網路成癮的診斷準則與評估工具：發展歷史與未來方向

The Diagnostic Criteria and Assessment Tools for Internet Addiction: Historical Context and Future Directions

本文旨在透過文獻回顧，統整近二十年來網路成癮的診斷準則與評估工具的論述與應用情形，並嘗試在此發展脈絡中提出對未來實證研究與臨床實務的具體建議。在網路成癮多元且紛歧的學術命名下，我們分別以物質依賴、衝動控制疾患及有問題的網路使用三類診斷準則來檢視其視框，並加入近期有關代償性的網路使用與腦造影／神經心理的研究發現，以整理網路成癮的診斷指標之發展現況；再針對目前常見的評估工具之心理計量實證研究進行檢視，以探討相關工具的可用性。研究結果發現：網路成癮雖與許多心理疾病有共病的現象，但不宜以精神病理指標作為診斷的唯一依歸，發展已久的評估工具雖已藉由各種方法驗證其心理計量品質，然而迄今仍未達成共識，而評估工具的應用也由單一量表轉向多元向度與方式。我們建議未來研究應納入使用者的經驗作為理解此現象的主軸概念，並據以發展出概念化模式來確認網路成癮的核心構念及發展歷程，以重新省思診斷指標與評估工具的發展與運用。在臨床實務工作上則宜全面性地理解網路成癮者的經驗，並據以針對網路成癮者的動機、需求與行為特徵，提供可行的治療方向與策略。

This paper aimed to sort out the development and application of the diagnostic criteria and assessment tools of internet addiction through reviewing and integrating related empirical and conceptual studies. We also offer future directions for research andclinical practice on this issue. After reviewing the diagnostic criteria and related assessment tools from the threeaspects of “substance abuse”， “impulsive control disorder” and “problematic internet use”，wealso included the compensatory use and neuropsychological /neuroimaging research findingsto obtain a picture of how the diagnostic indicators developed. We found that there were many psychiatric disordersassociated with internet addiction， butits diagnostic indicators cannot be developed solely based on the perspective of mental disorder. The psychometric properties of the assessment tools were validicated by many studies， but no concensus have been reached. The application of assessment tools shifted from a single scale to a package of tools with muti-dimensions and multiple assessing methods. Based onsuch findings， we recommend toinclude the experience of internet users as the foundational concepts for understanding the phenomenon of internet addiction， and propose a conceptual model to validate its constructs and formation process. Both the diagnostic criteria and assessment tools need to be reinvestigated. The clinician should obtain information from multiple perspectives of problematic internet users’ life experincesto offer interventions focused on their motivation， needs， and behavioral characteristics.