Internet Addiction Spawns US Treatment Programs

網路成癮在美催生(spawn)治療計畫

When Danny Reagan was 13, he began exhibiting signs of what doctors usually associate with drug addiction. He became agitated, secretive and withdrew from friends. He had quit baseball and Boy Scouts, and he stopped doing homework and showering.

      丹尼．雷根（Danny Reagan）13 歲時開始顯現出(exhibit)醫生們常會聯想到的藥物成癮跡象：他變得躁動不安(agitate)，行事詭異(secretive)且與朋友疏離(withdraw from . . .)；不僅放棄打棒球、退出男童軍，連作業也不寫，澡更不洗了。

◎ e自學空間寒假閉館公告

◎ 英語自學認證資訊

◎ 線上菲律賓語課程

線上菲律賓語課程開課囉~

外語教學暨資源中心專為本校教職員工生、退休教職員工及校友編製了線上菲律賓語課程，內容涵蓋了生活必需的 6 大主題，還有真人情境對話影片帶給您身歷其境的學習體驗，讓您輕鬆學會基礎菲律賓語會話。

詳情請見：東南亞語言暨文化資源網站首頁 → 線上菲律賓語課程

《電話英語》《一天看完的電話英文》

當您接到電話彼端傳來霹靂叭啦一連串英文時，您是否會覺得慌張到想掛電話? 英文會話已夠有壓力了，但至少面對面還可觀察對方眼神、表情及靠手勢來掌控氣氛，但在電話中的對談就很難理解雙方的反應。 別擔心，在此推薦兩本實用的學習書籍「電話英語」及「一天看完的電話英文」。顧名思義，書的內容就是提供您在日常生活上（接/聽/轉/留言/答錄機）、職場上（詢問/下單接單/客訴）、旅遊上（預約機票/住宿/餐飲娛樂）、緊急求救上（車禍/故障/報警/救護車）會碰到的情況所設計的電話英語基本句型，而且每一種句型更提供數種不同說法讓您選擇應用。相信熟讀後必能增加英語能力外，更有助於提升自信心，下次電話鈴響時再也不會結結巴巴了。
書籍置於本中心e自學空間—英語自學區之"說"區，歡迎前來多加利用。

Internet Addiction Spawns US Treatment Programs
VOA News
January 28, 2019 3:31 PM Associated Press (source)

Internet Addiction Spawns US Treatment Programs

網路成癮在美催生(spawn)治療計畫

January 28, 2019 3:31 PM

Associated Press

Cincinnati—

When Danny Reagan was 13, he began exhibiting signs of what doctors usually associate with drug addiction. He became agitated, secretive and withdrew from friends. He had quit baseball and Boy Scouts, and he stopped doing homework and showering.

But he was not using drugs. He was hooked on YouTube and video games, to the point where he could do nothing else. As doctors would confirm, he was addicted to his electronics.

"After I got my console, I kind of fell in love with it," Danny, now 16 and a junior in a Cincinnati high school, said. "I liked being able to kind of shut everything out and just relax."

Danny was different from typical plugged-in American teenagers. Psychiatrists say internet addiction, characterized by a loss of control over internet use and disregard for the consequences of it, affects up to 8 percent of Americans and is becoming more common around the world.

"We're all mildly addicted. I think that's obvious to see in our behavior," said psychiatrist Kimberly Young, who has led the field of research since founding the Center for Internet Addiction in 1995. "It becomes a public health concern obviously as health is influenced by the behavior."

Psychiatrists such as Young who have studied compulsive internet behavior for decades are now seeing more cases, prompting a wave of new treatment programs to open across the United States. Mental health centers in Florida, New Hampshire, Pennsylvania and other states are adding inpatient internet addiction treatment to their line of services.

Some skeptics view internet addiction as a false condition, contrived by teenagers who refuse to put away their smartphones, and the Reagans say they have had trouble explaining it to extended family.

Anthony Bean, a psychologist and author of a clinician's guide to video game therapy, said that excessive gaming and internet use might indicate other mental illnesses but should not be labeled independent disorders.

"It's kind of like pathologizing a behavior without actually understanding what's going on," he said.

'Reboot'

At first, Danny's parents took him to doctors and made him sign contracts pledging to limit his internet use. Nothing worked, until they discovered a pioneering residential therapy center in Mason, Ohio, about 22 miles (35 km) north of Cincinnati.

The "Reboot" program at the Lindner Center for Hope offers inpatient treatment for 11 to 17-year-olds who, like Danny, have addictions including online gaming, gambling, social media, pornography and sexting, often to escape from symptoms of mental illnesses such as depression and anxiety.

