Evidence map›Paper›PMID 42696283›Full record

Trial reportJAMA network open2026

Cognitive Behavioral Therapy vs Media Literacy for Prevention of Gaming Disorder and Unspecified Internet Use Disorder: A Randomized Clinical Trial.

Katajun Lindenberg, Sonja Kewitz, Ina Neumann, Sebastian Brand, Daniel Huth, Julia Lardinoix, Katharina Leo, Carolin Szász-Janocha, Daniel L King, Lutz Wartberg

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in JAMA network open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Trial
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Katajun LindenbergDepartment of Clinical Psychology of Childhood and Adolescence, Institute for Psychology, Heidelberg University, Heidelberg, Germany.
Sonja KewitzDepartment of Clinical Psychology of Childhood and Adolescence, Institute for Psychology, Heidelberg University, Heidelberg, Germany.
Ina NeumannDepartment of Clinical Psychology of Childhood and Adolescence, Institute for Psychology, Heidelberg University, Heidelberg, Germany.
Sebastian BrandDepartment of Clinical Psychology of Childhood and Adolescence, Institute for Psychology, Heidelberg University, Heidelberg, Germany.
Daniel HuthDepartment of Clinical Psychology of Childhood and Adolescence, Institute for Psychology, Heidelberg University, Heidelberg, Germany.
Julia LardinoixDepartment of Clinical Psychology of Childhood and Adolescence, Institute for Psychology, Heidelberg University, Heidelberg, Germany.
Katharina LeoDepartment of Psychotherapy for Children and Adolescents, Institute for Psychology, Goethe University Frankfurt, Frankfurt am Main, Germany.
Carolin Szász-JanochaDepartment of Clinical Psychology of Childhood and Adolescence, Institute for Psychology, Heidelberg University, Heidelberg, Germany.
Daniel L KingCollege of Education, Psychology and Social Work, Flinders University, Adelaide, Australia.
Lutz WartbergDepartment of Psychology, Faculty of Human Sciences, MSH Medical School Hamburg, Hamburg, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Importance: Mitigating the harmful effects of digitalization on youth mental health is essential. Objectives: To evaluate the effectiveness of cognitive behavioral therapy (CBT) compared with a media literacy-based intervention for gaming disorder and unspecified internet use disorder and to determine whether universal or indicated prevention yields stronger benefits. Design, Setting, and Participants: PROTECTconfirm was a randomized clinical trial conducted from July 1, 2020, to August 31, 2024, across 44 secondary schools in Baden-Württemberg, Germany, with 1-, 4-, and 12-month follow-up. All students were included in universal prevention analyses, whereas indicated prevention analyses included a subgroup of adolescents at high risk meeting 2 or more Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) criteria for gaming disorder or unspecified internet use disorder at baseline. Interventions: Students were individually randomized within 90 classes to PROTECTtraining, a CBT-based program; or PROTECTinfo, a structurally parallel media literacy program. Both consisted of four 90-minute sessions delivered weekly during school hours by trained local prevention professionals under live supervision and adherence protocols. Main Outcomes and Measures: The primary outcome was gaming disorder symptom severity and unspecified internet use disorder symptom severity, assessed at 12 months with a modified version of the Video Game Dependency Scale. Secondary outcomes included internalizing, externalizing, and transdiagnostic symptoms. Primary and secondary outcomes were analyzed according to the intention-to-treat principle. Results: A total of 1793 students were randomized to PROTECTtraining (n = 896; mean [SD] age, 13.1 [1.5] years; 498 male students [56.1%]) or PROTECTinfo (n = 897; mean [SD] age, 13.1 [1.5] years; 484 male students [54.8%]). Participants in the subsample of 205 adolescents at high risk showed significantly lower 12-month severity of gaming disorder and unspecified internet use disorder symptoms with PROTECTtraining than with PROTECTinfo (mean [SD] Modified Video Game Dependency Scale score: 14.7 [9.7] vs 17.7 [10.3]; within-group Cohen d = -0.91 [95% CI, -1.10 to -0.72] vs Cohen d = -0.61 [95% CI, -0.80 to -0.42]; between-group Cohen d = -0.30 [95% CI, -0.55 to -0.05]), but not in the total sample (mean [SD] Modified Video Game Dependency Scale score: PROTECTtraining, 8.8 [8.3] vs PROTECTinfo, 9.4 [8.4]; within-group Cohen d = -0.11 [95% CI, -0.18 to -0.05] vs Cohen d = -0.04 [95% CI, -0.11 to 0.02]; between-group Cohen d = -0.07 [95% CI, -0.16 to 0.01]). Secondary outcomes did not differ significantly between groups. Conclusions and Relevance: In this randomized clinical trial of 1793 adolescents, the CBT-based intervention reduced gaming disorder symptoms and unspecified internet use disorder symptoms more effectively than the media literacy-based intervention among adolescents at high risk. These findings support the use of CBT-based approaches primarily within indicated, rather than universal, prevention. Trial Registration: German Clinical Trials Register (DRKS) trial registration: DRKS00033989.

Indexed as

Cognitive Behavioral TherapyInternet Addiction DisorderVideo GamesAdolescentDigital MediaFemaleGermanyHumansMaleStudents

Identifiers

PMID42696283
PMCPMC13545672

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.