Thursday, September 25, 2014

How to create motivation in the addicted gamer?

Motivational Interviewing (MI) offers a new perspective on what the role of the mental health professional is in the mysterious, perplexing, and often frustrating process of instilling motivation in video game addicts.  Failure to “inspire” gaming addicts to reach their goals, despite our best coaching and cheerleading efforts, has been a significant contributor to the conclusion that gaming addicts cannot be helped.  

Psychologists William Miller and Stephen Rollnick (1991) have conceptualized lack of motivation as the experience of being “stuck” in ambivalence. They developed a counseling style that elicits behavior change by helping clients to explore and resolve this ambivalence. This style is similar to the client-centered, humanistic approach developed by Carl Rogers and others; however, it is notably more directive, and can demonstrate results in a relatively short period of time.

The concept of MI originally evolved from William Miller’s experiences with the treatment of problem drinkers.  Since then, however, MI has been applied to much broader settings. It operates from the premise that ambivalence is a normal state that affects many areas of one’s life. MI uses a set of skills and principles that guide the client and counselor through the process of resolving ambivalence (Miller and Rollnick, 1991). 

In my next blog I will begin to explain how MI works as well as why MI is effective with gaming addicts.

Christopher Mulligan LCSW

Monday, July 14, 2014

Porn addiction similar to drug addiction?

LONDON (Reuters) - Pornography triggers brain activity in sex addicts similar to the effect drugs have on the brains of drug addicts, researchers said on Friday - but that doesn't necessarily mean porn is addictive.
Although there are no precise figures, experts in the field believe as many as one in 25 adults is affected by compulsive sexual behavior, more commonly known as sex addiction - an obsession with sexual thoughts, feelings or behavior they are unable to control.
Excessive use of pornography is one of the main features of the condition. That can affect personal lives and work, causing distress and feelings of shame, the researchers from Britain's Cambridge University said in a study published in the journal PLOS ONE.
The study looked at brain activity in 19 male patients affected by sex addiction and compared them with the same number of volunteers. The patients had started watching pornography at earlier ages and in higher proportions than the volunteers.
"The patients in our trial were all people who had substantial difficulties controlling their sexual behavior and this was having significant consequences for them, affecting their lives and relationships," said Dr Valerie Voon, who led the study at Cambridge's department of psychiatry.
"In many ways, they show similarities in their behavior to patients with drug addictions. We wanted to see if these similarities were reflected in brain activity, too."
The study participants were shown a series of short videos featuring either sexually explicit content or sports. Their brain activity was monitored using functional magnetic resonance imaging (fMRI), which uses a blood oxygen level dependent (BOLD) signal to measure brain activity.
The researchers found that three regions in particular were more active in the brains of the sex addiction patients compared with the healthy volunteers.
Significantly, these regions – the ventral striatum, dorsal anterior cingulate and amygdala – are also activated in drug addicts when they are shown drug stimuli, the researchers said.
The ventral striatum is involved in processing reward and motivation, while the dorsal anterior cingulate is involved in anticipating rewards and drug craving, they said. The amygdala helps process the significance of events and emotions.
The researchers also asked the participants to rate their levels of sexual desire while watching the videos and say how much they liked them. Drug addicts are thought to be driven to seek their drug because they want it, rather than enjoy it.
This process is known as incentive motivation, Voon said, and is a compelling theory in addiction disorders.
Patients with sex addiction showed higher levels of desire towards the sexually explicit videos, but did not necessarily like them more.
"Whilst these findings are interesting, it's important to note ... that they could not be used to diagnose the condition," Voon said. "Nor does our research necessarily provide evidence that these individuals are addicted to porn – or that porn is inherently addictive.
"Much more research is required to understand this relationship between compulsive sexual behavior and drug addiction."
(Editing by Larry King)

