Effects of Cognitive-Behavioral Therapy Based Music Therapy in Korean Adolescents with Smartphone and Internet Addiction

Su Hyun Bong, Geun Hui Won, Tae Young Choi, Su Hyun Bong, Geun Hui Won, Tae Young Choi

Abstract

Objective: The purpose of this study was to evaluate the effects of adding music therapy (MT) to cognitive-behavioral therapy (CBT) on symptoms of smartphone/internet addiction and psychiatric comorbidities.

Methods: Overall, 155 patients diagnosed with addiction were assigned to either the CBT-MT group or CBT group. Both groups received CBT for 8 weeks, while the CBT-MT group received additional MT. The intervention was completed by 67 and 71 participants in the CBT-MT and CBT groups, respectively.

Results: The total scores of Young Internet Addiction Scale (YIAT) and Smartphone Addiction Proneness Scale (SAPS) decreased significantly (p<0.001 for both) in both groups, while the total scores of State Anxiety Inventory for Children (SAIC) (p<0.001), Trait Anxiety Inventory for Children (TAIC) (p<0.001), Conners-Wells' Adolescent Self-Report Scale-Short form (CASS(S)) (p=0.048), and Barratt Impulsiveness Scale-11 (BIS-11) (p<0.001) decreased only in the CBT-MT group. The decrements in YIAT (p=0.025), SAIC (p=0.043), TAIC (p=0.011), and BIS-11 (p=0.012) in the CBT-MT group were significantly greater than those in the CBT group.

Conclusion: Combined MT and CBT improved the symptoms of smartphone/internet addiction, anxiety, and impulsivity in adolescents. This combination could therefore be an effective treatment of smartphone or internet addiction along with behavioral disorders such as anxiety and impulsivity.

Keywords: Addictive behavior; Cognitive-behavioral therapy; Internet; Music therapy; Smartphone.

Conflict of interest statement

The authors have no potential conflicts of interest to disclose.

Figures

Figure 1.
Figure 1.
Flowchart depicting the study design. MT: music therapy, CBT: cognitive behavioral therapy

