Topic

Video Game Addiction

Video game addiction is hypothesized to be an
excessive or compulsive use of computer games or
video games, which interferes with a person's
everyday life. Video game addiction may present
itself as compulsive game-playing; social isolation;
mood swings; diminished imagination; and hyper-
focus on in-game achievements, to the exclusion of
other events in life. In May 2013, the American
Psychiatric Association (APA) proposed criteria for
video game addiction in the Diagnostic and
Statistical Manual of Mental Disorders, concluding
that there was insufficient evidence to include it as
an official mental disorder. However, proposed
criteria for "Internet Gaming Disorder" are included
in Section 3, Conditions for Further Study. While
Internet Gaming Disorder is proposed as a disorder,
it is still discussed how much this disorder is caused
by the gaming activity itself, or whether it is to
some extent an effect of other disorders.
Researchers have found that people who play
violent video games for three days have shown an
increase with their aggressive behavior and
hostility. They have also found that

Individuals who play nonviolent games showed no

difference in their aggression or hostility.

Preliminary diagnosis and symptoms

The American Psychiatric Association decided that

enough evidence exists to propose the potential
disorder of video game addiction as a "condition
requiring further study" in the Diagnostic and
Statistical Manual of Mental Disorders as Internet
Gaming Disorder. Video game addiction is a broader
concept than internet gaming addiction, but most
video game addiction is associated with internet
gaming. APA suggests, like Kahn, the effects (or
symptoms) of video game addiction may be similar
to those of other proposed psychological
addictions. Video game addiction may be like
compulsive gambling, an impulse control disorder.
APA explains why internet gaming disorder has
been proposed as a disorder:
This decision was based upon the large number of
studies of this condition and the severity of its
consequences. .... Because of the distinguishing
features and increased risks of clinically significant
problems associated with gaming in particular, the
Workgroup recommended the inclusion of only
internet gaming disorder in Section 3 of the DSM-5.

Excessive use of video games may have some or all

of the symptoms of drug addiction or other
proposed psychological addictions. Some players
become more concerned with their interactions in
the game than in their broader lives. Players may
play many hours per day, neglect personal hygiene,
gain or lose significant weight due to playing,
disrupt sleep patterns to play resulting in sleep
deprivation, play at work, avoid phone calls from
friends, or lie about how much time they spend
playing video games. In one extreme instance, it
was reported that a seventeen-year-old boy would
play for periods of up to 15 hours, skipping meals
and only stopping when he blacked out. APA has
developed 9 criteria for characterizing the proposed
internet gaming disorder:

Pre-occupation. Do you spend a lot of time thinking

about games even when you are not playing, or
planning when you can play next?

Withdrawal. Do you feel restless, irritable, moody,

angry, anxious or sad when attempting to cut down
or stop gaming, or when you are unable to play.

Tolerance. Do you feel the need to play for

increasing amounts of time, play more exciting
games, or use more powerful equipment to get the
same amount of excitement you used to get?
Reduce/stop. Do you feel that you should play less,
but are unable to cut back on the amount of time
you spend playing games?
Give up other activities. Do you lose interest in or
reduce participation in other recreational activities
(hobbies, meetings with friends) due to gaming?

Continue despite problems. Do you continue to play

games even though you are aware of negative
consequences, such as not getting enough sleep,
being late to school/work, spending too much
money, having arguments with others, or neglecting
important duties?

Deceive/cover up. Do you lie to family, friends or

others about how much you game, or try to keep
your family or friends from knowing how much you
game?
Escape adverse moods. Do you game to escape
from or forget about personal problems, or to
relieve uncomfortable feelings such as guilt,
anxiety, helplessness or depression?
Risk/lose relationships/opportunities. Do you risk or
lose significant relationships, or job, educational or
career opportunities because of gaming?

One of the most commonly used instruments for

the measurement of addiction, the PVP
Questionnaire (Problem Video Game Playing
Questionnaire; Tiger & Bereave, 2002 was
presented as a quantitative measure, not as a
diagnostic tool. According to Griffiths "all addictions
(whether chemical or behavioral) are essentially
about constant rewards and reinforcement".
Griffiths proposed that addiction has six
components: salience, mood modification,
tolerance, withdrawal, conflict, and relapse. But,
APA's 9 criteria for diagnosing internet gaming
disorder were made by taking point of departure in
8 different diagnostic/measuring tools proposed in
other studies. Thus, APA's criteria attempt to
condensate the scientific work on diagnosing
internet gaming disorder.

Public concern and formal study

One meta-analytic review of pathological gaming

studies concluded that about 3.0% of gamers may
experience some symptoms of pathological gaming.
The report noted problems in the field with defining
and measuring pathological gaming and concluded
that pathological gaming behaviors were more
likely the product of underlying mental health
problems rather than the inverse.

A report by the Council on Science and Public

Health to the AMA cited a 2005 Entertainment
Software Association survey of computer game
players and noted that players of MMORPGs were
more likely to play for more than two hours per day
than other gamers. In its report, the Council used
this two-hour-per-day limit to define "gaming
overuse", citing the American Academy of Pediatrics
guideline of no more than one to two hours per day
of "screen time". However, the ESA document cited
in the Council report does not contain the two-
hour-per-day data.

