Cyberpsychiatry Sudhir Bhave, Sushil Gawande, Abhijeet Faye, Anagha Sinha Saoji
INDEX
Page numbers followed by b refer to box, f refer figure, fc refer to flowchart, and t refer to table.
A
Acceptance and commitment therapy 62, 136
Action games 32
Addiction 53
to cyberspace 52, 68
Addictive behaviors 59
disorders due to 59
Addictive design 76
Adjustment disorders 189
Alcohol
addiction 132
use disorder 111
Alexithymia 203
Allied health literature 164
Alzheimer's project, international genomics of 166
Analyzing qualitative data, tools for 172, 172t
Anchoring 46
Animal-assisted therapy 138
Animal-shaped robot 209
Anorexia nervosa, genetic consortium for 166
Anthropomorphism 46
Anti-addiction 147
Antitechnology 129
Anxiety 7, 86, 111, 133, 201, 203
disorder 145, 203
AppDetox 139
Apps 149, 213
Artificial intelligence 163, 173, 206
in mental health, utility of 209t
Asynchronicity 49
Asynchronous 181, 182
communication 8, 9
Attention 210
deficit 127
hyperactivity disorder 8, 71f, 75, 93, 94, 111, 133, 145, 184, 201, 209
symptoms of 21
Audio 181
Authority, minimization of 50
Autism spectrum disorder 184
Automated communication 8, 9
B
Based gamification 210
Basic education 180
Behavior 53
change 40
Behavioral addiction 132
Behavioral therapy 137
Bias blind spot 46
Big-data engines 166
Binge-watching 42
Bisexual 87
Bluetooth 16
Bondage 157
Boon versus bane 199
Boredom 44
Brain 43
development 18
Bully-victim 201
Business entrepreneurship 24
Bygone era 16
C
Cambridge neuropsychological test automated battery 169
Cannabis 160
Captology 40
Cardiology 178
Chat rooms 158
Chat therapy 9
Chen's internet addiction scale 122, 134
Child and adolescent psychiatry 184
Child sexual abuse 184
Child Sexual Offences Act, prevention of 160
Children from Sexual Offences Act, protection of 160
Clearlock 139
Client-therapist relationship 193
Clinical psychology 207
Cognitive behavior
model focuses 54
therapy 57, 60, 82, 136, 184, 195, 209, 210
Cognitive development 19
Cognitive enhancement games 210
Cogstate brief battery 169
Commercial opportunities 24
Commitment therapy 138
Commodity 205
Common assessment tools 124
Common mental health conditions, prevalence rates of 111t
Common reference management tools, comparative characteristics of 168t
Common scientific databases, comparative characteristics of 165t
Communication 182, 205, 207
in telepsychiatry, modes of 181
modes of 181t
Comorbid psychiatric conditions 55
Comorbidity, assessment of 121, 127
Complex intervention 147
Comprehensive meta-analysis 169
Compulsive buying disorder 43
Compulsive internet use scale 124
Compulsive repetition 136
Computer
addiction 52, 74, 133
game addiction, short-term treatment for 138
pathological use of 74
Conduct disorder 75
Confidential mode 216
Confirmshaming 48
Consultation-care model 180
Consultation-liaison psychiatry 184
Consumables 128
Continued influence effect 46
Control filters 214
Cooperative games 32
Coping skills 134
Coronavirus disease 2019 6, 155, 177, 186f, 199, 206
pandemic 185
Counter strike 56
Crisis management 194
Cyber 1
addiction 103
aggression 24
business 2
civil rights initiative's non-consensual pornography study 87
contexts, societal change in 5
culture 2
dating abuse 47
education 2
effect 5
ethics 2
fashion 2
linked behaviors 109, 112
linked pathologies 80
mall 2
pollution 45
porn 2
psychiatric disorders 131, 132
psychiatry 11
psychology 4, 11, 12
psychopathologies 80
punk 2
racism 203
related factors 5
related problematic behaviors 81
relational addiction 52, 133
relationship 125, 202
security 2
selves 2
sexual 125
stalking 7
suicide 101
time 2
Tsunami 45
victimization 24
violence 47
Cyberage 16
growing in 15, 24
on development, impact of 18
Cyber-art 2
Cyber-behaviors 80
Cyberbully, secondary 91
Cyberbullying 2, 6, 7, 15, 24, 29, 32, 35, 47, 91, 92, 101, 106, 112, 133, 149, 201, 204
forensic aspects of 155
Cyber-café 2
Cyber-cash 2
Cyberchondria 3, 81, 82, 101, 108, 112, 133, 150
severity scale 82
Cyberchondriacs 80
Cybercrime 2, 24, 47
forensic aspects of 158
Cybercriminal activities 1, 5
Cyberespionage 2
Cyber-goth 2
Cybergrooming 108
Cyber-linked behavior
epidemiological perspectives on 101
physical and psychological consequences of 114
prevalence for 102
psychiatric comorbidity in 109, 112
risk factors for 102, 110t
Cyberloafing 43
Cybermedicine 176
Cyberoperations 2
Cyberpsychiatry
disorders, management principles of 131
forensic aspects of 153
future of 199
Cybersex 2, 7, 101, 107, 112, 201
Cybersexual addiction 52, 133
Cybershopping 1
Cybersociety 2, 4
Cyberspace 13, 5, 11, 1517, 29, 34, 36, 3941, 43, 44, 176, 177, 199, 200, 204, 205t
age of 15
control and energy 41
effect of 48t
environment of 10
human behavior in 3
impact of 1, 29, 48
nature of 1
nudges of 48
on cognitive 17
overuse of 200
power of 40
science of 1
structure of 1
use of 201, 203
Cyberstalking 2, 4, 47, 85, 107, 112, 202
forensic aspects of 155, 158
Cybersuicide 108
forensic aspects of 157
Cybersurfing 1
Cyberterrorism 48, 158
Cybertherapy 8, 9
Cyberthreats 2
Cybervictimization 105
D
Dark side 39
Data quest 166
Dementia
behavioral symptoms in 184
psychological symptoms in 184
Dentistry 178
Depression 7, 111, 133, 145, 203
higher risk for 201
self-help for 208
Depressive disorder 189
major 184
Dermatology 178
Digital data
analysis 171
collection software, comparative characteristics of different 170
summarization 167
Digital ECHO-NIMHANS 187
Digital footprints 159
Digital gratification 203
Digital immigrants 40
functioning profile of 41t
Digital native
brain 44
functioning profile of 41t
Digital primary data collection, web-based 169
Digital resilience 7
Digital risk 10
Digital screen 179, 203, 207
Digital self-harm 93
Digital technology, interconnected 199
Digital time 203
Digitalization 199
Digitally mediated research methods 163
Discipline 157
Disguised advertisements 48
Dissociative anonymity 49
Dissociative imagination 50
Distress 82, 203
Doctor-patient relationship 159
Double-edged sword 179
Drug 132
and Cosmetics Act 187
and magic remedies 187
risk 191
Dual-edged sword 196
Dunning-Kruger effect 46
Dysfunctional behavior 33
Dysphoria 24
E
Easyma 169
Eating disorders 133, 189
E-cash 54
E-chat 181
Echo chamber effect 45, 46
Ecological momentary assessment 163, 172
E-commerce 203
Education 203
resources information center 164
Educational institutions 144
E-evaluation 178
Electroacupuncture 137
Electronic cash 54
Electronic data capture 163, 169
Electronic gambling 203
Electronic gaming machine 105
Electronic health record 178
Electronic medical records and genomics network 166
E-mail 9, 158, 215
therapy 9
Emerging cyber-pathologies 96
Emotion 126
Emotional comfort 121
Enhancing social support 134
Enslavement by technology 205
Entertainment 128, 203
Environment 182
Environmental intervention 147
Environmental modifications 140
Environmental Protection Act 187
Eriksonian stage 21
Escapism 45
Ethnicity 105, 106
