청소년 온라인 문제 행동의 이질성: 중독의 가면을 쓴 비행

• 영문명: Heterogeneity of Problematic Online Behaviors in Adolescents: Delinquency Masked as Addiction
• 발행기관: 한국중독정신의학회
• 저자명: 김대진(Dae Jin Kim) 윤성훈(Sung Hoon Yoon) 이상열(Sang Yeol Lee) 양찬모(Chan Mo Yang)
• 간행물 정보: 『중독정신의학』Vol.29, No.2, 52~61쪽, 전체 10쪽
• 주제분류: 의약학 > 정신과학
• 파일형태: PDF
• 발행일자: 2025.09.30

국문 초록

Adolescent problematic smartphone use (PSU) and related online behaviors are pressing clinical concerns, yet their heterogeneity complicates diagnosis and treatment. We distinguish two prototypical subtypes: (1) self-medicative behavioral addiction, driven by internal distress and impaired control; and (2) instrumental delinquency masked as addiction, where the online environment functions as a tool for goal attainment (e.g., cyberbullying, deepfakes, illicit drug distribution, online fraud) rather than an object of compulsion. As a core marker of the latter, we highlight the DSM-5 limited prosocial emotions (LPE) specifier in conduct-disorder. We compare motivational and psychopathological mechanisms across subtypes and synthesize evidence on LPE-linked neurobiology—amygdala hyporesponsivity, reward hypersensitivity, and valuation/control deficits—that helps explain poor response to conventional addiction treatments. We also review assessment approaches for LPE and evaluate behavioral, contingency-based, and highly structured interventions that show promise for this subgroup. We argue for moving beyond a uniform addiction model toward precision psychiatry that incorporates underlying psychopathology when evaluating and treating adolescent online problem behaviors.

목차

서론: 임상적 난제로서의 청소년 온라인 문제 행동

개념적 틀의 재정립: 동기(Motivation)를 중심으로 한 유형 구분

LPE의 신경생물학적 특성과 치료적 함의

임상적 적용: 평가와 개입 전략의 전환

논의 및 향후 연구 제언

결 론

REFERENCES

키워드

청소년 행위중독 스마트폰 소년 비행 사이코 패시 냉담-무정서 특성 Adolescent Behavior addiction Smartphone Juvenile delinquency Psychopathy Callous-unemotional traits