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ENGL 102-001
I have considered myself an avid video gamer for the past ten years. In my childhood, I
had my hands on some of the generation’s gaming staples such as the original Xbox, the
Playstations 1 and 2, and the Sega Dreamcast but I did not pay them much attention because I
was still playing with children’s toys. It was not until the year 2008 that I grew interested in
joining the gaming community. That year, my father brought home an Xbox 360 with an Xbox
Live membership, a rickety plastic headset that would constantly slide off my small head, and
the most cutting edge game in the shooter genre of that time in Call of Duty 4: Modern
Warfare. Since then, I have gone through five Xbox consoles (three Xbox 360s and two Xbox
Ones) and thousands of dollars worth of games. I have accrued a total of 54,212 achievement
points, also known as gamerscore. I am less than 300 hours (12.5 days) away from having
accumulated a full year’s worth of gaming on just my Xbox One alone. Thankfully, I have
managed to get my account suspended only once. Lastly, I have connected and formed
friendships with a plethora of other gamers from various locations around our world that I
otherwise would not even know existed. I can go from playing virtual basketball in NBA2K with
Battlegrounds with my high school buds from California. The combinations of people, places,
However, throughout these same years, I have pondered what prolonged video gaming
may be doing to my overall health. Though I have always been and will continue to be relatively
active, I often fear that I will fall into the stereotype of becoming the obese gamer struggling to
Gaming Addiction: The Newest Mental Illness?
do the simplest of tasks such as walk my dog. Many of today’s games come with warnings
about how rapidly flashing lights within the gameplay may cause the user to experience an
epileptic seizure and those with past experiences with epilepsy should not play. Have I been
making myself more susceptible to this all along? In the past, I have grown so engaged in one
game that during the day all I could think about was completing missions and challenges in it. Is
video gaming affecting my ability to pay attention to what is happening in the real world around
me? And the most important question to haunt my mind: is it possible that I am becoming an
addict?
Internet gaming disorder (IGD) is a medical condition in which a person experiences the
symptoms of addiction towards their online gaming. Simply put, IGD is synonymous with video
game addiction or online gaming addiction, defined as “the persistent inability to control
excessive gaming habits despite associated social and emotional problems” (Brunborg, G.S., et
al., 2015). Gamers with IGD build up a tolerance for their game or game genre of choice; over
time, it takes longer and longer for them to get the same amount of enjoyment out of it as they
experienced previously (i.e. when they first found out they liked the game). Their video game
usage will often hinder their ability to do everyday tasks and performance as an employee,
student, and even a family member decline. Getting achievements, leveling up a character,
completing missions with online colleagues, etc. take precedence over everything else in their
life. Attempts to quit playing, result in the gamer having withdrawals and ultimately, they
return to their regular gaming routine. Because the symptoms of IGD nearly mimic that of a
drug addict, a chronic gambler, and any other mental health condition, I believe it should be
Gaming Addiction: The Newest Mental Illness?
recognized as a serious medical illness just like those examples are. However, as of 2013, the
Diagnostic and Statistical Manual for Mental Disorders (DSM-V) does not consider internet
gaming disorder to be an “official” disorder because there is still much research to be done and
much debate amongst psychiatrists and psychologists as to what criteria should make one
eligible for IGD diagnosis. They even go as far as to argue if IGD is a real condition people can
“The Diagnostic and Statistical Manual of Mental Disorders (DSM) is a primary method
for classifying psychiatric disorders. The fifth revision, DSM-5, includes non-substance
addictions for the first time” (Petry, N.M., et al.,2014). Prior to this edition, addiction had only
been linked to compulsive drug use, meaning non-substance abuse such as that of compulsive
gambling could not be included. This sparked debate over what the definition of addiction
meant in the context of diagnosis. Researchers then dove into the background of the word
itself. “The term “addiction” originated in Roman times and initially was not linked to substance
use. However, over time, the term addiction became increasingly linked to substance use such
as that around the time of DSM-III-R” (Potenza, M.N., 2014). Despite the etymology, “the term
was largely omitted from the DSM-III-R, in part given the charged nature of the term (perceived
as pejorative or stigmatizing) and associated complexities” (Potenza, M.N., 2014). Progress was
not made until the most recent DSM publication where the category simply titled “Substance-
Disorders” in DSM-V, allowing for the accommodation of gambling addiction and possibly
internet gaming disorder. At present, gambling disorder is the only addiction included that is
Gaming Addiction: The Newest Mental Illness?
