Purpose: This study was conducted to review physiological mechanisms of internet addiction and to construct a theoretical framework for cognitive behavioral therapy for internet addicts. Methods: We searched for relevant literature in the PubMed and RISS databases using the terms “internet addiction”, “internet game addiction”, “internet abuser”, and “online game”. Only English, full-text articles published from 2000 to 2015 were included in this review of physiological indicators of internet addiction. Finally, 12 articles were selected for review. Results: The theoretical framework developed based on the review proposes that excessive internet use itself may induce physiological stress responses with an increase of stress-related hormones and neurotransmitters. Prolonged abnormal responses of these physiological features produce negative structural and functional changes in the prefrontal cortex, which is mainly involved in cognitive and executive functions. These changes may result in decreased cognitive function. As a stressor, excessive internet use leads to transforming voluntary use into involuntary, habitual use and thus promotes the development of internet addiction. Conclusion: The proposed theoretical framework encompasses cognitive processes that may contribute to the effects of internet use-induced physiological stress on internet addiction. We believe that this framework has important implications for developing cognitive behavioral strategies for internet addicts.
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