Excessive internet use, physical and psychological consequences of 113, 113t
Excessive screen time 74
Excessive stress 203
Expanding resilience 122
External stimuli, cognitive responses to 54
Extortion 68
Extremists 5
Eye strain 57
Eyestrain, risk of 214
F
Facebook 8, 11, 23, 31, 33, 36, 102
age 40
messenger 182
Face-to-face 34, 154, 164
relationship 9
web-based 208
Factitious illness behavior 83
False information 68
Family 92, 148
dynamics 35
therapy 184
Fast-paced programs, avoid 213
Fatigue systems 147
Fear of missing out 71
anxious state of 33
First telepsychiatry consultation 190fc
First-person shooter 56
Forensic cyberpsychiatry, future of 160
Forensic psychiatry 184
Framing effect 46
Friend spam 49
Frontotemporal dementia 171
Functional magnetic resonance imaging 58
Future research, scope for 115
G
Gadgets 180
Gambler's fallacy 46
Gambling
disorder 59
potential for 202
Games 56
Gaming and artificial intelligence 195
Gaming and gambling 43
Gaming disorder, criteria for 57b
Gastrointestinal systems 203
Gender 106
General data protection regulation 10
Generalized anxiety disorder 111, 184
Generation X 40
Generational break 23
Generative adversarial network 173
Genetics 166
Geriatric psychiatry 184
Global internet usage 102
Google
age 40
deepmind 173
hangouts 182
meet 208
scholar 164
tensorflow 173
H
Hacking 158
Hacktivists 5
Headache, risk of 214
Health anxiety 178
Healthy online self-helping center 138
Hearing 113
Hepima 169
High frequency trading 73
Hostile attribution bias 46
Human development 15
Human factors 182
Human Organ Act, transplantation of 187
Human touch 200
Humans hackable 43
Hyperactivity disorder 21, 127, 148
Hyperchondriasis 202
Hypochondriasis 145
I
Iceberg, tip of 184
Identifiable victim effect 47
Identity formation 204
Identity thieves 158
IEEE Xplore 164
Imaginary communication 8
Incompetent stalkers 85
Indian Psychiatric Society 188, 197, 207
telepsychiatry guidelines 189b
Indigo children 44
Infections 113
Information 207
and communication technology 15, 92, 176
education, and communication 184, 209
overload 52, 133
syndrome 75
pollution 207
Providing Programs 147
Technology and Mental Healthcare Act 187
Injuries and accidents 113
Instagram 15, 102
Intellectual disability disorder 184
Internal medicine 178
Internal stimuli, cognitive responses to 54
International classification of diseases 7, 53, 57b, 122
gaming disorder in 69
Internet 16, 81
age 40
and addiction, unhealthy use of 202
based systems 181
compulsions 133
dependency 121
exercises, distraction with 122
gambling 104
munchausen by 82, 83
of humans 3
penetration of 102
protocol 164
related disorders, prevention of 144
related pursuits 122
risk factor 54
short-term treatment for 138
took over 19
usage 102, 105
Internet addiction 55b, 101, 103, 109, 111f, 113, 121, 131
diagnostic questionnaire 134
disorder 131
psychiatric comorbidity in 109
recovery program 138
risk factors for 105t
scale 124
specific 52
test 122, 133
Internet gaming disorder 56, 57b, 101, 103, 109, 111
physical and psychological consequences of 114
psychiatric comorbidity in 111
risk factors for 105t
Internet use 134
assessment of 121, 124
nature of 125
pattern of 145
problematic 109, 121
skills with 149
Internet-related psychopathology, classification of 201
Interpersonal communication 8, 9
Interpersonal situations, skills with 149
Intimacy seeking stalkers 85
Invisible communication 8, 9
K
Knowledge, attitude and practice 184, 185
Korsakoff's syndrome 171
L
Laptop 180
Learning 41
disability 184
Local area network 56
Loses power 147
M
Malware development 158
Marathon viewing 42
Masochism 157
Massively multiplayer online game 56
role-playing 31, 56
Media richness 30
Medical internet research 10
Medical professional, mistrust of 82
Medical Termination of Pregnancy Act 187
Melodious feedbacks 16
Mental disorder
common 184
diagnostic and statistical manual of 53, 57b, 69, 94, 102, 104, 122, 132
digital research tools for 169
severe 184
statistical manual of 59
Mental health 176
gaming interventions in 195t
Survey 166
Mental Healthcare Act 187
Mental reliance, advancement of 122
Mental stimulation 121
Messages 19
Metabolomics 166
Metacognitive 20
Microsoft excel 171
Microsoft's V-box 31
Microstructural organization 19
Minimal cognitive impairment 210
Ministry of Health and Family Welfare 187
Misogyny 5
Mobile 180
phone addiction 132
Moral development 24
Motor and physical development 24
Multiplatform 15
Multiplayer online
battle arena 56
video game 18
Multisensory stimulation 18
Musculoskeletal problems 113
Musculoskeletal sprain 57
Myelination 19
N
Narcotic Drugs and Psychotropic Substances Act 187
National Institute of Mental Health and Neurosciences 187, 188, 189b, 207
National Library of Medicine 164
National Mental Health Program 185
National Mental Health Survey 183
Natural language processing 173
Negative affective states 203
Negative consequences, assessment of 121, 128
Net binges 126
Net compulsions 52
NetMetaXL 169
Network bandwidth 208
Neurocognitive tasks 20
Neuroimaging 23
Neuromancer 1, 2
Neuroplasticity 16, 17
Neuropsychology 191
Nonaddiction internet use disorders, prevention of 149
Nonsuicidal self-injury 157
O
Obesity 148
risk of 214
Obsessive-compulsive
disorder 81, 145, 178, 209
symptom dimensions 82
Offline addiction 74
Offline variant 74
Omission bias 47
Oncology 178
Online addictions, specific 55
Online anonymity 5
Online designer drugs, forensic aspects of 160
Online gambling disorder 58
Online games 149
Online gaming disorder 55
Online harms 3
Online porn addiction 60
Online pornography use, problematic 60
Online psychiatric consultation and prescription, forensic aspects of 155
Online psychotherapy, forensic aspects of 154
Online risks 1
Online sexual
predators and pedophilia, forensic aspects of 160
victimization 150
Online shopping disorder 62
Online therapies, future of 207
Open access journals, directory of 164
Open diary 30
Ophthalmology 178
Oppositional defiant disorder 75
P
Painting 206
Panic disorder 189
Parental level 147
Parent-child conflict 144
Parkinson's disease 171
Pathological internet use 123t, 125
assessment of 125f, 211
Peltzman effect 47
Penn longitudinal database 166
People misbehave online 49
Person-affect-cognition-execution, interaction of 54
Personal computer 128
Personal digital-time management tips 215
Personal identification number 214
Personality characteristics 145
Personality disorders 178, 203
Pharmacy Act 187
Phishing 47, 158, 203
Phobias 178
Phone 180
Physical fitness and obesity 113
Physical injuries 24
Physiological effects 158
Policy changes 147
Policy interventions 76
Pornograhic videos 6
Pornography 149
addiction, forensic aspects of 156
Postgraduate trainees 184
Post-pandemic digitalization 206
Post-traumatic stress disorder 45, 86, 184, 189, 201
Potential mental health 200
Predatory stalkers 86
Prenatal Sex Determination Test Act 187
Prior sexual exploitation, history of 145
Privacy zuckering 49