considered non-substance related with other non-substance and behavioral addictions being
meet at least five of the nine criteria proposed by DSM Workgroups. These criteria are:
playing, loss of interests in other hobbies, excessive gaming despite problems, deception,
escape or relief from a negative mood, and jeopardized or lost relationships, educational
opportunities, and job opportunities. The DSM Workgroup elected to use a minimum of five
requirements because “online gaming is a popular behaviour in modern society and most
criteria could be found in healthy online gamers at a lower frequency, shorter duration or lower
intensity” (Ko, C., & Yen. J, 2014). Establishing diagnosis by assessing if a particular gamer is in
the majority of these criteria helps “determine the severity of the disorder and how it departs
from normality” (Ko, C., & Yen. J, 2014). Though the criteria is still a work-in-progress,
individuals can already begin seeking help for their conditions if they are believed to exhibit any
of these symptoms.
Preoccupation
as extreme or excessive concern with something or simply the state of being preoccupied. This
entails that the thing or act you are preoccupied with is worth being busy for. For most of the
general public, video games are not a productive part of their day and thus, not worth being
preoccupied for. “Preoccupation parallels criteria of substance use and gambling disorders and
Gaming Addiction: The Newest Mental Illness?
reflects the construct of “cognitive salience”, which relates to spending substantial amounts of
time thinking about an activity” (Kardefelt-Winther, D., 2015). Kardefelt-Winther argues that
though preoccupation may be a useful criterion for substance abuse, thinking about gaming
throughout the day could be viewed as being a part of the ordinary lifestyle because of the
social interactions that come with it. The normal gamer may plan which games they will play
later in the or schedule with friends what time they would like to meet up online. These may
also apply to “normal” activities such as going on dates, however one would not be addicted to
becomes preoccupied with obtaining their next high. A gambler becomes preoccupied with
their lust for hitting the jackpot. A porn addict is preoccupied with scrolling their site for hours
on end. The IGD patient becomes preoccupied with playing the game.
Withdrawal
Withdrawal occurs when the video gamer decides to quit playing “cold turkey,” when
they choose to wean themselves off of gaming, or either decision is made for them. “It is
greatly associated with psychological dependence but may result from behavioural addictions
as well” (Kardefelt-Winther, D., 2015). Similar to a drug addict, the player is cut off from their
addiction via an outside force (someone taking their way of playing away) or by virtue of the
technology itself (e.g. the console/game breaking). However, unlike a drug addict, the player
does not become physically ill. This is not to say the gamer will not experience behavior swings.
Kardefelt-Winther argues that “once again referring to the social and interactive nature of
online gaming, a person may be justifiably frustrated if they cannot engage in their favourite
activity… Frustration at being unable to play is then framed as a symptom of withdrawal rather
Gaming Addiction: The Newest Mental Illness?
insinuates that the social implications tied to gaming may muddy the water between anger
from withdrawal and anger from social exclusion or inability to temporarily alleviate stress. It is
because of this type of equivocation that there is much more research to be done on if
Tolerance
its desired effects” (Kardefelt-Winther, D., 2015). When the gamer is first trying out a game,
they do not need to play it for long to realize they will enjoy it. As mentioned, over time they
will need to play the game longer and longer to have the same amount of fun as when they first
opted to play that game. Often, the gamer will play for longer than they intended. The more
they play and the more progress they make in the game, means they will want to repeat this
same amount of time if not play longer. The game goes from being a pass-time to feeling like a
necessity and it is not until the gamer meets or exceeds that need that they begin having fun
with the game again. For myself, this happened with the popular sandbox game, Minecraft.
