Mental DisorderPROTECT+NCT03582839
Effects of an Internet Use Disorder and Internet Gaming Disorder Early Intervention Program
A study testing PROTECT+ in people with Mental Disorder, run by Pädagogische Hochschule Heidelberg.
Trial summary
Background. In the last two decades Internet usage has grown vastly. Pathological Internet usage (IUD; Internet Use Disorder) is associated with severe mental health problems affecting social, academic and daily life functioning. Internet Gaming Disorder (IGD) has been already included in the DSM-V. Read more about this study
- Who is it for?
- Ages 9 to 19 yearsHealthy volunteers can take part
- Conditions the study is for
- Mental Disorder
- What is being tested?
- PROTECT+
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 54 participants
- Where
- No sites listed yet
- Study dates
- 14 Apr 2016to 1 Apr 2019
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 9 to 19 years
- All sexes
- Healthy volunteers accepted
- Child, Adult
Who may be able to join
- Adolescents aged 9 to 19 years Self-selection
Who cannot join
- Severe comorbid mental health disorder
About this study
Background. In the last two decades Internet usage has grown vastly. Pathological Internet usage (IUD; Internet Use Disorder) is associated with severe mental health problems affecting social, academic and daily life functioning. Internet Gaming Disorder (IGD) has been already included in the DSM-V. Recently, the WHO declared to include Gaming Disorder (GD) in the upcoming ICD-11. Despite the increasing rates of adolescents with IUD and (I)GD, affected people are treated unsystematically and there is a lack of evidence based treatment programs. PROTECT+ is a low-threshold, cognitive behavioral short-term group intervention.
Methods. 54 patients, aged 9-19 years, received PROTECT+ intervention in Heidelberg, Germany. The PROTECT+ intervention group underwent a cognitive-behavioral 4-session group therapy. Follow-up data were collected at 1, 4, and 12 months after admission. Primary outcome was the change in (I)GD and IUD related symptoms at the 12-months follow-up. Secondary outcomes were changes in comorbid symptoms as well as in problem solving, cognitive restructuring and emotion regulation skills
Discussion. Treatment of IUD and IGD is still in its early stages. Recent reviews report increasing research on treatment but also a lack of well-designed studies and evidence based treatment programs. The PROTECT+ intervention is a theory driven and evidence based therapy program which is based on the PROTECT preventive intervention in school settings. In the intervention group a reduction of (I)GD and IUD symptom severity is expected over 12 months.
- Conditions
- Mental Disorder
- Being tested
- PROTECT+
- Medical subject headings
- Mental Disorders
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
PROTECT+Behavioural
The early intervention PROTECT+ consists of a cognitive-behavioral 4-session brief-protocol (100 minutes) and targets empirically identified risk factors of (I)GD/IUD, i.e. (1) boredom and motivational problems, (2) procrastination and performance anxiety, (3) social behavior and (4) emotion regulation. It addresses both risk-reduction and strength-promotion by cognitive behavioral (CB) interventions such as (1) psychoeducation, (2) cognitive restructuring (identification and modification of dysfunctional cognition), (3) behavior modification (improving problem solving skills, training of functional behavior and reinforcement) as well as (4) improving emotion regulation (training of sensory, imaginative and mindfulness based techniques).
| Study group | Role | What they receive |
|---|---|---|
| PROTECT+ | Experimental | The PROTECT+ intervention group is a self-selected sample, which receives the PROTECT+ group therapy (4 modules in 4 subsequent weeks à 100 min). Participants are assessed at T1 (baseline), T2 (post treatment, 1-month follow-up), T3 (4-months follow-up), and T4 (12-months follow-up). Receives: Behavioral: PROTECT+ |
What is being measured
The primary outcome is the main question the study is designed to answer.
Changes in IUD symptom severity (self-report)
IUD symptom severity is assessed by the Compulsive Internet Use Scale (CIUS; Meerkerk, Van Den Eijnden, Vermulst \& Garretsen, 2009). The CIUS is a broadly used and validated questionnaire including 14 Items assessing IUD.