Pseudomonas 114
Psychiatric comorbidities, common 111f
Psychiatric disorders 135, 203
Psychiatric genomic consortium 166
Psychiatric social work 207
services 194
Psychiatry 178, 207
adult 184
artificial intelligence in 208
department of 197
preventive 184
Psychoeducation 150
Psychological and personality factors 55
Psychological approaches 136
Psychological distress 7
Psychology 207
Psychosomatic challenges 128
Psychotherapy 154, 183, 192
and social work 184
Public shaming 68
PubMed 164
Puzzle games 32
Q
Qualitative data analysis software, computer-assisted 171
Qualitytime 139
R
Randomized controlled trials 58, 187
Rayyan 168t
Real communication 9
Reality therapy, effectiveness of 136
Reduced sleep 203
Rehabilitation 184
Relieve depression 167
Repetitive strain injury 127
Research
accessing digital data for 164
methodology 163
Resentful stalkers 85
Revenge porn 47, 50, 86, 133, 202
victims of 151
Revengeful pornography 107
RevMan 169
Right to health 200
Role-playing games 32
S
Sadomasochism 157
Schizophrenia 189
Security, sense of 133
Seizures 128
Selective serotonin reuptake inhibitors 135
Sensorimotor 18
Sensory 9
communication 8, 9
Sequenced treatment alternatives 167
Sex chats 202
Sexting 157
Sextortion 6
Sexual exploitation 68
Sexual extortion 90
Sexual harassment 158
Sexual interactions 202
Sexual offences, protection of children from 90
Sexual violence pandemic 6
Sexually transmitted diseases 107
Short-messaging services 9
Silver linings 207
Skills training 184
Skype 208
Sleep disorders 8
Sleeplessness, risk of 214
Sleep-wake cycle 24
Smartphone 16, 17, 21, 214
addiction, forensic aspects of 159
age 40
Snapchat 33, 72
Social and behavioral evaluation 163
Social anxiety 178
Social change 32
Social communication 24
Social contacts 41
Social factors 55
Social functioning 41
Social media 30, 71
addiction 69, 70, 71f
platforms 30
relationships 35
tribalism 46
Social networking sites 29, 30, 91, 149, 158
Social phobia 145
Social presence 30
Social relations and internet 203
Social structure 32
Social-emotional skills 213
Socioeconomic status 105, 106
Socioemotional development 21
Sock puppets 83, 84
Software 169
Solipsistic introjection 49
Sony's playstation 31
Stanford persuasive technology lab 40
Staphylococcus 114
Statistical analysis software 172
Stay off 139
Stickiness 42
Stigma 164
Stock trading addiction 72
Strategic games 32
Strengthen primary healthcare centers 184
Stress
and emotions 149
reactions, acute 189
Substance use 203
disorder 145
Substance, disorders due to 59
Suicidal ideation 7
Suicidal risk 191
Suicidality 203
Suicide prevention 184
Surveillance 68
Synchronous 8, 181
communication 8
T
Technological feasibility 208
Technology addiction 200
Technology information, attitude to 41
Technology use 204
Telemedicine
advantages of 178b
promises of 178
smartphone apps 181
Telemental health 178
services
applications of 184
utilizing cyberspace for 176
Telephone 181
Telepsychiatric consultations 183
Telepsychiatric social work practice 193fc
Telepsychiatry 179, 182, 191
challenges for 187
evidence for 187
guidelines 186
participate in 180
practice of 194
protocol 190fc
relevance of 183
scope of 180
service 191fc
utilization of 180
Telepsychotherapy services, guidelines for 192fc
Television 214
Text messaging 149
Theoretical explanatory models 54
Therapeutic robots 209
Toddlerhood 21
Toddlers 16
Touch screens 16
Transdisciplinary 11
Transhumanism 206
Triggers, assessment of 121, 126
Twitter 33
U
Updating status 36
V
Victim blaming 158
Video 181
conference 181
games 214
positive impact of 32t
Virtual connectivity 203
Virtual knowledge network 187
Vision 113
W
Web binges 121
Web of science 164
Webcam
child sex tourism 88
sex tourism 88
Websites 181
WeChat 33
Wellness check 196, 208
WhatsApp 8, 11, 33, 102, 159, 182, 208
Woebot 208
Work from home 206
Workplace 144
level 147
World Health Organization 122, 165
World wide web 30, 42
×
Chapter Notes

Save Clear


Nature, Structure, Impact, and Science of CyberspaceCHAPTER 1

Mary Aiken,
Sushil Gawande
 
SUMMARY
The term “cyber” refers to anything involving computers and the Internet. There are many new terminologies being used with reference to cyberspace. The understanding of cyberspace is changing over time however it is important to conceptualize cyberspace as a real place.
The relationship between cyberspace and the real world is more complex than it seems. It is a matter of great concern that real-world cyberspace symbiosis is tilting towards the latter.
Humans are behaving differently with technology when compared to the real world. The ease, convenience, and anonymity of cyberspace are having an unimaginable impact on human behavior. Although there are many benefits regarding the new environment of cyberspace, this evolution may also be facilitating addictive type behaviors.
Cyberspace is contributing to sociological and psychological changes across every age group. We are living through the largest unregulated social experiment of all time. Cybercriminal activities, online risks and harms are now ubiquitous.
This chapter discusses the above issues in depth and various forms of cybertherapy along with the precautionary principle transposed to cyberspace. Concluding that it is time for science, industry, governments, communities, and families to come together to create a roadmap for cybersociety.
 
WHAT IS CYBERSPACE: DEFINITION OF CYBERSPACE WITH REFERENCE TO THE CURRENT SCIENCE
The term “cyber” refers to anything involving computers and the Internet. The broad term cyberspace was coined by the fiction writer William Gibson. The term first featured in his 1982 science fiction short story “Burning Chrome” and was popularized in 1984 in his novel “Neuromancer.” However, by the 1990s it had started to enter into common usage, particularly with the popularity of the Internet. Cyber was being used as a term for anything related to computers and future information technology, for example, cybershopping, cybersurfing and cyberspace.1
Along with Wiener and Marshall, McLuhan was one of the most important influences on the Gibson vision of cyberspace, which represents computers as an extension of the body to the extent that the individual directly connects to the console 2through an interface, which in turn connects the brain to the electronic medium.2 The network of information technology, telecommunications networks and the Internet have rendered the concept of cyberspace as a global domain, within this environment of information. Notably, very different from Gibson's “Neuromancer” description of cyberspace, that is, “A graphic representation of data abstracted from banks of every computer in the human system. Unthinkable complexity. Lines of light ranged in the nonspace of the mind, clusters and constellations of data. Like city lights, receding William Gibson, Neuromancer (New York: Berkley Publishing Group, 1989), pp. 128”.
