Loading solutions for the problematic use of Internet

Framing the dangers of Internet for mental health

Digital growth and users’ connectivity took the fast lane over the last decade, culminating exponentially during the recent COVID-19 pandemic. The Internet has many advantages, and European citizens continued to harness the countless functionalities deriving from it.

But in the past years, other facets of Internet practices start to be labelled ‘problematic’, because of the evident negative impact on health and well-being. Whether this takes the shape of addiction or evident harmful symptoms, there has not yet been a clear definition of “Problematic Use of Internet” (PUI). As an emerging challenge for mental health research, there have been difficulties in classifying the dangers and consequences of exposure to the Internet. The little reliable information on its prevalence, clinical parameters, brain-based biology, and socio- health-economic impact make it even more difficult to conceptualise and sort a classification system to help tackle this topic.

Addressing PUI through European-led networking

Problematic Usage of the Internet includes a variety of behaviors such as excessive gambling, gaming, pornography watching, social media use, and compulsive shopping among others. It often affects young people and those suffering from mental disorders. In many cases, it becomes amplified because of social isolation and increased reliance on digital communication. With a scattered and diversified research environment, the need to reassemble the bits of different discoveries became essential, particularly to clarify and to develop effective interventions.

It is with this goal that a European-led network of researcher gathered in 2017 to kick-start the COST Action ‘European Network for Problematic Usage of the Internet’ (EU-PUI). A first of its kind, this network invited experts in neuroscience, genetics, clinicians, and bio and information technology to jointly address this issue, in collaboration with policymakers, health service planners, and patients themselves.

This COST Action focused on leveraging the existing funded research into a more coherent programme to advance the understanding of PUI from a bio-psycho-social perspective. For this, it defined five specific goals as a roadmap to guide its four-year activities:

Share knowledge

Build research capacity

Strengthen science communication

Foster ITC integration

Tackle PUI via new approaches

With these objectives, EU-PUI envisioned to drive the brain-based research into PUI and to help with the development of clinical tools and treatments. This body of work covered a broad range of aspects requiring the involvement of various stakeholders as well as citizen participation. The distribution of the Action’s different Working Groups mirrored the need to build knowledge, put a significant focus on dissemination and communication activities, and boost citizens’ involvement.   

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Four years of EU-PUI: a breakthrough story

During its 4 years of activities, the joint efforts of EU-PUI led to tremendous outputs. From landmark events to the exhaustive dissemination material and significant press impact. This COST Action reached many milestones in its research field: identifying the associated issues and capturing the related areas has been the conductive line of the Action to move towards a clear definition of PUI.

“PUI is an umbrella term incorporating a range of repetitive impairing behaviours. The Internet can act as a conduit for, and may contribute to, functionally impairing behaviours including excessive and compulsive video gaming, compulsive sexual behaviour, buying, gambling, streaming, or social networks use.”

EU-PUI Action Chair, Prof Naomi Fineberg

Diving into the topic brought the many associated fields to the surface. Issues linked with online gaming and gambling, cyberchondria, or social media activities have been identified as specific categories with each a different potential to conclude into negative impact on human well-being.

The Action EU-PUI has worked on developing an extensive library of public resources for each thematic and made it accessible on its website preceded by a specific definition for each section.

Raising awareness through citizen engagement

It was essential for this Action to go beyond the theoretical knowledge and collect empirical input to advance its research effectively. It focused therefore on producing material with the public for the public and has built education materials out-coming from life-based feedback.

“By prioritising citizen engagement and interacting fully with the public, particularly young people, including those in ITCs, we have generated a wealth of public-facing educational material raising awareness of PUI, as a first step toward reducing stigma and establishing new forms of intervention.” Prof Naomi A Fineberg.

Their materials encompass various products such as a documentary, an e-Book, educational video-clips, and social-media blogs on different aspects of PUI suitable for introduction into schools as educational aids, all freely available on the Action’s website. The Action has established a network of members of the public with first hand experience of PUI, 191 of whom engaged in a consultation exercise about PUI in Georgia, Greece, Malta, North Macedonia, Portugal, Spain. This resulted in the Action’s first online Festival of science and Arts.

Raising the public voice on PUI at the International Festival of Science and Arts

Organised online on 28 April 2021, the International Festival of Science and Arts tackled the various aspects of PUI in a creative and engaging way with the intention of fostering a real time citizen science survey. It featured the short film “Child” to introduce the topic of online gaming and discussed social media through a vigorous debate on the Netflix documentary” Social Dilemma”. 

But the objective was to engage with the public to hear participant’s opinion on the key issues deserving research into problematic Internet use. The final discussion focused on this aspect, inviting participants in a live poll.  

Screen shot with results of a poll

In total, 418 participants from 41 countries participated, raising awareness of the burden of problematic Internet use. This festival established the public’s views on the most important research questions and health policy questions to be addressed.

Read more on this: Internet addiction, a growing challenge for everyone’s health – COST

An EU-PUI e-book by the public for the public

Book cover "Learning to deal with Problematic Usage of the Internet"

Amongst this package of resources, the book ‘Learning to deal with Problematic Usage of the Internet‘ was entirely written for the public and edited by EU-PUI in collaboration with the International College of Obsessive Compulsive Spectrum Disorders (ICOCS) and the International Obsessive Compulsive and Related Disorders Research Network of the European College of Neuropsychopharmacology (OCRN-ECNP). The book presents a concise and up to date explanation of the field, describing how to recognise the most common types of problem, current scientific theories about the causes of problematic Internet usage as well as suggestions on how those struggling to control Internet use might deal with these issues, from a lay perspective.

