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Cyberpsychology refers to the study of the mind and behaviour in the context of interactions with technology. It is an emerging area focused on the various psychological phenomena linked to the increasing presence and usage of technology in our lives. It encompasses topics ranging from online relationships and digital identity, to the applications of virtual reality and the implications of artificial intelligence.<sup>1</sup>
<h3><strong>Why should doctors take note?</strong></h3>
From smartphone apps to telemedicine consultations, there are many companies and health service providers trying to get ahead of the latest trends. Understandably, such a broad array of developments can intimidate doctors who are simply trying to keep up with their patients. The sheer constellation of platforms, sites and apps available can be bewildering. In addition to its many clear benefits, technology also has the capacity to have a direct negative impact on one’s health. It can serve as a platform to enact oftentimes-hidden and damaging behaviours that can be associated with warranting medical attention. We have focused primarily on the negative aspects of technology in this regard for the purposes of this article.
<h3><strong>Is it relevant to my practice?</strong></h3>
Anything that significantly changes how people communicate with each other and seek out information could change how they interact — and importantly, how they expect to interact — with their doctors. Thus, it could be argued that cyberpsychology has almost universal relevance for the medical profession. This is particularly so for those working in general practice, addictions and mental health, especially those working with children and adolescents.
Many doctors are familiar with the patient who is utterly convinced of an exotic diagnosis gleaned from the pages of health websites — of varying quality — or generated by an alluring symptom-checking program.
The risks of misinformation on the Internet exist with every click. Many practitioners will have seen a patient complaining of chronic poor sleep, despite spending hours on end on their phone in bed, or one with a health anxiety exacerbated by extensive and excessive Internet research. This so-called ‘cyberchondria’ can escalate readily, lead to ‘doctor-shopping’ and has the clear potential for iatrogenic harm. Similarly, over-use of the Internet may have serious wider consequences for relationships, or even employment. These types of problems are neither uncommon nor surprising.
There are many other modern health issues, however, that carry a cyberpsychological dimension. Explaining the psychological basis of each is beyond the scope of this article. However, if we follow the life span and consider several examples, you may reflect on related issues you have encountered and ultimately consider how a better understanding of cyberpsychology might assist you in your day-to-day practice, regardless of your specialty.
<h3><strong>Across the life span</strong></h3>
Young parents may present to their doctor wondering about the efficacy of digital educational aids, or the appropriate age to allow young children to have access to ‘screen-time’ and ‘how much is too much’. As this child progresses in school, the issue of smartphone ownership will inevitably crop up and parents may understandably seek advice from their doctor.
The universal peer pressures familiar to us from our own school days may unfold on social media platforms. Thankfully, not many of us were likely to ‘go viral’ while still in school; our embarrassments and misadventures were typically consigned to mere memory alone. Sadly, this is not the case today. Bullying can naturally follow on these platforms. It can progress unnoticed by parents and teachers in this form and regretfully follows the child home after school via their smartphone and social media accounts.
Adults are not immune to the social media pressures experienced by children. Both adults and children alike can gradually become consumed with cultivating and curating idealised online representations of themselves for others. This can progress to Internet addiction, which can be at the cost of their own personal happiness or, ultimately, even their relationships. For frequent users of online dating apps, the initiation stages of a relationship have been drastically transformed. Important issues emergent from these apps may include changes in sexual behaviour, both online and offline, identity theft and ‘catfishing’ (where someone pretends to be someone they are not online and forms a friendship, or relationship with you). Regarding pornography, in some cases excessive use could see a drift in online content-seeking from more mainstream to hard-core and even illegal materials.
Children suffering from eating disorders or who begin to self-harm may see their harmful behaviour escalate in association with access to fora and websites misguidedly promoting such harmful behaviour among their peers. There may be pressure to send ‘sexts’ to classmates, with the associated risk of exploitation, blackmail and even onward transfer of these images into more sinister corners of the Internet, such as the ‘dark web’, where they may be traded.