When I first started, I joined a friend’s server and was instantly hooked by the colors and builds
the pixelated game had to offer. I only played for an hour or so before I was over it. I then
returned, started learning more about the game and before I knew it I had my own world and
was building extravagant structures in creative mode or exploring the depths of earth, mining
for precious ores. That one hour of play turned into multiple hours at a time. What was
occasional Minecraft play became a chore and I was not satisfied until I finished said chore. Like
a Minecraft “junkie,” casual gaming became putting in a full 8-hour shift on the console to finish
Gaming Addiction: The Newest Mental Illness?
my builds and there was no fun to be had until the architecture was complete. The drug addict
needs more of that substance to get a high; the IGD gamer needs more of the game to feel
satisfied.
“Most casual online gamers have, at some point, felt that they should play less, but on
some occasions failed to do so” (Ko, C., & Yen, J., 2014). This criterion concerns the same things
as withdrawal and tolerance. The gamer intends to cut back on their gaming if not stop
completely but simply cannot. The equivalent of this in the real addiction world would be a
relapse, a return or fallback into illness after convalescence or apparent recovery according to
Dictionary.com. “When doing other things, problematic gamers may feel a strong discomfort
both emotionally and physically (i.e. withdrawal symptoms), which is resolved by returning to
the game playing” (Hellman, M., et al., 2013). The gamer stops their involvement for a period of
time just to be pulled right back into their routine. This criterion is heavily debated among the
DSM workgroups as it does not concretely state that the individual with IGD is actually desires
to stop but, rather they stop as a result of “society’s punitive response to the behaviour”
(Kardefelt-Winther, D., 2015). Kardefelt-Winther offers a suggestion as to how they can resolve
problems with this criteria for diagnosis, saying “it may also be fruitful to broaden this criterion
to look at the life situation of the individual to determine whether gaming is simply the least
boring way to spend time, which could explain relapse without adhering to an addiction
Loss of interest in other hobbies denotes just that. The gamer will lose the desire to do
other activities such as meet with friends in the “real world” because of problematic gaming.
This is, again, comparable to substance abuse. The addict becomes consumed by the desire to
get more drugs by any means necessary, making no time for relationships. This would make the
drug even more toxic to their well-being than it already is as a substance itself. The same can
apply to the IGD gamer. Problem occurs in this criterion in the fact that gaming is not as
harmful an activity as drug use is. “Gaming on the other hand is not generally harmful and it
makes sense that as an individual spends more time playing games less time will be spent on
other recreational activities, but this is not harmful per se” (Kardefelt-Winther, D., 2015). As
gaming becomes more acceptable in our society, especially when it comes to “hanging with
friends,” more time will be spent online rather than face-to-face interaction where people
would be doing the same activities (if not less) that they could do virtually from the comfort of
their own homes. Their loss of interest to do other things outside of video games will then be
video games...” (Donati, M., et al., 2015). Though there may not be a concrete number of hours
set on what is an acceptable amount of time spent on playing video games, society knows when
something is done in excess. In the case of gaming, more is not better when the gamer has
other responsibilities. The example Kardefelt-Winther uses is a child and school. A child may not
find school to be important and would rather play video games with the time that would be
spent on homework or school itself. We know that school is instrumentally important for the
Gaming Addiction: The Newest Mental Illness?
future and that if that child continues to play video games despite reiteration that school is
more important, gaming is problematic to that child. This can also happen in adulthood as some
adult IGD gamers may put off work, education, etc. not because of the fruitfulness of their
gaming, but because they would just rather be gaming instead. Therefore, excessive gaming
Deception
Deception involves the addict lying about or covering up the severity of their addiction
to others. This criterion does not come without its conflict. It seems to be targeting children
who live with their parents and thus, lie to them about how much time they spend playing
video games rather than considering the adults living on their own with no one to lie to. “I
would add yet another social consideration; some people are less understanding of gaming
habits. Therefore the extent to which deception is necessary may depend on external attitudes
to gaming rather than the extent of gaming per se” (Kardefelt-Winther, D., 2015). By this
argument, deception could be more of a moral concern (the child lies to avoid punishment)
diagnosis.