References

    1. National Information Society Agency 2018 The survey on Smarphone overdependence. Available at: . Accessed October 20, 2019.
    1. American Psychiatric Association . Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington, VA: American Psychiatric Association; 2013.
    1. WHO ICD-11 Revision 2018. Available at: . Accessed October 20, 2019.
    1. King DL, Delfabbro PH. Internet gaming disorder treatment: a review of definitions of diagnosis and treatment outcome. J Clin Psychol. 2014;70:942–955.
    1. Han SA, Lee HM. Concern with online game addiction and juvenile delinquency. Korean Crim Psychol Rev. 2006;2:229–244.
    1. Bozkurt H, Coskun M, Ayaydin H, Adak I, Zoroglu SS. Prevalence and patterns of psychiatric disorders in referred adolescents with internet addiction. Psychiatry Clin Neurosci. 2013;67:352–359.
    1. Cao F, Su L, Liu T, Gao X. The relationship between impulsivity and internet addiction in a sample of Chinese adolescents. Eur Psychiatry. 2007;22:466–471.
    1. Carli V, Durkee T, Wasserman D, Hadlaczky G, Despalins R, Kramarz E, et al. The association between pathological internet use and comorbid psychopathology: a systematic review. Psychopathology. 2013;46:1–13.
    1. Kim K, Ryu E, Chon MY, Yeun EJ, Choi SY, Seo JS, et al. Internet addiction in Korean adolescents and its relation to depression and suicidal ideation: a questionnaire survey. Int J Nurs Stud. 2006;43:185–192.
    1. Lee YS, Han DH, Kim SM, Renshaw PF. Substance abuse precedes internet addiction. Addict behav. 2013;38:2022–2025.
    1. Mak KK, Lai CM, Watanabe H, Kim DI, Bahar N, Ramos M, et al. Epidemiology of internet behaviors and addiction among adolescents in six Asian countries. Cyberpsychol Behav Soc Netw. 2014;17:720–8.
    1. Yen JY, Ko CH, Yen CF, Wu HY, Yang MJ. The comorbid psychiatric symptoms of Internet addiction: attention deficit and hyperactivity disorder (ADHD), depression, social phobia, and hostility. J Adolesc Health. 2007;41:93–98.
    1. Yoo YS, Cho OH, Cha KS. Associations between overuse of the internet and mental health in adolescents. Nurs Health Sci. 2014;16:193–200.
    1. Young KS, Rogers RC. The relationship between depression and internet addiction. Cyberpsychol Behav. 1998;1:25–28.
    1. Beck AT. Cognitive Therapy and the Emotional Disorders. Oxford: International Universities Press; 1976.
    1. Davis RA. A cognitive-behavioral model of pathological internet use. Comput Hum Behav. 2001;17:187–195.
    1. Young KS. Cognitive behavior therapy with internet addicts: treatment outcomes and implications. Cyberpsychol Behav. 2007;10:671–679.
    1. Young KS. Treatment outcomes using CBT-IA with internet-addicted patients. J Behav Addict. 2013;2:209–215.
    1. Kim SM, Han DH, Lee YS, Renshaw PF. Combined cognitive behavioral therapy and bupropion for the treatment of problematic on-line game play in adolescents with major depressive disorder. Comput Hum Behav. 2012;28:1954–1959.
    1. Kim SH, Yim HW, Jo SJ, Jung KI, Lee K, Park MH. The effects of group cognitive behavioral therapy on the improvement of depression and anxiety in adolescents with problematic internet use. J Korean Acad Child Adolesc Psychiatry. 2018;29:73–79.
    1. Du YS, Jiang W, Vance A. Longer term effect of randomized, controlled group cognitive behavioural therapy for internet addiction in adolescent students in Shanghai. Aust N Z J Psychiatry. 2010;44:129–134.
    1. Lee H, Seo MJ, Choi TY. The effect of Home-based Daily Journal writing in Korean adolescents with Smartphone addiction. J Korean Med Sci. 2016;31:764–769.
    1. Stevens MWR, King DL, Dorstyn D, Delfabbro PH. Cognitive-behavioral therapy for Internet gaming disorder: a systematic review and meta analysis. Clin Psychol Psychother. 2018;26:191–203.
    1. Chae YG. The development and effect of arts psychotherapy program for game overflow of adolescents. Kor J Counsel. 2006;7:885–898.
    1. Aalbers S, Fusar Poli L, Freeman RE, Spreen M, Ket JC, Vink AC, et al. Music therapy for depression. Cochrane Database Syst Rev. 2017;11:CD004517.
    1. Hohmann L, Bradt J, Stegemann T, Koelsch S. Effects of music therapy and music-based interventions in the treatment of substance use disorders: a systematic review. PLoS One. 2017;12:e0187363.
    1. Cha ES, Kim TH. Effects of the group music therapy on behavior, self-control, social interaction and stress for the Internet-Addicted students in elementary school. Youth Facilities Environ. 2013;11:79–91.
    1. Lee EH, Bang SA. The effectiveness of music therapy program on self efficacy of juveniles with Internet game addiction. J Korea Acad Industr Coop Soc. 2012;13:2520–2527.
    1. Yeo JY. A case study of individual music therapy on adolescent with internet addiction. Korean J Music Ther. 2010;12:16–40.
    1. Czamanski-Cohen J, Weihs KL. The bodymind model: a platform for studying the mechanisms of change induced by art therapy. Arts Psychother. 2016;51:63–71.
    1. Kokal I, Engel A, Kirschner S, Keysers C. Synchronized drumming enhances activity in the caudate and facilitates prosocial commitment--if the rhythm comes easily. PLoS One. 2011;6:e27272.
    1. Young KS. Caught in the Net: How to Recognize the Signs of Internet Addiction and a Winning Strategy for Recovery. New York: John Wiley; 1998.