Danny was diagnosed with Attention Deficit Hyperactivity Disorder at age 5 and Anxiety Disorder at 6, and doctors said he developed an internet addiction to cope with those disorders..

"Reboot" patients spend 28 days at a suburban facility equipped with 16 bedrooms, classrooms, a gym and a dining hall.

They undergo diagnostic tests, psychotherapy, and learn to moderate their internet use.

Chris Tuell, clinical director of addiction services, started the program in December after seeing several cases, including Danny's, where young people were using the internet to "self-medicate" instead of drugs and alcohol.

The internet, while not officially recognized as an addictive substance, similarly hijacks the brain's reward system by triggering the release of pleasure-inducing chemicals and is accessible from an early age, Tuell said.

"The brain really doesn't care what it is, whether I pour it down my throat or put it in my nose or see it with my eyes or do it with my hands," Tuell said. "A lot of the same neurochemicals in the brain are occurring."

Even so, recovering from internet addiction is different from other addictions because it is not about "getting sober," Tuell said. The internet has become inevitable and essential in schools, at home and in the workplace.

"It's always there," Danny said, pulling out his smartphone.

"I feel it in my pocket. But I'm better at ignoring it."

Is it a real disorder?

Medical experts have begun taking internet addiction more seriously.

Neither the World Health Organization (WHO) nor the American Psychiatric Association recognize internet addiction as a disorder. Last year, however, the WHO recognized the more specific Gaming Disorder following years of research in China, South Korea and Taiwan, where doctors have called it a public health crisis.

Some online games and console manufacturers have advised gamers against playing to excess. YouTube has created a time monitoring tool to nudge viewers to take breaks from their screens as part of its parent company Google's "digital wellbeing" initiative.

WHO spokesman Tarik Jasarevic said internet addiction is the subject of "intensive research" and consideration for future classification. The American Psychiatric Association has labeled gaming disorder a "condition for further study."

"Whether it's classified or not, people are presenting with these problems," Tuell said.

Tuell recalled one person whose addiction was so severe that the patient would defecate on himself rather than leave his electronics to use the bathroom.

Research on internet addiction may soon produce empirical results to meet medical classification standards, Tuell said, as psychologists have found evidence of a brain adaptation in teens who compulsively play games and use the internet.

"It's not a choice, it's an actual disorder and a disease," said Danny. "People who joke about it not being serious enough to be super official, it hurts me personally."

丹尼．雷根（Danny Reagan）13 歲時開始顯現出(exhibit)醫生們常會聯想到的藥物成癮跡象：他變得躁動不安(agitated)，行事詭異(secretive)且與朋友疏離(withdraw from . . .)；不僅放棄打棒球、退出男童軍，連作業也不寫，澡更不洗了。

然而他並無吸食毒品，而是對YouTube 與電玩著迷(hook on . . .)到無心做任何事的地步，經醫生確診後證實為電子產品(electronics)成癮(be addicted to . . .)所致。

「遊戲主機(console)一到手後，我就好像愛上它了。」目前 16 歲，在美國俄亥俄州（Ohio）辛辛那提市（Cincinnati）一所高中就讀高三（11 年級）的丹尼說。「我喜歡那種把所有事拋諸腦後，只求放鬆的感覺。」

丹尼不同於美國時下經常使用電子產品的(plugged-in)青少年。精神科醫師(psychiatrist)說，網路成癮(addiction)最大的特點在於對網路的使用失去控制，並忽視(disregard for . . .)其後果。近 8% 的美國人受其影響(affect)，而在全球也愈發普遍。

「我們略微地(mildly)都有成癮的情況。我想這在我們行為中是顯而易見的。」精神科醫師金柏莉．楊格（Kimberly Young）說道。她自 1995 年創立(found)網路成癮治療中心（the Center for Internet Addiction）起，便一直是這研究領域的先驅。「由於健康受到這種行為影響，想當然耳地也就成為公眾健康議題。」她說。

像楊格醫師一樣鑽研強迫性(compulsive)網路行為數十年的精神科醫生，如今都發現了越來越多的個案，因而在全美促成(prompt)一股新的治療計畫風潮。在佛州（Florida）、新罕布夏州（New Hampshire）、賓州（Pennsylvania）和其他州的心理衛生中心都紛紛將網路成癮的住院(inpatient)治療列入他們的服務項目中。

有些對網路成癮抱持質疑觀點的人(skeptic)，認為其不過是個青少年用來拒絕放下他們手機而謀劃(contrive)的虛假託辭，而雷根家也說他們很難向整個家族解釋這是怎麼回事。