Measured: baseline, 1 month, 4-months, 12-months
Changes in (I)GD/IUD symptom severity (self-report and parental report)
(I)GD/IUD symptom severity is assessed via self-reports and via parental reports by the Video Game Dependency Scale (Computerspielabhängigkeitsskala; CSAS; Rehbein, Baier, Kleimann \& Mößle, 2015). The CSAS questionnaire has been adapted by including non-gaming IU.
Measured: baseline, 1 month, 4-months, 12-months
Changes in (I)GD/IUD symptom severity (Clinical Interview based on DSM-5)
At 12-months follow-up, we conduct a clinical interview based on the criteria of IGD according to the DSM-5. We adapted the criteria by non-gaming subtypes to assess IUD.
Measured: 12-months
Secondary outcomes (8)
Emotion Regulation
For the measurement of emotion regulation the German Questionnaire for Assessment of Emotion Regulation in Children and Adolescents (Fragebogen zur Erhebung der Emotionsregulation bei Kindern und Jugendlichen; FEEL-KJ; Grob \& Smolenski, 2011) is used. The questionnaire includes a measure of functional and dysfunctional emotion regulation strategies for the negative emotions fear, sadness and anger.
Measured: baseline, 1 month, 4-months, 12-months
Depressive Symptoms
Depressive symptoms are assessed using the German Depression Inventory for Children and Adolescents (Depressionsinventar für Kinder und Jugendliche; DIKJ; Stiensmeier-Pelster, Braune-Krickau, Schürmann \& Duda, 2014; Stiensmeier-Pelster, Schürmann \& Duda, 1989). The instrument allows for the detection and estimation of severity of depressive disorders according to the DSM-5 criteria (American Psychiatric Association, 2013).
Measured: baseline, 1 month, 4-months, 12-months
Comorbid emotional, oppositional, antisocial and attention deficit/ hyperactivity disorders
Comorbid Psychopathology is assessed using the Strength and Difficulties Questionnaire (SDQ; Goodman, Meltzer \& Bailey, 2003).
It includes the 5 scales (1) emotional problems, (2) behavior problems, (3) hyperactivity/ attention deficits, (4) interpersonal problems with peers and (5) prosocial behavior and can be used for epidemiological research and as an indicator for emotional, oppositional, antisocial and attention deficit/ hyperactivity disorder. The Total Difficulties Score of the SDQ indicates the risk for developing a mental health disorder.
Measured: baseline, 1 month, 4-months, 12-months
Anxiety Disorders: Social Anxiety
We assess social anxiety using the German version of the Social Interaction Anxiety Scale (SIAS; Mattick \& Clarke, 1998; Stangier, Heidenreich, Berardi, Golbs \& Hoyer, 1999). This questionnaire assesses anxiety in social interactions and allows for detection and the estimation of severity of social anxiety disorders.
Measured: baseline, 1 month, 4-months, 12-months
Anxiety Disorders: Performance and School Anxiety
We assess performance and school anxiety with the 7th scale of the German adaption of the Fear Survey Schedule for Children - Revised (Phobiefragebogen für Kinder und Jugendliche; PHOKI Döpfner, Schnabel, Goletz \& Ollendick, 2006; Muris \& Ollendick, 2002).
Measured: baseline, 1 month, 4-months, 12-months
Procrastination
Procrastination is assessed with the German Questionnaire for Procrastination (Allgemeiner Prokrastinationsfragebogen; APROF; Höcker, Engberding \& Rist, 2013).
Measured: baseline, 1 month, 4-months, 12-months
Social Behavior and Learning Behavior
For ratings of social competent behavior and academic motivation, we use the German Student Assessment List for Social and Learning Behavior (Schülereinschätzliste für Sozial- und Lernverhalten; SSL; Petermann \& Petermann, 2014; Petermann, Petermann \& Lohbeck, 2014).
