April 10, 2005

Internet Positives in Treatment

A very interesting new study was recently published (Feb. 1st)in the Journal of the American Academy of Child and Adolescent Psychiatry. In this study they looked at how the internet could be used as a positive developmental tool for a 15 year old boy who suffers from psychosis (the broader term that covers schizophrenia, and bipolar disorder and related disorders).

The case study "emphasizes some of the ways in which the Internet may have a positive impact on adolescent development, further research is indicated to evaluate the contexts in which the Internet serves healthy developmental processes and those in which its influence is potentially deleterious"

This study confirms what we see here at the schizophrenia.com web site - we hear from many people about how the web site and the chance to meet so many other people with the same challenges as them allows them to socialize much more easily and enjoyably than they could ever previously do. We hope to see more research like this in the future - and are open to working with Universities to work on studies like this, for larger samples.

Some good quotes that give a sense of what is covered in the research are below:

Case study: the Internet as a developmental tool in an adolescent boy with psychosis

Journal of the American Academy of Child and Adolescent Psychiatry
No. 2, Vol. 44; Pg. 187; ISSN: 0890-8567

"Despite the potential problems commonly associated with online communication, the Internet does offer a range of positive opportunities for adolescents. Most adolescents use the Internet for academic sources to assist with their schoolwork, to explore creative or cultural interests, and to communicate with friends and family. The Internet can also allow adolescents (especially those in isolated social settings) to make contact with others sharing their special interests, sexual orientation, or disabilities, while protecting their anonymity. For children and adolescents with social language difficulties, as in the case of those with pervasive developmental disorders, the de-emphasis of paraverbal cues and other challenges of face-to face communication may be an asset. These youngsters get the opportunity to practice less intimidating social interactions online."


    Mark, a 15-year-old boy, had intractable seizures since the age of 18 months. He had mild early psychomotor developmental delays that improved with intensive physical therapy. At 9 years of age, he developed psychotic symptoms that became chronic throughout his adolescence and were complicated by concurrent grand mal seizures. He started home schooling at age 11 after several months of hearing a voice that repeatedly told him that his teacher had had sex with him. By this point, Mark was unmanageable in the classroom due to agitation and socially intrusive behaviors. His seizures were so debilitating that he became more isolated at home with frequent medical hospitalizations. Hence, during his early adolescent years, there were few social interactions outside those with his family. At age 14, Mark had a vagal nerve stimulator inserted that resolved his grand mal seizures.

    Before the onset of his psychotic symptoms, the computer was very important to him, and he attained sophisticated computer skills with the help of his father. The Internet allowed Mark to socialize with peers and assisted him in his home study. He played many Internet games, including some involving virtual pets. He became interested in a virtual pet Web site through which he could be a virtual pet owner, check out shops, and buy food and toys for his "pet." Other aspects of this fantasy included owning his own store and selling virtual pets and stock in a virtual company related to the pets. The Web site also had chat rooms for other children who owned virtual pets.

    In addition, Mark used a chat group for children who have seizure disorders. This experience allowed him to share his worries and thoughts with other youngsters with seizures. He established a close friendship with John, a boy with a similar problem. These contacts helped decrease Mark's sense of isolation. He was able to have online relationships without the stress of face-to-face interactions. Mark's family reported increases in his level of confidence and self-esteem as he progressed in these complex games, and they attributed his improvement to these activities. As a teenager he started making his own Web sites and experienced relative freedom from psychotic symptoms as he entered cyberspace. In particular, Mark described being able to ignore "the voices" or actually push them out of his mind while he was engaged in computer-based activities. Mark's parents specifically reported that he was not observed talking to himself while online.

An e-mail approximately 1 year after discharge read as follows: "Hi Dr. Dude! Remember me? It's Mark, the red-headed boy who made you a Web site at the hospital. Thanks to you and Clozaril, I'm back in school and doing very well! I even have friends now." He communicated plans to start his own dog-walking business with the friend from the chat group for children with seizure disorders.


This case illustrates some ways in which the Internet can serve as a tool for promoting development. In Mark's case, use of the Internet assisted him in transitioning, first with his therapist and then with his friend John, from social isolation to integrating back into school with his peers. Mark had started corresponding with John through a chat group for teens with similar medical problems. Over time, this Internet relationship turned into a real-life friendship in which the two teens started a dog-walking service together.


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