Wednesday, January 29, 2020
Living in Families Essay Example for Free
Living in Families Essay How does the average person view the common family? In the picture of â€Å"a happy family†on commercials, conflict and hatred are replaced with sweetness and adoration – qualities that are apparent on the family members’ smiling faces. Pure happy days are simply not realistic. In real life, families have good reason to frown occasionally, which leads to a statement by the author Willa Cather about a family relationship. She comments that the seed of the family conflict is from the clash of each members’ individual personality, or identity. As one builds own identity, there is no choice but to struggle for appealing his or her ego to other family members; even though they are a family who is supposed to understand and concede to one another, ideally speaking. Cather also says that family members pursue the sense of security from mutual existence, and they want to eschew from the restraint and infringe on individual privacy at the same time.    Three works of literature which support Willa Cather’s idea about family relationships are: â€Å"I Stand Here Ironing†by Tillie Olsen, â€Å"Two Kinds†by Amy Tan, and â€Å"Sonny’s Blues†by James Baldwin. Through the eyes of these characters, we can see how the development of identity causes conflicts between family members. Ironically, they continue to pull away from each other even though they need each other. We should explore how the characters get over the â€Å"tragic necessity†(Cather 107-120).            Though the main conflict in â€Å"I Stand Here Ironing†doesn’t seem to appear on the surface the author shows that the conflict occurs inside narrator’s mind. When the narrator has Emily, her daughter, she â€Å"is nineteen and it is the pre-relief, pre-WPA world of the depression†(341). Living in the new era as a nineteen-year-old single mother, she has to confront her new identity. In other words, there is a struggle between two identities inside her, as an individual who tries to survive in tough circumstance and as a mother who tries to love her daughter. As she confesses that she â€Å"was a distracted mother†(345), her unstable identity does not allow her to take superior care of Emily. This is the situation which Cather referred to as a â€Å"double life†(107-120). The narrator has suffered from â€Å"the real life that stamps the faces and gives character to the voices of our friends†(Cather 107-120).            In laborious circumstances, her only family, Emily, is the reason why she is still alive, but also the burden from which she wants to escape. This is shown in â€Å"what was in my face when I looked at her,†the scene in which she realizes her frown face at her daughter saying â€Å"there were all the acts of love†(341). Because of her desperate fate, the narrator unconsciously tries â€Å"pulling away from†her daughter even though she â€Å"seeks†to feel (Cather 107-120) maternal affection for Emily. This irony is represented by Cather’s idea of â€Å"the tragic necessity of human life†(107-120).            At the end of the story, the narrator shows her will to finish the conflict she has endured. According to Emily who never believed herself to be special, finds her identity and path, which concludes with her mother lightening the pressure about being a role of breeder by â€Å"letting her be†(345).            Contrary to â€Å"I Stand Here Ironing,†the main conflict between family members in â€Å"Two Kinds†is revealed clearly; it is about the relationship between a mother and daughter. The peculiarity of this story is that the basis of the conflict is a clash of two different cultures, which can be interpreted as a clash of two identities; the Chinese mother who wants â€Å"obedient daughter†and the Americanized daughter, named Mei, who wants to â€Å"follow her own heart†(353). Her mother’s wishful thinking is clear on this quote; â€Å"you can be anything you want to be†(346), which means actually â€Å"you can be anything I want you to be.†This attitude is very different from the mother’s attitude in â€Å"I Stand Here Ironing.†On contrary to â€Å"letting her be†(345), Mei’s mother keeps pushing her daughter to do what she wants, not what her daughter wants – this is Mei’s mother’s personality. Mei’s response is:  â€Å"I won’t be what I’m not†(348). As a result, the conflict in this story is caused by the clash of individual identities, as Cather describes.            