Measured: baseline, 1 month, 4-months, 12-months
Self-Efficacy
Self- efficacy is rated on the German Self-Efficacy Scale (Skala zu Allgemeinen Selbstwirksamkeitserwartung; SWE; Schwarzer \& Jerusalem, 1999).
Measured: baseline, 1 month, 4-months, 12-months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted11 Jul 2018
- Study start14 Apr 2016
- Primary completion23 Dec 2018 (estimated)
- Study completion1 Apr 2019 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Mental DisorderStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Enrolment
- 54 participants (actual)
Sponsor and investigators
- Lead sponsor
- Pädagogische Hochschule Heidelberg
- Sponsor type
- University, hospital or other
- Collaborators
- Heidelberg University
- Responsible party
- Principal investigator, Dr. Katajun Lindenberg, Pädagogische Hochschule Heidelberg
- Investigators
- Katajun Lindenberg, PhD, Principal investigator, Institut für Psychologie der Pädagogischen Hochschule Heidelberg
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03582839
- Sponsor's protocol ID
- PH Heidelberg
- Acronym
- PROTECT+
- Status last verified
- Jun 2018
- First submitted
- 4 Jun 2018
- Last updated
- 11 Jul 2018
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Undecided
Publications
Szasz-Janocha C, Vonderlin E, Lindenberg K. Treatment outcomes of a CBT-based group intervention for adolescents with Internet use disorders. J Behav Addict. 2020 Nov 16;9(4):978-989. doi: 10.1556/2006.2020.00089.
PubMed 33216013
Study at a glance
From the registry record, last updated by the sponsor on 11 Jul 2018. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Effects of an Internet Use Disorder and Internet Gaming Disorder Early Intervention Program
- ClinicalTrials.gov ID
- NCT03582839
- Acronym / sponsor ID
- PROTECT+ / PH Heidelberg
- Conditions
- Mental Disorder
- Study type
- Interventional
- Recruitment status
- Unknown status
- Enrolment
- 54 participants (actual)
- Lead sponsor
- Pädagogische Hochschule HeidelbergUniversity, hospital or other
- Collaborators
- Heidelberg University
- Study start
- 14 Apr 2016 (actual)
- Primary completion
- 23 Dec 2018 (estimated)
- Study completion
- 1 Apr 2019 (estimated)
- First posted
- 11 Jul 2018 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Background. In the last two decades Internet usage has grown vastly. Pathological Internet usage (IUD; Internet Use Disorder) is associated with severe mental health problems affecting social, academic and daily life functioning. Internet Gaming Disorder (IGD) has been already included in the DSM-V. Recently, the WHO declared to include Gaming Disorder (GD) in the upcoming ICD-11. Despite the increasing rates of adolescents with IUD and (I)GD, affected people are treated unsystematically and there is a lack of evidence based treatment programs. PROTECT+ is a low-threshold, cognitive behavioral short-term group intervention.
Methods. 54 patients, aged 9-19 years, received PROTECT+ intervention in Heidelberg, Germany. The PROTECT+ intervention group underwent a cognitive-behavioral 4-session group therapy. Follow-up data were collected at 1, 4, and 12 months after admission. Primary outcome was the change in (I)GD and IUD related symptoms at the 12-months follow-up. Secondary outcomes were changes in comorbid symptoms as well as in problem solving, cognitive restructuring and emotion regulation skills
Discussion. Treatment of IUD and IGD is still in its early stages. Recent reviews report increasing research on treatment but also a lack of well-designed studies and evidence based treatment programs. The PROTECT+ intervention is a theory driven and evidence based therapy program which is based on the PROTECT preventive intervention in school settings. In the intervention group a reduction of (I)GD and IUD symptom severity is expected over 12 months.