Historically, the term cyber is derived from another term cybernetics, which was used by Norbert Wiener in the late 1940s. Interestingly, he defined it as the science of control. Cybernetics, is derived from the Ancient Greek “kybernētēs” which means pilot or governor (from kybernan to steer, govern),3 as discussed with the onset of the Internet, the term cyberspace has been applied to the virtual space that is created within the Internet, somewhat of a paradox since this space has little or no governance. Nonetheless, the term continues to evolve, in 2016 the North Atlantic Treaty Organization (NATO) ratified cyberspace as a domain of war, as an environment, acknowledging that the disputes of the future would take place on land, sea, air, and in cyberspace.4 Importantly, children and young people are now growing up in the psychological environment of cyberspace, Yan (2012) predicts that the cyber behavioral sciences will enjoy exponential growth—due to rapid acceleration of Internet technologies and the “unprecedentedly pervasive and profound influence of the Internet on human beings”.5
There are many other words using “cyber” as a prefix coined in early 90s such as cyber-punk, cyber-culture, cyber-society, cyber-art, cyber-talk, cyber-education, cyber-cash, cyber-business, cyber-mall, cyber-porn, cyber-sex, cyber-selves, cyber-ethics, cyber-fashion, cyber-café, cyber-goth and cyber-time.
Additionally, many other terminologies are being used with reference to activity in cyberspace, for example cybercrime, cybersecurity, cyberbullying, cyberstalking, cyberthreats, cyberespionage and cyberoperations. In fact, almost every activity undertaken in cyberspace could plausibly be considered as a cyberactivity. In the coming years we may find many new terminologies related to cyber, particularly as we move into an era of virtual and augmented reality.
 
RELATIONSHIP BETWEEN CYBERSPACE AND THE REAL WORLD
Man-computer symbiosis6 is a subclass of man-machine systems, which describes the interaction between man and computers. In the man-machine systems of the past, the human provided the initiative, direction and integration. The mechanical parts of the systems were extensions of the human. In this system there was only one kind of organism, that is, the man. The role of machines was to assist mankind.
During the last few years, rapid and remarkable changes have taken place in the man-computer system. Mechanical extension has advanced almost to the point of replacement of man. Human operators are increasingly only responsible for functions that are not feasible or cost effective to automate. Therefore the phenomenon of man-computer symbiosis is perhaps tilting in favor of machines. Artificial intelligence (AI) is becoming increasingly capable of rivaling human intellectual abilities in many areas 3of life. Despite this we should continue to strive to maintain a state of man-machine symbiosis, that is an interdependent and symbiotic relationship. Cooperation and interaction could undoubtedly enhance the cognitive processes of man and improve the functioning of the machine, which would work towards ensuring harmony, balance, and mutual benefit going forward, in other words a symbiotic relationship.
According to man-machine concepts, cyberspace can be conceptualized as an extension of human intellect, as a powerful psychological space. Cyberspace is impacted by the aspirations and desires of human beings. We are now moving towards an “Internet of Humans”.7 Cooper describes the “Triple A” engine, three key factors that combine to give the Internet its power, namely, access, affordability, and anonymity.8 The ease, convenience and anonymity of cyberspace are all having an impact on the real world in multiple dimensions. As is true for man-machine symbiosis, real world cyberspace symbiosis may conceivably be tilting towards the latter.
 
HUMAN BEHAVIOR IN CYBERSPACE
It is interesting to note that we can behave differently when mediated by technology when compared with how we behave with others face to face. Technology can amplify, escalate, and alter the nature of our actions. At a basic human computer interaction level, even the act of searching for health-related information online, can lead to escalation to review morbid or serious content, which in turn can cause anxiety, this phenomenon is described as cyberchondria.9 The democratization of access to information online is a positive evolution and the Internet is a source of valuable medical information, however, it has the potential to increase anxiety in people who have no medical training, when it is employed as a diagnostic procedure. Further research is required to find a balance between positive aspects of search such as increased knowledge and reassurance, and the worry and anxiety that may be engendered, this is particularly relevant in the context of the 2020 global pandemic and the associated media ‘infodemic.’10 arguably this premise is true when it comes to any human behavior mediated by technology. There are many benefits regarding the connectivity afforded by cyberspace, however, the apps; devices; and social media platforms that populate this space may in fact be instrumental in creating new addictive type behaviors. A former software engineer describes how behind every screen on your phone, there are generally more than a thousand engineers that have worked hard to make it as addictive as possible.11 There needs to be a greater awareness regarding what can only be described as “addiction by design” products and services that are designed to target our psychological Achilles heel, designed to diminish rather than enhance the human species.12 The point is, technology in itself is not good or bad—it is either designed, and then used, well, or poorly by humans. “If we really want to tackle online harms, addiction by design, autonomous surveillance, dark AI, behavioral manipulation online, misinformation and disinformation” along with ever evolving social media “weapons of mass distraction”, then we need to work towards understanding these new phenomena and work towards seeking solutions.13
There is a need to conceptualize technology in a new way for example conceptualizing cyberspace as an actual physical space that has a profound and pervasive impact on humankind. It is extremely important to acknowledge the repercussions of this space on vulnerable groups such as children, developing youth, additionally we 4must factor in those with delinquent or criminal intent. There is therefore a need to draw on the learnings of the behavioral sciences regarding the relationship between environment and human behavior. Ecological psychology studies have theorized that behavior is largely influenced by social settings. Roger Barkers's work in the early 1940s in this regard is noteworthy. Barker proposed the concept of “behavior setting” which explains the effect of an environment on its inhabitants. In 1987, the environmental psychologist Harold Proshansky14 discussed how the field was “value-oriented” due to environmental psychology's commitment to bettering society through problem identification. This is a valuable observation when it comes to the consideration of the individual in a psychological context, and the group in a sociological context, or what has been described as “cybersociety”.15
Proshansky, however, only considered environment as a real-world construct, the challenge now for academics, researchers and practitioners is to transpose these valuable learnings to cyberspace.
Cyberpsychology16 focuses on the study of impact of technology on human behavior; specifically how the Internet and digital activities affect human behavior, forensic cyberpsychology17 is an emerging area of research, that is, the study of criminal, deviant and abnormal behavior online. We spend a significant part of our life in cyberspace and we are all aware of the unimaginable benefits of cyberspace. However, these benefits must be considered in the context of potential risks and harms in this new environment.
“Claims for the independence of cyberspace are based on a false dichotomy, physical and virtual are not opposed; rather the virtual complicates the physical, and vice versa”.18
In other words, activity in cyberspace can have consequences in the real world and vice versa. The online disinhibition effect19 is commonly observed in cyberspace. It can make an individual feel less inhibited when they are online compared to real-life situations. Anonymity, or perceived anonymity online is also a strong behavioral driver, arguably there may exist comorbidities in that anonymity may fuel disinhibited behavior and vice versa. Due to the powerful psychological effect of anonymity, some individuals may have behavioral deficits regarding appropriate decision making or judgment. Online disinhibition can also affect human behavior in technology mediated environments.
Empathy may also be compromised when humans are online. It has been observed that some people have decreased empathy and heightened detachment from the feelings and rights of others when they are online. This phenomenon has led to various deviated human behaviors. Research supports that narcissism is rising and empathy is declining among American college students20 and given hyper global connectivity these changes are undoubtedly universal.