Thursday, June 26, 2014

Watching Online Porn May Change The Structure of the Brain

Men who watch large amounts of sexually explicit material have brains with smaller reward systems, a study finds.
"That could mean that regular consumption of pornography more or less wears out your reward system," says Simone Kühn, psychologist at the Max Planck Institute for Human Development in Berlin and lead author of the study, published in the "JAMA Psychiatry" journal.
Your reward system is a collection of neural structures in the brain that regulate and control behavior by inducing pleasure.
The researchers scanned the brains of 64 men aged between 21 and 45 with a MRI machine.
Those probands - or study subjects - who watched porn often had a smaller striatum, which is an important part of the reward system and also involved in sexual arousal.
The study also found that the reward systems of porn-experienced men were less active when they watched sexually arousing pictures inside the MRI machine.
"We assume that probands with a high porn consumption need increasing stimulation to receive the same amount of reward," Simone Kühn says.
Consequence or precondition?
But were men with smaller striatum seeking more porn because they needed more external stimulation, or did the higher consumption of porn make this part of the brain smaller?
The researchers admit both could be true. But they say the latter is more likely.
Kühn says existing psychological, scientific literature suggests consumers of porn will seek material with novel and more extreme sex games.
"That would fit perfectly the hypothesis that their reward systems need growing stimulation."
MRI scan
Photo: Andreas Gebert, dpa
A brain scan can reveal a lot.
In future studies the researchers plan to observe brain changes in study subjects over a period of time to see whether the reward system really changes with increasing porn consumption.
Like cocaine and gaming
Kühn says the team had predicted it would observe changes in the reward system - but the opposite of what it ultimately found.
The striatum is also involved in drug addiction.
In 2001, researchers found that reward-system-related brain parts were up to ten percent larger in cocaine addicts than in non-dependent probands.
And as if that wasn't enough: "In a study with teenagers we found that frequent PC games playing leads to an increase in the size of the striatum," says Kühn. But she notes she was surprised to see that male porn-watchers had smaller - not larger - striatum than the other men in the study.
She says she had expected porn consumption to increase the size of the reward system - rather than make it shrink.
Is porn addiction real?
"Pornography is no longer an issue of minority populations but a mass phenomenon that influences our society," the researchers write in the journal, adding that an estimated 50 percent of all Internet traffic is related to sex.
Psychiatrists have been debating whether it is possible to develop an addiction to porn. But they have yet to even agree on a clinical definition of pornography addiction.
In February, psychiatrists wrote in "Current Sexual Health Reports" that there is no such thing as porn addiction. There was no sign, they wrote, that use of pornography causes any changes to the brain.
This latest research may change their minds.

Cris Rowan Offers 10 Reasons Why Handheld Devices Should Be Banned for Children Under 12