Moreover, the trouble reaches a peak at their quarrel following the piano recital. In this scene, Mei pretends to â€Å"pull away†(Cather 107-120) from her mother by saying â€Å"the magic words†(353). What Mei says was not from the bottom of her heart: it could be seen when Mei gets the piano as â€Å"a sign of forgiveness†(353), she â€Å"feels proud, as if it were a shiny trophy†(354). In other words, she cannot deny that she misses her family even though she wants to get away from them. After all, the daughter seeks to get out of the â€Å"tragic necessity†(Cather 107-120) by realizing that the two piano pieces â€Å"pleading child†and â€Å"perfectly contented†(354) is one song, which means that the pleading child has become perfectly contented.            Compared to the other two works above, the conflict in â€Å"Sonny’s Blues†occurs between a sibling relationship, not between parent and child relationship as in the preceding examples. The origin of the conflict is the same; the clash of identities. At the beginning of the story, the fact that the narrator, Sonny’s brother, gets Sonny’s news from the newspaper shows that the relationship between two brothers is not secure; their relationship as a family has already been â€Å"pulled away†(Cather 107-120). The reason why they have been separated from each other for a long time was the lack of comprehension of the other’s individual personality. To overcome â€Å"the darkness outside†(384), which describes the discrimination in that era, both brother have to develop their identities which helps them as they endure hardships. Unfortunately, the identities they developed are very different; the narrator is practical and conservative, and Sonny is emotional and unconventional.            The clash of the identities has divided the brothers and causes Sonny to pursue â€Å"escaping, running away, and trying to break the net†(Cather 107-120) which leads to his addiction to heroin. In fact, Sonny â€Å"had always been a good boy†(377) as a member of the family. In his subconscious, he had â€Å"another secret, passionate and intense†(Cather 107-120). Though the narrator tries to care for Sonny in order to fulfill the promise made to his mother, He cannot understand Sonny’s â€Å"another†(Cather 107-120) aspect. This conflict is the reason why they keep pulling away each other.            Nevertheless, at the end of story, they get back together with perfect comprehension. Listening to Sonny’s play, the narrator â€Å"understands, at last†(398), his brother’s identity and why they were pulling away from each other; he realizes that the root of the conflict the brothers had was not because of Sonny’s rebellion but of his own misunderstanding of the suffering Sonny has endured. The brothers prepare to overcome the â€Å"tragic necessity,†which initially separated them, with â€Å"a Scotch and milk†(399) in the end.            In conclusion, through the analysis of the three works of literature, Willa Cather’s idea of â€Å"the double life†and â€Å"tragic necessity of human relationship†(107-120) can be seen as a universal theme in various stories. The development of identity causes the conflicts between family members, and the irony is that they continue to pull away from each other even though they need each. In Cather’s view, family members have a chance to overcome the conflicts they have had, as demonstrated by the narrator of â€Å"I Stand Here Ironing,†Mei from â€Å"Two Kinds,†and Sonny’s brother from â€Å"Sonny’s Blues†. Each character gets the better of his or her own conflicts to a certain extent. As they should; families are supposed to stick together. References Cather, Willa. Katherine Mansfield. Willa Cather on Writing. Lincoln, NE: University of Nebraska Press, 1988. 107-120. Schilb, John, and Clifford, John. Making Literature Matter. Boston, MA: Bedford/St. Martin’s, 2006
Tuesday, January 21, 2020
Essay on Camus’ The Stranger (The Outsider): Apathy -- Camus Stranger
Apathy in The Stranger (Outsider) Often times an author incorporates a thought or philosophy into a work that can shape or reshape the attitude emitted from the novel. In Albert Camus', The Stranger, the Existential philosophy that the author fills into the work give an aura of apathy. With the opening lines of "Mother died today. Or, maybe, yesterday; I can't be sure," Camus immediately sets a tone of indifference (1). Though the protagonist, Mersault, is not completely without cares, the overall attitude of passiveness he has toward himself, as well as toward others, give the entire novel a tone of apathy. With an analyzation of Mersault's character, an automatic attitude of nonchalance is quickly seen. Mersault does not lie to himself, let alone to others, because he has no need to. He does not care about the set laws of society, and he feels that he has no one to please, including himself, which is a reason why he has no qualms about being brutally honest and not hiding his feelings. This is ...