The popularity of video games — some extremely violent in content — is not limited to children and adolescents. Patients may present with worrying patterns of excessive gaming suggestive of dependency and to the detriment of their schoolwork, relationships or work life. The potentially devastating costs of excessive online gambling may emerge at a later stage than in the days pre-Internet. Nowadays, gamblers can remain essentially anonymous and there is a vast array of websites which users can access from their home or smartphone 24 hours a day.
Patients may present to their doctors suffering from side-effects from, or dependency on, Internet-bought illicit or prescription drugs. These are widely available on the dark web. Such patients may present acutely to emergency departments and doctors working in these settings will benefit from keeping abreast of the latest substances commonly being abused. The proliferation of such marketplaces online may lead to less typical demographics beginning to misuse various substances.
<h3><strong>Technology as therapy</strong></h3>
The advent of psychotherapy in the digital domain has been shrouded in doubt and scepticism. Two modalities, however, are steadily gaining research support and funding: Computerised cognitive behavioural therapy (cCBT) for mild-to-moderate depression and anxiety; and virtual reality (VR) exposure therapy for post-traumatic stress disorder (PTSD).
These do not serve to entirely replace the therapist and treatments are best delivered when guided by an appropriately-trained and experienced professional. These modalities represent cost-effective means of delivering individualised treatment.
<h3><strong>Issues on the horizon</strong></h3>
This article highlighted many of the psychological issues doctors may encounter in clinical practice secondary to our increasing use of technology in our environment. However, in order to fulfil increasingly complex demands, this technology may eventually have to be taught how to ‘think for itself’. In some instances, engineers and developers will even have to teach it how to reason morally when faced with complex dilemmas. For some, artificial intelligence is an exciting prospect with boundless potential. For others, it hangs like a spectre and it remains unclear how best to police the area while it remains in its relative infancy. For all however, the prospect of artificial intelligence is clear and highly contentious. Although still on the distant horizon, in time, we will eventually have to contend with issues emergent from this.
Issues of particular relevance to medicine are the almost ubiquitous use of smartphones, the plethora of health apps, the Internet as a first port of call for researching health issues, the impact of technology on the developing child, and the real-life consequences of social media and the dark web, to name but a few. For doctors faced with such issues in a clinical context, a sensible place to start is by firstly considering the psychology behind our increasing dependence on technology. Understanding the psychological basis of our own online behaviour could help us in assisting our patients.
<h3><strong>Resources at a glance</strong></h3>
Cyberpsychology Research Network (www.cypsy.com).
<em>Cyberpsychology: Journal of Psychosocial Research on Cyberspace.</em> www.cyberpsychology.eu.
<em>Cyberpsychology, Behaviour and Social Networking</em>. http://online.liebertpub.com/loi/CYBER.
<em>Journal of Cybertherapy and Rehabilitation</em>. http://journalofcybertherapy.webs.com.
Aiken, M. (2016). <em>The Cyber Effect</em>. Spiegel and Grau.
Attrill, A. (2015). <em>Cyberpsychology</em>. Oxford University Press.
Barak, A. (2008). <em>Psychological Aspects of Cyberspace: Theory, Research, Applications</em>. Cambridge University Press.
Connolly, I. (2016). <em>An Introduction to Cyberpsychology</em>. Routledge.
Tettegah, S. (2016). <em>Emotions, Technology and Health</em>. Academic Press.
MSc Cyberpsychology, Institute of Art, Design and Technology, Dún Laoghaire www.iadt.ie/courses/cyberpsychology.
MSc Cyberpsychology, Nottingham Trent University, www.ntu.ac.uk/study-and-courses/courses/find-your-course/social-sciences/pg/2017-18/msc-cyberpsychology.
British Psychological Society, (2017). <em>A to Z of psychology</em>. Available at: https://beta.bps.org.uk/a-z-of-psychology.
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