An interventional study of Acceptance and Commitment Therapy (ACT) in Internet Addiction, sponsored by National University of Modern Languages. Completed at 1 site in Pakistan. Open to participants aged 18 Years to 29 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2026-08-13.
Sponsored by National University of Modern Languages · Not applicable, Interventional, and Treatment
Internet addiction, a growing epidemic among young adults, significantly impairs mental health, emotional regulation, and overall well-being. The pervasive overuse of digital technologies-particularly smartphones, social media, and the internet-has led to rising rates of anxiety, depression, and social isolation in this demographic. Traditional therapeutic interventions such as Cognitive Behavioral Therapy (CBT) fail to address the underlying psychological processes contributing to addiction. This research explores the potential of Acceptance and Commitment Therapy (ACT)-a mindfulness-based, values-driven approach-as an effective treatment for internet addiction in young adults. By enhancing psychological flexibility, ACT aims to reduce addictive behaviors while promoting better emotional regulation and mental resilience. The study will assess the efficacy of ACT in improving mental health and mitigating internet addiction within a culturally relevant context for Pakistani youth.
Introduction and Problem Statement:
Young adulthood is a pivotal developmental phase (18-29 years), during which individuals are particularly vulnerable to the negative impacts of internet addiction. Excessive use of smartphones, the internet, and social media has become a ubiquitous issue, severely affecting the academic, social, and emotional well-being of young adults. While internet addiction is increasingly prevalent in Pakistan, with studies indicating that 25-35% of the youth are affected, conventional therapeutic models like CBT predominantly focus on symptom management rather than the psychological underpinnings of addictive behaviors. This research aims to fill a critical gap by investigating the application of ACT, which has shown promise in treating various forms of addiction, to internet addiction specifically.
Literature Review:
The relationship between internet addiction and mental health disorders such as anxiety, depression, and stress has been well-documented. Recent studies by Moreno et al. (2022) and Ghali et al. (2023) underscore the profound psychological consequences of excessive internet and social media use in young adults. In contrast to CBT, ACT focuses on enhancing psychological flexibility-the ability to accept distressing thoughts and feelings while pursuing value-driven actions. ACT has been shown to improve emotional regulation, reduce symptoms of depression and anxiety, and enhance mindfulness, making it a promising intervention for internet addiction. This research builds on the foundational work of Swain et al. (2015) and Googhari et al. (2022), who demonstrated the efficacy of mindfulness-based interventions, including ACT, in enhancing mental health outcomes.
Rationale:
Internet addiction is not only a growing public health crisis but also a barrier to personal development and social integration in young adults. While traditional therapies like CBT focus on symptom reduction, they do not sufficiently address the cognitive and emotional mechanisms that drive addictive behaviors. ACT offers a more comprehensive approach by fostering psychological flexibility and emotional resilience-key factors in the recovery from addiction. Moreover, ACT's adaptability to diverse cultural contexts makes it an ideal intervention for Pakistan's rapidly digitalizing youth population. This research seeks to evaluate ACT's effectiveness in reducing internet addiction and improving mental health outcomes in this group.
Research Objectives and Hypotheses:
This study aims to evaluate the effectiveness of ACT in reducing internet addiction and enhancing mental health among emerging adults in Pakistan. The specific objectives are to:
Hypotheses:
Research Design and Methodology:
The study will employ a randomized controlled trial (RCT) with pre- and post-test assessments. The sample will consist of 100 emerging adults(ages 18-29), with 50 participants in the experimental group and 50 in the control group. Participants will be recruited via social media platforms, using a snowball sampling technique. Inclusion criteria include self-reported internet addiction and high scores on screening tools.
Internet addiction, a growing epidemic among young adults, significantly impairs mental health, emotional regulation, and overall well-being. The pervasive overuse of digital technologies-particularly smartphones, social media, and the internet-has led to rising rates of anxiety, depression, and social isolation in this demographic. Traditional therapeutic interventions such as Cognitive Behavioral Therapy (CBT) fail to address the underlying psychological processes contributing to addiction. This research explores the potential of Acceptance and Commitment Therapy (ACT)-a mindfulness-based, values-driven approach-as an effective treatment for internet addiction in young adults. By enhancing psychological flexibility, ACT aims to reduce addictive behaviors while promoting better emotional regulation and mental resilience. The study will assess the efficacy of ACT in improving mental health and mitigating internet addiction within a culturally relevant context for Pakistani youth.
