Wednesday, May 6, 2020
The Fall and Rise of the Roman Empire Essay - 637 Words
How powerful the Roman Empire was! Rome the ultimate country of its time slowly declined and vanished from our world. After starting with a small settlement off the Tiber River in Italy Rome expanded its borders and claimed territory around the entire Mediterranean and more. Rome also lasted for over a thousand years elapsing over late B.C.E and early C.E. In spite of all that, Rome was far from perfect. This powerful state was brought to its collapse through challenges that would be cataclysmic to the governments of world powers today. Romeââ¬â¢s descent was mostly from the inside out. Internal issues of Rome such as political turmoil, social apathy, weakening military, and over taxation fueled this countryââ¬â¢s decline. Social apathy wasâ⬠¦show more contentâ⬠¦The poorly executed drafts caused the army to be short staffed and rely on mercenaries. Mercenaries are foreign soldiers; their loyalty is only to the money that the state pays them. Mercenaries left Rome vulner able when the state could not pay them. In addition to this the early Roman Empire wore breastplates and helmets during battles and preformed ground drills to practice for combat (Document 2). Due to negligence both the armor and drill were removed and the late Roman Empire fought with very little protection; archers then picked off many soldiers leading to the loss of great Roman cities and still no one thought to restore the armor (Document 2). The military also had to deal with an outside threat the Huns. The Huns were a group of wild, nomadic people; they lived a life of savagery and were considered ungovernable (Document 5). These people had no sense of right and wrong; they slaughtered all those who lived around them (Document 5). If the late Roman military was a better-organized force the Huns may not have been such a threat towards the empire. A government must put time, effort, and care into its military, if it hopes to be successful. The government of Rome had an economic problem of over taxation as well. As a result of the weak army the empire needed extra money to maintain it; leading to strangling taxation on the citizens (Document 8). With over taxation polluting the economy tenants were forced to leave their farms, along with businessmen andShow MoreRelatedThe Rise and Fall of the Roman Empire Essay1041 Words à |à 5 PagesThe era dominated by Roman empire is one the most well-known and influential periods of history, home to famous names from Julius Caesar to Jesus Christ. At its height, Romeââ¬â¢s territory stretched from the Atlantic coastline to the Middle East, reigning over 60 million people, one-fifth of the population of the ancient world. However, the Roman empireââ¬â¢s treatment of their conquered peopleââ¬â¢s and their own citizens ultimately led to the permanent downfall of Rome. Even in the century before theRead More Rise and Fall of the Roman Empire Essay1091 Words à |à 5 PagesThe Romans were on one of the greatest people of all. They had power, wealth, and even a half of the world. They built one of the strongest and vast empire that world has ever seen. They came from nothing to something awesome. It started of as a city and ended up being one of the greatest empire of all. This essay is going to focus on the Roman Empire from the rise to the fall and the government, architecture, mythology, Family Structure, and Food of the Romans. As the story goes, Rome was foundingRead MoreThe Roman Empire And The Rise And Fall Of The Papacy1337 Words à |à 6 Pagesestablishment of Christianity may be considered a very essential part of the history of the Roman Empire and the rise and fall of the papacy. The history of the Papacy began over two thousand years ago with the reign of John Paul II. Peter, the humble fisherman of Galilee and an Apostle of Jesus Christ, became the figure head and the basis for the institution that has outlined not only the Roman and Byzantine empires but also the Carolingian Gaul, medieval Germany, Spain, Britain, the Third Reich of HitlerRead MoreThe Rise and Fall of the Roman Empire Essay examples1385 Words à |à 6 Pagesrather than conquered provinces. The only threats that ever came were from the unorganized barbarian tribes whos conquest brought nothing to the Empire. (Mahoney, 2001) The rise of the Roman Empire had many contributors. These factors would include strength in the military, society, leadership, religious, and architectural aspects of the Roman Empire. The Roman army was the largest of the group though. The army was at first only meant to defend the city of Rome but later set out to conquer. The armyRead MoreEssay on The Rise and Fall of The Roman Empire1033 Words à |à 5 Pagesthe greatest and most predominant empires ever built that controlled and reined over much of the entire continent of Europe is known as the Roman Empire. The Romans were beyond the most tactical and strategic army, and obtained the most authoritative military control throughout ancient history. The Roman Empire was not only a militia of brute force and authority, but their political systems also were amongst the most developed and functional governances. The Romans contained a civic virtue, which wasRead MoreThe Rise of the Papacy948 Words