essay on addiction of video games

Video Game Addiction

The argument against video game addiction, many researchers are skeptical that video games are truly "addictive.".

Updated July 3, 2023 | Reviewed by Devon Frye

• What Is Video Game Addiction?
• Find a therapist near me
• Video games have many benefits for gamers.
• Research on gaming disorder—aka video game addiction—is flawed and not sufficiently conclusive.
• Because video games are less socially acceptable, they may be unfairly targeted.
• There are other explanations for many reports of video game addiction, including autism, ADHD, and depression.

This is half of a pair of articles that highlight the evidence for and against the existence of video game addiction . Read the counter-argument here .

For decades, psychologists, parents, and gamers have asserted that video games can be addictive. Although video games seem to influence enthusiasts differently from those of other hobbies, there is insufficient empirical evidence to designate them as an actual addiction . Further, video games are a fun and socially beneficial activity for many, so labeling them as addictive would prevent many from accessing these benefits.

For example, video games connect lonely or introverted people with one another , relieve stress , and even help people explore their own identities . Some therefore argue that, because of video games’ benefits and popularity, gaming addiction should not be considered an official diagnosis until overwhelming evidence supports this assertion.

Flawed Research

Several studies have concluded that gaming disorder qualifies as an addiction. Because addictions share several characteristics, researchers created theoretical criteria that a gamer must meet to have the diagnosis. For example, people with addictions suffer consequences in various aspects of their life and struggle to quit without help. This is true regardless of the substance.

Based on the assumption that people with video game addiction must be affected similarly, researchers have surveyed gamers on similar criteria to determine what percent have an addiction. These include questions such as, “How often do you find it difficult to stop gaming?” and “Have you deceived a family member, significant other, employer, or therapist regarding the amount of time spent engaging in gaming activities?”

Although questions like these may reasonably assess someone’s behavior, researchers use too many different questionnaires to be compared cleanly. Even when researchers use the same survey, they sometimes interpret the results differently.

In other words, someone would need to answer “Yes” to six of the eleven Gaming Addiction Screening questions to be considered addicted. They would need to respond “Sometimes” or “Often” to five or more of the ten questions in the Ten Item Internet Gaming Disorder Test to qualify. If the same person took both surveys, one survey might conclude that they had an addiction and the other might not. Further, some studies only measure how many hours per week a person spends gaming instead of targeting the effect games have on their functioning.

This has resulted in wildly different estimates of gaming addiction’s prevalence. It is difficult to draw meaningful conclusions from these data until researchers use standardized measures.

It is also very difficult to estimate one’s actual screen time each week. One meta-analysis of the research found that in 95 percent of studies, participants did not accurately report how much time they spend on screens . This calls into question all studies which rely on participants’ subjective estimates of how they use their time because they have based their conclusions on a statistic that is likely inaccurate.

Why Not Other Hobbies?

Other critics of the diagnosis point out that gaming has been unfairly targeted and pathologized. A person who plays golf instead of spending time with family is inconsiderate. A person who plays video games instead of spending time with family is addicted.

This demonstrates a clear bias . Society considers video games a waste of time, so an enthusiastic gamer is criticized more harshly than someone with a more acceptable hobby.

What Else Might Account for Excessive Gaming

Many of my clients report that they feel addicted to technology. When I continue the assessment process, many report that they were previously diagnosed with autism or ADHD . This complicates the diagnostic process because many people with these disorders already struggle to stop scrolling through social media or playing video games.

Most of us have looked up from our phones and realized that half an hour or more had suddenly passed. The hypnotic “flow” which we experienced blinded us to the passage of time. Autistic people* and those with ADHD are especially susceptible to this phenomenon. So if, for example, a person with ADHD finds it particularly difficult to turn off a game, does that person have an addiction or is it simply how this kind of stimulus affects those with ADHD?

Some research has found that heavy gamers have reduced gray matter in areas of the brain associated with attention , impulse control. However, these studies do not sufficiently demonstrate that gaming caused the differences, only that they are associated. Correlation is not causation. Some studies even show that brain scans for people with ADHD look remarkably similar to scans of those with gaming disorder , even after treatment.

One researcher pointed out this conundrum by relating it to depression . “We would not diagnose depressed individuals with hypersomnia with a comorbid ‘bed addiction.’” In other words, someone with depression might stay in bed for days, but this does not mean that they are addicted to the bed. In the same way, an autistic person or someone with depression or ADHD might appear to be addicted to video games even when they are not. In short, many diagnosed with gaming disorder may simply be autistic or have ADHD.

It is possible that video games are addictive. However, the current body of research is too flawed to state decisively that the negative consequences outweigh the benefits the games afford players. It is premature to consider gaming disorder to be an official addiction.

*Although many refer to autistic people as “people with autism” or “people with autism spectrum disorders,” almost 90 percent of autistic adults prefer “autistic person.” This language is used here to respect that preference.

Bean, A. M., Nielsen, R. K. L., van Rooij, A. J., & Ferguson, C. J. (2017). Video game addiction: The push to pathologize video games. Professional Psychology: Research and Practice, 48 (5). Retrieved from http://psycnet.apa.org/record/2017-29288-001

Diament, M. (2022, December 2). 'Autistic' or 'person with autism'? It depends. Disability Scoop. https://www.disabilityscoop.com/2022/12/02/autistic-or-person-with-auti…

Fishman, A. (2019, January 22). Video games are social spaces. Psychology Today. https://www.psychologytoday.com/us/blog/video-game-health/201901/video-…

Fishman, A. (2022, November 7). Why it's so hard to walk away from a video game. Psychology Today. https://www.psychologytoday.com/us/blog/video-game-health/202211/why-it…