The book’s goal is also to act as a platform to strengthen and build an extended community of people with lived experience of PUI as a robust citizen science reference group.

Bringing research to wide audiences through art-collaborations

The Action also produced a series of animated video thanks to a creative collaboration with artists. Led by Prof Ornella Corazza from the University of Hertfordshire, this series aimed at bringing new and excellent research in the field to a wider audience, while raising awareness about the risks associated with such behaviours and providing innovative solutions. 

View this series here:

“This video project is a fantastic achievement where the arts of animation, music, sound design and addiction science come together to convey an evidence-based message on the problematic use of the Internet to a public audience through the medium of film. I hope you will enjoy the clips as we enjoyed the process of making.”

Prof Ornella Corazza

EU-PUI communication and dissemination

Closely connected with the Action’s efforts to raise awareness, EU-PUI’s dissemination and communication activities were extremely dynamic and successful as well. Led by the Science Communication Coordinator Dr Julius Burkauskas, an extensive dissemination plan was drafted to set targets for each dissemination activity with a monitoring system to evaluate outcomes. The dissemination plan aimed to optimise the impact of the scientific content, and accordingly the Action promoted therefore Open Access to research articles, shared access to databases, and Open Access where possible to educational resources.

Planning before acting has serve the Action’s objectives greatly as these activities resulted in a wide range of scientific trainings, educational and dissemination initiatives, including international conferences, short term scientific missions (STSM’s) and ITC Conference Grants.  

Some of these activities included:

On September 2019:

The article ‘The Interaction of Person-Affect-Cognition-Execution (I-PACE) model for addictive behaviors: Update, generalization to addictive behaviors beyond internet-use disorders, and specification of the process character of addictive behaviors‘ from Dr Matthias Brand was published in Neuroscience Biobehavioral Reviews. The review highlighted that addictive behaviors are associated with diminished inhibitory control and that habitual behaviors are developed in the process of addictive behaviors.

In May 2020:

The study ‘Preventing problematic internet use during the COVID-19 pandemic: Consensus guidance’ was published Comprehensive Psychiatry.

In October 2020:

Members and observers of EU-PUI organised the online international Training School on Problematic Internet Use. All recordings of lectures are available on the action website for future dissemination and further teaching opportunities

Press impact

One of the Action’s biggest achievements lies in the impressive impact it had in the mainstream media.

It started with the Action’s original manifesto ‘For a European research network into Problematic Usage of the Internet’ launched in 2018. The manifesto was turned into a press release by the University of Hertfordshire’s Press Office who registered it in the British national news agency Reuters. Quickly the manifesto was picked-up by Science Communications Centres, initiating additional interviews of the Action’s members. This rapidly turned into a significant press campaign where mainstream media marked strong interest into the network’s activities. Media such as the BBC Television and national newspapers like the Guardian and The Telegraph dedicated large segments about the Action. Collecting the press clipping and monitoring the impact showed millions in audience reach!

Discover more about EU-PUI’s dissemination and communication activities by listening to Science Communication Coordinator Prof Burkauskas intervention in the COST Podcast.

Adoption of Gaming Disorder as a diagnosable disorder by the World Health Organisation

The Action played an instrumental role in the adoption of a new diagnosis of Gaming Disorder, as the first disorder of addictive digital behaviour, in the World Health Organisation International Classification of Diseases 11th Revision (ICD-11).

A successful international network

EU-PUI established a truly global network comprising of 54 Management Committee Members. The network engages expertise from almost all countries in Europe, several Near Neighbour Countries, and covered all parts of the World. The network continuously included new members and had a focus on ITC countries (18 ITC countries; 56 % of MC Membership).

EU-PUI also established an Early Career Network on PUI which was launched at the International Training school on 2021 and has enrolled 62 young researchers.

“By nurturing a broad and diverse multidisciplinary network of experts, drawn from around Europe and the rest of the world, working alongside citizens groups including young people who are most at risk, the COST Action European Network for Problematic Usage of the Internet has considerably raised the profile of Problematic Usage of the Internet among scientists and the public at large and advanced the understanding of this emerging public health problem at a global level.“

EU-PUI Action Chair, Prof Naomi Fineberg

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IMPACT & future activities

Towards a common understanding of PUI

Successful dissemination has led to a common understanding of the scientific challenges facing the field and the key achievable scientific research priorities needed to address these challenges. The Action’s manifesto has been used to support a coordinated international approach to investigating PUI. Thanks to the Action’s efforts, the science on this matter will be better coordinated.

Continuing with new projects: COST Actions as pre-portal

The impact is also changing the way future research is conducted. Several new collaborative projects have emerged and the Action itself developed proposals based on citizen-science. A recent multi-national Horizon Europe project will aim to identify the cost and impact of PUI among European school-children, including several ITC countries, in order to develop cost-effective self-management and healthcare policy interventions promoting improved mental-health and wellbeing and prevent PUI in vulnerable groups. By enabling networking activities amongst researchers, the COST Actions create the space to move research forward and often have a ripple effect to help grow these activities into continuous and larger projects.

The COST Action ‘European Network for Problematic Usage of the Internet’ is a perfect example of how COST Actions can have an incremental impact. And for this case, the ultimate impact will be improved health and well-being of citizens.