Monday, January 13, 2020
Internet Addiction Essay
Abstract Problematic computer use is a growing social issue which is being debated worldwide. Internet Addiction Disorder (IAD) ruins lives by causing neurological complications, psychological disturbances, and social problems. Surveys in the United States and Europe have indicated alarming prevalence rates between 1.5 and 8.2% [1]. There are several reviews addressing the definition, classification, assessment, epidemiology, and co-morbidity of IAD [2-5], and some reviews [6-8] addressing the treatment of IAD. The aim of this paper is to give a preferably brief overview of research on IAD and theoretical considerations from a practical perspective based on years of daily work with clients suffering from Internet addiction. Furthermore, with this paper we intend to bring in practical experience in the debate about the eventual inclusion of IAD in the next version of the Diagnostic and Statistical Manual of Mental Disorders (DSM).Problematic computer use is a growing social issue which is bein g debated worldwide. Internet Addiction Disorder (IAD) ruins lives by causing neurological complications, psychological disturbances, and social problems. Surveys in the United States and Europe have indicated alarming prevalence rates between 1.5 and 8.2% [1]. There are several reviews addressing the definition, classification, assessment, epidemiology, and co-morbidity of IAD [2-5], and some reviews [6-8] addressing the treatment of IAD. The aim of this paper is to give a preferably brief overview of research on IAD and theoretical considerations from a practical perspective based on years of daily work with clients suffering from Internet addiction. Furthermore, with this paper we intend to bring in practical experience in the debate about the eventual inclusion of IAD in the next version of the Diagnostic and Statistical Manual of Mental Disorders (DSM). Keywords: Addiction, Computer, Internet, reSTART, Treatment. INTRODUCTION The idea that problematic computer use meets criteria for an addiction, and therefore should be included in the next iteration of the Diagnostic and Statistical Manual of Mental Disorders (DSM), 4th ed. Text Revision [9] was first proposed by Kimberly Young, PhD in her seminal 1996 paper [10]. Since that time IAD has been extensively studied and is indeed, currently under consideration for inclusion in the DSM-V [11]. Meanwhile, both China and South Korea have identified Internet addiction as a significant public health threat and both countries support education, research and treatment [12]. In the United States, despite a growing body of research, and treatment for the disorder available in out-patient and in-patient settings, there has been no formal governmental response to the issue of Internet addiction. While the debate goes on about whether or not the DSM-V should designate Internet addiction a mental disorder [12-14] people currently suffering from Internet addiction are seeking treatment. Because of our experience we support the development of uniform diagnostic criteria and the inclusion of IAD in the DSM-V [11] in order to advance public education, diagnosis and treatment of this important disorder. CLASSIFICATION There is ongoing debate about how best to classify the behavior which is characterized by many hours spent in non-work technology-related computer/Internet/video game activities [15]. It is accompanied by changes in mood, preoccupation with the Internet and digital media, the inability to control the amount of time spent interfacing with digital technology, the need for more time or a new game to achieve a desired mood, withdrawal symptoms when not engaged, and a continuation of the behavior despite family conflict, a diminishing social life and adverse work or academic consequences [2, 16, 17]. Some researchers and mental health practitioners see excessive Internet use as a symptom of another disorder such as anxiety or depression rather than a separate entity [e.g. 18]. Internet addiction could be considered an Impulse control disorder (not otherwise specified). Yet there is a growing consensus that this constellation of symptoms is an addiction [e.g. 19]. The American Society of Addiction Medicine (ASAM) recently released a new definition of addiction as a chronic brain disorder, officially proposing for the first time that addiction is not limited to substance use [20]. All addictions, whether chemical or behavioral, share certain characteristics including salience, compulsive use (loss of control), mood modification and the alleviation of distress, tolerance and withdrawal, and the continuation despite negative consequences. DIAGNOSTIC CRITERIA FOR IAD The first serious proposal for diagnostic criteria was advanced in 1996 by Dr. Young, modifying the DSM-IV criteria for pathological gambling [10]. Since then variations in both name and criteria have been put forward to capture the problem, which is now most popularly known as Internet Addiction Disorder. Problematic Internet Use (PIU) [21], computer addiction, Internet dependence [22], compulsive Internet use, pathological Internet use [23], and many other labels can be found in the literature. Likewise a variety of often overlapping criteria have been proposed and studied, some of which have been validated. However, empirical studies provide an inconsistent set of criteria to define Internet addiction [24]. For an overview see Byun et al. [25]. Beard [2] recommends that the following five diagnostic criteria are required for a diagnosis of Internet addiction: (1) Is preoccupied with the Internet (thinks about previous online activity or anticipate next online session); (2) Needs t o use the Internet with increased amounts of time in order to achieve satisfaction; (3) Has made unsuccessful efforts to control, cut back, or stop Internet use; (4) Is restless, moody, depressed, or irritable when attempting to cut down or stop Internet use; (5) Has stayed online longer than originally intended. Additionally, at least one of the following must be present: (6) Has jeopardized or risked the loss of a significant relationship, job, educational or career opportunity because of the Internet; (7) Has lied to family members, therapist, or others to conceal the extent of involvement with the Internet; (8) Uses the Internet as a way of escaping from problems or of relieving a dysphoric mood (e.g., feelings of helplessness, guilt, anxiety, depression) [2]. There has been also been a variety of assessment tools used in evaluation. Young’s Internet Addiction Test [16], the Problematic Internet Use Questionnaire (PIUQ) developed by Demetrovics, Szeredi, and Pozsa [26] and the Compulsive Internet Use Scale (CIUS) [27] are all examples of instruments to assess for this disorder. PREVALENCE The considerable variance of the prevalence rates reported for IAD (between 0.3% and 38%) [28] may be attributable to the fact that diagnostic criteria and assessment questionnaires used for diagnosis vary between countries and studies often use highly selective samples of online surveys [7]. In their review Weinstein and Lejoyeux [1] report that surveys in the United States and Europe have indicated prevalence rates varying between 1.5% and 8.2%. Other reports place the rates between 6% and 18.5% [29]. â€Å"Some obvious differences with respect to the methodologies, cultural factors, outcomes and assessment tools forming the basis for these prevalence rates notwithstanding, the rates we encountered were generally high and sometimes alarming.†[24] ETIOLOGY There are different models available for the development and maintenance of IAD like the cognitive-behavioral model of problematic Internet use [21], the anonymity, convenience and escape (ACE) model [30], the access, affordability, anonymity (Triple-A) engine [31], a phases model of pathological Internet use by Grohol [32], and a comprehensive model of the development and maintenance of Internet addiction by Winkler & Dà ¶rsing [24], which takes into account socio-cultural factors (e.g., demographic factors, access to and acceptance of the Internet), biological vulnerabilities (e.g., genetic factors, abnormalities in neurochemical processes), psychological predispositions (e.g., personality characteristics, negative affects), and specific attributes of the Internet to explain â€Å"excessive engagement in Internet activities†[24]. NEUROBIOLOGICAL VULNERABILITIES It is known that addictions activate a combination of sites in the brain associated with pleasure, known together as the â€Å"reward center†or â€Å"pleasure pathway†of the brain [33, 34]. When activated, dopamine release is increased, along with opiates and other neurochemicals. Over time, the associated receptors may be affected, producing tolerance or the need for increasing stimulation of the reward center to produce a â€Å"high†and the subsequent characteristic behavior patterns needed to avoid withdrawal. Internet use may also lead specifically to dopamine release in the nucleus accumbens [35, 36], one of the reward structures of the brain specifically involved in other addictions [20]. An example of the rewarding nature of digital technology use may be captured in the following statement by a 21 year-old male in treatment for IAD: â€Å"I feel technology has brought so much joy into my life. No other activity relaxes me or stimulates me like technolo gy. However, when depression hits, I tend to use technology as a way of retreating and isolating.