Author: Cris Rowan
The American Academy of Pediatrics and the Canadian Society of Pediatrics state infants aged 0-2 years should not have any exposure to technology, 3-5 years be restricted to one hour per day, and 6-18 years restricted to 2 hours per day (AAP 2001/13, CPS 2010). Children and youth use 4-5 times the recommended amount of technology, with serious and often life threatening consequences (Kaiser Foundation 2010, Active Healthy Kids Canada 2012). Handheld devices (cell phones, tablets, electronic games) have dramatically increased the accessibility and usage of technology, causing escalating usage, especially by very young children (Common Sense Media, 2013). Cris Rowan, pediatric occupational therapist is calling on parents, teachers, and government to ban the use of all handheld devices for children under the age of 12 years. Following are ten research evidenced reasons for this ban. Please visit to view the Zone’in Fact Sheet for referenced research.
  1. Rapid brain growth
    Between 0 and 2 years, infant’s brains triple in size, and continue in a state of rapid development to 21 years of age (Christakis 2011). Early brain development is determined by environmental stimuli, or lack thereof. Stimulation to a developing brain caused by over exposure to technologies (cell phones, internet, iPads, TV), has been shown to negatively affect executive functioning, and cause attention deficit, cognitive delays, impaired learning, increased impulsivity, and decreased ability to self-regulation e.g. tantrums (Small 2008, Pagini 2010).
  2. Delayed Development
    Technology use restricts movement, resulting in delayed development. One in three children now enter school developmentally delayed, negatively impacting on literacy and academic achievement (HELP EDI Maps 2013). Movement enhances attention and learning ability (Ratey 2008). Use of technology under the age of 12 years, is detrimental to child development and learning (Rowan 2010).
  3. Epidemic Obesity
    TV and video game use correlates with increased obesity (Tremblay 2005). Children who are allowed a device in their bedrooms have 30% increased incidence of obesity (Feng 2011). One in four Canadian, and one in three U.S. children are obese (Tremblay 2011). 30% of children with obesity, will develop diabetes, and be at risk for early stroke and heart attack, gravely shortening life expectancy (Centre for Disease Control and Prevention 2010). Due to obesity, 21st century children may be the first generation many of whom will not outlive their parents(Professor Andrew Prentice, BBC News 2002).
  4. Sleep Deprivation
    60% of parents do not supervise their child’s technology usage, and 75% of children are allowed technology in their bedrooms (Kaiser Foundation 2010). 75% of children aged 9 and 10 years are sleep deprived to the extent that their grades are detrimentally impacted (Boston College 2012).
  5. Mental Illness
    Technology overuse is implicated as a causal factor in rising rates of child depression, anxiety, attachment disorder, attention deficit, autism, bipolar disorder, psychosis, and problematic child behavior (Bristol University 2010, Mentzoni 2011, Shin 2011, Liberatore 2011, Robinson 2008). One in six Canadian children have a diagnosed mental illness, many of whom are on dangerous psychotropic medication (Waddell 2007).
  6. Aggression
    Violent media content causes child aggression (Anderson 2007). Young children are increasingly exposed to rising incidence of physical and sexual violence in today’s media. Grand Theft Auto V portrays explicit sex, murder, rape, torture, and mutilation, as do many movies and TV shows. The U.S. has categorized media violence as a Public Health Risk due to causal impact on child aggression (Huesmann 2007). Media reports increased use of restraints and seclusion rooms with children who exhibit uncontrolled aggression (Vancouver Sun 2013).
  7. Digital dementia
    High speed media content causes attention deficit, as well as decreased concentration and memory, due to the brain pruning neuronal tracks to the frontal cortex (Christakis 2004, Small 2008). Children who can’t pay attention, can’t learn.
  8. Addictions
    As parents attach more and more to technology, they are detaching from their children. In the absence of parental attachment, detached children attach to devices, resulting in addiction(Rowan 2010). One in 11 children aged 8-18 years are addicted to technology (Gentlie 2009). Never in the history of humankind have there been child addictions.
  9. Radiation emission
    In May of 2011, the World Health Organization classified cellphones (and other wireless devices) as a category 2B risk (possible carcinogen) due to radiation emission (WHO 2011). James McNamee with Health Canada in October of 2011 issued a cautionary warning stating “Children are more sensitive to a variety of agents than adults as their brains and immune systems are still developing, so you can’t say the risk would be equal for a small adult as for a child” (Globe and Mail 2011). In December, 2013 Dr. Anthony Miller from the University of Toronto’s School of Public Health recommend that based on new research, radio frequency exposure should be reclassified as a 2A (probable carcinogen), not a 2B (possible carcinogen). American Academy of Pediatrics requested review of EMF radiation emissions from technology devices, citing 3 reasons regarding impact on children (AAP 2013).
  10. Unsustainable
    The ways in which children are raised and educated with technology are no longer sustainable(Rowan 2010). Children are our future, but there is no future for children who overuse technology.  A team based approach is necessary and urgent in order to reduce the use of technology by children. Please reference below slides shows on under videos to share with others who are concerned about technology overuse by children.
Problems – Suffer the Children – 4 minutes
Solutions – Balanced Technology Management – 7 minutes
The following guidelines for technology use by children and youth were developed by Cris Rowan pediatric occupational therapist and author of Virtual Child, Dr. Andrew Doan neuroscientist and author of Hooked on Games and Dr, Hilarie Cash, Director of reSTART Internet Addiction Recovery Program and author of Video Games and Your Kids, with contribution from the American Academy of Pediatrics and the Canadian Pediatric Society in an effort to ensure sustainable futures for all children.