Introduction and Problem Statement:
Young adulthood is a pivotal developmental phase (18-29 years), during which individuals are particularly vulnerable to the negative impacts of internet addiction. Excessive use of smartphones, the internet, and social media has become a ubiquitous issue, severely affecting the academic, social, and emotional well-being of young adults. While internet addiction is increasingly prevalent in Pakistan, with studies indicating that 25-35% of the youth are affected, conventional therapeutic models like CBT predominantly focus on symptom management rather than the psychological underpinnings of addictive behaviors. This research aims to fill a critical gap by investigating the application of ACT, which has shown promise in treating various forms of addiction, to internet addiction specifically.
Literature Review:
The relationship between internet addiction and mental health disorders such as anxiety, depression, and stress has been well-documented. Recent studies by Moreno et al. (2022) and Ghali et al. (2023) underscore the profound psychological consequences of excessive internet and social media use in young adults. In contrast to CBT, ACT focuses on enhancing psychological flexibility-the ability to accept distressing thoughts and feelings while pursuing value-driven actions. ACT has been shown to improve emotional regulation, reduce symptoms of depression and anxiety, and enhance mindfulness, making it a promising intervention for internet addiction. This research builds on the foundational work of Swain et al. (2015) and Googhari et al. (2022), who demonstrated the efficacy of mindfulness-based interventions, including ACT, in enhancing mental health outcomes.
Rationale:
Internet addiction is not only a growing public health crisis but also a barrier to personal development and social integration in young adults. While traditional therapies like CBT focus on symptom reduction, they do not sufficiently address the cognitive and emotional mechanisms that drive addictive behaviors. ACT offers a more comprehensive approach by fostering psychological flexibility and emotional resilience-key factors in the recovery from addiction. Moreover, ACT's adaptability to diverse cultural contexts makes it an ideal intervention for Pakistan's rapidly digitalizing youth population. This research seeks to evaluate ACT's effectiveness in reducing internet addiction and improving mental health outcomes in this group.
Research Objectives and Hypotheses:
This study aims to evaluate the effectiveness of ACT in reducing internet addiction and enhancing mental health among emerging adults in Pakistan. The specific objectives are to:
Hypotheses:
Research Design and Methodology:
The study will employ a randomized controlled trial (RCT) with pre- and post-test assessments. The sample will consist of 100 emerging adults(ages 18-29), with 50 participants in the experimental group and 50 in the control group. Participants will be recruited via social media platforms, using a snowball sampling technique. Inclusion criteria include self-reported internet addiction and high scores on screening tools. Participants with severe mental health disorders or undergoing other psychological treatments will be excluded.
Phases:
Data Analysis and Expected Outcomes:
Statistical analyses will include ANCOVA to compare post-test results between the experimental and control groups, as well as repeated measures ANOVA to evaluate within-group changes. The study expects to demonstrate that ACT significantly reduces internet addiction and improves mental health outcomes, including depression, impulsivity, emotional regulation, and mindfulness.
Implications and Future Directions:
The findings from this study could have significant implications for public health policies related to mental health and internet use among young adults. By demonstrating the effectiveness of ACT, the research could contribute to the development of more targeted, mindfulness-based interventions for addressing internet addiction in Pakistan. Additionally, future research may explore the long-term effects of ACT on addiction and its broader applicability to other forms of behavioral addictions, such as gaming and compulsive internet use.
Exclusion Criteria:
Participants received a culturally adapted Acceptance and Commitment Therapy (ACT) intervention designed to reduce Internet Addiction and improve psychological functioning among emerging adults. The intervention was delivered according to the study protocol.
Behavioral: Acceptance and Commitment Therapy (ACT)
Participants assigned to the wait-list control group did not receive the ACT intervention during the study period. They completed all study assessments and were offered the intervention after completion of the trial.
Acceptance and Commitment Therapy (ACT) is a culturally adapted behavioral intervention for emerging adults with Internet Addiction. The intervention focuses on enhancing psychological flexibility through acceptance, cognitive defusion, mindfulness, values clarification, self-as-context, and committed action. Participants attended structured therapy sessions delivered according to the study protocol.