†REINFORCEMENT/REWARD What is so rewarding about Internet and video game use that it could become an addiction? The theory is that digital technology users experience multiple layers of reward when they use various computer applications. The Internet functions on a variable ratio reinforcement schedule (VRRS), as does gambling [29]. Whatever the application (general surfing, pornography, chat rooms, message boards, social networking sites, video games, email, texting, cloud applications and games, etc.), these activities support unpredictable and variable reward structures. The reward experienced is intensified when combined with mood enhancing/stimulating content. Examples of this would be pornography (sexual stimulation), video games (e.g. various social rewards, identification with a hero, immersive graphics), dating sites (romantic fantasy), online poker (financial) and special interest chat rooms or message boards (sense of belonging) [29, 37]. BIOLOGICAL PREDISPOSITION There is increasing evidence that there can be a genetic predisposition to addictive behaviors [38, 39]. The theory is that individuals with this predisposition do not have an adequate number of dopamine receptors or have an insufficient amount of serotonin/dopamine [2], thereby having difficulty experiencing normal levels of pleasure in activities that most people would find rewarding. To increase pleasure, these individuals are more likely to seek greater than average engagement in behaviors that stimulate an increase in dopamine, effectively giving them more reward but placing them at higher risk for addiction. MENTAL HEALTH VULNERABILITIES Many researchers and clinicians have noted that a variety of mental disorders co-occur with IAD. There is debate about which came first, the addiction or the co-occurring disorder [18, 40]. The study by Dong et al. [40] had at least the potential to clarify this question, reporting that higher scores for depression, anxiety, hostility, interpersonal sensitivity, and psychoticism were consequences of IAD. But due to the limitations of the study further research is necessary. THE TREATMENT OF INTERNET ADDICTION There is a general consensus that total abstinence from the Internet should not be the goal of the interventions and that instead, an abstinence from problematic applications and a controlled and balanced Internet usage should be achieved [6]. The following paragraphs illustrate the various treatment options for IAD that exist today. Unless studies examining the efficacy of the illustrated treatments are not available, findings on the efficacy of the presented treatments are also provided. Unfortunately, most of the treatment studies were of low methodological quality and used an intra-group design. The general lack of treatment studies notwithstanding, there are treatment guidelines reported by clinicians working in the field of IAD. In her book â€Å"Internet Addiction: Symptoms, Evaluation, and Treatment†, Young [41] offers some treatment strategies which are already known from the cognitive-behavioral approach: (a) practice opposite time of Internet use (discover patientâ €™s patterns of Internet use and disrupt these patterns by suggesting new schedules), (b) use external stoppers (real events or activities prompting the patient to log off), (c) set goals (with regard to the amount of time), (d) abstain from a particular application (that the client is unable to control), (e) use reminder cards (cues that remind the patient of the costs of IAD and benefits of breaking it), (f) develop a personal inventory (shows all the activities that the patient used to engage in or can’t find the time due to IAD), (g) enter a support group (compensates for a lack of social support), and (h) engage in family therapy (addresses relational problems in the family) [41]. Unfortunately, clinical evidence for the efficacy of these strategies is not mentioned. Non-psychological Approaches Some authors examine pharmacological interventions for IAD, perhaps due to the fact that clinicians use psychopharmacology to treat IAD despite the lack of treatment studies addressing the efficacy of pharmacological treatments. In particular, selective serotonin-reuptake inhibitors (SSRIs) have been used because of the co-morbid psychiatric symptoms of IAD (e.g. depression and anxiety) for which SSRIs have been found to be effective [42-46]. Escitalopram (a SSRI) was used by Dell’Osso et al. [47] to treat 14 subjects with impulsive-compulsive Internet usage disorder. Internet usage decreased significantly from a mean of 36.8 hours/week to a baseline of 16.5 hours/week. In another study Han, Hwang, and Renshaw [48] used bupropion (a non-tricyclic antidepressant) and found a decrease of craving for Internet video game play, total game play time, and cue-induced brain activity in dorsolateral prefrontal cortex after a six week period of bupropion sustained release treatment. Methylphenidate (a psycho stimulant drug) was used by Han et al. [49] to treat 62 Internet video game-playing children diagnosed with