à |à 4 PagesThis paper will lo ok into the primary reasons for the rise of the Roman papacy to power, and a few of the many things that aided the papacy in getting there. The fall of the Roman Empire is clearly a key factor in the rise of the papacy, so a look into the factors that caused the fall of the Roman Empire is essential. Secondly, a look into how the church positioned itself, to step into the vacuum of power left behind by the fall of the Roman Empire will prove to be needed. Lastly, there will be a briefRead MoreEssay on His 112/ the Crisis of the Third Century1314 Words à |à 6 Pages His/112 September 2 2011 The Crisis of the Third Century The Crisis of the Third Century was the era in which the Roman Empire almost collapsed under the many myriad of pressures including economic depression, civil war, plague and invasion. Because war was expensive, the Roman Empire had to increase taxes and this caused for many of the Romans to be upset and for the economy to be in a crisis. Revolts were also started because many of the civilians retaliated back because ofRead MoreThe Rise And Fall Of Empires1580 Words à |à 7 Pagesthesis that the rise and fall of empires was due to tolerance, inclusion, difference, and diversity is shown to be true of the Roman Empire because of the way that tolerance allowed and caused the empire to rise, enter its golden age, and fall. The Roman Empire was a ââ¬Å"hyperpowerâ⬠that lasted from 44 BCE to 476 CE. The empire contained Western, Southern, and Eastern Europe, along with North Africa; thus, there was an abundance of culture from many different conquered groups. Romans wante d to make theseRead MoreThe Fall Of The Roman Empire846 Words à |à 4 PagesFinal Fall 2014 A1. For an empire that lasted nearly 500 years, the fall of the Roman Empire was influenced by various different events. Four troubled ingredientes lead to the demise of the the greatest empire of all time; politics, money, social, and war. It is important to note that the fall of the Roman Empire does not mean that the romans lost everything, it is just a reference to the fall of the western roman empire. One of the causes of the fall of the west was that of the rise of theRead MoreThe Fall Of The Roman Empire856 Words à |à 4 PagesAlthough it was believed that the Roman Empire would never come to an end, inevitably it fell. The Roman Empire is an extremely historic empire that left a massive legacy behind. It collapsed during the fifth century. The empire was having serious military struggles. They received threats from other European tribes along with diminished military funding. A military who does not have proper funding will slowly fall apart. Other than the military, th e Roman Empire had a few key social and cultural
Tuesday, May 5, 2020
Globalization Migration Essay Example For Students
Globalization Migration Essay Globalization is the interrelated web of communications between states and different civilizations including engineering. concern and civilization. Migration is the motion of people into or out of a different state. Migration additions globalisation by making a greater diverseness of civilizations. different thoughts. and increasing the manner the economic system grows. The cyberspace is one of the biggest planetary communicating systems. In the 1980s. mail order married womans were introduced. Work force in the US seeking Asiatic brides could now merely travel onto the cyberspace and happen a married woman and communicate with them. Work forces normally want to get married aliens because they are viewed as more ââ¬Å"exoticâ⬠and ââ¬Å"dependentâ⬠than adult females raised in the US. Without the cyberspace ( facet of globalisation ) there wouldnââ¬â¢t be communicating between US work forces and their possible partners. Globalized consumerism besides affects the subject of the relationship between globalisation and migration. When companies are making a new merchandise. they have to make the design. Once the design is created. the merchandise is made so the company pays for the distribution of the merchandise. The people who make the merchandises are normally immigrants. They do this because ââ¬Å"there is a demand for unskilled labour in the North and because there is a big supply of unskilled workers in the South who are ready and willing to migrate North. â⬠Usually the workers in the South migrate to the North for higher paying occupations. There are great differences in the wage from the South and the wage from the North. In 1995. workers in the US ( North ) were paid $ 17. 20 an hr. 71 cents per hr in the Philippines ( South ) . 46 cents per hr in Thailand ( South ) . and 25 cents per hr in China ( South ) . Peoples from third-world states are besides parts of migration and globalisation. In 1945. two brothers from Chinantlan. Mexico moved to New York and got occupations wipe uping floors. As the old ages passed they pooled their income and started directing the money they saved to their hometown. They began an organisation where more of their relations from Chinantlan joined them in New York and sent money back place to better their community. By 1990. the organisation had already sent $ 2 million each twelvemonth. This shows that migration can better third-world states and their metropoliss.