    1. Kim D, Lee Y, Lee J, Nam JK, Chung Y. Development of Korean smartphone addiction proneness scale for youth. PLoS One. 2014;9:e97920.
    1. Kim MS. Development of the Children’s Social Support Scale. Fam Environ Res. 1995;33:37–47.
    1. Barnes HL, Olson DH. Parent-adolescent communication and the circumplex model. Child Develop. 1985;56:438–447.
    1. Beck AT. Beck Depression Inventory-II. San Antonio, TX: The Psychological Corporation; 1996.
    1. Sung HM, Kim JB, Park YN, Bai DS, Lee SH, Ahn HN. A study on the reliability and the validity of korean version of the Beck Depression Inventory-II (BDI-II) J Korean Soc Biol Ther Psychiatry. 2008;14:201–212.
    1. Spielberger CD, Gorsuch RL, Lushene RE. Manual for the State-Trait Anxiety Inventory for Children. Palo Alto, CA: Consulting Psychologists Press; 1970.
    1. Cho SC, Choi JS. Development of the Korean form of the State-Trait anxiety Inventory for Children. Seoul J Psychiatry. 1989;14:150–157.
    1. Rosenberg M. Rosenberg Self-Esteem Scale (SES) Princeton, NJ: Princeton University Press; 1965.
    1. Jeon BJ. Self-esteem: a test of its measurability. Yonsei Nonchong. 1974;11:109–129.
    1. Bahn GH, Shin MS, Cho SC, Hong KE. A preliminary study for the development of the assessment scale for ADHD in adolescents: reliability and validity for CASS(S) J Korean Acad Child Adolesc Psychiatry. 2001;12:218–224.
    1. Barratt ES. Anxiety and impulsiveness related to psychomotor efficiency. Percept Motor Skill. 1959;9:191–198.
    1. Lee SR, Lee WH, Park JS, Kim SM, Kim JW, Shim JH. The study on reliability and validity of Korean version of the Barratt Impulsiveness Scale11-Revised in nonclinical adult subjects. J Korean Neuropsychiatr Assoc. 2012;51:378–386.
    1. National Association of Korean Music Therapists What is Music Therapy? Available at: . Accessed September 30, 2019.
    1. Edgerton CL. The effect of improvisational music therapy on the communicative behaviors of autistic children. J Music Ther. 1994;31:31–62.
    1. Edwards J. The Oxford Handbook of Music Therapy. Oxford: Oxford University Press; 2016.
    1. Geretsegger M, Elefant C, MÖssler KA, Gold C. Music therapy for people with autism spectrum disorder. Cochrane Database Syst Rev. 2014;2014:CD004381.
    1. Pavlicevic MJ. Improvisation in music therapy: human communication in sound. J Music Ther. 2000;37:269–285.
    1. Soshensky R. Everybody is a star: recording, performing, and community music therapy. Music Ther Perspect. 2011;29:23–30.
    1. Zhang F, Liu K, An P, You C, Teng L, Liu Q. Music therapy for attention deficit hyperactivity disorder (ADHD) in children and adolescents. Cochrane Database Syst Rev. 2017;2017:CD010032.
    1. Choi TY, Jang HJ, Lee HJ, Seo ES, Jang SY, Chung YK. Game immersion music therapy program manual. Game Culture Foundation. Available at: . Accessed October 20, 2019.
    1. Winkler A, D?rsing B, Rief W, Shen Y, Glombiewski JA. Treatment of internet addiction: a meta-analysis. Clin Psychol Rev. 2013;33:317–329.
    1. Sakong JK. Internet addiction. J Korean Soc Biol Ther Psychiatry. 2002;8:176–185.
    1. Lee H, Choi TY. The psychosocial approaches of Internet/Game addiction. J Korean Soc Biol Ther Psychiatry. 2015;21:65–72.
    1. Bolton OK, Scherer DG. Therapeutic engagement with adolescents in psychotherapy. Psychother-Theor Res. 2003;40:215–225.
    1. Kazdin AE. Dropping out of child psychotherapy: issues for research and implications for practice. Clin Child Psychol Psychiatry. 1996;1:133–156.
    1. Minty B, Anderson C. Non-attendance at initial out-patient appointments at a hospital-based child psychiatric clinic. Clin Child Psychol Psychiatry. 2004;9:403–418.
    1. Jang HJ, Kim JW, Choi TY. The effect of group therapy using art program on Internet/Smartphone addictive behaviors of adolescents: a pilot study. J Korean Soc Biol Ther Psychiatry. 2017;23:171–180.
    1. Saba L, Byrne A, Mulligan A. Child art psychotherapy in CAMHS: which cases are referred and which cases drop out? Springerplus. 2016;5:1816.
    1. Yeun YR, Han SJ. Effects of psychosocial interventions for school-aged children’s Internet addiction, self-control and self-esteem: meta-analysis. Healthc Inform Res. 2016;22:217–230.
    1. Seo MJ, Choi TY, Woo JM, Kim JH, Lee JH. A comparative study of smartphone and internet addiction on adolescent psychopathology. J Korean Soc Biol Ther Psychiatry. 2013;19:154–162.
    1. Wong PWC. Potential changes to the hikikimori phenomenon in the wake of the Covid-19 pandemic. Asian J Psychiatr. 2020;54:102288.
    1. Kato TA, Sartorius N, Shinfuku N. Forced social isolation due to COVID 19 and consequent mental health problems: Lessons from hikikomori. Psychiatry Clin Neurosci. 2020;74:506–507.
    1. Tateno M, Teo AR, Ukai W, Kanazawa J, Katsuki R, Kubo H, et al. Internet addiction, smartphone addiction, and hikikomori trait in Japanese young adult: social isolation and social network. Front Psychiatry. 2019;10:455.
    1. King DL, Delfabbro PH, Billieux J, Potenza MN. Problematic online gaming and the COVID-19 pandemic. J Behav Addict. 2020;9:184–186.

Source: PubMed

Sponsors and Collaborators

Medical Conditions

Drug Interventions

3
Subscribe