attention-deficit hyperactivity disorder. After eight weeks of treatment, the YIAS-K scores and Internet usage times were significantly reduced and the authors cautiously suggest that methylphenidate might be evaluated as a potential treatment of IAD. According to a study by Shapira et al. [50], mood stabilizers might also improve the symptoms of IAD. In addition to these studies, there are some case reports of patients treated with escitalopram [45], citalopram (SSRI)- quetiapine (antipsychotic) combination [43] and naltrexone (an opioid receptor antagonist) [51]. A few authors mentioned that physical exercise could compensate the decrease of the dopamine level due to decreased online usage [52]. In addition, sports exercise prescriptions used in the course of cognitive behavioral group therapy may enhance the effect of the intervention for IAD [53]. Psychological Approaches Motivational interviewing (MI) is a client-centered yet directive method for enhancing intrinsic motivation to change by exploring and resolving client ambivalence [54]. It was developed to help individuals give up addictive behaviors and learn new behavioral skills, using techniques such as open-ended questions, reflective listening, affirmation, and summarization to help individuals express their concerns about change [55]. Unfortunately, there are currently no studies addressing the efficacy of MI in treating IAD, but MI seems to be moderately effective in the areas of alcohol, drug addiction, and diet/exercise problems [56]. Peukert et al. [7] suggest that interventions with family members or other relatives like â€Å"Community Reinforcement and Family Training†[57] could be useful in enhancing the motivation of an addict to cut back on Internet use, although the reviewers remark that control studies with relatives do not exist to date. Reality therapy (RT) is supposed t o encourage individuals to choose to improve their lives by committing to change their behavior. It includes sessions to show clients that addiction is a choice and to give them training in time management; it also introduces alternative activities to the problematic behavior [58]. According to Kim [58], RT is a core addiction recovery tool that offers a wide variety of uses as a treatment for addictive disorders such as drugs, sex, food, and works as well for the Internet. In his RT group counseling program treatment study, Kim [59] found that the treatment program effectively reduced addiction level and improved self-esteem of 25 Internet-addicted university students in Korea. Twohig and Crosby [60] used an Acceptance & Commitment Therapy (ACT) protocol including several exercises adjusted to better fit the issues with which the sample struggles to treat six adult males suffering from problematic Internet pornography viewing. The treatment resulted in an 85% reduction in viewing at post-treatment with results being maintained at the three month follow-up (83% reduction in viewing pornography). Widyanto and Griffith [8] report that most of the treatments employed so far had utilized a cognitive-behavioral approach. The case for using cognitive-behavioral thera py (CBT) is justified due to the good results in the treatment of other behavioral addictions/impulse-control disorders, such as pathological gambling, compulsive shopping, bulimia nervosa, and binge eating-disorders [61]. Wà ¶lfling [5] described a predominantly behavioral group treatment including identification of sustaining conditions, establishing of intrinsic motivation to reduce the amount of time being online, learning alternative behaviors, engagement in new social real-life contacts, psycho-education and exposure therapy, but unfortunately clinical evidence for the efficacy of these strategies is not mentioned. In her study, Young [62] used CBT to treat 114 clients suffering from IAD and found that participants were better able to manage their presenting problems post-treatment, showing improved motivation to stop abusing the Internet, improved ability to control their computer use, improved ability to function in offline relationships, improved ability to abstain from sexually explicit online material, improved ability to engage in offline activities, and improved ability to achieve sobriety from problematic applications. Cao, Su and Gao [63] investigated the effect of group CBT on 29 middl e school students with IAD and found that IAD scores of the experimental group were lower than of the control group after treatment. The authors also reported improvement in psychological function. Thirty-eight adolescents with IAD were treated with CBT designed particularly for addicted adolescents by Li and Dai [64]. They found that CBT has good effects on the adolescents with IAD (CIAS scores in the therapy group were significant lower than that in the control group). In the experimental group