Tuesday, April 14, 2020
Zxcvzxc dfgdfgs Essay Example For Students
Zxcvzxc dfgdfgs Essay England went through dramatic changes in the 19th century. English culture, socio-economic structure and politics where largely influenced by the principles of science. Many social expressions occurred due to these changes. Transformations which categorized this time period could be observed in social institutions; for instance: the switch from popular Evangelicalism to atheism, emergence of feminism and the creation of new political ideologies (Liberalism, Conservatism and Radicalism). These are just a few of the changes that took place. All of this social alteration can be attributed to the importance of science. The English people began to trust more in empiricism and logical thought than in faith and glory of the empire . One who contributed greatly to this transformation was Charles Darwin. In his two most famous works, The Origin of Species and The Decent of Man, Darwin introduces the concept of the survival of the fittest and The Darwinian ideas introduced into English society justified a great number of political policies and social movements. England at the turn of the century was still a largest power in the international system. The English perceived, through the justification of Darwinism, they were fit to be the imperial hegemon in the world. The issue this essay will deal with is Imperialism and how Darwinism justified its practice. Darwin argued in his work, The Decent of Man, When civilised nations come into contact with barbarians the struggle is short except where a deadly climate gives its aid to the native race. . . the grade of civilisation seems to be a most important element in success in competing nations.(Darwin, Decent of Man, p. 297). We will write a custom essay on Zxcvzxc dfgdfgs specifically for you for only $16.38 $13.9/page Order now In this observation, Darwin connotated superiority to civilized nations. In this same work, he referred to the indigenous people as savages, barbarians and tribal men. This immediately transfers a condescending attitude toward the uncivilised people. Darwin classified them as tribes while the English and other Aryan cultures These claims of basic inequality gave the English the jurisdiction philosophically, to exploit the colonies to a greater level than previously attained. The drive to Christianize the colonies was abandoned, politically. The view shifted from owing the primitive world education and Christianity, to a more self-interested we English are naturally better. Therefore, the we should be exploiting you, because, that is why you are here. Charles Darwin had a tremendous amount of influence on the scientific community and the English population. It can be seen that Darwinism played a large part in justifying the imperial behavior of England. Darwins studies on nature and the behavior of animals had unlocked Pandoras Box in a manner of speaking. He studies reveal how close to nature humanity really is. The English empire quickly saw themselves as a dominant predatorial species of the world. In conclusion, the English empire used Darwinian concept to justify the on-going process of imperialism. Charles Darwins ideas elevated the egos of the English people to over-estimate themselves socially and globally. The affects of Darwinism can be seen throughout the spectrum of social interaction both in the animal kingdom and human Bibliography:England went through dramatic changes in the 19th century. English culture, socio-economic structure and politics where largely influenced by the principles of science. Many social express ions occurred due to these changes. Transformations which categorized this time period could be observed in social institutions; for instance: the switch from popular Evangelicalism to atheism, emergence of feminism and the creation of new political ideologies (Liberalism, Conservatism and Radicalism). These are just a few of the changes that took place. All of this social alteration can be attributed to the importance of science. The English people began to trust more in empiricism and logical thought than in faith and glory of the empire . One who contributed greatly to this transformation was Charles Darwin. In his two most famous works, The Origin of Species and The Decent of Man, Darwin introduces the concept of the survival of the fittest and natural selection. The Darwinian ideas introduced into English society justified a great number of political policies and social movements. England at the turn of the century was still a largest power in the international system. The Engl ish perceived, through the justification of Darwinism,
Thursday, March 12, 2020
The Role of Marketing Managers
