Research Article

Research on Social Work Practice

22(3) 282-292
An Empirical Review of Internet ª The Author(s) 2012
Reprints and permission:
sagepub.com/journalsPermissions.nav
Addiction Outcome Studies in China DOI: 10.1177/1049731511430089
http://rsw.sagepub.com

Chennan Liu1, Minli Liao1, and Douglas C. Smith1

Abstract
Objectives: The authors systematically reviewed the outcomes and methodological quality of 24 Internet addiction (IA) treatment
outcome studies in China. Method: The authors used 15 attributes from the quality of evidence scores to evaluate 24 outcome
studies. These studies came from both English and Chinese academic databases from 2000 to 2010. Results: Among
the 15 attributes, only sequence generation and intention-to-treat were reported by more than 50% of the 24 studies. None
of the studies contained treatment adherence ratings or collateral reports. Cognitive behavior therapy combined with family
therapy or group therapy emerged as possibly efficacious treatments. Conclusions: More rigorously designed studies, accompa-
nied by transparent reporting of methods and findings are needed to identify promising IA treatments.

Keywords
Internet addiction treatment, methodological quality, review

Internet addiction (IA; also called pathological Internet use,
excessive computer and video game playing, Internet overuse,
problematic Internet use, etc.) has become a widespread prob-
lem among youth ages 9–23. According to a 2009 national Har-
ris poll survey with a randomly selected sample of American
youth ages 8–18, about 8% of video game players exhibited
pathological patterns of play (Gentile, 2009), which is also con-
sidered a type of IA. In a 2005 survey in Germany, among 323
children from 11 to 14 years of age, 9.3% of the children ful-
filled all criteria for excessive computer and video game play-
ing (Gruesser, Thalemann, Albrecht, & Thalemann, 2005). In
Australia, excessive computer playing corresponding to addic-
tive behavior was found in 12.3% of school-age children, ado-
lescents, and emerging adults (Batthyany, Muller, Benker, &
Wolfling, 2009). This public health problem might be even
worse in China. According to the China Youth Internet Asso-
ciation’s 2009 Report on Youth IA Disorder, around 14.3%
of youth ages 13–17 and around 15.6% of youth ages 18–23
in China with computer access had IAs (China Youth Internet
Association, 2010).
Although there are many cross-sectional studies on the
correlates of IA and some review articles, most articles only
discuss promising treatments in passing (Brezing, Derevensky,
& Potenza, 2010; Chou, Condron, & Belland, 2005; Huang, Li,
& Tao, 2010; Young, 2009a, 2009b). Thus, there is no compre-
hensive review of outcomes of different IA treatments, and there
is no review article that focuses on the methodological quality of
such studies. Chou, Condron, and Belland (2005) systematically
reviewed research on IA definitions, assessments, risk factors,
addictive potentials before 2005. However, only two empirical
treatment studies, which used cognitive–behavior therapy
(CBT) and motivational enhancement therapy, were included
in this review. Widyanto and Griffiths (2006) also explored IA
research but did not contain detailed information about treat-
ment outcome studies. These above two reviews suggest that
cognitive behavioral therapy has been used to treat IA, but with
so few studies, conclusions about its effectiveness are prema-
ture. In addition, Young (2009) describes a cognitive behavioral
therapy model that includes behavior therapy and self-
monitoring (i.e., a daily Internet use log) to treat IA. However,
this article is only description of potential IA treatments but not
actual empirical study.
Although few studies outcome studies exist in the United
States, many outcome studies have been conducted in China.
Therefore, this review article aims to systematically review
IA treatment outcome studies published in English and Chinese
language journals that focused on IA treatment in China from
2000 to 2010. Our primary objective is to evaluate the metho-
dological quality of different treatment outcome studies. Our
secondary objective is to find out which treatments are empiri-
cally supported. Based on evidence-based practice require-
ments, this systematic review on IA outcome studies will
help social workers identify the most effective treatments for
IA. Further, by focusing on methodological attributes of these
1
School of Social Work, University of Illinois at Urbana-Champaign, Urbana, IL,
USA
Corresponding Author:
Chennan Liu, School of Social Work, University of Illinois at Urbana-Champaign,
Room 2014, 1010 W Nevada, Urbana, IL 61801, USA
Email: liu197@illinois.edu

Downloaded from rsw.sagepub.com at OAKLAND UNIV on April 6, 2015

Liu et al.
studies, we will identify those practices with the largest effects
sizes from the highest quality studies.
Definitions of IA vary considerably among different
scholars. Some definitions, and the resulting measures that have
been developed like Young’ (2004) IA scales, flow from the
conceptualizations of substance use disorders and pathological
gambling in the Diagnostic and Statistical Manual of Mental
Disorders (DSM-IV; Fisher, 1994; Skoric, Teo, & Neo, 2009;
Young, 2004). Similar to these problems, IA is conceptualized
as a problem where frequent use leads to significant impairment
in one’s life (i.e., urges to play, ignoring personal responsibilities,
and loved ones). According to Block (2008), IA appears to be a
common disorder that merits inclusion in DSM-V and concep-
tually the diagnosis is a compulsive-impulsive spectrum disorder
that involves excessive online and/or computer usage use, with-
drawal, and tolerance. Although a thorough discussion of diag-
nostic issues surrounding IA is outside of the scope of this
article, when we refer to IAhere, we include both problematic
Internet and computer use (i.e., video game) that has been diag-
nosed with the best available, empirically validated measures.
Some of the most commonly used scales in China are
Young’s (1995–2004) diagnostic questionnaires. Young
developed four questionnaires, based on pathological gambling
measurement, called the IA scales (IAS). They range from 7 to
20 items (IAS-7, IAS-8, IAS-10, and IAS-20). Example items
include ‘‘do you feel the need to use the Internet with increas-
ing amounts of time in order to achieve desired satisfaction?’’
and ‘‘have you repeatedly made unsuccessful efforts to control,
cut back, or stop Internet use?’’ The Chinese Internet Addiction
scales (CIAS 1998 and CIAS 2005) are based on Young’s
(1995–2004) scales (Yang, Zheng, & Ruan, 2004; Zhang,
2009). The CIAS 1998 include four factors: tolerance, compul-
sive behavior and time, withdrawal symptoms, and related mental
health problems (Yang et al., 2004). The CIAS 2005 were used in
a large epidemiological study in China, called the Chinese Ado-
lescent IA Report 2005 (Zhang, 2009). China developed its own
diagnostic criteria for IA in late 2008 and currently uses them in
treatment settings (Liu, Wang, & Zhuang, 2008). The criteria are
as follows: (a) more than 6 hr a day of Internet use; (b) this heavy
Internet use persists for more than 3 months; (c) social, study, and
communication skills dysfunctions; (d) dependence symptoms
(e.g., a strong desire and impulse) are present; and (e) withdrawal
(e.g., uncomfortable, easy angered, attention deficit, sleep
disorder without Internet use).
In addition to these criteria developed in China, there is
evidence that IA is associated with attention deficits, bad
academic performance, depression, self-injury, hostility, and
violent behaviors (Batthyany et al., 2009; Bernardi & Pallanti,
2009; Bioulac, Arfi, & Bouvard, 2008; Caplan, Williams, &
Yee, 2009; Chan & Rabinowitz, 2006; Frolich, Lehmkuhl, &
Dopfner, 2009; Gentile, 2009; Ha, Yu, Park, & Lim, 2009;
Hwang, Cheong, & Feeley, 2009; Kim, Namkoong, Ku, &
Kim, 2008; Ko, Yen, Chen, Yeh, & Yen, 2009; Lam, Peng,
Mai, & Jing, 2009; Skoric et al., 2009; Sun, Ma, Bao, Chen,
& Zhang, 2008). Therefore, researchers sometimes use the
Symptoms Checklist 90 (SCL-90; Derogatis, 1994; Wang,
Downloaded from rsw.sagepub.com at OAKLAND UNIV on April 6, 2015
283
Wang, & Ma, 1999) to evaluate the treatment outcomes of
IA besides the IAS and CIAS in hospitals and clinical settings.
Method
Study Selection
An extensive literature search was conducted both in English
academic databases (social sciences citation index [SSCI],
Social Services Abstracts, Social Work Abstracts, PsycINFO
w/ PsycARTICLES) and Chinese academic databases (Wan-
Fang Database, China national knowledge infrastructure [CNKI]
Chinese academic journal web databases, WeiPu databases)
published from 2000 to May 2010. Keywords such as ‘‘Internet
addiction, pathological Internet use, excessive Internet use, pro-
blematic Internet use, video game addiction’’ were used in the
searching combined with keywords of ‘‘treatment’’ or ‘‘interven-
tion’’ or ‘‘evaluation’’. Based on this search, we selected studies
that (a) reported posttreatment outcomes, (b) included partici-
pants ages 9–23 that were treated for an IA, (c) were conducted
in China, and (d) for which we could obtain the full text report.
Review papers and case study reports are not included in this
review. We chose a large age rage since we preferred to contain
as many studies as possible on IA treatment and usually studies
which were done in clinical settings in China had a large age
range. Using these criteria, we located 24 studies, which are
evaluated in this article.
Selection of Methodological Criteria
Methodological quality attributes of IA outcome studies in this
article were established based on a recent review of adolescent
substance abuse trials (Becker & Curry, 2008). Becker and
Curry reported whether 14 methodological attributes were
present in adolescent substance abuse treatment trials. These
attributes are consistent with the Consolidated Standards of
Reporting Trials (CONSORT statement; Moher, Schulz, &
Altman, 2001). The study attributes that were coded included
objective, sample size, power, outcome, random sequence
generation (i.e., how randomization was achieved), allocation
concealment, active comparison, baseline data, manualized
treatment (1 ¼ yes, 0 ¼ no), treatment adherence rating,
collateral report, collection of an objective measure besides
self-report (e.g., collateral report; 1 ¼ yes, 0 ¼ no), intention-
to-treat (ITT) analysis, and blind assessment. In our study,
we also coded whether the follow-up data were collected at
least 30 days after the study treatments ended. Thus, we used
15 attributes to evaluate the methodological strength of the
24 IA treatment outcome studies (see Table 1).
Rating Process
The first and second authors independently reviewed the 24 stud-
ies based on the 15 attributes. After that, k coefficients were used
to assess the reliability of each attribute. Discrepancies were
resolved through discussion with the third author. All three
authors engaged in a discussion until consensus was reached.
284 Research on Social Work Practice 22(3)

Table 1. Attributes of Methodological Quality

Attributes Criteria for Rating

Objective 1 ¼ Specific objectives and hypotheses. Hypotheses are amenable to explicit

statistical evaluation
0 ¼ Objectives or hypotheses not explicitly established
Sample size 1 ¼ Process for determining the sample size discussed along with any interim
analyses and stopping rules
0 ¼ Determination of sample size not discussed
Power 1 ¼ Study is sufficiently powered to detect differences between treatment groups
(e.g., at least 27 subjects per condition with passive comparison, at least 71
subjects per condition with active comparison)
0 ¼ Study is not sufficiently powered
Outcome 1 ¼ Established primary and secondary outcome measures. Primary outcome is
specified as outcome of greatest importance
0 ¼ Primary or secondary outcome measures are not specified
Random sequence generation 1 ¼ Process for generating a random sequence described with sufficient detail to
confirm that each participant had an unpredictable, independent chance of
receiving each intervention
0 ¼ Process was not purely random, unspecified
Allocation concealed 1 ¼ The result of initial assessment was not affected by whether participants in
treatment group or not. (e.g., initial assessment was before the random
assignment or initial assessment was done by unknown investigator)
0 ¼ Process was not concealed, unspecified
Active comparison 1 ¼ At least one active comparison (e.g., alternate model, treatment as usual)
0 ¼ All comparison conditions were passive (e.g., waitlist, no-treatment control,
placebo, attention control)
Baseline data 1 ¼ Baseline demographic and clinical characteristic reported by condition
0 ¼ Baseline demographic or clinical characteristic not reported
Treatment manual used 1 ¼ At least one treatment condition was guided by a manual
0 ¼ None of the treatments were guided by a manual, unspecified
Treatment adherence ratings 1 ¼ Treatment adherence monitored with scales, checklists, or rating forms
completed by therapist, supervisor, independent observer, an/or patients
0 ¼ Treatment adherence was not monitored using rating forms, unspecified
Collateral report 1 ¼ At least one outcome is a collateral report (e.g., parent, caregiver, teacher)
0 ¼ No collateral report
Objective measure 1 ¼ At least one outcome is an objective measure (e.g., computer recorded time
online, blood samples)
0 ¼ No objective verification
Intention-to-treat 2 ¼ ITT analysis. All subjects analyzed in groups to which they were assigned
1 ¼ Available cased analysis. Only subjects who completed one or more research
assessments were analyzed
0 ¼ Treated case analysis. Only subjects who completed a portion of the treatment
were analyzed
Blind assessment 1 ¼ Follow-up assessments completed by treatment-blind evaluator
0 ¼ Follow-up assessment not completed by treatment-blind evaluator, unspecified
Follow-up length >30 days posttreatment 1 ¼ At least part of follow-up data were collected at least 30 days after the study
treatments ended
0 ¼ No follow-up data were collected at least 30 days after the study treatments
ended

In conjunction with Becker and Curry’s (2008) article, we also
used a composite quality of evidence score (QES) to indicate the
number of methodological attributes each study met. We coded
each attribute 0 (not met or unclear) or 1 (met), except for the
ITT analysis item where items ranged from 0 to 2 (0 ¼ treated
case analysis, 1 ¼ available cased analysis, and 2 ¼ full ITT
analysis).
We report QES scores separately for three different study
designs found in the literature, as some QES items do not apply
to some designs. The first type of design is a one group pretest
and posttest, called a ‘‘preexpeerimental design’’ study. The
second design style is nonrandomized comparison groups
design. The third one is the experimental design (Rubin &
Babbie, 2011). For preexperimental design studies, some attri-
butes (e.g., random sequence generation, allocation conceal-
ment, active comparison, and baseline data) did not apply
and were coded as 0 for such studies. After summing items, the
range of the total QES is 0–16 for experimental design studies,

Downloaded from rsw.sagepub.com at OAKLAND UNIV on April 6, 2015

Liu et al. 285

Table 2. Design Characteristics of Internet Use Disorder Outcome Studies

Preexperimental Nonrandomized Comparison Experimental

k (n ¼ 8; %) Groups (n ¼ 4; %) Design (n ¼ 12; %)

Design Characteristics
Objective 1 12.5 0 8.33
Baseline data 0.75 – 0 41.67
Sample size 1 0 0 8.33
Power 0.63 50 25 16.67
Outcome 0.57 50 50 33.33
Active comparison group 0.52 – 25 58.33
Random sequence generation 0.89 – – 50
Allocation concealed 0.79 – 0 16.67
Treatment manual used 0.63 12.5 0 16.67
Treatment adherence ratings 1 0 0 0
Collateral report 1 0 0 0
Objective measure 0.63 12.5 25 16.67
ITT 0.92 62.5 50 66.67
Blind assessment 0.65 0 0 16.67
Follow-up length >30 days 0.88 25 0 33.33
Total QES score (M, SD) – 2.75 (1.58) 2.25 (1.5) 4.58 (2.23)
Note. ITT ¼ intention-to-treat analysis; QES ¼ quality of evidence scores; SD ¼ standard deviation.

0–15 for nonrandomized comparison group design studies also transformed negative effect size scores to positive scores for
while the total QES is from 0 to 12 for preexperimental design better interpretation.
studies.

Effect Size Calculation Process Results

We calculated the effect sizes of the studies mainly by using
Cohen’s d (Cohen, 1988). The studies primarily used IAS or
SCL-90 as the outcome measurement tools in the 24 studies.
According to these two measurement tools, higher scores indi-
cate more severe IA or health problems, respectively. For studies
which only used SCL-90, we chose depression factor as the rep-
resentative outcome factor to calculate effect size, since depres-
sion was the most common correlate of IA disorders in China. If
the studies used continuous outcome measures and there were
control groups, we calculated the effect size by subtracting postt-
est control group outcomes from those of the experimental treat-
ment group, dividing by the standard deviation of the controls.
Similarly, for studies with continuous outcome measures and
preexperimental designs, we calculated the effect size by sub-
tracting pretest values of the dependent measures from post
treatment values, dividing by the standard deviation of the pret-
est data wave. Finally, for studies using dichotomous outcome
indicators, we used risk ratios as estimates of the effect size.
Therefore, the effect sizes are initially expressed as negative val-
ues, since posttest scores and treatment group scores were
smaller than the pretest scores and control group scores, respec-
tively. So, we transformed negative values to positive ones so
that higher positive values indicate larger effect sizes in favor the
treatment group (i.e., comparison group design) or posttest wave
(i.e., preexperimental designs). In order to prevent outliers from
exerting too much influence on analyses, we used winsorizing to
compare effectiveness of single treatments and multimodal treat-
ments (Erceg-Hum & Mirosevich, 2008). In this analysis, we
Methodological Attributes Across Studies
The k values for each of the 15 methodological attributes are
described in Table 2. Except for 2 of the 15 attributes, outcome
(k ¼ .57) and active comparison (k ¼ .52), we reached moder-
ate or high agreement (ranged from 0.63 to 1.00). The average
k value across the studies is .79, indicating a substantial agree-
ment between the two raters, in accord with Landis and Koch’s
(1977) benchmark. Discrepancies were resolved through com-
munication with the third author, who had advanced clinical
and research experience in outcome study evaluation. The two
raters ultimately reached unanimous agreement on each attri-
bute in order to calculate the QES.
The reviewed studies are classified into three categories. We
examined how each type of study meets the 16 characteristics
separately because some criteria are not applicable to all studies.
Over 50% of the studies were methodologically strong in two
characteristics, sequence generation, and ITT analysis. However,
less than 50% of the studies were strong in the following 13 attri-
butes: objective, baseline data, sample size, power, outcome,
active comparison, allocation concealment, manualized treat-
ment, treatment adherence rating, objective measure, blind
assessment, and 30 days follow-up.
Most frequently reported attributes. Random sequence gener-
ation is one of the most frequently mentioned attributes. It is only
applicable to the experimental design studies, as opposed to pre-
experimental studies and nonrandomized comparison group
design studies, which do not need to carry out this process. Half
of the experimental design studies (n ¼ 6) mentioned that they