Desensitization effect is also a commonly observed change in human behavior online, perhaps given the endless amount of violent and extreme content in online media, viewers may be losing some sensitivity? Perhaps due to overexposure, initial concerns may turn to lack of sensitivity?
Human behavior is often amplified and accelerated online.9 The principles of Skinner's operant conditioning play an important role in the amplification of human 5behavior in cyberspace. Immediate rewards and gratifications reinforce behavior21 and increase the chance of repetition of similar behaviors. Discomfort or distress of not being online may also arguably reinforce online behavior.
Online anonymity, convenience of use, easy accessibility, disinhibition and escapism are important cyber-related factors which may be associated with amplification and escalation of human behavior in cyber contexts.
Whenever a technology interfaces with a basic human tendency, the result is often a form of amplification or acceleration. There exists a “cyber effect’ which has been hypothesized as online syndication,12 whereby deviant, criminal or abnormal groups can syndicate to find each other online within a few clicks, and in doing so conceivably normalize and socialize their behaviors.
This online syndication effect is undoubtedly a factor regarding the manifestation of serious deviant behaviors online. Sex offenders, proponents of hate speech, racism, misogyny, cybercriminals, hacktivists, extremists and young people with self-harm disorders may be affected by this phenomenon, that is, syndicating to connect with each other online and in doing so socializing their behaviors. Potentially this form of syndicated hyperconnectivity may be a major factor in recently reported surges of COVID-19 related criminal behavior in cyberspace.22
 
CYBERSPACE IS A REAL PLACE
Space is a place or an area that is empty. It is easy to imagine a physical space however the new term “cyberspace” may be confusing for some as it is difficult to imagine or conceptualize its abstract dimensions. Is cyberspace an actual place? This question has been widely debated. And the answer is, yes. It is an actual space. As soon as we go online, we are taken to a different location in terms of awareness, emotions, responses and behaviors. Depending on age, physical and mental development and personality traits our reactions may vary. Though physically we are sitting in the classroom, bedroom or any other location but awareness-wise and emotionally we are often taken to a different location when online. The more time we spend in cyberspace, the less time we are available in the physical world. Humans have evolved over centuries to utilize physical space, but cyberspace is still a new place where humans have yet to evolve and adapt to this new environment.23
Therefore in our quest to scientifically understand and investigate evolving and changing human behavior, it is important to conceptualize cyberspace as an environment that impacts human behavior, as a real place. This will help us to study human-cyberspace dynamics and will have explanatory value regarding the impact of technology on human behavior.
 
SOCIETAL CHANGE IN CYBER CONTEXTS
It is perhaps unusual that the design of the Internet has been created as a democratic environment, in which all users are treated and regarded equally without any individual differences. Expecting that all the Internet end users are equal is cyber utopian and unrealistic. Some in society are more vulnerable than others. Children, young people, elders, those with mental health issues, learning difficulties, the neurodiverse or those 6lacking education are all very vulnerable online, they are all potentially high-risk victims. They may be unaware regarding darker aspects of the Internet, the potential risks and harms, and are therefore extremely vulnerable.
It has been said that we are living through the largest unregulated social experiment of all time.12 Our younger generations have been exposed to the best and worst aspects of the Internet. However there is no global statutory body to regulate cyberspace, no authority charged with maximizing benefits and minimizing harms. Professor John Suler, the father of cyberpsychology, described an evolving framework for understanding how people react to and behave in cyberspace, his landmark research has inspired many cyber behavioral scientists worldwide.
Children are being affected practically from birth; devices are increasingly distracting parental and caregiver attention which in turn impacts on essential eye contact with an infant.24 In terms of smartphone checking, the average adult touches their smartphone 2,617 times (p.7) a day, the study noted that ‘At 7AM, touches explode” (p.9).25 Children are being exposed to cyber technological advancements at a very early age, in the UK 1% of 3–4-year-old have a smartphone, 21% have a tablet26 despite the fact that one study found that more than 2 hours of screen time a day could damage children's brain development.27 The expectation that children should be aware of all of positive and negative effects of this new cyber world is not acceptable, particularly as from a scientific perspective many effects are as yet unknown. Unsupervised use of the Internet by children can expose them to cybercriminals.28 Europol has reported a significant increase in online coercion and sextortion with children as young as 7 years being targeted.29 The global impact of COVID-19 means that children are spending more time online, in some cases, they are lonely or isolated, which make them more vulnerable to offenders, who may attempt to connect with them in order to blackmail or coerce them into producing explicit material or to arrange a meeting in real life.30 They are also vulnerable in terms of cyberbullying, harassment, and exposure to legal but age-inappropriate extreme content online31 including extreme violence, pornography and hate speech. Importantly, children require supervision for their online activity, just in the same way that we supervise them in the real world.
The numbers of hours spent by teenagers online have increased significantly as they are able to connect with many of their friends. Their online activities consist of academic activities, gaming, watching movies, social networking, and for some, viewing pornography. Zimbardo (2015) describes how the average American boy watches 50 pornograhic videos a week all easily accessible online.32 The average US child first encounters pornography at the tender age of 8 years. By the time an average male is 21 years old, he has played 10,000 hours of video games (two-thirds of that in isolation). Zimbardo argues that both gaming and pornography have effectively caused a digital rewiring of boys’ brains to need novelty, excitement, and constant arousal, perhaps this may have explanatory value regarding current youth sexting behavior in India?33 and perhaps may also help to illuminate what has been described as a “sexual violence pandemic in India”34 as rape cases doubled in last 17 years, perhaps mirroring the growth and penetration of the Internet?
Adolescents are the highest Internet users, compared to infants and children, in the U.S 45% of teens report to be online almost constantly (Pew Research Center, 2018),35 7There is an increasing global body of evidence regarding the harmful effects of social technologies on the well-being of children and young people such as sleep deprivation, obesity and compulsive use, along with vulnerability to advertising. The literature supports that being exposed to risks such as hateful, violent or adult content, or being groomed or bullied, may all lead to harms such as psychological distress, anxiety, depression, self-harm or suicidal ideation (RCPsych, 2020).36 While simply being online or on social media particularly for long periods of time, may lead to physical health issues such as obesity and loss of sleep (House of Commons, 2019) A myriad of negative consequences is emerging, in terms of psychological impact screentime is associated with a higher incidence of poor mental health “higher anxiety symptoms, depression/depressive symptoms, depressed affect in girls, externalising problems, internalising problems, health complaints and overall mental health problems”.37
This is supported by the Royal College of Psychiatrists, who say that “there is emerging evidence that increased use of social media or screen time may result in poorer well-being” (RCPsych, p.30). Concerningly, anxiety and depression in young people have risen 70% in the last 25 years38 additionally a recent UK government study39 found that an alarming 18% of young people in UK did not think that life was worth living. In fact the UK's chief medical officer has stated that parents should “ban screens from bedtimes and the dinner table”.40 The House of Commons (2019) report recommends that “parental engagement can play a vital role in helping children develop ‘digital resilience’, so that they can confidently identify and judge online risks themselves. Parents, however, need high-quality support to ensure these conversations are as effective as possible” (p.47).41
The decreased levels of happiness among youth have been linked by some experts in this area to their increased use of social media. Perhaps excessive online socializing by young people has affected their relationships with friends and paradoxically at some level is undermining self-esteem and engendering feelings of inadequacy? Further research is required to explore the impact of technology on the mental health and well-being of young people.