In a 2005 Tom's Games interview, Dr. Marissa Ozark

estimated that 40% of the players of World of
Warcraft (an MMORPG) were addicted, but she did
not indicate a source for the estimate. She may
have derived the estimate from the informal survey
managed by Nick Yee at The Daedalus Project, who
notes that caution should be exercised when
interpreting that data. Other critics have satirized
the idea of MMORPG addiction, illustrating that the
genre has built-in mechanisms for burning-out
players, which is contrary to the concept of
addiction. (Check ref)
A 2006 lecture reported by the BBC indicated that
12% of polled online gamers reported at least some
addictive behaviors. The lecturer, Professor Mark
Griffiths of Nottingham Trent University, stated in
another BBC interview that addicts are "few and far
between."

In 2007, Michael Cain, director of broadband and

gaming for Parks Associates (a media/technology
research and analysis company), said that "Video
game addiction is a particularly severe problem in
Asian countries such as China and Korea." Results of
a 2006 survey suggested that 2.4% of South Koreans
aged 9 to 39 suffer from game addiction, with
another 10.2% at risk of addiction.

A 2007 Harris Interactive online poll of 1,187 United

States youths aged 8–18 gathered detailed data on
youth opinions about video game play. About 81%
of youths stated that they played video games at
least once per month. Further, the average play
time varied by age and gender, from eight hours per
week (responses from teen girls) to 14 hours per
week (responses by teen boys). "Tweens" (8–12-
year-olds) fell in the middle, with boys averaging 13
hours per week of reported game play and girls
averaging 10. Harris concluded that 8.5% "can be
classified as pathological or clinically 'addicted' to
playing video games", but did not explain how this
conclusion was reached.

Since the American Psychiatric Association decision

in 2007, studies have been conducted at Stanford
University School of Medicine related to video game
play. Researchers found evidence that video games
do have addictive characteristics. An MRI study
found that the part of the brain that generates
rewarding feelings is more activated in men than
women during video game play.
The 2009 OSDUHS Mental Health and Well-Being
Report, by the Centre for Addiction and Mental
Health (CAMH) in Toronto, Ontario, showed almost
10% of 9,000 surveyed students from Grades 7 to
12 get at least 7 hours a day of "screen time". A
little over 10% also reported having video gaming
problems in the previous year. A recent article
Pediatrics (journal) found a mild association
between watching television and playing a video
game and attention issues in more than 1,300
children ages eight to 11 years old. Children who
played video games or watched television for more
than the normal two hours a day maximum, which
is recommended by the American Academy of
Pediatrics were 1.5 2 times more likely to show
signs of attention issues, the researchers found.
However, the study was further criticized in letters
to the same journal for failing to use well-validated
measures of attention problems or control for other
important variables. A more recent study using the
Child Behavior Checklist and controlling for family
and mental health variables, found no link between
video game use and attention problems. Also, a
study in Pediatrics found problematic gaming
behaviors to be far less common, about 4%, and
concluded that such problems were the result of
underlying mental health problems rather than
anything unique to gaming.
Writing in the American Psychological Association
journal Review of General Psychology's special issue
on video games, Barnett and Coulson expressed
concern that much of the debate on the issue of
addiction may be a knee jerk response stimulated
by poor understanding of games and game players.
Such issues may lead both society and scholars to
exaggerate the prevalence and nature of
problematic gaming, and over focus on games
specifically while ignoring underlying mental health
issues.

Other scholars have cautioned that comparing the

symptoms of problematic gaming with problematic
gambling is flawed, and that such comparisons may
introduce research artifacts and artificially inflate
prevalence estimates. For instance Richard Wood
has observed that behaviors which are problematic
in regards to gambling may not be as problematic
when put into the context of other behaviors that
are rewarding such as gaming. Similarly Barnett and
Coulson have cautioned that discussions of
problematic gaming have moved forward
prematurely without proper understanding of the
symptoms, proper assessment and consequences.

Some scholars suggest that psycho-social

dependence may revolve around the intermittent
reinforcements in the game and the need to belong.
Some scholars explain that the social dependence
that may arise due to video games occurring online
where players interact with others and the
relationships "often become more important for
gamers than real-life relationships".
Through interviews with gamers who were addicted
to a MMORPG but have quit playing, multiple
reasons causing gamers to leave their game has
been disclosed. This also reflects a number of
aspects of online game addiction.

General critiques on addiction research

Though the study on the topic of gaming addiction

is growing, the research is still young, therefore
conducive to critique. Common challenges involve
the reliability of the methodology and validity of the
results in some studies. Many rely on self-surveys
from University students and also lack time frames
making it difficult to study the impact, if any, of
addiction on a long term scale. Other concerns also
address the definition of addiction and how to
measure it, questioning whether or not time is a
proper unit to determine how addicted someone is
to gaming. A 2014 study done by Bromberg,
Mentone and Foreland found that video game
addiction does have a correlation with negative
outcomes, such as depression. However, as stated
in the article, the link between time spent on
gaming and the same outcomes were found to be
weaker than the former, showing that time may not
be the only factor in gaming addiction.
Other challenges include the lack of context of the
participant’s life and the negative portrayal of
gaming addicts. Some state that gamers sometimes
use video games to either escape from an
uncomfortable environment or alleviate their
already existing mental issues - both possibly
important aspects on determining the psychological
impact of gaming. Negative portrayal also deals
with the lack of consistency in measuring addictive
gaming. This leads to discussions that sometimes
exaggerated the issue and create a misconception
in some that they, themselves, may be addicted
when they are not.
Though the critiques are present, studies on this
topic are still relatively young and growing and
there is much too still be explored in this realm.