“Another potential criterion for game addiction is mood modification; games can be
utilized to modify one’s mood from a negative to a neutral or positive state (by coping or
escapism), but also modify a neutral or positive state into an even more positive state
(euphoria/high)” (Hellman, M., et al., 2013). Each game has its own way of rewarding the user.
This dates back to the arcade era with a big banner saying “new high score” and in today’s
Gaming Addiction: The Newest Mental Illness?
gaming atmosphere with credits, tokens, loot, virtual currency, etc. that incentivize the user to
keep playing and keep winning. As with almost anything that fits under the definition of reward,
the gamer associated obtaining that reward with happiness. Thus, when they finally get it, it
immediately uplifts their mood higher than it previously was; if they were sad and won some in-
game coins at the end of a mission, they are happier now. Couple this with the gamer’s
tolerance and that same reward just is not enough. The gamer needs more of the rewards to
escape from their current mood. Going back to a comparison of substance abuse, a drug addict
may use that drug to escape from their current situation and experience a temporary high.
Tolerance then factors in and they need more to create the same effect, a modification in their
mood.
Escapism and mood modification could also apply to assuming an alternate persona. In
multiplayer games, no one on the other side of the screen knows anything about the gamer
unless they choose to give that information out. This results in the user being able to know that
whatever made them upset or gave them a negative mood in the real world, does not translate
to that of the virtual world. In the recent novel-turned-film Ready Player One, the protagonist, a
poor teenager from the ghettos of Columbus, Ohio in the year 2045, escapes his reality by
donning a visor that enters him into an augmented virtual reality where he can create a second
life and become whatever he wants, in whatever video game he wants. This occurs today
without the highly advanced VR technologies, including within myself. In real life, I was the
scrawny benchwarmer for the varsity basketball team in high school. I was one seat away from
being the waterboy and at times, my name was only called to pass water down the bench to
the guys who actually played. But, when I cut on my Xbox, I become the 6’3” star point guard
Gaming Addiction: The Newest Mental Illness?
for the Los Angeles Clippers named Lucius Lights Out who can shoot the ball like Steph Curry,
pass like Jason “White Chocolate” Williams, and dunk like Russell Westbrook. Face-scan
technology and the ability to create and customize your player within the limits of your
imagination (and the game’s built-in features) allow for the user to nearly do what the main
character in Ready Player One has done with exception to literally being in the game.
Jeopardized Relationships/Opportunities
gaming despite problems. The gamer plays so much that they lose friendships they have built
over time, relationships with both family and mates, and often miss out on job opportunities
(e.g. interviews) or chances to further education. This is not without its own problems as well
much like most of the other criteria. Loss of friendships assumes that the gamer did not have
friendships that can crossover into the gaming world. It also assumes that they cannot establish
new ones that will last via the power of the internet. Missing out of job opportunities assumes
that gaming itself could not be a job opportunity. With the arrival of live-streaming sites like
Twitch.tv, YouTube Gaming, and Mixer, gamers can showcase their console skills and
personality while also making money from the comfort of their homes. This also does not
include opportunities arising from competition as eSports are steadily gaining popularity, most
otherwise would not know or care. Lastly, when it comes to furthering education, this part of
the criterion assumes that the gamer has a desire to continue. Ultimately, jeopardized
relationships and opportunities could play a viable part in diagnosis for internet gaming
Gaming Addiction: The Newest Mental Illness?
disorder, but it seems as though this is meant to “reflect more serious issues” (Kardefelt-
Demographic
The majority of people playing video games are adolescents. The Pew Research Center
reports that 72 percent of all teenagers within this decade play games whether on their mobile
device(s), game console, or personal computers. Within this 72 percent of all teens playing, 84
percent of all boys are playing and a near-median 59 percent of all girls. When it comes to race
and nationality, black non-hispanic adolescents are in first place with 83 percent reporting that
they play video games and white non-hispanics placing second with 71 percent. Two percent
less represents that of the hispanic gamers. However, this study does not account for the Asian
gamers. “Asian countries report the highest prevalence of IGD” (Subramaniam, M., 2014). Why
this is has yet to be figured out; meanwhile research is being done to see how one’s culture or
environment may factor into determining why they might be more prone to IGD.