著有電玩遊戲治療臨床指南的心理學家安東尼‧賓恩（Anthony Bean）表示，過度(excessive)沉迷電玩與網路使用可能意味著患有其他精神疾病(mental illness)，不應被標記(label)為純粹的失調(disorder)。

「這比較像是將行為當作一種疾病治療(pathologize)，卻沒有了解實際情形。」他說。

「重新出發」

起初，丹尼的父母帶他去看醫師，並且讓他簽下承諾(pledge)限制網路使用的切結書。然而這些舉措卻毫無助益，直到他們發現一家創新的(pioneering)居住型治療(therapy)中心。這家中心位在俄亥俄州梅森市（Mason），距離辛辛那提北部約22哩（35公里）。

治療中心稱為「林德納希望中心（Lindner Center for Hope）」，其「重新出發」計畫針對 11 到 17 歲，像丹尼一樣對線上遊戲、賭博、社群媒體、色情影片(pornography)和色情簡訊(sexting)成癮的青少年提供住院治療。這些青少年的成癮行為往往是為了逃避如憂鬱(depression)和焦慮等精神疾病症狀。

丹尼在 5 歲及 6 歲時分別被診斷(diagnose)出有注意力不足過動症（Attention Deficit Hyperactivity Disorder，ADHD）與焦慮症（Anxiety Disorder），而醫生說他因此養成網路成癮以面對這些症狀。

「重新出發」的患者們花 28 天待在一處位於郊區的場所，其配有 16 間臥室、教室、一間健身房及一間餐廳。

他們接受(undergo)診斷(diagnostic)檢測、心理治療(psychotherapy)並學習節制(moderate)使用網路。

成癮治療的臨床(clinical)醫療主任克里斯‧圖爾（Chris Tuell）在發現包括丹尼在內的許多青少年使用網路而非藥物和酒精來「自我治療(self-medicate)」後，便於 12 月（編按：2018 年）開始了這項計畫。

圖爾表示，網路雖然還未經官方證實為成癮物質(addictive substance)，卻同樣會觸發(trigger)並釋放出能使人愉悅的化學物質來控制住大腦的回饋系統，而這項機制在幼年時期就能產生。

「大腦並不在乎造成成癮的物質是什麼，無論我是吞嚥、用鼻子聞、用雙眼看，還是用雙手操作。」圖爾說。「大腦會因此產生許多相同的神經化學物質(neurochemical)。」

即便如此，網路成癮的恢復過程並不同於其他的成癮，因為患者無法「清醒(sober)」，圖爾解釋。畢竟網路在校園、家庭和職場上都已變得無可避免(inevitable)且不可或缺。

「它一直都在那。」丹尼掏出智慧型手機說道。

「我可以感覺到它在我的口袋裡，不過現在比較能不去理會它了。」他說。

這真的是種疾病嗎？

醫學家們已開始更加認真地看待網路成癮問題。

無論是聯合國世界衛生組織（World Health Organization，WHO；以下簡稱「世衛組織」），還是美國精神醫學學會（American Psychiatric Association，APA）都將路成癮視為疾病。然而，在根據中國（China）、南韓（South Korea）與臺灣的多年研究之後，去年（編按：2018 年）世衛組織更明確指出電玩失調症（Gaming Disorder）的存在，而進行這些研究的醫生們已稱之為公眾健康危機(crisis)。

部分線上遊戲和遊戲臺製造商(manufacturer)已建議玩家們避免過度(excess)使用。YouTube 也已設置時間監測(monitor)器以敦促(nudge)觀眾從螢幕前歇息片刻，而這也是其母公司 Google 提倡的「數位健康(wellbeing)」行動其中的一環。

世衛組織發言人塔里克‧亞薩雷維奇（Tarik Jasarevic）表示，網路成癮是「密集研究（intensive research）」的主題，並考慮在未來予以分級(classification)。

美國精神醫學學會已將電玩失調症標記為「有待進一步研究的疾病(condition)」。

圖爾說：「無論失調症狀是否分級，人們都面臨了這些問題。」

圖爾回想(recall)起曾有人成癮症嚴重到寧可排泄(defecate)在自己身上，也不願放下電子產品去上廁所。

隨著心理學家發現強迫性地(compulsively)玩電玩與使用網路的青少年大腦中出現變化(adaptation)的證據後，網路成癮研究可能很快就會產生以實驗為依據的(empirical)結果，以達到醫學分類的標準，圖爾解釋道。

「這是身不由己，這是真真確確的失調與疾病。」丹尼說。「那些認為網路成癮沒有嚴重到被正式歸類為疾病，因而把它當成笑話不認真看待的人 . . . . . . 這對我個人造成了傷害。」

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