Technology Use Guidelines for Children and Youth

Technology Use Guidelines for Children and Youth6

Sunday, June 22, 2014

Wilderness Day Group for Video Game Addicted Kids

                                  CYBER ADDICTION RECOVERY CENTER 
                                       CHRISTOPHER MULLIGAN LCSW
                                                       "Get Unplugged!
                Wilderness Adventures for “Tech” Dependent/Addicted Kids

Christopher Mulligan LCSW is offering therapeutic activities in our local-natural surroundings (Los Angeles) designed to help children and teens break the destructive cycle of compulsive internet and gaming behavior. Children/teens will be presented with the opportunity to participate in outdoor adventures that unfold in a therapeutic sequence that will develop self-awareness, physical skills, communication skills, trust in self and others, respect, psychological and physical courage, and empathy.

In order to create new and adaptive behaviors tech dependent/addicted children/teens must get “unplugged” from their home environment. Participating in outdoor activities is one of the most effective ways to help tech dependent/addicted children/teens create an accurate awareness of how technology is damaging the quality of their lives and develop new social skills and recreational interests that will help them “plug” in to a non technological dependent life style.

Prior to the start of each wilderness experience there will be a group check-in where therapists will facilitate introductions, allow for the exploration of each person’s history including what brings them to our program, set the stage for the events of the day, and focus on helping the group members develop their observational skills and a greater awareness of their environment as well as the impact they have on their environment.

Therapists will review and emphasize the importance of the safety of group members and discuss how communication, trust, and accountability factor into the activities chosen for a given day. Throughout the day therapists supervise and process individual and group dynamics and connect these dynamics to tech dependence/addiction. After the completion of the group activities, therapists check-in with the group and review reflections and lessons from the day.

Adventure 1: Day Hike Adventure 2: 2-Day Hike (1 Overnight) Adventure 3: Climbing Adventure 4: Learning to Rappel Adventure 5: Hiking and Rappelling Adventure 6: Multi-day Outing

For more information, contact Christopher Mulligan LCSW at 855-735-HELP (4357) or email

Huffington Post Blog on Cyber Porn

Watching Porn Linked To Less Gray Matter In The Brain

Posted: Updated: 
Print Article

Right or wrong, porn has been blamed for all sorts of social ills, from perpetuating sexist attitudes to destroying relationships. But does porn affect the brains of men who watch it?
To answer that question, German researchers recruited 64 men between the ages of 21 and 45 who watched an average of four hours of pornography per week. The researchers did MRI scans of men’s brains while showing them a mixture of sexually explicit images and non-sexual imagery. Their research was published May 28 in the journal JAMA Psychiatry.
"Our findings indicated that gray matter volume of the right caudate of the striatum is smaller with higher pornography use," the researchers wrote in the journal article, referring to an area of the brain associated with reward processing and motivation. Men who watched more porn also showed less activity in another area of the striatum, called the left putamen, which usually lights up in response to sexual images.
Heavy porn consumers also had a weaker connection between the striatum and the prefrontal cortex, an area of the brain associated with decision-making.
"Dysfunction of this circuitry has been related to inappropriate behavioral choices, such as drug seeking, regardless of the potential negative outcome," the researchers wrote in the article.
Yikes. So does that mean porn can really shrink guys' brains? Not necessarily, the researchers say.
“It's not clear, for example, whether watching porn leads to brain changes or whether people born with certain brain types watch more porn,” study author Dr. Simone Kühn of the Max Planck Institute for Human Development in Berlin told Reuters in an email.
Kuhn and her colleagues said they hoped future studies would reveal how "excessive porn consumption" may affect the brain over time, and how it affects the brains of new viewers.
Until then, the jury's still out on porn's effect on the brain.
“Everything is going to be bad in excess and it’s probably not terrible in moderation,” Dr. Gregory Tau, a psychiatry professor at Columbia University who was not involved in the new research, told Reuters.


Thursday, June 5, 2014

The industry of human trafficking and sex slavery is utilizing 21st-century digital media to target children.

The industry of human trafficking and sex slavery is utilizing 21st-century digital media to target children. How does this work? First, technology abuse and exposure to pornography during childhood can produce promiscuous children and teens who then go on to post sexually suggestive photos on social media. The sex trafficking/slavery industry (pimps) can target these children, befriend them on social media, play online games with them, in an attempt to lure them away for abduction into sex slavery. Children and teens can be tricked into leaving their families to meet with a fantasy online “lover,” only to be abducted by organized criminals for the purpose of sex trafficking. As children and teens use social media excessively and play more games than spending with real people, they are vulnerable to falling prey to online predators on social media, Minecraft, PS3/4 network, Xbox live, and online games. Sex in human trafficking is now more lucrative than narcotics. It has been reported that one pimp with five girls can generate nearly $1 million in revenue annually.