These statistics are important because of the sheer amount of teenagers that are in the
world at any given moment. According to the United States Department of Health and Human
Services, nearly thirteen percent of the US population is made up of adolescents; that is around
more than 42 million people. 72 percent of those 42 million are playing video games on any
platform readily available. More than 30 million people from different genders, ethnicities,
socioeconomic statuses, etc. are all vulnerable to possibly developing IGD in the United States
alone. These figures do not reflect that of a worldwide perspective, where the same games
Game Genres
In their study on versatility and its correlation with time spent gaming and game
addiction, Maria Anna Donati, Ph.D and her colleagues “hypothesized a greater level of
pathological gaming would be predicted not only by increased time spent on gaming, but also
by the participation in a greater number of video game genres” (Donati, M., et al., 2015). Not
only do the symptoms and criteria factor into who is affected by IGD, but also what games they
are playing. The study broke video gaming as a whole down into fourteen different general
categories representing the genres most games fall into: management (e.g. The Sims series),
browser (e.g. Farmville), first-person shooters (e.g. Call of Duty), real-time strategy (e.g.
Starcraft, Clash of Clans), role playing (e.g. Elder Scrolls series), action (e.g. Grand Theft Auto,
Assassin’s Creed), simulation (e.g. Train Simulator), massively multiplayer online (also known by
the acronym MMO; e.g. World of Warcraft), fighting (e.g. Mortal Kombat), arcade/platform
(e.g. Super Mario), retro (e.g. Final Fantasy), indie (e.g. Minecraft), sports (e.g. Madden NFL
series), and casual (e.g. Angry Birds, Candy Crush). To no surprise, 99% of the participants in the
study had played more than one genre in the past six months. “The most common activities
were action (88%), casual (86%), and sports (84%)” (Donati, M., et al, 2015) with first person
shooters also ranking highly at 83% participation. With the advancements made in gaming
technologies, such as better graphics, participation in retro, real time strategy, and MMO games
What does all this mean? More users than one previously may have speculated are
susceptible to internet gaming disorder. Look at the casual gamer participation alone and the
example given, Angry Birds. In its heyday, the highly addictive mobile game was totalling
Gaming Addiction: The Newest Mental Illness?
upwards to 260 million monthly users. Within the same genre, 93 million people were playing
Candy Crush Saga in 2014. By 2017, the game had been downloaded by 2.7 billion users. Now,
look at the shooter genre and the most popular game of today, the aforementioned Fortnite.
Within a year of its release of the Battle Royale game mode, the game had surpassed 125
million users with over 40 million being active monthly players. We can even see immense user
base numbers in the lower participation games such as the real-time strategy genre and Clash
of Clans. The mobile strategy game peaked at nearly 100 million daily users and amassed more
than a million dollars in revenue via microtransactions back in 2015 despite being a free-to-play
game. Millions upon millions of people are playing these games with even more crossing
between genres, playing mobile games at work or school and console games in the comfort of
their homes. Every single individual playing just these four games alone is a candidate for IGD
In 2013, the founder of Game Quitters (a community focused on supporting those with
video game addiction) Cam Adair spoke at TEDxBoulder about his own struggle with video game
addiction. He starts by saying he was addicted to gaming for ten years and his obsession with
playing led him to drop out of high school at the age of fifteen. Adair’s parents then forced him
to find a job, which he pretended to do. His father would drop him off at a restaurant where he
said he was a dishwasher and when his father drove away, he would catch a bus back home and
go to sleep. He was sleeping in the morning because he had been up in the middle of the night
playing. “I didn’t want to do these things, I just did. The addiction controlled the behavior”
(TED, 2013). He then moved to another city in hopes that the new environment would inspire
Gaming Addiction: The Newest Mental Illness?
him to change his ways. This was to no avail; Adair returned back to the games, playing “sixteen
hours a day for five months straight” (TED, 2013). Adair later mentions that he used video
games to escape the reality of the real world around him. Upon searching for answers as to
how to stop playing video games on Google, Adair found nothing helpful. One solution
suggested that he use that same time spent gaming to study, yet the only reason he played was
to avoid studying in the first place. Another said he should hangout with friends instead but, all
of his friends were fellow gamers and their “hangouts” were all online.
