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Abstract: Aim: Studies on brief interventions for Internet use disorders (IUD) are lacking. In this pilot study we tested the feasibility and preliminary efficacy of an approach applying Motivational Interviewing and elements of cognitive behavioral therapy. Methods: Clients in four job centers and the job agency in Lübeck, Germany, were approached for a proactive screening in order to identify problematic Internet use or IUD with the Compulsive Internet Use Scale (CIUS). Screening-positives were checked in a clinical interview for fulfilling three or more criteria according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Participants were randomized into intervention (personal counselling and up to three counselling sessions via telephone) and control group. A two-month follow-up was conducted. Results: Of all 3,600 clients approached, 1680 clients could be screened and 298 were screening-positive (17.7%). After a diagnostic interview 36 participants could be allocated to intervention and control group. In the two-months follow-up, decrease of problematic Internet use was higher in the intervention group, although not statistically significant (p=.216) (0.216) a small to medium effect size could be observed. Conclusion: The feasibility of this early intervention approach was evident. Larger sample sizes are needed to examine the efficacy of similar interventions. Findings of this study are promising and suggest future research. Evidence of effectiveness of such short interventions could enhance the impact and magnitude of measures and make an important contribution to preventative efforts.

Introduction: Previous studies analyzing friendships with people only known through the Internet mainly focused on quantitative aspects (e.g., the number of online friends or the time spent with them). Little is known about the perceived quality of online compared to real-life friends in individuals with an Internet use disorder (IUD). This study aimed to analyze associations of the increased subjective importance of online friends and IUD by controlling for the perceived real-life social support and comorbid mental disorders. Methods: Based on a general population sample, 192 participants who were screened positive for risky Internet use took part in face-to-face clinical diagnostic interviews. IUD was assessed using the structure of the Munich-Composite International Diagnostic Interview (M-CIDI) and the adapted criteria of Internet gaming disorder in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The number and the increased subjective importance of online compared to real-life friends were assessed with the Online and Real-Life Friends scale (ORLF), real-life social support was assessed with the Berlin Social Support Scales (BSSS), and comorbidity was assessed with the M-CIDI. Data were analyzed with binary regression models. Results: Of 192 participants with risky Internet use, 39 participants (19 men; age M = 29.9, SD = 12.2) fulfilled the criteria of IUD in the last 12 months. IUD was not associated with the number or perceived social support of online friends per se. In multivariate analyses, IUD was associated with increased subjective importance of online friends, independently from comorbid anxiety or mood disorders. However, when controlling for real-life social support, associations of IUD and increased subjective importance of online friends were no longer present. Conclusion: These findings highlight the necessity of therapeutic interventions aimed at strengthening social skills and engaging in real-life relationships in the prevention and therapy of IUD. Due to the small sample size and the cross-sectional analysis, however, further research is needed.

Abstract: Background: Vocational students have an increased risk to engage in health-risk behaviors compared to same-aged peers. To date, evidence-based digital prevention approaches that address multiple health-risk behaviors are rare. Method: The randomized-controlled trial (RCT) "Prevention of at-risk substance and Internet use disorders among vocational students" (PARI) investigates the efficacy of an app-based prevention approach compared to a waitlist-control condition. The aim is to prevent substance-related and behavioral addictions and improve life skills. An existing app (ready4life) was adapted under consideration of focus groups with teachers, prevention experts, and students. A Delphi expert group rated the quality of the approach. The efficacy of the modified ready4life app is currently being tested in a RCT. The proactive recruitment takes place in German vocational schools. After participating in an app-based screening (T0), participants get individualized feedback and will be cluster-randomized per class to the intervention group (IG; n=1.250) or control group (CG; n=1.250). The IG chooses two out of six modules: Social competence, stress management, cannabis, tobacco, alcohol, social media/gaming. The CG receives information on how to improve health behaviors. Follow-ups are conducted after 6 months (T1) and 12 months (T2). Conclusion: This RCT provides data on a multibehavioral prevention approach for vocational students. Final results are expected in 2023.