Fishman, A. (2023, February 20). How gamers use video games to explore their gender identity. Psychology Today. https://www.psychologytoday.com/intl/blog/video-game-health/202302/how-…

Gentile, D. (n.d.) Gaming Addiction Screening. University of California, Santa Cruz. https://caps.ucsc.edu/pdf/gaming-addiction-screening.pdf

Han, D.H., Bae, S., Hong, J., Kim, S.M., Son, Y.D., & Renshaw, P. (2019). Resting-state fMRI study of ADHD and Internet Gaming Disorder. Journal of Attention Disorders, 25 (8). Retrieved from https://journals.sagepub.com/doi/10.1177/1087054719883022

Király, O., Bőthe, B., Ramos-Díaz, J., Rahimi-Movaghar, A., Lukavska, K., Hrabec, O., Miovsky, M., Billieux, J., Deleuze, J., Nuyens, F., Karila, L.M., Griffiths, M.D., Nagygyörgy, K., Urbán, R., Potenza, M., King, D.L., Rumpf, H., Carragher, N., Lilly, E., & Demetrovics, Z. (2019). Ten-Item Internet Gaming Disorder Test (IGDT-10): Measurement invariance and cross-cultural validation across seven language-based samples. Psychology of Addictive Behaviors, 33 (1). Retrieved from https://www.researchgate.net/publication/328615597_Ten-Item_Internet_Ga…

Parry, D.A., Davidson, B.I., Sewall, C.J.R., Fisher, J.T., Mieczkowski, H., & Quintana, D.S. (2021). Nature Human Behavior, 5 . Retrieved from https://www.nature.com/articles/s41562-021-01117-5

van Rooij, A.J., Ferguson, C., Carras, M.C. Kardefelt-Winther, D., Shi, J., Aarseth, E., Bean, A., Bergmark, K.H., Brus, A., Coulson, M., Deleuze, J., Dullur, P., Dunkels, E., Edman, J., Elson, M., Etchells, P.J., Fiskaali, A., Granic, I., Jansz, J...& Przybylski, A.K. (2018). A weak scientific basis for gaming disorder: Let us err on the side of caution. Journal of Behavioral Addictions, 7 (1) Retrieved from https://www.researchgate.net/publication/323542721_A_weak_scientific_ba…

van Rooij, A.J., Schoenmakers, T., van den Eijnden, R.J.J.M., Vermulst, A.A., & van de Mheen, D. (2012). Video Game Addiction Test: Validity and psychometric characteristics. Cyberpsychology, Behavior, and Social Networking, 15 (9). Retrieved from https://www.researchgate.net/publication/230696095_Video_Game_Addiction…

Andrew Fishman is a licensed social worker in Chicago, Illinois. He is also a lifelong gamer who works with clients to understand the impact video games have had on their mental health.

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Can You Really Be Addicted to Video Games?

The latest research suggests it’s not far-fetched at all — especially when you consider all the societal and cultural factors that make today’s games so attractive.

Credit... Concept by Pablo Delcan. Photo illustration by Justin Metz.

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By Ferris Jabr

• Published Oct. 22, 2019 Updated Oct. 23, 2019

Charlie Bracke can’t remember a time when he wasn’t into video games. When he was 5, he loved playing Wolfenstein 3D, a crude, cartoonish computer game in which a player tries to escape a Nazi prison by navigating virtual labyrinths while mowing down enemies. In his teenage years, he became obsessed with more sophisticated shooters and a new generation of online games that allowed thousands of players to inhabit sprawling fantasy worlds. Ultima Online, World of Warcraft, The Elder Scrolls — he would spend as much as 12 hours a day in these imaginary realms, building cities and fortifications, fighting in epic battles and hunting for treasure.

During his childhood, Bracke’s passion for video games, like that of most young Americans, didn’t cause him any serious problems. At school, he got along with just about everyone and maintained straight A’s. His homework was easy enough that he could complete it on the bus or in class, which allowed him to maximize the time he spent gaming. After school, he would often play video games for hours with his cousin and a small group of close friends before going home for dinner. Then he would head to the den and play on the family computer for a few more hours before bed. When his parents complained, he told them it was no different from their habit of watching TV every night. Besides, he was doing his homework and getting good grades — what more did they want? They relented.

When Bracke went to Indiana University Bloomington, everything changed. If he skipped class or played games until 3 in the morning, no one seemed to care. And only he had access to his grades. After a difficult breakup with a longtime high school girlfriend and the death of his grandmother, Bracke sank into a period of severe depression. He started seeing a therapist and taking antidepressants, but by his junior year, he was playing video games all day and seldom leaving his room. He strategically ignored knocks at the door and text messages from friends to make it seem as though he were at class. Eventually, he was failing most of his courses, so he dropped out and moved back in with his parents in Ossian, Ind., a town of about 3,000 people, where he got a job at Pizza Hut.

His life there fell into a familiar rhythm: He woke up, went to work, returned home, played video games until late and repeated the whole cycle. “It did not strike me as weird at all,” he recalls. It felt a lot like high school, but with work instead of classes. “And the time I used to spend hanging out with friends was gone, because they had moved to different areas,” he says. “And I kind of just thought that was the way of the world.”

When Bracke was 24, he decided to get his real estate license and move from Indiana to Virginia to work at the same brokerage as his brother Alex, a decision that led to another breakup with another girlfriend and a deep sense of loneliness in a town where, once again, he had no friends. He eventually got in touch with his ex, hoping she would take him back, only to find out that she was dating someone else. “At that point, I lost it,” he says. By his estimate, he started playing video games about 90 hours a week. He did the bare minimum amount of work required to pay his bills. When it was time to log his progress in the brokerage’s internal system, he would just make something up: sent an email to this client; left a voice mail message for that one.