the scores of depression, anxiety, compulsiveness, self-blame, illusion, and retreat were significantly decreased after treatment. Zhu, Jin, and Zhong [65] compared CBT and electro acupuncture (EA) plus CBT assigning forty-seven patients with IAD to one of the two groups respectively. The authors found that CBT alone or combined with EA can significantly reduce the score of IAD and anxiety on a self-rating scale and improve self-conscious health status in patients with IAD, but the effect obtained by the combined therapy was better. Multimodal Treatments A multimodal treatment approach is characterized by the implementation of several different types of treatment in some cases even from different disciplines such as pharmacology, psychotherapy and family counseling simultaneously or sequentially. Orzack and Orzack [66] mentioned that treatments for IAD need to be multidisciplinary including CBT, psychotropic medication, family therapy, and case managers, because of the complexity of these patients’ problems. In their treatment study, Du, Jiang, and Vance [67] found that multimodal school-based group CBT (including parent training, teacher education, and group CBT) was effective for adolescents with IAD (n = 23), particularly in improving emotional state and regulation ability, behavioral and self-management style. The effect of another multimodal intervention consisting of solution-focused brief therapy (SFBT), family therapy, and CT was investigated among 52 adolescents with IAD in China. After three months of treatment, the scores on an IAD scale (IAD-DQ), the scores on the SCL-90, and the amount of time spent online decreased significantly [68]. Orzack et al. [69] used a psychoeducational program, which combines psychodynamic and cognitive-behavioral theoretical perspectives, using a combination of Readiness to Change (RtC), CBT and MI interventions to treat a group of 35 men involved in problematic Internet-enabled sexual behavior (IESB). In this group treatment, the quality of life increased and the level of depressive symptoms decreased after 16 (weekly) treatment sessions, but the level of problematic Internet use failed to decrease significantly [69]. Internet addiction related symptom scores significantly decreased after a group of 23 middle school students with IAD were treated with Behavioral Therapy (BT) or CT, detoxification treatment, psychosocial rehabilitation, personality modeling and parent training [70]. Therefore, the authors concluded that psychotherapy, in particular CT and BT were effective in treating middle school students with IAD. Shek, Tang, and Lo [71] described a multi-level counseling program designed for young people with IAD based on the responses of 59 clients. Findings of this study suggest this multi-level counseling program (including counseling, MI, family perspective, case work and group work) is promising to help young people with IAD. Internet addiction symptom scores significantly decreased, but the program failed to increase psychological well-being significantly. A six-week group counseling program (including CBT, social competence training, training of self-control strategies and training of communication skills) was shown to be effective on 24 Internet-addicted college students in China [72]. The authors reported that the adapted CIAS-R scores of the experimental group were significantly lower than those of the control group post-treatment. The reSTART Program The authors of this article are currently, or have been, affiliated with the reSTART: Internet Addiction Recovery Program [73] in Fall City, Washington. The reSTART program is an inpatient Internet addiction recovery program which integrates technology detoxification (no technology for 45 to 90 days), drug and alcohol treatment, 12 step work, cognitive behavioral therapy (CBT), experiential adventure based therapy, Acceptance and Commitment therapy (ACT), brain enhancing interventions, animal assisted therapy, motivational interviewing (MI), mindfulness based relapse prevention (MBRP), Mindfulness based stress reduction (MBSR), interpersonal group psychotherapy, individual psychotherapy, individualized treatments for co-occurring disorders, psycho- educational groups (life visioning, addiction education, communication and assertiveness training, social skills, life skills, Life balance plan), aftercare treatments (monitoring of technology use, ongoing psychotherapy and group work), a nd continuing care (outpatient treatment) in an individualized, holistic approach. The first results from an ongoing OQ45.2 [74] study (a self-reported measurement of subjective discomfort, interpersonal relationships and social role performance assessed on a weekly basis) of the short-term impact on 19 adults who complete the 45+ days program showed an improved score after treatment. Seventy-four percent of participants showed significant clinical improvement, 21% of participants showed no reliable change, and 5% deteriorated. The results have to be regarded as preliminary due to the small study sample, the self-report measurement and the lack of a control group. Despite these limitations, there is evidence that the program is responsible for most of the improvements demonstrated. CONCLUSION As can be seen from this brief review, the field of Internet addiction is advancing rapidly even without its official recognition as a separate and distinct behavioral addiction and with continuing disagreement over diagnostic criteria. The ongoing debate whether IAD should be classified as an (behavioral) addiction, an impulse-control disorder or even an obsessive compulsive disorder cannot be satisfactorily resolved in this paper. But the symptoms we observed in clinical practice show a great deal of overlap with the symptoms commonly associated with (behavioral) addictions. Also it remains unclear to this day whether the underlying mechanisms responsible for the addictive behavior are the same in different types of IAD (e.g., online sexual addiction, online gaming, and excessive surfing). From our practical perspective the different shapes of IAD fit in one category, due to various Internet specific commonalities (e.g., anonymity, riskless interaction), commonalities in the underlying behavior (e.g., avoidance, fear, pleasure, entertainment) and overlapping symptoms (e.g., the increased amount of time spent online, preoccupation and other signs of addiction). Nevertheless more research has to be done to substantiate our clinical impression. Despite several methodological limitations, the strength of this work in comparison to other reviews in the international body of literature addressing the definition, classification, assessment, epidemiology, and co-morbidity of IAD [2-5], and to reviews [6-8] addressing the treatment of IAD, is that it connects theoretical considerations with the clinical practice of interdisciplinary mental health experts working for years in the field of Internet addiction. Furthermore, the current work gives a good overview of the current state of research in the field of internet addiction treatment. Despite the limitations stated above this work gives a brief overview of the current state of research on IAD from a practical perspective and can therefore be seen as an important and helpful paper for further research as well as for clinical practice in particular.
Saturday, January 4, 2020
The Dissolution Of Yugoslavi Yugoslavia - 903 Words
The Dissolution of Yugoslavia The country of Yugoslavia was first formed as a kingdom in 1918 after combining land areas from the now both defunct Ottoman and Austro-Hungarian Empires and then recreated as a Socialist state in 1945 after the Axis powers were defeated in World War II. The Soviet Union took control of Yugoslavia after the war and wrote a new constitution for the country that established six constituent republics in the federation: Bosnia-Hercegovina, Croatia, Macedonia, Montenegro, Serbia and Slovenia. The Republic of Serbia also had two self-governing provinces: Vojvodina and Kosovo. Yugoslavia was a part of the Soviet Union until the Union dissolved in 1991 and as a result Yugoslavia soon followed, but this is about†¦show more content†¦Exceptions to this pattern of stability were the marked increase of the Albanian population and a steep decline in the numbers of Jews, ethnic Germans, and Hungarians after World War II (Cushman). Another definitive cause of the Yugoslavian breakup was the nationalism of ethnic groups in the early 1990s. Nationalism replaced communism as the dominant ideology in the country. Slovenia and then Croatia were the first to break away, but this caused Serbia to become hostile towards the two nations. Consequently, the war in Croatia led to hundreds of thousands of refugees and also brought back memories of the harsh acts of the Nazis in the 1940s. By 1992 a further conflict had broken out in Bosnia, which had also succeeded from Yugoslavia. The Serbs who lived there were determined in remaining within Yugoslavia and to help build a more homogenous Serbia. They received strong backing from radical groups in Belgrade. Muslims were driven from their homes in carefully planned operations that become known as ethnic cleansing. By 1993 the Bosnian Muslim government was besieged in the capital Sarajevo, surrounded by Bosnian Serb forces who controlled around 70% of Bosnia. In Central Bosnia, the mainly Muslim army w as fighting a separate war against Bosnian Croats who wished to be part of a greater Croatia. The presence of United Nations peacekeepers was required to contain the situation. The idea from culminated in the Yugoslav Peace Conference,
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