What is the most effective way of safeguarding children and teens? Providing education to children and teens about the human trafficking/sex slavery industry combined with parents who can maintain an open and honest dialogue about online sexual behavior dramatically decrease risk. Children and teens that fear talking to their parents about their online activities are far more likely to be secretive about online risk-taking and mistakes. Hence, the best practice in terms of protecting children and teens is a relationship with parents/caregivers that encourages honest and candid discussions that occur on a regular basis. This solution often makes parents/caregivers uncomfortable because it requires a discussion about human sexuality and online sexual behavior. Many parents opt for parental controls to do the work of keeping their children safe from predatory behavior. Research supports the view, however, that it is parents who can engage in an open and clear discussion about healthy human sexuality as well as the risks of posed by predators that ultimately serve to keep children safe.

Thursday, May 29, 2014

Being a Cyber Savvy Kid

Teach children to be cyber savvy by explaining the following:
All media is permanent (photos, videos, messages, posts, etc.)!
All your online information is available to the public.
If you don’t want people to know something about your life then don’t do it online!
Even though you may feel invisible when online, everything you do is visible – it’s like living in a glass house.

*Talking with your parents is the key to online safety
Don’t hide your feelings about what happens online.
When you are confused, always ask questions!
Stay away from “adults only” areas of the Internet!
Tell your parents about anything that makes you feel uncomfortable!
Most harm that is done to children online can be prevented by talking to a trusted adult.

Tuesday, May 13, 2014

Policy statement: American Academy of Pediatrics (AAP)

The AAP is finally getting on board with the crucial need to integrate a media consumption assessment for all children at every well-child visit! Pediatricians are encouraged to take media history and ask two media questions at every well-child visit: 1) How much recreational screen time does your child or teenager consume daily? 2) Is there a television set or Internet-connected device in the child's bedroom? Parents are now encouraged to establish a family home use for all media. The policy statement also includes the following; "Media influences on children and teenagers should be recognized by schools, policymakers, product advertisers, and entertainment producers." This marks the first time that the AAP has fully acknowledged that media, including cell phones, iPads, and social media, are a dominant force in children's lives.The AAP states that is concerned by evidence about potential harmful effects of media messages and images. Finally some movement in the right direction!

Friday, May 9, 2014

Online Child Pornography Offenders are Different

Online Child Pornography Offenders are Different: A Meta-analysis of the Characteristics of Online and Offline Sex Offenders Against Children.


The current meta-analysis compared the characteristics of online child pornography-only offenders, typical (offline) sex offenders against children, and offenders with both child pornography and contact sex offences against children (mixed). Based on 30 unique samples (comparison ns ranging from 98 to 2,702), the meta-analysis found key differences between groups. Offenders who committed contact sex offences were more likely to have access to children than those with only child pornography offences. In contrast, offenders who used the internet to commit sexual offences had greater access to the internet than those with contact sex offenders. Differences between the groups, however, were not limited to differential opportunities. Sex offenders against children and mixed offenders were found to score higher on indicators of antisociality than online child pornography offenders (CPOs). CPOs were also more likely to have psychological barriers to sexual offending than sex offenders against children and mixed offenders (e.g., greater victim empathy). Mixed offenders were found to be the most pedophilic, even more than CPOs. The findings suggest that offenders who restricted their offending behavior to online child pornography offences were different from mixed offenders and offline sex offenders against children, and that mixed offenders were a particularly high risk group.
[PubMed - as supplied by publisher]

Tuesday, May 6, 2014

The Dopamine Hook: Why the Net and Gaming Are Addictive

The word addiction is derived from a Latin term for "enslaved by" or "bound to." Anyone who has struggled to overcome an addiction -- or has attempted to help someone else to do so -- certainly understands what these terms really mean.

Addiction, unfortunately exerts a long and powerful influence on the brain that manifests in three ways: craving for the object of addiction, loss of control over its use, and continuing engagement with it despsite significant negative consequences.