Also known as: ACT
Change in Internet Addiction Test Total Score
Internet addiction was assessed using the Chen Internet Addiction Scale. The scale contains 26 items scored from 1 to 4. Item scores are summed to produce a total score ranging from 26 to 104. Higher scores indicate more severe internet addiction and therefore a worse outcome. A reduction from baseline indicates improvement.
Time frame: Baseline and immediately after completion of the intervention (Post-intervention, approximately 8 weeks)
Change in Patient Health Questionnaire-9 Total Score
Depressive symptoms were assessed using the Patient Health Questionnaire-9. The scale contains nine items scored from 0 to 3. Item scores are summed to produce a total score ranging from 0 to 27. Higher scores indicate greater severity of depressive symptoms and therefore a worse outcome. A reduction from baseline indicates improvement.
Time frame: Baseline (pre-intervention) and immediately after completion of the ACT intervention (post-intervention)
Change in Acceptance and Action Questionnaire-II Total Score
Psychological inflexibility was assessed using the Acceptance and Action Questionnaire-II. The seven items are scored from 1 to 7 and summed to produce a total score ranging from 7 to 49. Higher scores indicate greater psychological inflexibility or experiential avoidance and therefore a worse outcome. A reduction from baseline indicates improvement.
Time frame: Baseline (pre-intervention) to immediately post-intervention.
Change in Attentional Control Scale Total Score
Attentional control was assessed using the Attentional Control Scale. The scale contains 20 items scored from 1 to 4. After reverse-scoring the applicable items, responses are summed to produce a total score ranging from 20 to 80. Higher scores indicate better attentional control and therefore a better outcome. An increase from baseline indicates improvement.
Time frame: Baseline (pre-intervention) to immediately post-intervention.
Change in Cognitive Fusion Questionnaire-5 Total Score
Cognitive fusion was assessed using the Cognitive Fusion Questionnaire - 5. The five items are scored from 1 to 7 and summed to produce a total score ranging from 5 to 35. Higher scores indicate greater cognitive fusion, meaning that thoughts have a stronger influence over behavior, and therefore represent a worse outcome. A reduction from baseline indicates improvement.
Time frame: Baseline (pre-intervention) to immediately post-intervention.
Change in Emotion Regulation Questionnaire Subscale Scores
Emotion regulation was assessed using the Emotion Regulation Questionnaire. This 10-item instrument produces two separate scores; a single total score is not calculated. The Cognitive Reappraisal subscale contains six items scored from 1 to 7, producing a score ranging from 6 to 42. Higher scores indicate greater use of cognitive reappraisal and are interpreted as a better outcome. The Expressive Suppression subscale contains four items scored from 1 to 7, producing a score ranging from 4 to 28. Higher scores indicate greater use of expressive suppression and are interpreted as a worse outcome. An increase in cognitive reappraisal and a reduction in expressive suppression indicate improvement.
Time frame: Baseline (pre-intervention) to immediately post-intervention.
Change in Five Facet Mindfulness Questionnaire-14 Total Score
Mindfulness was assessed using the Five Facet Mindfulness Questionnaire-14. The 14 items are scored from 1 to 5. After reverse-scoring the applicable items, responses are summed to produce a total score ranging from 14 to 70. Higher scores indicate greater mindfulness and therefore a better outcome. An increase from baseline indicates improvement.
Time frame: Baseline (pre-intervention) to immediately post-intervention.
Change in Impulsive Behavior Short Scale-8 Subscale Scores
Impulsivity was assessed using the Impulsive Behavior Short Scale-8. The instrument contains eight items and measures four dimensions: urgency, lack of premeditation, lack of perseverance, and risk appetite. Each dimension contains two items. After reverse-scoring the applicable items, the mean for each subscale is calculated, producing a score ranging from 1 to 5. Higher scores indicate a greater level of the corresponding impulsive tendency and are interpreted as a worse outcome in this study. A reduction from baseline indicates improvement.
Time frame: Baseline (pre-intervention) to immediately post-intervention.
Change in Rational Behavior Inventory Total Score
Rational beliefs were assessed using the Rational Behavior Inventory. The scale contains 37 items scored from 1 to 5. After reverse-scoring the applicable items, responses are summed to produce a total score ranging from 37 to 185. Higher scores indicate more rational beliefs and attitudes and therefore a better outcome. An increase from baseline indicates improvement.
Time frame: Baseline (pre-intervention) to immediately post-intervention.
Plan to share: No
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National University of Modern Languages