The Role of Marketing Managers The role of marketing managers in modern organizations is continuously discussed by professional researchers, business administrators, and journalists. They may be regarded as heroic leaders who shape the strategies of their companies and ensure their successful performance. Yet, they may also be viewed people who attribute the companyââ¬â¢s successes only to their own actions while overlooking the efforts of other people. This paper is aimed at assessing the roles of these people in from various perspectives.Advertising We will write a custom essay sample on The Role of Marketing Managers specifically for you for only $16.05 $11/page Learn More First, it should be noted that scholars may distinguish two types of managers, successful and effective (Luthans, 130). According to Luthans, those people, who stress effectiveness, are good at HR management and communicating (130). These managers emphasize employeesââ¬â¢ skills, performance, and their professi onal growth (Luthans, 130). Thus, one can say that marketing manages perform such functions as planning, monitoring, decision-making, and motivating. These people help other employees develop products or improve services. Moreover, they coordinate the work of other departments which are responsible for the promotion of products and establishing relations with customers. Yet, it should be kept in mind that there are also successful managers who attach more importance on socializing with subordinates and try to overcome formal barriers (Luthans, 130). Thus, marketing managers should be able to go beyond their formal duties. However, very people are able to balance personal and professional relations in the workplace. To better understand the activities of marketing managers, one can refer to the study done by Philip Zimbardo. He and his colleagues demonstrated that people were very likely to accept their institutional roles even if such roles contradicted their personal principles (Zi mbardo et al, 9). Similarly, marketing managers attach importance to their formal duties such as planning or coordinating. These managers want to maintain traditional workplace hierarchy. However, not all of them are able to be more personal and engage his or her subordinates. Again, as it has been said by Luthans, this is a skill of very successful managers (130). One cannot assume that every marketing manager can act in such a way. Finally, the debate about the role of marketing managers stems from a common stereotype about managers created by mass-media. The thing is that corporate executives were often portrayed as heroic figures who could dramatically transform their companies (Mintzberg, Simons and Basu 67). Admittedly, there were managers who did change the marketing strategies of their companies and strengthened their positions in the market.Advertising Looking for essay on business economics? Let's see if we can help you! Get your first paper with 15% OFF L earn More In this regard, one can certainly mention such people as Steve Jobs or Steven Reinemund who often performed the functions of marketing managers. Such people envisioned better services and products. Nonetheless, marketing managers focus more on their traditional roles, such as analysis of market trends, product development, advertising, and so forth. These people do not usually position themselves as all-powerful figures. On the whole, this discussion shows two important things. First, marketing managers attach more importance to their direct duties such as strategy development. They also have to make sure that the company can adapt to the changing needs of the customers. However, at the same time, they should enable other people to fulfill their talents. As it has been argued only few managers can combine personal and professional relations. Finally, these people usually do not act as heroic figures. Still, they can profoundly affect the performance of a company. Luthans, Fred. ââ¬Å"Successful vs. Effective Real Managersâ⬠. The Academy ofà Management Executive, 2. 2 (1988): 127-132. Web. Mintzberg, Henry, Simons, Robert, and Basu, Kunal. ââ¬Å"Beyond Selfishnessâ⬠. MITà Sloan Management Review, 44:1 (2002), 67-74. Print. Zimbardo, Philip, Haney, Charles., Banks, Willan. C., and Jaffe, Donald. ââ¬Å"The mind is a formidable jailer: A Pirandellian prison.â⬠The New York Times Magazine, 38- 47. Print.
Monday, February 24, 2020
Airborne Express Essay Example | Topics and Well Written Essays - 250 words
Airborne Express - Essay Example Now it was easier for companies to invest in jets and pose threat to profitability of firms. With respect to the power of suppliers, it can affect the relationship between a business and its customers by influencing the quality and price of the final product. Power of buyers had great impact on the profitability as they began to negotiate in groups and enjoy discounts and lower costs. Availability of substitutes is high in the industry and with the advancement of technology and better systems, more promising channels flared up, inflicting damage to the profitability of the industry. Competitive prices also lead to a decline in its profitability levels. Competition from conventional rival has had the biggest impact in depressing industry profitability: the express package delivery industry has become more concentrated in recent years, because of mergers between companies and bankruptcies of many firms. What strategies did Airborne adopt to try and increase profitability? Why was it un able to gain any competitive advantage over FEDEX and UPS? Generally Airborne strategies focused on gathering information about competitors in the market, the serviceââ¬â¢s uniqueness, description of key clients, channels for distribution, pricing strategy, expenses and research and development.