For decades, medical experts believed that only alcohol and certain drugs could cause addiction. Neuroimaging technologies and more recent research, however, have clearly shown that certain pleasurable activities or behavioral processes, such as gambling, shopping, and sex, can also co-opt the brain.

The brain registers all pleasures in the same way, whether they originate with a drug, a monetary reward, a sexual encounter, or even a satisfying meal. In the brain, pleasure has a distinct neurochemical signature: the release of the neurotransmitter dopamine in the nucleus accubens, a cluster of nerve cells lying underneath the cerebral cortex.

Dopamine release in this nucleus is so consistently tied with pleasure that neuroscientists refer to this region as the brain's pleasure center. All drugs associated with abuse, from nicotine to heroin, cause a particularly powerful surge of dopamine. The likelihood that the use of the drug or participation in a rewarding activity will lead to addiction is directly linked to the speed with which it promotes dopamine release, the intensity of that release, and the reliability of that release.

As it turns out, interaction with the Internet and video gaming quickly stimulates the pleasure center in the brain, causing a release of dopamine that is both intense and reliable. This new information helps us understand why the Internet and gaming are so difficult to control and why children, teens, and adults experience intense cravings, tolerance, and ongoing engagement despite negative consequences.

Once the dopamine hook is in place it is extraordinarily difficult to modify behavior and it is crucially important that the person who is experiencing addiction to the Internet or video gaming go through a sustained period of being unplugged or detoxing. Without a sustained break from the dopamine surges there is no way to learn new behaviors that can produce pleasure. In my next blog. I will discuss how it is possible to retrain the pleasure center in the brain to release dopamine when it is stimulated by healthy, life-affirming, off-line activities.

Sunday, April 27, 2014

Teen Internet Addiction

I was invited to speak on teen internet addiction by The Asian and Pacific Islander Children, Youth and Family Council in Chinatown. My presentation focused comparing and contrasting the terms "process addiction" and "substance addiction." My discussion described the neurobiology of process addictions in teens and then highlighted at risk populations:" ADHD, Autism, Depression, and Social Anxiety Disorder. If you would like a copy of my power point, please email me at I will also post a copy of my power point on my website:

Monday, March 24, 2014

Early Screening and Early Intervention for Technology Overuse

In my last blog I discussed the need to conduct early technology screenings and the need for early intervention - by "early" I am referring to preschool and elementary school. Due to the proliferation of tech devices young children are saturated with digital media which creates change resistant patterns of technology consumption.

The key is for parents to carefully regulate technology use in order to prevent change resistant patterns from emerging. How much time should children be using technology?

0 to 2 years NONE

3 to 5 years 1 hour per day of non violent TV/DVD (no handheld devices or video games!)

6 to 9 years 2 hours per day of  total screen time (non violent TV/DVD and non violent video games such as Wii Sports or Resorts - no handheld devices of any kind!).

9 to 12 years 2 hours per day of total screen time (non violent TV/DVD 60 minutes, non violent video games 30 minutes, handheld devices 30 minutes).

13 to 18 years 2 hour per day of total screen time (non violent TV/DVD 30 minutes, non-violent video game, violent video games 30 minutes, hand devices 30 minutes).

No technology in bedrooms!

Rule of screen time use: for every one hour of screen time your child/teen must engage in 2 hours of physical activity.

In my next blog I will discuss 5 ways to successfully unplug children and teens from technology with the aim of maintaining a balance between offline life on cyber life.

Monday, March 3, 2014

The Importance of Early Screening for Technology Overuse

It is a common place occurrence in my practice to receive a phone call from a parent describing a teen -- usually a son -- who is in a video game addiction free fall: failing grades, social withdrawal, weight gain or weight loss, sleep deprivation, depression and anger when unplugged from gaming, and ever increasing preoccupation with gaming.

The first question I ask is "What have you tried to decrease you son's gaming?" In many cases the parent has tried many different strategies, including removing computers and tablets, gaming consoles and even unplugging wifi. Many parents have imposed restrictions on the amount of time and many have tied their son's grade point average to access to gaming. In short, most parents have made a good faith effort and, yet, their son's gaming only seems to increase over time.