Downloaded from rsw.sagepub.com at OAKLAND UNIV on April 6, 2015

286
implemented the process for generating a random sequence. For
example, these studies indicated that they used either a random
number table or statistical software to generate random numbers
in order to ensure that each participant had an equal chance to get
intervention. For the remaining half of the studies, we cannot tell
how the randomization was achieved because they did not
describe the process explicitly.
The next attribute reported frequently is ITT analysis. Five
of the eight preexperimental studies applied true ITT analyses.
The remaining three either used treated case analysis (n ¼ 2) or
available case analysis (n ¼ 1). Half of the nonrandomized
comparison design studies used ITT analyses, and the other
half used treated case analyses (n ¼ 2). For the experimental
design studies, 66.67% of the studies applied ITT analyses
(n ¼ 8), whereas two used available case analyses, and two
used treated case analyses. Since sample attrition is inevitable
in intervention studies, dealing with missing data in the analy-
sis is a challenge in program evaluation. ITT analysis, in which
all participants allocated to the study are included in the anal-
ysis, regardless of whether they received the treatment or not,
has been established to produce less bias in estimating the true
program effect than that produced by other analysis methods,
such as available case analysis and treated case analysis (Freed-
man, 2005). The application of this method in these studies is
an indication of researchers’ efforts to address the estimation
bias of the treatment.
Least frequently reported attributes. Two of the least fre-
quently reported attributes were treatment adherence ratings
and collateral reports. None of the studies reported these
two characteristics. These studies did not use scales, check-
lists, or rating forms to monitor the process of treatment
implementation, in the absence of which we can determine
neither whether the participants complied with the treat-
ments nor whether the therapists implemented the models
as intended. Consequently, it is difficult to tell what treat-
ments were provided. Similarly, none of the studies used
collateral reports, Therefore there is no control of potential
bias in self-reported outcomes.
The next least frequently reported attributes included base-
line data, sample size, allocation concealment, and blind
assessment. Only less than 50% of the experimental design
studies reported these four attributes. Nonrandomized compar-
ison group design studies ignored these four attributes com-
pletely. None of preexperimental design studies reported the
baseline data, sample size, and blind assessment. Five of the
12 experimental studies provided information concerning base-
line demographics and clinical characteristics of participants in
both experimental groups and control groups. For example,
they provided t tests or chi-square tests for the demographic
characteristics and participants’ Internet use behavior at base-
line, through which we established whether there was preexist-
ing selection bias between the two groups. Only one
experimental study explicitly showed their power calculation
formula to show how the sample size was determined. Two
experimental studies specifically mentioned that they collected
their baseline data before they randomized the intervention
Downloaded from rsw.sagepub.com at OAKLAND UNIV on April 6, 2015
Research on Social Work Practice 22(3)
group and control group or that they collected the baseline data
without knowing who was in which group. Similarly, two stud-
ies conducted the follow-up assessment by means of a
treatment-blind evaluator.
Approximately a quarter of the studies reported the fol-
lowing characteristics: objective, manualized treatment, and
objective measure. Only one of the eight preexperimental
studies and one of the 12 experimental studies specify their
study objectives and hypotheses. The lack of information
about hypotheses indicates that they have not articulated
which outcomes are the most important for their studies.
There were few preexperimental studies (n ¼ 1) and experi-
mental studies (n ¼ 2) that mentioned using standardized
training manuals to guide their treatments, whereas most
of them simply used self-designed manuals or no manual
at all. In terms of the measurement of the outcome, less than
a quarter of any of these studies used objective measures as
opposed to self-report scales. The final block of infrequently
encountered attributes included power, outcome, active
comparison, and follow-up assessment longer than 30 days.
Half of the preexperimental studies (n ¼ 4) achieved ade-
quate statistical power for their design with at least 30 par-
ticipants for the pretests and posttests. However, studies
with comparison groups were less likely to achieve adequate
statistical power because at least 71 subjects per condition
were needed for active comparison, and 27 subjects per con-
dition were required for passive comparison (Kazdin &
Bass, 1989). Half of the preexperimental studies (n ¼ 4) and
half of the nonrandomized studies (n ¼ 2) established pri-
mary and secondary outcome measures, while only two
experimental studies specified which outcome was more
important. One quarter of the nonrandomized experimental
studies (n ¼ 1) used active comparison involving psy-
chotherapy to treat IA for the control group, and 7 of the
12 experimental studies applied active comparison such as
medication or exercise therapy. Finally, two preexperimen-
tal studies conducted a follow-up assessment after 30 days
to track the lasting effects of the treatment, whereas 4 of the
12 experimental studies did so.
Quality of Evidence and Effect Sizes
Among the 24 studies, the most commonly used treatments
for IA are exercise programs (EP), CBT, electroacupuncture
(EA), family therapy (FT), group-based treatment (GT), moti-
vational interviewing (MI), and psychotropic medications
(M). As indicated in Table 3, more than half of the studies
have multiple treatments. Except for studies by Du, Jiang,
and Vance (2010) and Pan and Dai (2010), the rest of 22
studies all have statistically significant effects favoring the
treatment. The overall mean effect size is 1.89, indicative
of very large effects. Some of the studies which use CBT,
M, and FT have extremely high effect size (> 5), such as
Shen (2008), Yang, Shao, and Zheng (2005), and Shao,
Yang, Luo, and Zheng (2004). However, most of those
Liu et al. 287

Table 3. Effect Sized and Methodological Quality Scores for Chinese Internet Addiction Studies

Outcomes

Author, Year, (Quality Score) n Treatment(s) d (IAS) d (SCL-90)

Continuous Outcome Measures-Comparison Group Designs

1. Du, Jiang, and Vance, 2010 (10) 56 CBT 0.13
2. Guo, Yu, Chao, and Huang, 2008 (1) 32 GT, CBT 2.08
3. Li, Chen, Zhang, and Jia, 2009 (3) 32 EP 3.26 4.44
4. Liao and Wang, 2009 (1) 50 EP 0.82
5. Lin, Zou, Xie, Lv, and Lin, 2006 (4) 30 M, CBT 0.68
6. Liu and Li, 2008 (5) 60 CBT, FT, GT 2.58
7. Shao, Yang, Luo, and Yang, 2005 (5) 66 M, CBT 2.88 0.54
8. Sun and Wang, 2008 (4) 220 CBT, GT 2.80
9. Wei, 2008a (4) 60 MT, EP, GT, FT, HE 3.83
10. Wu, Yan, and Han, 2007 (3) 27 EA 3.78
11. Wu and Yang, 2008 (3) 126 M, CBT 4.06
12. Zhang, 2009 (4) 163 EP 0.3386
13. Zhan and Li, 2009 (5) 60 M, CBT 1.35
14. Zhong, Tao, Zhu, Sha, and Yang, 2009 (7) 51 MT, CBT, GT 1.27
15. Zhu, Jin, Zhong, Chen, and Li, 2008 (4) 45 EA, CBT 1.86
Continuous outcome measures-preexperimental designs
16. Li, Li, Wang, and Zhang, 2008 (4) 48 M, CBT, FT, GT 0.67
17. Pan and Dai, 2010 (1) 11 EBT 0.29 1.14
18. Shao, Yang, Luo, and Zheng, 2004 (2) 20 CBT 14.5
19. Shek, Tang, and Lo, 2009 (4) 59 CBT, MI, FT, VS 1.45
20. Shen, 2008 (0) 27 CBT, M 10.7 18
21. Wei, 2008b (3) 273 EP, CBT, FT, GT, HE 1.71
22. Yang and Hao, 2005 (4) 52 CBT, FT, SBT 2.69
23. Yang, Shao, and Zheng, 2005 (1) 23 CBT, FT, M 13.43
Dichotomous outcome indicators
24. Liu, Yang, and Yao, 2007 (4) 40 M, CBT 0.875

Note. CBT ¼ cognitive behavior therapy; EA ¼ electroacupuncture; EBT ¼ electroencephalographic biofeedback treatment; EP ¼ exercise program; FT ¼ family
therapy; GT ¼ group-based treatment; HE ¼ health education; M ¼ medication; MI ¼ motivational interview; MT ¼ military training; SBT ¼ solution-focused brief
therapy; VS ¼ voluntary service.

studies have low quality scores (<5), which means that the
quality of the evidence is low.
CBT treatments combined with medications were the most
frequently used therapies in the 24 studies. The QES scores for
these studies ranged from 0 to 5 (mean ¼ 3.4). The average
effect size of CBT treatments combined with medications is
3.93. There are three studies which only used EP as the treat-
ment (shown in Table 4). The average effect size of the three
studies is 1.47 while the mean QES is 2.7. Two studies only
used CBT. For one such study with a high QES (i.e., 10) the
effect size is .13 (not statistically significant). However, for the
lower quality study (QES ¼ 2), the effect size is 14.5. Two
studies used EA. This was a unique treatment in China, which
uses electric stimulation to the body to reduce the desire to use
the Internet. Since 2009, this method has been suspended in
China due to the unclear negative consequences (Wei sheng
bu jiao ting dian ji zhi liao wang yin [Chinese Ministry of
Health ban on electric stimulus therapy for Internet addition
disorder], 2009). One study used EBT which is a new biofeed-
back machine treatment. However, the findings showed that
biofeedback machine therapy did not have statistically signifi-
cant effects on IA. The combination of CBT, GT, FT, or others
have average effect sizes ranging from 1.27 to 5.86, but the
methodological quality for these studies is around 4. Based
on Tables 3 and 4, when there are extremely large effect sizes
(>5) as study 18, 20, 23 the QES falls below 2.
Single Treatments and Multimodal Treatments
We compared effect sizes of studies which used single treat-
ments with studies which used multiple treatments. The aver-
age effect size for single treatments is 1.77, and the average
effect size for multiple treatments is 2.3. However, the t test
is not statistically significant (t ¼ .39). Using Chambless and
Hollons’ (1998) criteria most of the treatments we reviewed
would be considered possibly efficacious, with no replication
studies for any treatment we reviewed (Chambless & Hollon,
1998).
Discussion and Applications to
Social Work
The primary objective of the study was to review the published
outcome studies on IA in the Chinese context. Following the
procedures of Becker and Curry (2008) we evaluated 24 IA
treatment studies. Our main finding was that only 2 of the 15

Downloaded from rsw.sagepub.com at OAKLAND UNIV on April 6, 2015

288
Table 4. Quality of Evidence Scores and Effect Size by Type of Treatment
Treatment Study Number
EP 12, 3, 4
CBT 1, 18
EA 10
EBT 17
CBT, M 11, 7, 13, 5, 20, 24
CBT, GT 2, 8
CBT, EA 15
CBT, GT þ others 14
CBT, FT þ others 22, 23, 19
CBT, GT, FT þ others 6, 21, 16
MT, BT, GT, FT, HE 9 4
Note. CBT ¼ cognitive behavior therapy; EA ¼ electroacupuncture; EBT ¼ electroencephalographic biofeedback treatment; EP ¼ exercise program; FT ¼ family
therapy; GT ¼ group-based treatment; HE ¼ health education; M ¼ medication; MI ¼ motivational interview; MT ¼ military training; QES ¼ quality of evidence
scores; SBT ¼ solution-focused brief therapy; VS ¼ voluntary service.
attributes were reported by more than 50% of the three types of
study designs. Although random sequence generation is a
necessity for experimental studies, only half of them mentioned
how they generated a random sequence, and the other half did
not indicate how they randomized participants. In addition, the
remaining methodological criteria were poorly met, indicating
most research did not establish reporting guidelines for clinical
trials (Moher et al., 2001).
None of the studies contained treatment adherence ratings or
collateral reports, which indicates that research paid a minimal
amount of attention to these areas. Only the experimental stud-
ies reported baseline data, sample size, allocation concealment,
and blind assessment. Few studies indicated which outcomes
were primary. Similarly, few studies used manualized treat-
ments. Replication by outside investigators, a criterion for
establishing a treatment as empirically supported (Chambless
& Hollon, 1998), would be difficult in the absence of treatment
manuals. The lack of objective measures also threatened the
reliability of the outcomes. Finally, the small sample sizes of
these studies was concerning, as inadequate statistical power
limits our abilities to detect true differences if they were indeed
present.
Our secondary objective was to determine which treatment
was more effective. However, based on low methodological
quality scores here and the limited number of studies, this was
a difficult task. Thus, we have only described trends in this
study, and have not completed formal moderation analyses.
In future studies, the QES criteria could be explored as modera-
tors of treatment effects. However, due to the limited number of
studies, there was not enough statistical power in this study to
enable such an analysis. Another approach is to find studies
with high methodological quality, and then to see whether such
studies have high effect sizes. Comparatively, in Becker and
Curry’s (2008) study, the median QES was 7, reflecting the rel-
atively higher maturity of the evidence-base for that popula-
tion. That was, in our study, only 1 study of the 24 studies
examined that has a QES larger than 7. And this study had a
low effect size of .13 without statistically significant differ-
ences between treatment conditions. Most of the studies in this
Downloaded from rsw.sagepub.com at OAKLAND UNIV on April 6, 2015
Research on Social Work Practice 22(3)
Mean QES (Range) Mean Effect Size (Range)
2.7 (1–4) 1.47 (0.34–3.26)
6 (2–10) 7.3 (0.13–14.5)
3 3.78
1 0.29
3.4 (0–5) 3.93 (0.68–10.7)
2.5 (1–4) 2.44 (2.08–2.8)
4 1.86
7 1.27
3 (1–4) 5.86 (1.45–13.43)
4 (3–5) 1.65 (0.67–2.58)
3.83
review article had a QES lower than 5. Because of this finding,
it is important that future trials use more rigorous designs and
adhere to established standards of clinical trial reporting.
According to Chambless and Hollon (1998), at least two
repeated rigorous treatment studies are needed to identify a
promising treatment. Using Chambless and Hollons’ (1998)
criteria most of the treatments we reviewed would be desig-
nated as possibly efficacious, since no replication studies
existed for any treatment we reviewed and power was too low
in most cases to detect moderate effect sizes. Rigorous designs
and reporting can help researchers and social workers to iden-
tify whether studies are rigorously replicated. The rigorous
design and reporting will also prevent potential biased estima-
tion of effect size for the IA treatment in the future. There is
evidence that inadequate methodological approaches and
reporting are associated with over-estimation of treatment
effects and failure to consider the quality of methodology and
reporting limits the ability to detect potentially inflated treat-
ment estimates, identify sources of bias and inform best prac-
tices in the field (Juni, Altman, & Egger, 2001; Moyer &
Finney, 2005).
There were some limitations for this study. First, we
reported low k values with respect to two attributes, outcome
and active comparison, indicating a relatively low interrater
reliability for some characteristics. There were high discrepan-
cies initially for these two characteristics. For example, one
rater believed the outcome was presented only if the study dif-
ferentiated which outcome was primary and which was second-
ary. However, another rater was more generous in coding the
outcome as ‘‘1’’ as long as the study presented two or more out-
comes in which at least one pertained to IA behavior. Similarly,
one rater believed the study applied active comparison only if
the comparison group had received evidenced-based interven-
tion to treat Internet addition, whereas the other rater applied a
broader rule and coded a ‘‘1’’ if the comparison group received
some treatments, no matter whether they were evidenced-based
or not. Despite the low interrater reliability for these two attri-
butes, we observed modest or high k values for the rest of the
attributes. In addition, for these two attributes and other
Liu et al.
attributes having k values lower than one, unanimous
agreement was achieved through dialogue with an experienced
colleague.
It was also possible that studies were more rigorous than we
have estimated, as we could only score studies based on their
reporting of methodological attributes. Thus, it was possible
that we underestimated the QES scores for some studies. As
long as the authors did not explicitly mention the attributes in
the article, we treated them as not having those attributes
although they may have simply not reported doing so. The
research conventions in the context of Chinese academic
language might divert the publication format away from the
American academic conventions even further. For example,
many articles were between one to four pages in length, which
is a highly condensed publication format.
The limited number of studies and nonconsistent outcome
measurement tools constrained our ability to fulfill the second
main objectives of this review. Thus, we were limited by our
small sample size of 24 studies. In addition, these 24 studies
used different outcomes measurement tools to report how peo-
ple recover from IA. Some of the studies only reported changes
in symptoms, such as depression or anxiety, without reporting
changes in IA criteria. It was problematic to compare effect
sizes calculated based on different outcome measurement tools.
Finally, we acknowledge that it is yet unclear how vulnera-
ble and impoverished youth are affected by IA. For example,
Eamon’s (2004) analysis of a nationally representative sample
found that poor youth had less computer access and were less
likely to use computers less for nonacademic purposes. Future
clinical research should explicitly report participant demo-
graphic characteristics so social workers know if vulnerable
youth are affected by IA and represented in these studies.
Given that few of the methodological standards were met,
researchers are encouraged to include as many essential ele-
ments of design as possible and contribute to establishing
reporting guidelines for intervention studies. As the classic
experimental design is characterized by criteria such as
sequence generation, allocation concealment, and baseline
data, these attributes should be reported when they have been
implemented. Some criteria such as using objective measures,
establishing primary outcome measures, having adequate
power, and using manualized treatment, are easier to meet than
other criteria; therefore, researchers should report them. For
those attributes, including treatment adherence rating, collat-
eral report, objective measure, and blind assessment, as they
are embedded in more rigorous designs and are difficult to be
fulfilled, researchers might consider including them while
designing their studies. The bottom line is that when imple-
menting a design, researchers should not neglect to report
them. Otherwise, the audience will assume that the study has
not been conducted rigorously.
The overall QES of the 24 studies is relatively low (Mean ¼
3.58, SD ¼ 2.12, Median ¼ 4, Range ¼ 0–10), suggesting there
are many improvements needed for experimental studies on IA
treatment. As experimental designs are weighted heavily in the
determination of whether practices are empirically supported, it
Downloaded from rsw.sagepub.com at OAKLAND UNIV on April 6, 2015
289
is discouraging that the QES scores for experimental studies in
this review are not higher. Indeed, they were lower than those
of randomized trials in other reviews (Becker & Curry, 2008),
indicating that methodology quality is relatively weak in the
area of IA intervention studies. The lack of scientifically
established evidence hampers researchers’ abilities to inform
practitioners of promising treatments for IA. Therefore, we
suggest researchers apply more rigorous experimental designs
in their research because only through randomized controlled
experiment design can a counterfactual model be set up to
determine true treatment effectiveness (Shadish, Cook, &
Campbell, 2002).
The second implication of this study is that there exists a
need for a more uniform reporting style for outcome studies
in China. The CONSORT statement (Moher et al., 2001) is
lauded as the gold standard for transparency in clinical trial
reporting in the United States. Chinese scholars could develop
similar reporting criteria or follow CONSORT criteria to
enhance the quality of study and reporting.
Finally, one implication for social work practice pertains to
social workers choosing the best evidence about IA treatments.
In short, this study highlights how, social workers should not
choose treatments only based on simple counts of how many
studies have found positive effects for a specific treatment.
As we have seen in this study, not all clinical trials are equally
rigorous. Thus, criteria for determining whether a particular
treatment is empirically supported should consider a more
sophisticated weighting scheme to account for studies with low
methodological quality, which could inflate effect sizes. To be
specific, social workers should continue to receive training in
being good consumers of research, with emphasis on identify-
ing attributes of studies that are associated with higher
methodological quality. Although the literature is limited with
regards to the most promising IA treatments, studies reviewed
here with a QES equal or larger than 4 (i.e., the median) have
relatively higher methodological quality.
In terms of IA treatment, the most popular treatment is CBT.
Unfortunately, replication studies are needed to conclusively
determine whether CBT is a promising treatment, since one
study had a low QES score, and a more rigorous trial found a
weak, statistically insignificant effect (d ¼ .13). With the above
evidence, social worker can only treat CBT as a possibly effi-
cacious treatment. CBT combined with medication seems like
a promising therapy with a mean effect size of 3.93 and mean
QES of 3.4. However, when we looked deeply, we found that
five of the CBT plus medication studies used the SCL-90 as the
outcome measurement, and did not report actual changes in IA
symptoms. Although the studies were using medications that
targeted depression, it would also be informative to know if
these medications work for IA symptoms. Future trials could
use 2  2 designs to partition the effects of medications and
cognitive behavioral treatments. EPs had a mean effect size
of 1.47 and mean QES of 2.7. The effect size was high however
the quality of the studies was low. Taking into consideration
of effect size inflation, EP should be viewed somewhat
skeptically, and studied further in more rigorous trials.
290
Electroencephalographic biofeedback treatment did not have
statistically significant effects (d ¼ .29), so social workers
should proceed with caution with this treatment until additional
studies support its efficacy. CBT, combined with group therapy
and military training had a QES of 7 and effect size of 1.27.
This treatment fulfilled the criteria with a relatively higher
methodological quality and effect size. Therefore, this treat-
ment was the most promising treatment we reviewed in this
study. CBTs combined with either group or FT had a mean
QES of 4 and mean effect size of 1.65. The average effect size
was high, but these studies were only average in terms of
methodological quality. Relative to other treatments we
studied, these seem promising, with the general caveat that
greater specification of these treatments and more rigorously
designed studies are needed. Based on this review, possibly
efficacious treatments for IA are cognitive behavior therapies
that are combined with group therapy, military training, or FT.
Acknowledgments
The authors would like to thank Mary Keegan Eamon and Jun Sung
Hong for their helpful comments on an earlier draft of this article.
Declaration of Conflicting Interests
The authors declared no potential conflicts of interest with respect to
the research, authorship, and/or publication of this article.
Funding
The authors received no financial support for the research, authorship,
and/or publication of this article.
References
Batthyany, D., Muller, K. W., Benker, F., & Wolfling, K. (2009).
Computer game playing: Clinical characteristics of dependence
and abuse among adolescents. Wiener Klinische Wochenschrift,
121, 502-509.
Becker, S. J., & Curry, J. F. (2008). Outpatient interventions for ado-
lescent substance abuse: A quality of evidence review. Journal of
Consulting and Clinical Psychology, 76, 531-543.
Bernardi, S., & Pallanti, S. (2009). Internet addiction: A descriptive
clinical study focusing on comorbidities and dissociative symp-
toms. Comprehensive Psychiatry, 50, 510-516.
Bioulac, S., Arfi, L., & Bouvard, M. P. (2008). Attention deficit/
hyperactivity disorder and video games: A comparative study of
hyperactive and control children. European Psychiatry, 23,
134-141.
Brezing, C., Derevensky, J. L., & Potenza, M. N. (2010).
Non-substance-addictive behaviors in youth: Pathological
gambling and problematic internet use. Child and Adolescent
Psychiatric Clinical of North America, 19, 625-641.
Caplan, S., Williams, D., & Yee, N. (2009). Problematic internet use
and psychosocial well-being among MMO players. Computers in
Human Behavior, 25, 1312-1319.
Chambless, D. L., & Hollon, S. D. (1998). Defining empirically sup-
ported therapies. Journal of Consulting and Clinical Psychology,
66, 7-18.
Downloaded from rsw.sagepub.com at OAKLAND UNIV on April 6, 2015
Research on Social Work Practice 22(3)
Chan, P. A., & Rabinowitz, T. (2006). A cross-sectional analysis of
video games and attention deficit hyperactivity disorder symptoms
in adolescents. Annals of General Psychiatry, 5, 16.
China Youth Internet Association. (2010, January). 2009 nian qing
shao nian wang yin diao cha bao gao [2009 report on youth inter-
net addiction disorder]. Retrieved from http://www.docin.com/p-
46439854.html
Chou, C., Condron, L., & Belland, J. C. (2005). A review of the
research on internet addiction. Educational Psychology Review,
17, 363-388.
Cohen, J. (1988). Statistical power analysis for the behavior sciences
(2nd ed.). Hillsdale, NJ: Lawrence Erlbaum.
Derogatis, L. R. (1994). Symptom Checklist 90-R: Administration,
scoring, and procedures manual (3rd ed.). Minneapolis, MN:
National Computer Systems.
Du, Y. S., Jiang, W. Q., & Vance, A. (2010). Longer term effect of
randomized, controlled group cognitive behavioral therapy for
internet addiction in adolescent students in Shanghai. Australian
and New Zealand Journal of Psychiatry, 44, 129-134.
Eamon, M. K. (2004). Digital divide in computer access and use
between poor and non-poor youth. Journal of Sociology and Social
Welfare, 31, 91-112.
Erceg-Hum, D. M., & Mirosevich, V. M. (2008). Modern robust
statistical methods. American Psychologist, 63, 591-601.
Fisher, S. (1994). Identifying video game addiction in children and
adolescents. Addictive Behaviors, 19, 545-553.
Frolich, J., Lehmkuhl, G., & Dopfner, M. (2009). Computer games in
childhood and adolescence: Relations to addictive behavior,
ADHD, and aggression. Zeitschrift Fur Kinder-Und Jugendpsy-
chiatrie Und Psychotherapie, 37, 393-402.
Gentile, D. (2009). Pathological video-game use among youth ages 8
to 18: A national study. Psychological Science, 20, 594-602.
Gruesser, S. M., Thalemann, R., Albrecht, U., & Thalemann, C. N.
(2005). Excessive computer usage in adolescents: A psychometric
evaluation. Wiener Klinische Wochenschrift, 117, 188-195.
Guo, M., Yu, F., Chao, X. L., & Huang, G. M. (2008). Impact evalua-
tion of group counseling on internet addiction adolescents. Chinese
Journal of School Health, 29, 17-19.
Ha, J., Yu, J., Park, D. H., & Lim, W. (2009). Depression is a major
cause of internet addiction in adolescents and young adults: 2 year
experience in internet addiction clinic. International Journal of
Psychiatry in Clinical Practice, 13, 30-31.
Huang, X. Q., Li, M. C., & Tao, R. (2010). Treatment of internet
addiction. Current Psychiatry Report, 12, 462-470.
Hwang, J. M., Cheong, P. H., & Feeley, T. H. (2009). Being young and
feeling blue in Taiwan: Examining adolescent depressive mood and
online and offline activities. New Media & Society, 11, 1101-1121.
Block, J. J. (2008). Issues for DSM-V: Internet addiction. The
American Journal of Psychiatry, 165, 306-307.
Juni, P., Altman, D. G., & Egger, M. (2001). Systematic reviews in
health care: Assessing the quality of controlled clinical trials.
British Medical Journal, 323, 42-46.
Kim, E. J., Namkoong, K., Ku, T., & Kim, S. J. (2008). The relation-
ship between online game addiction and aggression, self-control
and narcissistic personality traits. European Psychiatry, 23,
212-218.
Liu et al.
Ko, C. H., Yen, J. Y., Chen, C. S., Yeh, Y. C., & Yen, C. F. (2009).
Predictive values of psychiatric symptoms for internet addiction
in adolescents: A 2-year prospective study. Archives of Pediatrics
& Adolescent Medicine, 163, 937-943.
Lam, L. T., Peng, Z., Mai, J., & Jing, J. (2009). The association
between internet addiction and self-injurious behavior among
adolescents. Injury Prevention, 15, 403-408.
Li, L., Chen, Y., Zhang, Y., & Jia, F. (2009). Jian shen yun dong chu
fang dui da xue sheng wang yin gan yu xiao guo de ying xiang [The
effects of fitness exercise prescriptions on intervening college stu-
dent’s internet addiction]. Journal of Physical Education, 16, 55–58.
Li, L., Li, G. Y., Wang, Y. Y., & Zhang, S. Y. (2008). The effects of
residential hospital treatment on 48 internet addiction patients.
Journal of Psychiatry, 21, 356-360.
Liao, X. H., & Wang, Z. Z. (2009). You yang jian shen cao dui wang
luo cheng yin da xue sheng gan yu xiao guo de yan jiu [Intervention
of aerobic exercise for internet addiction college student]. Journal
of Hunan University of Technology, 23, 86-88.
Lin, Z. X., Zou, X. B., Xie, B., Lv, D., & Lin, J. D. (2006). Qing shao
nian wang luo cheng yin xin li yao wu lian he zhi liao [Psycholo-
gical and medical treatments on youth internet addiction disorder].
Nervous Diseases and Mental Health, 6, 127-129.
Liu, Q. S., & Li, Z. Q. (2008). Zhu yuan wang luo cheng yin huan zhe
xin li gan yu de kang fu xiao guo ping jia [Rehabilitation effect of
the psychological intervention on internet addiction patients in
hospital]. Chinese Journal of School Health, 29, 1117-1119.
Liu, X. Q., Wang, J. G., & Zhuang, H. H. (2008, November 11). The
Chinese diagnostic criteria for internet addiction was approved by
clinic experts. Xin Hua News Agency. Retrieved from http://
www.gov.cn/jrzg/2008-11/08/content_1143277.htm
Liu, Y., Yang, G. D., & Yao, X. M. (2007). The effect of pharma-
cotherapy and psychotherapy with 40 IAD cases. Chinese Journal
of Drug Abuse Prevention and Treatment, 13, 88-91.
Moher, D., Schulz, K. F., & Altman, D. (2001). The CONSORT
statement: revised recommendations for improving the quality
of reports of parallel-group randomized trials. Lancet, 357, 1191-
1194.
Moyer, A., & Finney, J. W. (2005). Rating methodological quality:
Toward improved assessment and investigation. Accountability
in Research, 12, 229-313.
Pan, S. J., & Dai, X. Y. (2010). Nao dian sheng wu fan kui zhi liao
zhong xue sheng wang luo cheng yin de xiao guo guan cha [Effi-
ciency of electroencephalographic biofeedback treatment in mid-
dle school students with internet addiction disorder]. Journal of
Ningxia Medical University, 32, 71-73.
Rubin, A., & Babbie, E. R. (2011). Research methods for social work
(7th ed.). Belmont, CA: Brooks/Cole.
Shao, Z., Yang, R., Luo, K. L., & Yang, K. (2005). Fu xi ting dui ban
yi yu de zhong xue sheng wang luo cheng yin zheng de lin chuang
jiao zhi zuo yong [The effect of fluoxetine in treating middle school
students with depressant internet addiction disorder]. Chinese
Journal of Nervous and Mental Disorder, 31, 422-425.
Shao, Z., Yang, R., Luo, K. L., & Zheng, Y. (2004). Xin li zhi liao zhong
xue sheng wang luo cheng yin zheng de lin chuang yan jiu [Clinical
research on psychological treatment for adolescent internet addic-
tion]. Chinese Journal of Child Health Care, 12, 548-549.
Downloaded from rsw.sagepub.com at OAKLAND UNIV on April 6, 2015
291
Shek, D. T. L., Tang, V. M. Y., & Lo, C. Y. (2009). Evaluation of an
internet addiction treatment program for Chinese adolescents in
Hong Kong. Adolescence, 44, 359-373.
Shen, Z. M. (2008). Xi tai pu lan zhi liao zhong du wang luo yi lai
27 li liao xiao fen xi [Treatment effect of anti-depression drug
on internet addiction for 27 clients]. Tianjin Pharmacy, 20, 61-
74.
Skoric, M. M., Teo, L. L. C., & Neo, R. L. (2009). Children and video
games: Addiction, engagement, and scholastic achievement.
Cyberpsychology & Behavior, 12, 567-572.
Sun, D. L., Ma, N., Bao, M., Chen, X. C., & Zhang, D. R. (2008).
Computer games: A double-edged sword? Cyberpsychology &
Behavior, 11, 545-548.
Sun, J., & Wang, H. C. (2008). Evaluation of multiple therapy inter-
vention to internet addiction for college students. Chinese Journal
of School Health, 29, 1137-1139.
Wang, X. D., Wang, X. L., & Ma, H. (1999). Xin li wei sheng ping
ding liang biao shou ce [Mental health assessment manual].
Beijing: Chinese Mental Health Journal Institution.
Wei, Q. X. (2008a). The role of psychological nursing intervention in
the treatment of internet addiction. Journal of Heze Medical Col-
lege, 10, 16-18.
Wei, Q. X. (2008b). Xing wei jiao zhi yu xin li gan yu dui wang luo
cheng yin huan zhe kang fu xiao guo de ying xiang [Affection of
behavior correction and mental intervention on the rehabilitation
efficacy of internet addicts]. Journal of Military Surgeon in South-
west China, 10, 16-18.
Wei sheng bu jiao ting dian ji zhi liao wang yin [Chinese Ministry of
Health ban on electric stimulus therapy for internet addition disor-
der]. (2009, July 13). Retrieved from http://news.163.com/09/
0713/17/5E4D5T7P000120GU.html
Wu, L. Z., Yan, J. J., & Han, J. S. (2007). 2/100 Hz jing pi xue zhu dian
chi ji dui 27 li qing shao nian wang luo cheng yin zheng de zhi liao
zuo yong [Treatment on 27 adolescents with Internet addiction by
2/100 HZ Han’s acupoint nerve stimulation]. Chinese Journal of
Drug Dependence, 16, 32-35.
Wu, S. L., & Yang, Y. X. (2008). The evaluation of cognitive behavior
therapy on internet addiction. China Medical Herald, 5, 161-162.
Yang, F. R., & Hao, W. (2005). 52 li wang luo cheng yin qing shao
nian xin li she hui zong he gan yu de liao xiao guan cha [The effect
of integrated psychosocial intervention on 52 adolescents with
internet addiction disorder]. Chinese Journal of Clinical Psychol-
ogy, 13, 343-346.
Yang, R., Shao, Z., & Zheng, Y. (2005). zhong xue sheng wang luo
cheng yin zheng de zong he gan yu [Comprehensive intervention
on internet addiction of middle school students]. Chinese Mental
Health Journal, 19, 457-459.
Yang, R., Zheng, Y., & Ruan, K. L. (2004). Wang luo cheng yin shi
zheng yan jiu jin zhan [Research progress on internet addiction dis-
order]. Journal of Southwest China Normal University, 30, 2-5.
Young, K. (2009a). Internet addiction: Diagnosis and treatment
consideration. Journal of Contemporary Psychotherapy, 39, 241-
246.
Young, K. (2009b). Understanding online gaming addiction and treat-
ment issues for adolescents. American Journal of Family Therapy,
37, 355-372.
292
Young, K. S. (2004). Internet addiction: A new clinical phenomenon
and its consequences. American Behavioral Scientist, 48, 402-415.
Zhan, L. Y., & Li, R. Q. (2009). Nei guan ren zhi liao fa dui wang yin
huan zhe xin li kang fu de zuo yong [Effect of neikan cognitive
therapy on psychological status of inpatients with internet
addiction]. Journal of Nursing Science, 24, 77-79.
Zhang, Y. H. (2009). Yi ti yu huo dong wei zhu yao shou duan gan yu
da xue sheng wang luo cheng yin de shi zheng yan jiu tan jiu
[Experimental study to interfere with college students’ internet
addiction by using sports as main means]. Journal of Tonghua
Teachers College, 30, 74-76.
Downloaded from rsw.sagepub.com at OAKLAND UNIV on April 6, 2015
Research on Social Work Practice 22(3)
Zhong, X., Tao, R., Zhu, S., Sha, S., & Yang, F. C. (2009). Tuan ti xin
li gan yu dui qing shao nian wang luo cheng yin de xiao guo yan jiu
[Effect of group psychological intervention in adolescent on
internet addiction]. Journal of Capital Medical University, 30,
494-499.
Zhu, T. M., Jin, R. J., Zhong, X. M., Chen, J., & Li, H. (2008). Dian
zhen jie he xin li gan yu dui wang yin huan zhe jiao lv zhuang tai ji
xie qing NE bian hua de ying xiang [Effects of electroacupuncture
combined with psychological interference on anxiety state and
serum NE content in the patient of internet addiction disorder].
Chinese Acupuncture & Moxibustion, 28, 561-564.