Problematic interactive media use in teens: comorbidities, assessment, and treatment

Problematic Interactive Media Use (PIMU), aka internet or video game addiction, is increasingly presenting to pediatricians for care. The majority of youth now use mobile media almost constantly to communicate, learn, and entertain themselves, but for some, uncontrolled video gaming, social media use, pornography viewing, and information-bingeing on short videos or websites contribute to functional impairment. PIMU can result in academic failure, social withdrawal, behavioral problems, family conflict, and physical and mental health problems. There is no formal diagnosis to describe the spectrum of PIMU behaviors and therefore no standardized therapeutic interventions. Anticipatory guidance will help identify youth at risk and empower parents to recognize and prevent problems. In addition, epidemiology and etiology indicate that Attention-Deficit/Hyperactivity Disorder (ADHD), affective disorders, and Autism Spectrum Disorder (ASD) may predispose to and, in some cases, result from PIMU, offering opportunities for effective treatment by addressing underlying pathology that is manifesting itself in the interactive media environment. Efforts to establish evidence-based diagnoses, develop and evaluate therapeutic strategies, and to train clinicians in recognition and care of PIMU are reviewed.