When I ask how long their son has had a problem regulating gaming, the answer is typically 3 to 5 years. Parents often explain that their son was able to figure out a way to continue gaming, no matter what steps they took and no matter what barriers they put in place.

I explain that all is not lost - that we can work together to figure out a new way to decrease gaming and thereby restore balance between technology use and engagement in 3D reality. I also explain that changing gaming habits/patterns is a difficult process and requires time and focus and energy -- especially when the teen is fully opposed to change.

Parents often express frustration with the fact that no one gave them any warning or raised the issue of technology overuse or addiction. I then explain that in an ideal world there would have been some form of technology use screening early in their son's life so that they, as parents, could have put in place a structure or system that would have addressed the need for balance.

Unfortunately, with the possible exception of a pediatrician asking about screen time, very young children are consuming vast quantities of digital media and are developing what looks very much like a form of addiction to technology.

The key piece that is missing is early screening and early intervention. We need to treat digital media or "screen time" as a public health problem and put in place routine screenings - as we do with food and physical activity in order to prevent childhood obesity. As a society we need to understand that children are now growing up in a media saturated world that badly needs limits and structure in order to help prevent all forms of technology overuse and addiction.

If we can screen and intervene with a child rather than a teen, we stand a far greater chance of preventing the negative impact of technology overuse on development and mental health. Who would be responsible for this screening process: parents, pediatricians, mental health professionals, and educators.What is currently missing is information on the screening process. In my next blog I will review how to screen and intervene with children. In the meantime, go to my website and complete my technology screening test. This test will give a clear picture.of your son's current use and the need to intervene.

Wednesday, February 12, 2014

American Academy of Pediatrics: Pediatricians weigh in on screen time!

Media and Children

Media is everywhere. TV, Internet, computer and video games all vie for our children's attention. Information on this page can help parents understand the impact media has in our children's lives, while offering tips on managing time spent with various media. The AAP has recommendations for parents and pediatricians.
Today's children are spending an average of seven hours a day on entertainment media, including televisions, computers, phones and other electronic devices. To help kids make wise media choices, parents should monitor their media diet. Parents can make use of established ratings systems for shows, movies and games to avoid inappropriate content, such as violence, explicit sexual content or glorified tobacco and alcohol use.
Studies have shown that excessive media use can lead to attention problems, school difficulties, sleep and eating disorders, and obesity. In addition, the Internet and cell phones can provide platforms for illicit and risky behaviors.
By limiting screen time and offering educational media and non-electronic formats such as books, newspapers and board games, and watching television with their children, parents can help guide their children's media experience. Putting questionable content into context and teaching kids about advertising contributes to their media literacy.
The AAP recommends that parents establish "screen-free" zones at home by making sure there are no televisions, computers or video games in children's bedrooms, and by turning off the TV during dinner. Children and teens should engage with entertainment media for no more than one or two hours per day, and that should be high-quality content. It is important for kids to spend time on outdoor play, reading, hobbies, and using their imaginations in free play.
Television and other entertainment media should be avoided for infants and children under age 2. A child's brain develops rapidly during these first years, and young children learn best by interacting with people, not screens.
Additional Resources
- See more at:

Monday, February 10, 2014

Teen Depression and Internet and Video Game Use

The article below was written by John Grohol PSY.D for PsychCentral.

When you show a correlation between two things, you can’t say which way the relationship goes. Do people carrying umbrellas on a city street cause it to rain? Or does the rain cause people to carry their umbrellas?

We know the answer to this question, only because we know the relationship between rain and umbrellas — the rain came first, and then someone invented the umbrella.
So it is surprising to read that an NPR news story recently noted, “More Time Online Raise Risk For Teen Depression.” The only problem with that headline?
It’s not true.

The research they quote is from the journal World Psychiatry, and the European researchers examined 12,395 teenagers from eleven different European countries. They measured a bunch of at-risk behaviors, such as excessive alcohol use, illegal drug use, heavy smoking and being overweight.

They also measured behaviors we don’t typically associate with being “at-risk” for anything — sedentary behavior, reduced sleep and high media use. Media use included all use of a TV, the Internet and playing video games.