Problematic Internet use has been commonly seen amongst teenagers. International Classification of Diseases-11 (ICD-11) has laid down criteria for disorders of addictive behavior such as online gaming disorder and online gambling disorder. Keles et al. (2019) found that the main risk factors for depression, anxiety and psychological distress for young people using social media were the amount of time spent undertaking certain activities (e.g. repeated checking for messages), personal investment (the act of putting time and effort into social media) and addictive or problematic use.42
Cyber use has become a regular feature of the working life of many adults. Similar to teenagers, their online activities vary from the professional to the personal. Many adults are using the Internet for philanthropy. Many social activists across the globe are coming together to work for the betterment of humankind. In this regard, the Internet has been playing an important role. But as with teenagers, many adults are becoming involved in harmful, deviant and antisocial behavior online. The prevalence of cyberbullying, cyber stalking, cybersex addiction, online gambling disorder, online gaming disorder, online shopping addiction and social media addiction are all a cause for concern.8
Many psychological problems, such as anxiety disorders, depressive disorders, sleep disorders, and attention-deficit hyperactivity disorders (ADHD) are associated with problematic Internet use, and while we need to be mindful of issues surrounding causation and correlation there is an urgent need for psychiatrists to undertake clinical studies to investigate emerging technology related disorders. It has been noticed that Internet addictive type behaviors are quite often accompanied by other diagnoses. In a Korean study, the authors reported that the average participant with Internet addiction had 1.5 other diagnoses.43
Cybercriminal activity is now ubiquitous. Perpetrators are targeting both individuals and businesses. There is also a remarkable rise in the incidences of trolling, online bullying, commercialization of human data and gamification of electoral processes Aiken (2018).44
Time spent in cyberspace can consume a significant proportion of our family and social life. On the one hand it has opened opportunities for socialization across the globe, while on the other it has diminished real-life human face to face interactions. The effect of cyberspace on society can vary from building to breaking relationships. The impact of social media is increasingly apparent in lawsuits worldwide. Especially so in divorce cases where it has been reported in popular media that WhatsApp and Facebook are being used as major sources of information to substantiate a case.55 Countries such as Italy, US, and UK are also experiencing these trends57 and observations in India are not very different.45
 
CYBERTHERAPY (ARTIFICIAL INTELLIGENCE AND E-THERAPY)
Researchers and clinicians define cybertherapy or e-therapy as clinical work via e-mail or chat. It is a text-based communication and is mostly or exclusively conducted through the Internet.
Whilst there are many risks and problems with regard to the connectivity afforded by the Internet, there are also positives, for example, the ability to use technology to deliver therapeutic protocols remotely. The most important benefit of therapy is the opportunity to reach people who are unable to visit a psychotherapist due to geographical, physical or lifestyle limitations. Cybertherapy could serve as a stepping stone to face-to-face therapy or it could be conducted following an initial face-to-face therapeutic assessment.
According to Suler46 there are five features of the communication pathway between therapist and client in cybertherapy. There are distinct advantages and disadvantages of each style of communication.
  • Synchronous/asynchronous communication
  • Text/sensory communication
  • Real/imaginary communication
  • Automated/interpersonal communication
  • Invisible/present communication
  • Synchronous communication: In this type of communication, the therapist and client are sitting at their computers at the same time and interacting with each other. e.g., text chats, multimedia chats, Internet telephoning, audio-video conferencing, instant messaging, short messaging system, and e-mails, if they are online and interacting in real time.9
Asynchronous communication: In asynchronous type of communication, the therapist and client do not have to sit at the computer at the same time. Examples—e-mails and audio-video recording.
  • Text/sensory communication:
    • Text: Many interactions on the Internet are done via typed text. It lacks sensory enrichment such as sounds and images. E.g., e-mails and short-messaging services (SMS).
    • Sensory: Audio-visual conferencing is an example of sensory communication. Sensory modalities are used to facilitate the communication between the therapist and the client.
  • Imaginary/real communication:
    • Imaginary: Cyberspace is filled with many fantasy-based communities, some purely text-driven and some highly visual, such as online virtual reality systems and multimedia chat communities.
    • Real communication: It is an actual face-to-face meeting of the therapist with the client.
  • Automated/interpersonal communication:
    • Automated communication: There are programs being designed to guide clients to develop self-insight regarding behavioral and cognitive changes. They can be used as adjuncts to psychotherapy or as primary components of a self-help program.
      The field of AI is evolving rapidly and may be able to closely simulate major aspects of verbal human interaction.
    • Interpersonal communication: Computers are far inferior to humans in feeling and reasoning about human conditions. Humans need humans. In psychotherapy, interpersonal relationships are therapeutic for many clients.
  • Invisible/present communication:
    • Invisible communication: The invisibility of the therapist that computers allow overlaps with the automated/interpersonal dimension. If clients believe they are only talking to a computer, then the therapist is essentially invisible. In computer-mediated therapy, the degree of presence of the therapist can be regulated.
    • Present communication: Psychotherapies that rely on a healing human relationship will require a professional who is present.
Psychotherapists and mental health professionals may evaluate these dimensions of cybertherapy quite differently. Those who use psychotherapy, which is more procedure oriented rather than relationship oriented, may find automated interventions very useful. On the other hand, therapists who uphold the therapeutic power of a face-to-face relationship may not be that comfortable with computer-mediated psychotherapy.
There are three ways to conceptualize computer-mediated psychotherapy:
  1. Computers can be incorporated into pre-existing psychotherapy.
  2. We can develop new therapies such as “e-mail therapy” and “chat therapy”.
  3. We can develop “cybertherapy” as a single and multifaceted style of psychotherapy with the features that can be controlled, combined, and modified according to the needs of the clients.10
A recent report in the Journal of Medical Internet Research (JMIR) Mental Health47 maintains that although use of digital technology can help people to access information or provide support for their mental health problems, it can also expose them to significant risk. Authors argue that it is important to consider Internet-related risk behavior (digital risk) within psychiatric risk assessment protocols.
The positive news is that research supports that technology-based approaches to mental healthcare are well received by young adults,48 and in some cases preferred over traditional talk additionally the importance of online clinics, blended treatment, digital assessment, and digital training has been noted.49
Therefore, there is a need for the psychiatric, counseling and therapeutic professions to address how best therapeutic protocols made be conceptualized, tested and ultimately administered by means of technology.
 
THE ENVIRONMENT OF CYBERSPACE: PRECAUTIONARY PRINCIPLE
In May 2018, General Data Protection Regulation (GDPR) was introduced in Europe. It aims to make the technology sector more responsible and to strengthen the rights of individuals. Protection of children is one of the most important aspects of this regulation. The digital age of consent is addressed in article 8. GDPR sets this age at 16 years. It is the age at which children have the power to let a social media company target them, profile them and gather their personal data.
The GDPR is just one area of protection concerning the data of adults and minors. There are many other areas that must be addressed. These areas include cyber fraud, identity theft, online harassment and with regard to minors, age-inappropriate content online such as extreme violence, self-harm material, and adult pornography.