Saturday, February 8, 2020
Managing at the Edge Research Paper Example | Topics and Well Written Essays - 2000 words
Managing at the Edge - Research Paper Example This is an approach that underestimates the abilities of the employees to carry out tasks and to innovate and improvise as they go. In this kind of companies, each and every decision has to be taken at top level and the employees in the lower levels of hierarchy only have to mechanically obey what they are told. There will a fixed chain of command that will often be lengthy as well (Carney and Getz, 2009, p.23). The decision making will be highly ââ¬Å"procedure-drivenâ⬠(Carney and Getz, 2009, p.23). Lack of flexibility caused by stringent rules and stunning of the possibilities of creative contribution from employees, are two major drawbacks of 'how' companies. In contrast to this, a 'why' company is one which shares with its employees a single quest, namely, 'why we are doing what we are doing?' (Carney and Getz, 2009, p.16). Naturally, it is a common quest for the company and the employees. The only answer possible for this question is, ââ¬Å" to keep the customers happyâ ⬠(Carney and Getz, 2009, p.17). Thus the 'why' company wants the employees to keep its customers happy and does not bother much about how it is attained (Carney and Getz, 2009, p.17-18). This is an approach that allows maximum contribution and participation from the employees. It gives freedom to the employees to innovate and improvise and through that, will enhance their motivation and self-esteem. In traditional 'how' companies, the strict control can help achieve good growth and profits (Carney and Getz, 2009, p.43). But this positive aspect will be counter-balanced by the detachment and stress that the employees feel in an environment where there is least freedom (Carney and Getz, 2009, p.43). This will get reflected in their output as well (Carney and Getz, 2009, p.43). References Carney, B.M. And Getz, I. (2009) Freedom, Inc., New York: Crown Business. 2. What are the characteristics of a Level 5 Leader? Level 5 leader is someone who has the capability to lead a company f rom ââ¬Å"good to greatâ⬠, according to Collins (2001). The term, level 5, is used to indicate ââ¬Å"a five-level hierarchyâ⬠(Collins, 2001). Collins (2001) has explained these five levels as given below: Level 1 relates to individual capability, Level 2 to team skills, Level 3 to managerial competence, and Level 4 to leadership as traditionally conceived. Level 5 leaders possess the skills of levels 1 to 4 but also have an "extra dimension": a paradoxical blend of personal humility ("I never stopped trying to become qualified for the job") and professional will ("sell the mills"). People who inhabit the level 5 leadership category are not egocentric and dislike showing off (Collins, 2001). All the same, they have the strength and will power to take bold decisions when the hour needs so (Collins, 2001). It is the goals, the organization and the meaningfulness of the whole exercise that come first for them rather than their personal ego (Collins, 2001). They are highly a mbitious but not in the real sense the word, ambition is commonly used (Collins, 2001). Level 5 leaders are ambitious not towards their own narrow personal career goals but for greatness of the job involved and the organization (Collins, 2001). Level 5 leader will always be only partially satisfied by the results achieved and would constantly seek self-improvement (Collins, 2001). The greatest motivation of such a leader is to leave behind a real
Wednesday, January 29, 2020
Internet Addiction Essay Example for Free
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 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). 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]. Sinceà 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. Youngââ¬â¢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 theirà 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]. ââ¬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.â⬠[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 ââ¬Å"excessive engagement in Internet activitiesâ⬠[24]. NEUROBIOLOGICAL VULNERABILITIES It is known that addictions activate a combination of sites in the brain associated with pleasure, known together as the ââ¬Å"reward centerâ⬠or ââ¬Å"pleasure pathwayâ⬠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 ââ¬Å"highâ⬠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: ââ¬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 wayà of retreating and isolating.â⬠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 ââ¬Å"Internet Addiction: Symptoms, Evaluation, and Treatmentâ⬠, Young [41] offers some treatment strategies which are already known from the cognitive-behavioral approach: (a) practice opposite time of Internet use (discover patientâ â¬â¢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 canââ¬â¢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 Dellââ¬â¢Osso et al. [47] to treat 14 subjects with impulsive-compulsive Internet usage disorder. Internet usageà 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 ââ¬Å"Community Reinforcement and Family Trainingâ⬠[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 theirà 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 therap y (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 groupà 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 patientsââ¬â¢ 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 decreasedà 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 firstà 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 goodà 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.
Subscribe to:
Posts (Atom)