How researchers define the problem often pre-determines their result. In this case, the researchers defined “high media use” as anything over 5 hours per day. And they found that there’s a group of teens — an “invisible” group — that meet this definition of high media use and report increased psychiatric symptoms.

The problem with that arbitrary1 number? It doesn’t reflect the reality of teenage media use today. For instance, this study from 2010 found that, in the U.S. anyway, teens are now spending on average 7.5 hours/day on media.

If something is average or the norm, it can’t also be defined as “high” media use. And the 2010 study was from 4 years ago — I can imagine it’s only higher now.2 So the cutoff is both arbitrary and just plain wrong.

But the researchers didn’t measure whether the teens were depressed before they spent more time online, so the researchers had no way of telling which came first. Is a teen depressed and then turns more to the online world for support, friends, distraction, and emotional engagement? Or do people who spend enormous amounts of time online get more depressed?

The act of spending more time online doesn’t raise the risk of depression in a teenager. That’s not what the study found or said. Instead, it merely showed that if your teen is spending a lot of time online, playing video games, or watching TV, these may be signs that teen is suffering from some depressive symptoms. I know those two things sound very similar, but they’re not the same.

Going back to the umbrella example, if you see people outside walking down the street with an umbrella, you don’t think, “Oh wow, they must be trying to make it rain.” Instead, you just know that the umbrella is associated with rain, and yes, it may be raining outside. Or it may not be — carrying an umbrella has no impact on the weather.

These are subtle but important distinctions, and I certainly hope the news team at NPR understand them if they’re going to write about this kind of psychological research.
Otherwise, parents who just scan the headlines will just nod their head and say, “Oh, look, another study shows the more time a teen spends online, the more depressed they become.”

  1. I say “arbitrary” because no rationale was given for it in the study []
  2. It’s hypothetically possible that European teen media use is significantly lower than the U.S.’s, but I couldn’t find any data to support that contention. []

Friday, February 7, 2014

The Impact of The Internet on Adolescent Mental Health

Dear Readers,

Yesterday I had the great pleasure of presenting at conference in Los Angeles entitled "Navigating the Teenage Brain" where Dr. Daniel Siegel was the keynote speaker. My presentation focused on the impact of the internet on adolescent mental health. My presentation covered current research on how the internet is influencing both developmental and psychiatric disorders in teens. I have uploaded my power point to my www.teenvideogameaddiction website. Go to the "Products" page and you will see my power point under the title: The Impact of the Internet on Adolescent Mental Health. 

Saturday, January 18, 2014

Cyber Lecture for Educators

Cyber Addiction Recovery Center

"Empowering Educators in an Evolving Media Landscape"

This presentation addresses the rapidly evolving changes in media and technology that confront educators as they proceed into the 21st century. Students are now presented with opportunities, challenges, and risks related to the evolving media landscape that can be difficult for educators to understand and successfully navigate.

This presentation will engage educators in an in-depth discussion of current media and technological advances and challenges.

This presentation will cover the following topics:

Technology overuse and adolescent mental health
Risky behaviors and online safety
Privacy, publicity, and reputation
Information dissemination: youth-created content and quality of information
Benefits of electronic media for youth
Risks of electronic media for youth
Peer-two-peer harm on the Internet
Problematic content on the Internet
Effectiveness of content control technologies and protective strategies on the Internet

This presentation can be scheduled for a teacher in-service or retreat. This presentation can be scheduled for 2, 3, or 4 hours (depending on the needs and time constraints of the audience)

For more information contact Christopher Mulligan:
Or e-mail

Thursday, January 16, 2014

The 5 C's for for safe media consumption

The Center for Media and Child Health at Harvard recommends the 5 C's for shaping media's influence on your child or teen:

Control time: No more that 1 to 2 hours per day (max).

Content matters: All media is educational. Some forms of media teach accurate and healthy lessons while others teach distorted and harmful lessons.

Context is important: Where, when, how, why and WITH WHOM young people use media strongly influences whether the media enriches or harms children.

Critical thinking: Teaching children active, critical media use is essential for healthy development.

Create and model media mastery: What we feed children's minds is as important as what we feed their bodies. Teach children a healthy media diet and continually engage in a discussion about media rather than passively consuming media.