His employer got wise to the scheme and put Bracke on probation. Realizing he had a problem, Bracke dismantled his computer, stashed the pieces among a bunch of storage boxes in the garage and tried to focus on work. About a month later, after making a big sale, he talked himself into celebrating by playing League of Legends for an evening. He retrieved the components of his computer, reassembled them and started gaming around 6 p.m. Ten hours later, he was still playing. The week slipped away. He kept playing.

In May, the World Health Organization officially added a new disorder to the section on substance use and addictive behaviors in the latest version of the International Classification of Diseases: “gaming disorder,” which it defines as excessive and irrepressible preoccupation with video games, resulting in significant personal, social, academic or occupational impairment for at least 12 months. The latest edition of the Diagnostic and Statistical Manual of Mental Disorders, the American Psychiatric Association’s clinical bible, recognizes “internet gaming disorder” — more or less the same thing — as a condition warranting more research.

The W.H.O.’s decision has received substantial pushback, in part because the modern meaning of “addiction” is an uneasy amalgam of several contradictory legacies: a religious one, which has censured excessive drinking, gambling and drug use as moral transgressions; a scientific one, which has characterized alcoholism and drug addiction as biological diseases; and a colloquial one, which has casually applied the term to almost any fixation. People have written about behavioral addictions — to eating, sex and gambling — for centuries. In recent decades, some psychiatrists and counselors have even specialized in their treatment. But the idea that someone can be addicted to a behavior, as opposed to a substance, remains contentious.

Predictably, some of the W.H.O.’s staunchest critics are leaders in the gaming industry , many of whom fear that the new diagnostic label will further stigmatize their products, which have been smeared as promoting slothfulness, social ineptitude and violence. A sizable faction of scientists also disputes the idea that video games are addictive. The arguments against the validity of video-game addiction are numerous, but they generally converge on three main points: Excessive game play is not a true addiction but rather a symptom of a larger underlying problem, like depression or anxiety; the notion of video-game addiction emerges more from moral panic about new technologies than from scientific research and clinical data; and making video-game addiction an official disorder risks pathologizing a benign hobby and proliferating sham treatments. “It’s absolutely not an addiction,” says Andrew Przybylski, director of research at the Oxford Internet Institute. “This whole thing is an epistemic dumpster fire.” People enjoy and sometimes form all-consuming passions for countless activities — fishing, baking, running — and yet we don’t typically pathologize those.

Throughout history, technological innovations and new forms of entertainment have consistently provoked alarmism. In Plato’s “Phaedrus,” Socrates remarked that writing would “create forgetfulness in the learners’ souls, because they will not use their memories.” In the late 1800s, the sordid tales in penny dreadfuls and dime novels were blamed for juvenile crime. In 1906, the composer John Philip Sousa lamented the “menace of mechanical music,” worrying that children might become “simply human phonographs” without “soul or expression.” As technologies proliferated at an overwhelming rate, so did concerns about their potential harm. Trains, electricity, phones, radios, personal computers: All have been subjected to technophobia. Given the long history of hysteria surrounding technology, it’s tempting to agree with those who dismiss claims that video games are addictive. After all, millions of people around the world enjoy video games without any marked repercussions; some studies have even concluded that the right kind of game play can relieve symptoms of depression and anxiety.

But these denials become more difficult to accept when juxtaposed with the latest research on behavioral addictions. A substantial body of evidence now demonstrates that although video-game addiction is by no means an epidemic, it is a real phenomenon afflicting a small percentage of gamers. This evidence has emerged from many sources: studies indicating that compulsive game play and addictive drugs alter the brain’s reward circuits in similar ways ; psychiatrists visited by young adults whose lives have been profoundly disrupted by an all-consuming fixation with gaming; striking parallels between video games and online gambling; and the gaming industry’s embrace of addictive game design.

Timothy Fong, a professor of addiction psychology at the University of California, Los Angeles, says he is convinced that video-game addiction is real. “It’s quite possible and common to have both addiction and another mental or behavioral disorder simultaneously,” he told me, like depression or anxiety. “At least half the time, compulsive gamers come in with clinical histories and mind-sets that are essentially the same as patients with heroin addiction, alcoholism or gambling disorder. They have all the hallmarks.”

The debate over video-game addiction is about much more than diagnostic nomenclature; at its center is a shifting scientific understanding of addiction itself. For too long the concept of addiction has been fettered by models and frameworks too meager to accommodate its complexity. Addiction has been attributed solely or primarily to weak willpower, or neural circuitry gone awry, or the inherent dangers of drugs themselves. In both the medical community and the public consciousness, the conflation of addiction and chemical dependency has stubbornly persisted.

Researchers in a wide variety of fields — from psychology to public health — are increasingly pushing back against the reductive schema of the past. Addiction is no longer considered synonymous with physiological dependence on a substance, nor can it be reduced to the activity of neurons in a few regions of the brain. Rather, experts now define addiction as a behavioral disorder of immensely complex origins. Addiction, they say, is compulsive engagement in a rewarding experience despite serious repercussions. And it results from a confluence of biology, psychology, social environment and culture. In this new framework, addictions to certain types of modern experiences — spinning virtual slot machines or completing quests in a mythical realm — are entirely possible. In the case of video-game addiction, the most vulnerable population seems to be young men like Bracke.

‘The more I played, the more depressed I got. But the more depressed I got, the more I played.’

— Nate Bowman (right), 20, photographed with Wren Viele (left), 18, in September at reStart’s campus in Carnation, Wash.

Shortly after Bracke’s employers put him on probation, his parents, Sally and Steve, visited him in Virginia. One day, while driving back from the grocery store, Sally worked up the courage to ask her son a question that had been troubling her for some time: “Charlie, are you a gaming addict?” She was terrified of using that word — “addict” — terrified that Bracke would perceive it as an accusation and that their relationship would suffer for it. Bracke contemplated the question silently for a long time as they drove. In truth, the thought had occurred to him, but he had never taken it seriously, let alone said it out loud. Finally he answered: “Yeah, I think I might be.” Back home, he found an online questionnaire that assessed whether someone was an alcoholic. Wherever the quiz mentioned drinking, Bracke substituted gaming. He needed to answer yes to only a few of the questions to qualify as an addict; he affirmed almost all of them.

In the spring of 2015, Bracke was officially kicked off his real estate team. That summer, he stayed at his brother Alex’s house to take care of the dogs while Alex and his wife and son were on vacation. On the first day of his stay, he suddenly realized that his brother’s life — the home, the family, the steady job and income — was everything he wanted and would never have. It was a startling epiphany and the prelude to a period of profound self-loathing. He discontinued his antidepressants because he didn’t think he deserved them. He stopped bathing regularly. He left his brother’s house just twice in nine days, to grab snacks and frozen pizzas from a nearby grocery store. Gaming was the only thing that distracted him from his mental anguish. Nothing felt as good as gaming; nothing else felt good.

By August, he had a detailed suicide plan. He decided he would kill himself in November, around the same time of year his grandmother died; that way, he reasoned, his mother would have to endure only one morbid anniversary. About two months before Bracke intended to take his own life, his parents returned to Virginia to celebrate their grandchild’s birthday. They surprised Bracke with a visit one afternoon. Although they knew their son was struggling, they didn’t know the extent of it. They were shocked at the state of his apartment — cluttered with clothes, trash and empty pizza boxes — and Bracke’s own bedraggled appearance. He knew his gaming had become a terrible problem, he told them, but he felt powerless to stop.

In the following weeks, Sally called every rehab center and addiction hotline number she could find, searching for a program that recognized video-game addiction and knew how to treat it. Every single center turned her away, saying they didn’t offer treatment for her son’s condition. She called so many organizations — some of which used the same telephone switchboards — that she ended up speaking to certain individuals multiple times without realizing it. One day, an exasperated operator interrupted her sobs to tell her that they had already spoken and that he had some good news: His supervisor had recently mentioned a new rehab center in Washington State called reStart , which specialized in internet and video-game addiction.

Bracke and his parents were overjoyed to have finally found some recourse — but the price was staggering. It would cost about $22,000 for the minimum stay of 45 days, and their health insurance wouldn’t cover it. (At the time, there was no official diagnostic code for gaming addiction.) “I remember at one point saying we don’t know how we can afford this, and at the same time we don’t know how we can afford not to,” Bracke’s father told me. Ultimately, they decided to remortgage their house.

In the 1950s, the American psychologist James Olds and the Canadian neuroscientist Peter Milner performed a landmark experiment . They implanted electrodes in various parts of rats’ brains and placed the animals in boxes equipped with levers. Whenever the rats pressed a lever, their brains received a brief jolt of electricity. Zapping some areas of the brain did not change the animals’ behavior, whereas stimulation in other regions seemed to make them avoid the levers. When the researchers placed electrodes near a part of the brain known as the nucleus accumbens, something remarkable happened: The rats became fixated on the levers, pressing them as often as 80 times a minute for as long as 24 consecutive hours. Olds, Milner and other scientists showed that rats would gallop uphill, leap hurdles and even forsake food in order to keep stimulating that region of the brain. It seemed that science had located the brain’s pleasure center, the hypothesized area that made it feel so good to do things conducive to survival and reproduction, like having sex or eating calorie-rich meals. Perhaps, some scientists proposed, addictive drugs had some effect on this same area.

In the following decades, as the tools of neuroscience improved, researchers formed a more complete map of the brain’s reward system, which is a constellation of neural circuits involved in attention, motivation, desire and learning. Studies revealed that healthy rats became obsessed with drug-dispensing levers, but rats whose reward circuits had been disrupted showed little to no interest. Related experiments singled out the neurotransmitter dopamine as the most important chemical messenger in the reward system, demonstrating how certain addictive drugs drastically increased the amount of the dopamine traveling between neurons. With neuroimaging techniques developed in the 1990s, scientists could watch the brain’s reward center respond almost instantly to an injected drug and examine how the brain’s structure and behavior changed with continued use. In parallel, scores of studies identified heritable gene sequences that seemed to be associated with an increased risk for addiction.

These findings formed the core of what has come to be called the brain-disease model of addiction, which has been embraced by most major health organizations, including the National Institute on Drug Abuse and the American Medical Association. According to this model, addiction is a chronic disease of the brain’s reward system caused by continual exposure to particular substances and the dopamine release they trigger. The brain compensates by producing less dopamine in general and becoming less sensitive to it over all, forcing the user to take even larger doses to experience the same level of reward — a development known as tolerance. The neurochemical chaos produced by continued drug use also degrades the neural pathways that connect the reward center to the prefrontal cortex, which is crucial for planning, managing emotions and controlling impulses. The longer an addiction progresses, the higher someone’s tolerance, the stronger their cravings and the harder it may be to quit without relapsing.

From the 1990s to the late 2000s, neuroscientists demonstrated that many of the neurobiological changes underlying drug addiction occurred in pathological gamblers as well. For most of the 20th century, the psychiatric community regarded pathological gambling as a disorder of impulse control — more related to compulsive tics than to addiction. As scientists developed a more sophisticated understanding of the biology underlying addiction, however, many mental-health experts began to change their minds. Like certain drugs, gambling elicits a surge of dopamine in the reward circuit. Over time, compulsive gambling diminishes the ability to experience reward and inhibits circuits in the prefrontal cortex that are crucial for impulse control.

Studies of Parkinson’s disease provided further confirmation . Between 3 and 6 percent of people with Parkinson’s are compulsive gamblers, which is substantially higher than the estimate of 0.25 to 2 percent of the general population. Parkinson’s, which results in part from the death of dopamine-secreting neurons in the midbrain, is sometimes treated with the drug levodopa, which increases the amount of dopamine in the brain and nervous system. Some researchers have proposed that by raising dopamine levels, levodopa essentially mimics certain aspects of addiction, making the brain more susceptible to risk-taking and compulsive behavior. In 2013, after reviewing the mounting evidence, the American Psychiatric Association moved gambling disorder to the addictions section of the D.S.M.

In the last 10 years, scientists have been making similar discoveries about compulsive gaming. Neuroimaging studies have confirmed that video games trigger a release of dopamine in the reward circuit and that dopamine does not behave as it should in the brains of compulsive gamers. In a study performed in China , frequent gamers displayed unusually low activity in their reward circuits when anticipating a monetary prize. Some researchers think an inherently unresponsive reward system predisposes people to addiction by pushing them to seek big thrills; others interpret it as an early sign of tolerance. Last year, the psychologist Daria J. Kuss, part of the International Gaming Research Unit at Nottingham Trent University, and her colleagues published a review of 27 studies investigating the neurobiological correlates of compulsive gaming. They concluded that, compared with healthy individuals, compulsive gamers exhibit worse memory, poorer decision-making skills, impaired emotion regulation, inhibited prefrontal cortex functioning and disrupted electrochemical activity in their reward circuits — all similar to what researchers have documented in people with drug addictions.

“I don’t think we as psychologists can be justified in saying gaming addiction doesn’t exist,” Kuss told me. “From my experience of researching it for over 10 years, I can tell you I am very sure that this is indeed a real addiction requiring professional help.”

There’s a danger, though, in making neuroscience the ultimate arbiter of addiction. In the past decade, many researchers have argued persuasively that the brain-disease model of addiction has gained more prominence than it deserves. Neuroscientists have discovered that the relationship between the reward circuit and addiction is much more convoluted than is typically acknowledged. It turns out, for example, that only some addictive drugs, namely cocaine and amphetamine, dependably provoke huge releases of dopamine; many others — including nicotine and alcohol — do so inconsistently or hardly at all. Moreover, dopamine is not as closely linked to pleasure as once thought; it is much more important for wanting than liking , for anticipating or seeking out a reward than for enjoying it. And dopamine is involved in far more than reward and motivation; it is also important for memory, movement and immune-system regulation. But the explanatory power of neurobiology is so appealing that the basic tenets of the brain-disease model have seeped into public consciousness, popularizing a somewhat reductive understanding of addiction.

Sally Satel, a psychiatrist and Yale University lecturer, puts it this way: “Addiction is not a brain problem. It’s a human problem.” Derek Heim, an addiction psychologist at Edge Hill University in England, agrees completely: “People get very excited when they see pictures of a brain, but we’ve overextended that explanation. We need to think of addiction as an extremely multifaceted problem.” Video-game addiction perfectly exemplifies this multiplicity. It’s not just a biological phenomenon — it’s a cultural one too.

‘I stopped going to class. I stopped caring, and then everything kind of slipped. Second semester I didn’t have a roommate, so I didn’t have anybody to be accountable to. I was just kind of like, Screw it, I can do what I want for however long I want to.’

— Thomas Kuhn, 19, in September at reStart’s campus in Fall City, Washington.

When Bracke was born in the late 1980s, video games were still being assimilated into mainstream American culture. Today they are ubiquitous. Globally, more than two billion people play video games, including 150 million Americans (nearly half the country’s population), 60 percent of whom game daily. Professional athletes routinely perform goofy victory dances from Fortnite. Game Informer has the fifth-highest circulation of any American magazine, surpassed only by AARP’s Magazine and Bulletin, Costco Connection and Better Homes & Gardens. When Grand Theft Auto V was released in September 2013, it generated $1 billion of revenue within three days. No single entertainment product has ever made so much money in so little time. Video games are now one of the most lucrative sectors of the entertainment industry, having overtaken film, television, music and books. Games are also the most popular and profitable type of mobile app, accounting for about a third of all downloads and 75 percent of Apple’s App Store revenue.

A typical gamer in the United States spends 12 hours playing each week; 34 million Americans play an average of 22 hours per week. About 60 percent of gamers have neglected sleep to keep playing, and about 40 percent have missed a meal. Somewhere around 20 percent have skipped a shower. In 2018, people around the world spent a collective nine billion hours watching other people play video games on the streaming service Twitch — three billion more hours than the year before. In South Korea, where more than 95 percent of the population has internet access and connection speeds are the fastest in the world, compulsive game play has become a public-health crisis. In 2011, the South Korean government passed the Shutdown Law, which prevents anyone under 16 from playing games online between midnight and 6 a.m.

Video games are not only far more pervasive than they were 30 years ago; they are also immensely more complex. You could easily spend hundreds of hours not only completing quests but also simply exploring the vast fantasy kingdom in The Legend of Zelda: Breath of the Wild, a gorgeously rendered virtual world in which every blade of grass responds to the pressure of a footstep or the rush of a passing breeze. Fortnite attracted a large and diverse audience by blending the thrill of live events with the strategic combat and outrageous weaponry of first-person shooters, airbrushing it all with a playful cartoon aesthetic. In The Witcher 3: Wild Hunt, the choices players make change the state of the world and ultimately steer them toward one of 36 possible endings. All games — whether tabletop, field or electronic — are simulations: They create microcosms of the real world or gesture at imaginary ones. But these simulations have become so expansive, intricate and immersive that they can no longer be labeled mere entertainment, no more engrossing than an in-flight movie or a pop song. They are alternate realities.

Even games that are intentionally designed with a retro feel can be surprisingly absorbing. Take Stardew Valley, a quaint farming game with 16-bit graphics that reminded me of the early Pokémon titles for Game Boy. Apart from Candy Crush and word puzzles, I hadn’t spent much time playing video games since high school, so, while reporting this article, I decided that Stardew Valley might be an appealing way to reacquaint myself. It seemed like the kind of thing I could play for an hour here or there as my schedule allowed. The premise is simple: You leave your soul-deadening corporate office job and move to the country to revive your grandfather’s neglected farm. It seems refreshingly, perhaps deliberately, distinct from all the frenzied and ultracompetitive first-person shooters and survival games. Each day in the game equals about 17 minutes of real-world time, so a week passes in just under two hours.

At first, I was enchanted by the game’s pastoral setting and its emphasis on collaboration, compassion and discipline. As I became more deeply invested in my pixelated life, though, my attitude changed. I started to lose patience with my neighbors and their daily prattle and stopped noticing all the thoughtful details that once delighted me: the soft glow of fireflies on summer evenings, the fleeting shadow of an owl in flight, the falling petals in spring. And what disturbed me most was the sheer quantity of time I was pouring into the game. It was so easy to play continuously through an afternoon or an evening, in part because the great satisfaction of my achievements was so disproportionate to the effort I expended. I found it extremely difficult to stop playing, even at “nighttime,” when my character went to sleep, which doubles as a natural point to save your progress and quit. If I kept going, just another 20 minutes, I could get so much done. Compared with the game, everything else in my real life suddenly seemed so much harder — and so much less gratifying.

The fact that video games are designed to be addictive is an open secret in the gaming industry. With the help of hired scientists, game developers have employed many psychological techniques to make their products as unquittable as possible. Most video games initially entice players with easy and predictable rewards. To keep players interested, many games employ a strategy called intermittent reinforcement, in which players are surprised with rewards at random intervals. Some video games punish players for leaving by refusing to suspend time: In their absence, the game goes on, and they fall behind. Perhaps the most explicit manifestation of manipulative game design is the rising popularity of loot boxes, which are essentially lotteries for coveted items: a player pays real money to buy a virtual treasure box, hoping it contains something valuable within the world of the game.

As modern video games have become so immersive, their carefully composed dreamscapes have begun to offer a seductive contrast to the indifferent, and sometimes disappointing, world outside screens. Games, by definition, have rules; goals are often explicitly defined; progress is quantified. Although games frequently put players in challenging situations, they continuously offer tutorials, eliminate real-world consequences of failure and essentially guarantee rewards in exchange for effort. Games imbue players with a sense of purpose and accomplishment — precisely the kind of self-worth that can be so hard to attain in their actual lives, especially in a job market that can be punishing for the inexperienced.

From 2014 to 2017, American men in their 20s worked 1.8 fewer hours per week than they had in the three-year period 10 years earlier; in tandem, they increased the time they spent playing video games by the exact same amount. One economics study suggests that this correlation is not a coincidence — that young American men are working less in order to game more. For young men like Bracke, who have either not completed a four-year college degree or have not found work equal to their education and skills, video games can become something like a surrogate occupation — a simulacrum of success. Why suffer in a world that has no place for you when you can slip so easily into one that is designed to keep you happy, and is more than happy to keep you?

‘In my case, it was an avoidant coping mechanism. It was easier for me to go and avoid the anxiety of my recent breakup, the anxiety of my parents, the anxiety of school. It was easy to avoid all of the difficult situations through gaming.’

— Walker Wadsworth, 22, in September at reStart’s campus in Fall City, Washington.

On the evening of Oct. 21, 2015, a relative picked up Bracke from the Seattle airport and dropped him off at reStart’s main facility, a large two-story blue house in Fall City, Wash., surrounded by a garden and acres of forest. He checked in with the staff, dropped off his luggage in the house and joined a small group of young men sitting around a campfire. They were eating hot dogs and conducting their evening meeting, a ritual Bracke would come to know well: Each took his turn sharing what he accomplished that day and what he planned for the next. “Some of the guys, just to help me feel more comfortable, told part of their history about how they ended up here,” Bracke recalls. “Just being around other people who had gone through what I had gone through and knew what it felt like made a huge difference. I felt accepted. It almost sounds corny to say it, but I got there and immediately felt I had made the right choice.”

Because video-game addiction is a relatively new disorder, there are few published studies examining how best to treat it. Some clinicians warn that rehab programs and retreats focused on internet and video-game addiction make unsubstantiated claims, give people false hope and take advantage of desperate parents and adolescents. (In China, there have been disturbing reports of internet-addiction boot camps that use electroconvulsive therapy and corporal punishment, resulting in at least one teenager’s death.) But many compulsive gamers and their families counter that they have no other viable options; treatment centers focusing on substance abuse or gambling addiction often decline to help them or cannot provide a recovery environment that they think is suitable. ReStart opened in 2009, and it remains one of few dedicated long-term rehabilitation programs for internet and video-game addiction in the United States. Hilarie Cash, one of reStart’s founders, estimates that 80 percent of clients complete Phase I and that 70 percent complete Phase II. Former clients think it may be a lot less than that; they have seen many friends relapse or leave the program early.

Bracke spent about seven weeks at the house in an initial “detox” phase, following a strict schedule of chores, exercise, meals, group meetings and therapy sessions. Lights out by 10:30 p.m. No cellphones or computers. One landline for outgoing calls. The program forced him to try new activities — hiking, camping, Frisbee golf — many of which he enjoyed. He developed a “life balance plan,” which focused on strategies for responsible technology use after the program, for example forgoing a computer and limiting internet access. And he learned how to have difficult conversations using a “wheel of communication,” which required him to verbalize what he was feeling and thinking and to reiterate what the other person in the conversation had just said. “Toward the end of my time gaming, I was getting to the point where I felt like I couldn’t converse with people at all, unless it was about video games,” Bracke says. “So going through something like that really made it click that I can actually talk to people, I can really communicate with them.”

A huge component of reStart’s philosophy is the importance of maintaining relationships. “These guys have almost universally what I would call an intimacy disorder,” Cash told me. “They don’t really know how to build and maintain intimate relationships. The solution to addiction is connection. We are building a real recovery community with our guys. It’s all about building friendship and community that is face to face, in person, rather than online.”

Of course, for many people video games are explicitly and gratifyingly social. A raucous multiplayer game like Fortnite can bring large groups of friends and neighbors together online or in someone’s living room. People who struggle with severe social anxiety, or who cannot regularly leave their homes, may find camaraderie through an avatar. But video games are a poor substitute for meaningful human companionship. Virtual interactions are often stripped of behavioral cues and facial expressions; masked identities empower people to mistreat one another; and it’s easier to vanish from someone’s life if you’ve never met them. Games, like online social networks in general, sometimes provide the semblance of genuine connection while actually pushing someone into a dangerously secluded way of life.

The economic and cultural ascendancy of video games has collided with a social crisis that we are only beginning to understand: the isolation, emotional stagnation and profound loneliness of American men. Recent surveys indicate that loneliness is reaching epidemic proportions among Americans. According to a 2018 Cigna survey , more than 40 percent of Americans feel that their relationships are not meaningful and that they are generally isolated from others; 20 percent rarely or never feel close to anyone. Young adults between 18 and 22 score higher on scales of loneliness than any other group.

There’s good reason to think that single men are uniquely vulnerable to social isolation and its repercussions. Studies suggest that men rely primarily on a partner for emotional intimacy, whereas women are more likely to have additional support from close friends; men in their late 30s lose friends at a faster rate than women; and men are more likely to kill themselves because of prolonged emotional or social detachment. In three decades of research , Niobe Way, a professor of developmental psychology at New York University, has observed a striking pattern of behavior among American boys: in early adolescence, they are openly affectionate with one another, speaking freely of love and lifelong bonds; by late adolescence, as they become cultured to project an image of masculinity, heterosexuality and stoicism, they start to distance themselves from their same-sex friends. One 17-year-old told Way that “it might be nice to be a girl, because then you wouldn’t have to be emotionless.”

And while addiction was once regarded as a kind of vice or chemical thrall — and in more recent decades has been framed as dysfunctional neural circuitry — there is now a substantial body of research contextualizing addiction as a consequence of social isolation . People who are deprived of a dependable social network, or who have severe difficulty connecting with others, have a much higher risk of both developing an addiction and relapsing. Addiction itself can drastically magnify loneliness . Video-game addiction afflicts between 1 and 8 percent of gamers, according to estimates published by researchers. As a group, gamers are now more diverse than ever , comprising a wide range of ages and increasingly equal numbers of men and women. Yet as evidenced by both scientific studies and the experiences of clinical psychiatrists, self-identified video-game addicts are overwhelmingly male . To be more specific, they are typically single young adult men — the very segment of the population that may be most prone to social detachment. In the course of my conversations with dozens of compulsive gamers, a familiar narrative began to emerge: A young man repeatedly suffered some form of rejection from his peers; hurt, he turned to video games to soothe and distract himself; the games gave him a pretense of the kinship and achievement he never knew in the real world; when he left home for college or moved into his own place — and the familial checks on his day-to-day activities were lifted — his fixation on games intensified until it consumed him.

This is more or less the story that Cam Adair , perhaps the leading spokesman for the legitimacy of video-game addiction, tells in his public appearances. Like Bracke, he nearly committed suicide but sought help in the 11th hour. In 2011, he posted his story and insights on a blog and received thousands of responses from people with similar experiences. Inspired by this outpouring, Adair founded Game Quitters, an online support community for video-game addicts that today has about 75,000 members from 95 countries. Thanks to his ability to articulate the fraught reality of a fringe diagnosis, Adair is now self-employed as a full-time public speaker.

“I just really inquired, ‘Why do I game?’ ” Adair told me. “For me, it was so obvious that it wasn’t just that games were fun. They allowed me to escape. They allowed me to socially connect. They allowed me to see measurable progress. And they allowed me to feel a sense of certainty.” To Adair, the gaming industry’s repeated disavowal of video-game addiction is embarrassing. “It’s just not honest, and it’s not based in reality,” he says. “People have been coming forward for years, saying they are really struggling. What really matters is that you feel you have to keep playing despite it having a negative impact on your life. That’s addiction. I think, as a society, we should be saying, ‘How can we help?’ ”

Those who deny the reality of video-game addiction often overlook a fundamental ambiguity central to addiction itself. Current diagnostic criteria for addiction are not so much a definitive scientific description as a useful guideline. To insist that addiction must be restricted to certain substances is to presume a level of understanding that we have not yet reached. If addiction is an evolving concept, and an official expansion of that concept would profoundly benefit people who clearly need help, can we justify clinging to the status quo?

In the summer of 2016, shortly after he started working at a Costco near his home in Redmond, Wash., Bracke found himself surrounded, once again, by video games. Niantic had released Pokémon Go, an augmented-reality game for mobile devices that superimposed animated Pokémon onto screen-based images of a player’s actual surroundings — a pidgey in the park, a magikarp on the beach. You could catch them by swiping a finger across the screen. The game was downloaded more than 100 million times by the end of July and for a while was the single most active mobile game in the United States.

Many of Bracke’s co-workers were captivated by Pokémon Go. They would surreptitiously play during their shifts, occasionally keeping the game running in their pockets to increase their chances of encountering a Pokémon. Some of them asked him about it: What level was he? Which Pokémon had he caught so far? Bracke hadn’t tried the game yet, but he was extremely tempted. He decided he would download it so that he could immediately block all access to it using a “screen accountability” program called Covenant Eyes, which was originally designed to help people stop watching pornography.

Today, Bracke — a cordial, brown-bearded 31-year-old — still works at that Costco, though he recently completed a degree in accounting at Bellevue College and has begun his studies at the University of Washington. He owns a Samsung Galaxy smartphone and an “intentionally crappy” laptop, but he doesn’t have an internet connection at home. He hasn’t touched video games since starting rehab in the fall of 2015. Like Adair, he has become an outspoken advocate for video-game addicts, once appearing on the “Today” show .

Rehab taught him that in order to stay sober, he would have to do more than avoid video games — he needed to replace them with something else. In Washington, he started reading more. He broadened his social network, making new friends through work, school and mutual acquaintances. When the weather was nice, he went hiking, took his dog on a long walk or played Frisbee golf. At home, he enjoyed the occasional board game. “I’ve tried to branch myself out into a lot of hobbies that I take shallower dives into, rather than having one that occupies everything,” he told me.

After touring reStart this September, I visited Bracke at the apartment where he was living at the time. When I walked in, I was greeted by several of Bracke’s friends and roommates, all young men in their 20s who participated in reStart (they asked to remain unnamed). The apartment was small, with somewhat shabby furniture. A two-foot-tall artificial Christmas tree stood in one corner, a holdover from last year. Bracke’s small white dog, Minerva, ran between us, yipping and nudging our legs.

I chatted with Bracke and his friends for about two hours. We talked about their experiences in reStart, how they navigate life with so little internet access and their long-term plans. Each of them believed he would have killed himself without some type of formal treatment. Each stressed how important reStart’s emphasis on social connection had been to his recovery. And each said that, at least for the time being, he planned to stay in Washington — the place where they all had finally learned, or relearned, how to connect with others outside the context of multiplayer games. “I still hung out with people before,” one of Bracke’s friends said, “but most of the time, we would just talk about stuff we were going to do, like playing video games or something else that wasn’t particularly serious. I can just walk up to either of them,” he continued, gesturing to the other men beside him, “and be like, ‘This is what’s going on in my life.’ I’ve never really had that before.”

His admission stuck with me, in part because it so closely echoed conversations I had with other self-identified gaming addicts. As Bracke told me at one point, a huge part of his rehab was “allowing myself to rely on others, and being there to support others when they need it as well.” He explained that even if he had technically been socializing while gaming — talking with other players on his headset — he had never been genuinely interested in their lives, nor they in his. In contrast, the relationships he developed during rehab, in the complete absence of games, felt sincere and enduring: “A lot of the guys I met there were some of the only people I could be totally honest with.”

The more I spoke with the young men in Bracke’s living room, the clearer it became that they were not simply friends — they were family. They had suffered in such similar ways. They had arrived in Washington feeling helpless and utterly alone. Most of them had forgotten what it was like to have a meaningful conversation with another person. For months, they cooked and ate together, shared bedrooms and bathrooms and managed the same household. They exchanged mundane niceties and confessed deeply personal fears, hopes and secrets — their abandoned aspirations, their suicide plans. They cried in front of one another, repeatedly, because of anger or guilt or grief. They witnessed one another become more trusting and confident, less anxious and withdrawn, even hopeful.

Although each had his own future to focus on, whether school or work or both, they still lived together and encouraged one another in these pursuits. Perhaps they would never fully understand the reasons for their compulsions or distill the culpability of games from all the other elements of their lives. Perhaps it didn’t matter anymore. If addiction is the compulsive substitution of an artificially rewarding experience for essential human intimacy, then these men had found its opposite in one another.

Ferris Jabr is a contributing writer for the magazine. He last wrote about the evolution of beauty.

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2 A History and Overview of Video Game Addiction

Mark D. Griffiths, PhD, International Gaming Research Unit, Psychology Department, Nottingham Trent University, UK

Halley M. Pontes, PhD, MSc, University of Tasmania, Australia; The International Cyberpsychology and Addictions Research Laboratory, University of Tasmania, Australia

• Published: 08 October 2020
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The past decade has witnessed a significant increase in the number of empirical studies examining various aspects of problematic video game play, video game addiction, and, more recently, gaming disorder. This chapter begins with a brief past history of how research into video game addiction has developed during the past four decades in the 1980s (arcade video game addiction), 1990s (home console video game addiction), and 2000s and beyond (online video game addiction). The chapter also overviews the features of gaming addiction, its prevalence rates, demographics and gaming addiction, negative consequences of excessive video game use, Internet gaming disorder and the DSM-5, and treatment of gaming addiction. Based on the published evidence, particularly from studies conducted in the past decade, it appears that, in extreme cases, excessive gaming can have potentially damaging effects on individuals who appear to display compulsive and/or addictive behavior similar to other more traditional addictions. However, the field has been hindered by the use of inconsistent and nonstandardized criteria to assess and identify problematic and/or addictive video game use.

According to the Entertainment Software Association (ESA, 2014 ), 59% of the entire American population plays video games, with an average of two gamers in each game-playing household. Additionally, among US households 68% play video games on consoles, 53% play on smartphones, and 41% play on wireless devices (ESA, 2014 ). During 2012, playing video games via smartphones and wireless devices increased by 22% and 37%, respectively. The average video game player is 31 years old - and about 52% of these video game players are male and 48% are female (ESA, 2014 ).

Given the pervasiveness of gaming across several countries and different segments of the population, the study of its associated effects on general human behavior, physical and mental health has become an important topic for dedicated research agendas from various scientific domains in addition to psychology and psychiatry (e.g., Blocher, 2015 ; Dreier, