mental strain, and would considerably cause no harm. Below are few excerpts from the article by Kumar et al.

1. ...Although current Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-V) does not recognize compulsive internet overuse as a mental illness, there is now sufficient evidence that certain psychological, neurological, and physical health problems arising from it do exist [60-62]. It needs an ardent emphasis that health problems associated with internet overuse should be clearly differentiated from drug addiction and substance abuse. The clinical characteristics of compulsive internet overuse and withdrawal may be milder than the drug addiction and substance abuse but, nevertheless, do exist [32, 33].

2. Scientific literature now provides some important details of brain regions affected in heavy internet users. Major affected brain regions have been noted: those involved in decision making and impulse control - prefrontal cortex [20, 41, 42], memory - hippocampus [29, 42, 43], and habit formation - basal ganglia or nuclei [23, 44, 45]. The many structurally and/or functionally connected brain regions constitute the system responsible for controlling specific behavioural aspects of an organism. In addiction and also in internet overuse the systems implicated/involved are those controlling motivational behaviour-reward system, and emotionlimbic system [46, 47].

3. Certain life conditions (solitude, loneliness, bereavement, depression, psychiatric disorders etc.) are known to make an individual prone for internet overuse [94]. Individuals suffering from such problems find solace in overuse of internet and also reach out more towards SNS [95]. Adolescents are more prone to this habit as they are for addictive disorders. Internet overuse has also been shown to cause a plethora of mental health problems in such individuals [96, 97] presumably due to incomplete maturity of the decision making faculties and brain structures (prefrontal cortex, which maintains an inhibitory control over reward system) in adolescents [98]. Academic stress and negative emotions have also been suggested as the risk factors for compulsive internet overuse in adolescents [99].

4. Definitive diagnostic criteria for health problems caused by heavy internet use have not yet been established institutionally although a few individual scale reports have proposed important preliminary guidelines [73]. We suggest that in case of the presence of one or more stated clinical characteristics (as mentioned in Table 2), stress caused by internet overuse should also be suspected as one possible etiological factor, and logical remissive approaches should be advised after ruling out other competing hypotheses. As the etiomechanism of the ill health effects caused by internet overuse resembles that of the chronic stress, non-medicinal remissive approaches applied for it will hardly be harmful (even if the actual etiological factor is missed in the diagnosis). Owing to non-recognition of the compulsive internet overuse as a clinical entity, designated therapeutic modules for the consequent health ailments are largely lacking.

Article Addictive Influences and Stress Propensity in Heavy Internet...