We should take specific precautions to protect our children and young people from “online harms”.50 Engagement of parents in the lives of young people online is important, just as they are engaged in the real-world. There is an urgent need for new ideas, innovations and solutions for the problems that have erupted in cyberspace, in fact the UK government has just published a major report titled “safer technology, safer users”,51 which encourages investment in and development of technology solutions to technology facilitated problem behaviors.
The precautionary principle52 in terms of the environmental movement places an onus or “duty of care” on industry to protect the environment. Cyberspace industries and social technology companies in particular should take on the responsibility of protecting this environment and protecting users from harm. Government, medical, social, and environmental activists should force cyberspace enterprises to be more responsible for the ‘content pollution’ of cyberspace, and most importantly the exposure of cyber citizens to cyber harms. Notably the Indian government recently acted to protect young people and the sovereignty and integrity of Indian cyberspace by banning a pervasive social media app, that had been downloaded an estimated 600 million times in India.53
In India, the Information Technology Act, 2000 (ITA 2000) deals with cybercrime. The act was amended in 2008 with the introduction of provisions addressing child abuse material, cyber terrorism and voyeurism.
There are many controversies surrounding digital age in India. According to ITA-2000, child means a person less than 18 years of age. The minimum age to use 11Facebook is 13 years, while it is set at 16 years for WhatsApp, however many underage children are active users of social media. There is little or no independent oversight regarding the implementation of digital age restrictions which urgently needs to be addressed going forward.54
There is a lot of work to be done to protect the children and youth of India and indeed worldwide. The medical and behavioral sciences have an important role to play along with parents, educators, academics policymakers, statutory authorities and industry. It is important to remember that “What is new is not always good. Technology only brings progress when we are able as a society to mitigate its most harmful effects”.12
 
THE FUTURE: CYBERSPACE AND CYBERPSYCHIATRY
As discussed, NATO has now acknowledged cyberspace as a new frontier in defense. Cyberattacks are recognized as a new weapon. Many nations and organizations are trying to equip themselves to prevent and counter such attacks. However, most of the preventive measures are falling short regarding rapid developments in cyberspace.
The technological revolution that delivered connectivity, computers, and cyberspace has produced seismic changes for our species. Humans are now desperately trying to adapt in cyberspace, but struggling to keep pace with advancements in technology. Most of us use the technologies of cyberspace involuntarily, exactly the way we breathe air and drink water. It has become an inseparable part of our developmental, social, professional and personal lives. However, these cyber effects should not distract us from things that are more important and crucial for our personal happiness and survival.
We are living in a unique period of human history, which is characterized by intense technological advancement. Babies are being born and growing up in the cyber world. Society is being reshaped. Content pollution of cyberspace is going to be one of the toughest challenges for humankind going forward. We urgently need to reconsider how we handle behavioral problems in this new environment. We need cyber leadership in this crucial area—we need “academic first responders” in cyberspace. The best response is transdisciplinary. With the inputs of experts in this field, communities and government, new strategies to tackle issues related to cyber systems, networks and platforms need to be devised.12
The scientific study of cyberspace began in the early 1990s, led by the acknowledged founder of cyberpsychology, Professor John Suler. Researchers have attempted to analyze and predict human behavior in this new domain with some success. Traditional theories in psychology have often proven to be insufficient in explaining the relatively novel and specific behaviors in this technology-mediated environment. A deeper understanding of cyberspace has lead us to challenge the fundamentals of the science of behavior. Traditional research may not be able to keep pace with rapidly changing behavioral phenomena. Accessible funding for a “rapid research” enterprise along with multidisciplinary collaboration of policymakers and governments may help broaden scientific investigation. The contributions of academics and scientists will undoubtedly aid in crystallizing new ideas and conquering this new scientific frontiers. Technological advancement will be an important factor in the structure of 12cybertherapy in future. An analogy can be drawn from the mental health workers such as the psychologists and psychiatrists who collaborate to work towards a common goal of mental health despite differences in education and scope of practice.
Psychology has made significant advances in the development of the advance discipline of cyberpsychology, in fact, Norman (2008) has declared that cyberpsychology “is the new psychology”, the question is, will “cyberpsychiatry” become the new psychiatry in an age of technology?
REFERENCES
  1. Yar M, Steinmetz KF. Cybercrime and Society. Thousand Oaks, CA: SAGE Publications Ltd,  2019.
  1. Lance Strate, (2014), The Origin of Cyberspace, Lance Strate's Blog Time Passing, September 3, 2014, http://lancestrate.blogspot.com/2014/09/the-origin-of-cyberspace.html
  1. Merriam-Webster. Cybernetics. [online] Available from https://www.merriam-webster.com/dictionary/cybernetics. [Last accessed December, 2020].
  1. North Atlantic Treaty Organization (NATO). (2016). Cyber Defence Pledge. [online] Available from https://www.nato.int/cps/en/natohq/official_texts_133177.htm. [Last accessed December, 2020].
  1. Yan Z. Encyclopedia of Cyber Behavior. Hershey, Pennsylvania: IGI Global;  2012 p. 7.
  1. Licklider JCR. (1960). Man-Computer Symbiosis. [online] Available from https://groups.csail.mit.edu/medg/people/psz/Licklider.html. [Last accessed December, 2020].
  1. Viola V. (2017). Internet of Humans-How we would like the internet of the future to be. [online] Available from https://ec.europa.eu/digital-single-market/en/news/internet-humans-how-we-would-internet-future-be. [Last accessed December, 2020].
  1. Cooper AL. Sexuality and the Internet: Surfing into the New Millennium. Cyberpsychol Behav. 2009;1(2):187–93.
  1. White RW, Horvitz E. (2009). Cyberchondria: Studies of the Escalation of Medical Concerns in Web Search. [online] Available from https://dl.acm.org/doi/10.1145/1629096.1629101. [Last accessed December, 2020].
  1. Aiken MP, Kirwan GH, Berry MJ, O Boyle CA. The Age of Cyberchondria. R Coll Surg Irel Stud Med J. 2012;5:71–4.
  1. Andersson H. (2018). Social media apps are ‘deliberately’ addictive to users. [online] Available from https://www.bbc.com/news/technology-44640959. [Last accessed December, 2020].
  1. Aiken MP. The Cyber Effect. New York: Random House, Spiegel & Grau;  2016.
  1. Aiken MP. The Social Diatribe. Psychologist. 2020;33:65.
  1. Proshansky HM. The field of environmental psychology: securing its future. In: Stokols D, Altman I [Eds]. Handbook of Environmental Psychology. New York: John Wiley & Sons;  1987.
  1. Jones S. Virtual Culture: Identity and Communication in Cybersociety. Thousand Oaks, CA: SAGE Publications;  1997.
  1. Power A, Kirwan G. Cyberpsychology and New Media: A thematic reader, 1st edition. United Kingdom: Psychology Press;  2013.
  1. Connolly I, Palmer M, Barton H. An Introduction to Cyberpsychology. New York, NY: Routledge;  2016. pp. 3–14.
  1. Slane A. Democracy, social space and the Internet. Univ Tor Law J. 2007;57:81–104.
  1. Suler J. The Online Disinhibition Effect. Int J Appl Psychoanal Stud. 2005;2(2):184–8.
  1. Konrath S, O'Brien EH, Hsing C. Changes in dispositional empathy in American college students over time: a meta-analysis. Pers Soc Psychol Rev. 2011;15:180–98.