Adair exhibited seven of the nine proposed criteria for an internet gaming disorder
diagnosis. He was preoccupied with playing games so much that it affected his performance in
school leading to him dropping out (preoccupation and jeopardized opportunities). He deceived
his parents into thinking he had a job and was doing better when he really was just sneaking
back into his home and sleeping (deception). He attempted to stop by withdrawing himself
from video games after changing his residence. Yet, he found a way to not only fall back into
gaming, but to begin gaming for extensive amounts of time (withdrawal, unsuccessful attempts
to stop, and excessive gaming despite problems). Lastly, gaming became his escape hatch from
the world. Adair references how he was bullied in school and was unable to improve his social
status. Thus, he relied on games to provide that second life where no one knew him for him;
they knew him for his gaming skills. He also says he went through a rough breakup at the age of
eighteen and to get away from the harsh reality, he turned to games (escape or relief from a
negative mood).
evidence base” (King, D., & Delfabbro, P.H., 2014). Because it is not officially diagnosable, there
is no official treatment for IGD. After all, the criteria is not concrete in and of itself. Therefore
any diagnosis would be viewed as arbitrary. Gamers seeking outreach can, however, find help
for their condition. “Although treatment clinics for internet gaming disorder exist in the United
States and other countries, limited data are available on the natural course of the condition,
comorbidities with other psychiatric disorders or how best to intervene” (Petry, N.M. & O’Brien,
C.P., 2013). Ironically, Cam Adair’s Game Quitters is an online program and forum where game
addicts can speak with peers from more than 90 countries who are trying to kick gaming habits
as well like an alcoholics or narcotics anonymous meeting for gamers worldwide. Within the
same site, addicts also have access to a guide providing them with hobby ideas they can pick up
Conclusion
symptoms towards video gaming. The nine proposed symptoms and or criteria for an IGD
time spent playing, loss of interest in other hobbies, excessive gaming despite problems.
deception, escape or relief from a negative mood, and jeopardized relationships (family and
friends) or opportunities (job, career, and education). These criteria are not without their own
individual conflicts that blur the lines between normality and addiction. It is because of this
difficulty to differentiate between the two in each of the symptoms and the fact that there is
still much research to be done that the Diagnostic and Statistical Manual for Mental Disorders
Gaming Addiction: The Newest Mental Illness?
fifth revision [DSM-V] does not recognize IGD as an official mental health disorder. However,
IGD symptoms nearly parallel that of conditions that are already considered mental illnesses
such as porn addiction, substance abuse, gambling disorder, alcoholism, etc. Atop this, there is
an astonishing amount of people who list playing video games as a part of their life thus,
making them subject to possible IGD diagnosis. Therefore, internet gaming disorder should be
recognized as a serious mental illness. Despite not being regarded as such, help is available
through clinics and online resources for those who may feel that their addiction is a problem
that needs to be taken care of immediately. Based on this research, I do not believe I am
addicted to video gaming though I do loosely fit into some of the proposed criteria.
Gaming Addiction: The Newest Mental Illness?
References
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Donati, M. A., Chiesi, F., Ammannato, G., & Primi, C. (2015). Versatility and Addiction in Gaming:
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thing as online video game addiction? A cross-disciplinary review. Addiction Research &
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Gaming Addiction: The Newest Mental Illness?
Kardefelt-Winther, D (2015). A critical account of DSM-5 criteria for internet gaming disorder.
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Ko, C., & Yen, J. (2014). THE CRITERIA TO DIAGNOSE INTERNET GAMING DISORDER FROM
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TED. (2013). Escaping video game addiction: Cam Adair at TEDxBoulder. Retrieved from
https://www.youtube.com/watch?v=EHmC2D0_Hdg