Study design
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| PROTECT+ | Experimental | Behavioral: PROTECT+The PROTECT+ intervention group is a self-selected sample, which receives the PROTECT+ group therapy (4 modules in 4 subsequent weeks à 100 min). Participants are assessed at T1 (baseline), T2 (post treatment, 1-month follow-up), T3 (4-months follow-up), and T4 (12-months follow-up). |
Who may qualify
- Ages
- 9 to 19 years
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Child, Adult
Key inclusion criteria (1 listed)
- Adolescents aged 9 to 19 years Self-selection
Key exclusion criteria (1 listed)
- Severe comorbid mental health disorder
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| PROTECT+The early intervention PROTECT+ consists of a cognitive-behavioral 4-session brief-protocol (100 minutes) and targets empirically identified risk factors of (I)GD/IUD, i.e. (1) boredom and motivational problems, (2) procrastination and performance anxiety, (3) social behavior and (4) emotion regulation. It addresses both risk-reduction and strength-promotion by cognitive behavioral (CB) interventions such as (1) psychoeducation, (2) cognitive restructuring (identification and modification of dysfunctional cognition), (3) behavior modification (improving problem solving skills, training of functional behavior and reinforcement) as well as (4) improving emotion regulation (training of sensory, imaginative and mindfulness based techniques). | Behavioural | PROTECT+ |
Primary outcome
Changes in IUD symptom severity (self-report)
Time frame: baseline, 1 month, 4-months, 12-months
IUD symptom severity is assessed by the Compulsive Internet Use Scale (CIUS; Meerkerk, Van Den Eijnden, Vermulst \& Garretsen, 2009). The CIUS is a broadly used and validated questionnaire including 14 Items assessing IUD.
Changes in (I)GD/IUD symptom severity (self-report and parental report)
Time frame: baseline, 1 month, 4-months, 12-months
(I)GD/IUD symptom severity is assessed via self-reports and via parental reports by the Video Game Dependency Scale (Computerspielabhängigkeitsskala; CSAS; Rehbein, Baier, Kleimann \& Mößle, 2015). The CSAS questionnaire has been adapted by including non-gaming IU.
Changes in (I)GD/IUD symptom severity (Clinical Interview based on DSM-5)
Time frame: 12-months
At 12-months follow-up, we conduct a clinical interview based on the criteria of IGD according to the DSM-5. We adapted the criteria by non-gaming subtypes to assess IUD.
8 secondary outcomes
Emotion Regulation
Time frame: baseline, 1 month, 4-months, 12-months
Depressive Symptoms
Time frame: baseline, 1 month, 4-months, 12-months
Comorbid emotional, oppositional, antisocial and attention deficit/ hyperactivity disorders
Time frame: baseline, 1 month, 4-months, 12-months
Anxiety Disorders: Social Anxiety
Time frame: baseline, 1 month, 4-months, 12-months
Anxiety Disorders: Performance and School Anxiety
Time frame: baseline, 1 month, 4-months, 12-months
Procrastination
Time frame: baseline, 1 month, 4-months, 12-months
Social Behavior and Learning Behavior
Time frame: baseline, 1 month, 4-months, 12-months
Self-Efficacy
Time frame: baseline, 1 month, 4-months, 12-months
Results and safety
Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 11 Jul 2018.
- Derived from this study: PubMed 33216013Szasz-Janocha C, Vonderlin E, Lindenberg K. Treatment outcomes of a CBT-based group intervention for adolescents with Internet use disorders. J Behav Addict. 2020 Nov 16;9(4):978-989. doi: 10.1556/2006.2020.00089.
- Individual participant dataSharing planned: Undecided
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Katajun Lindenberg, PhD principal investigator
Institut für Psychologie der Pädagogischen Hochschule Heidelberg
Questions about this trial
What is this clinical trial studying?
A study testing PROTECT+ in people with Mental Disorder, run by Pädagogische Hochschule Heidelberg.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 1 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: status not confirmed, as of the sponsor's last update on 11 Jul 2018. Status can change between updates, so confirm with the study contact before making plans.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
Results are not available in the source record.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Changes in IUD symptom severity (self-report) (time frame: baseline, 1 month, 4-months, 12-months). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT03582839, which also lists 1 linked publication.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 11 Jul 2018.