  1. Rose S, Dhandayudham A. Towards an understanding of Internet-based problem shopping behaviour: The concept of online shopping addiction and its proposed predictors. J Behav Addict. 2014;3(2):83–9.
  1. Aiken MP. Life in Cyberspace. Kirchberg, Luxembourg: European Investment Bank;  2019 with.

  1. 13 Radesky JS, Kistin CJ, Zuckerman B, Nitzberg K, Gross J, Kaplan-Sanoff M, et al. Patterns of mobile device use by caregivers and children during meals in fast food restaurants. Pediatrics. 2014;133(4):e843–9.
  1. Dscout. (2016). Putting a Finger on Our Phone Obsession. Mobile touches: a study on how humans use technology. [online] Available from https://blog.dscout.com/mobile-touches. [Last accessed December, 2020].
  1. Ofcom. (2017). Children's Media Use and Attitudes. [online] Available from https://www.ofcom.org.uk/research-and-data/media-literacy-research/childrens. [Last accessed December, 2020].
  1. Reichel C. (2019). The health effects of screen time on children: A research roundup. [online] Available from https://journalistsresource.org/studies/society/public-health/screen-time-children-health-research/. [Last accessed December, 2020].
  1. Radesky JS, Schumacher J, Zuckerman B. (2015). Mobile and Interactive Media Use by Young Children: The Good, the Bad, and the Unknown. [online] Available from http://pediatrics.aappublications.org/content/135/1/1. [Last accessed December, 2020].
  1. EUROPOL. (2017). Online Sexual Coercion and Extortion as a Form of Crime Affecting Children: Law Enforcement Perspective. [online] Available from https://www.europol.europa.eu/publications-documents/online-sexual-coercion-and-extortion-form-of-crime-affecting-children-law-enforcement-perspective. [Last accessed December, 2020].
  1. EUROPOL. (2020). Covid-19: Child Sexual Exploitation. [online] Available from https://www.europol.europa.eu/covid-19/covid-19-child-sexual-exploitation. [Last accessed December, 2020].
  1. O'Neill B, Aiken MP, Caffrey M, Carthy J, Lupton R, Lynch A, et al. (2014). Report of the Internet Content Governance Advisory Group. Department of Communications, Energy and Natural Resources,  Ireland. [online] Available from http://www.dcenr.gov.ie/NR/rdonlyres/0BCE1511-508E-4E97-B1A9-23A6BE9124AA/0/InternetContentGovernanceAdvisoryGroup.pdf. [Last accessed December, 2020].
  1. Zimbardo P, Coulombe ND. Man Disconnected: How technology has sabotaged what it means to be male. Ebury Digital;  2015.
  1. Klettke B, Mellor D, Silva-Myles L, Clancy E, Sharma MK. (2018). Sexting and mental health: A study of Indian and Australian young adults. [online] Available from https://cyberpsychology.eu/article/view/11410/0. [Last accessed December, 2020].
  1. India Today. (2019). Sexual violence pandemic in India: Rape cases doubled in last 17 years. [online] Available from https://www.indiatoday.in/diu/story/sexual-violence-pandemic-india-rape-cases-doubled-seventeen-years-1628143-2019-12-13. [Last accessed December, 2020].
  1. Pew Research Center. (2018). Teens, Social Media & Technology 2018. Washington: Pew Research Center. 
  1. Royal Society for Public Health. (2017). Social media and young people's mental health and wellbeing. [online] Available from https://www.rsph.org.uk/our-work/policy/social-media-and-young-people-s-mental-health-and-wellbeing.html. [Last accessed December, 2020].
  1. Booth R. (2019). Anxiety on rise among the young in social media age. [online] Available from https://www.theguardian.com/society/2019/feb/05/youth-unhappiness-uk-doubles-in-past-10-years. [Last accessed December, 2020].
  1. Laursen L. (2019). Kids Shouldn't Have Devices at Bedtime or the Dinner Table, Says U.K. [online] Available from https://fortune.com/2019/02/07/uk-screen-time-advice/. [Last accessed December, 2020].
  1. Ahn DH. Korean policy on treatment and rehabilitation for adolescents’ Internet addiction, in 2007 International Symposium on the Counseling and Treatment of Youth Internet Addiction. Seoul, Korea, National Youth Commission;  2007. p. 49.
  1. Indo-Asian News Service. (2014). WhatsApp Blamed for Increased Divorce Rates in Italy. [online] Available from https://gadgets.ndtv.com/apps/news/whatsapp-blamed-for-increased-divorce-rates-in-italy-619847. [Last accessed December, 2020].
  1. Suler JR. Psychotherapy in cyberspace: A 5-dimension model of online and computer-mediated psychotherapy. Cyber Psychol Behav. 2000;3:151–60.
  1. Aref-Adib G, Landy G, Eskinazi M, Sommerlad A, Morant N, Johnson S, et al. Assessing Digital Risk in Psychiatric Patients: Mixed Methods Study of Psychiatry Trainees’ Experiences, Views, and Understanding. JMIR Ment Health. 2020;7(7):e19008.
  1. Aiken MP, Berry M. Posttraumatic stress disorder: possibilities for olfaction and virtual reality exposure therapy. Virtual Reality Journal. 2015;19(2):95–109. Http://rd.springer.com/article/10.1007/s10055-015-0260-x/fulltext.html
  1. Fairburn CG, Patel V. The impact of digital technology on psychological treatments and their dissemination. Behav Res Ther. 2017;88:19–25.
  1. DCMS (Department for Digital, Culture, Media & Sport). (2019). Online Harms White Paper. [online] Available from https://www.gov.uk/government/consultations/online-harms-white-paper. [Last accessed December, 2020].
  1. DCMS (Department for Digital, Culture, Media & Sport). (2020). Safer technology, safer users: The UK as a world-leader in Safety Tech: A Sectoral Analysis of UK Online Safety Technology. [online] Available from https://www.gov.uk/government/publications/safer-technology-safer-users-the-uk-as-a-world-leader-in-safety-tech. [Last accessed December, 2020].
  1. The precautionary principle: Definitions, applications and governance https://www.europarl.europa.eu/thinktank/en/document.html?reference=EPRS_IDA(2015)573876
  1. Agrawal R. (2020). Why Is India Banning China's TikTok? [online] Available from https://foreignpolicy.com/2020/07/02/india-banning-chinese-mobile-apps-tiktok-tech-market/. [Last accessed December, 2020].
  1. Ministry of Electronics & Information Technology. (2020) Information Technology Act 2000. [online] Available from https://www.meity.gov.in/content/view-it-act-2000. [Last accessed December, 2020].
  1. Bialik C. Irreconcilable Claim: Facebook Causes 1 in 5 Divorces. New York: The Wall Street Journal;  2011.
  1. INTERPOL. (2020). INTERPOL report shows alarming rate of cyberattacks during COVID-19. [online] Available from https://www.interpol.int/en/News-and-Events/News/2020/INTERPOL-report-shows-alarming-rate-of-cyberattacks-during-COVID-19. [Last accessed December, 2020].
  1. New York Post. (2012). More than a third divorce filings contain the word Facebook. [online] Available from https://nypost.com/2012/05/21/more-than-a-third-of-divorce-filings-contain-the-word-facebook/. [Last accessed December, 2020].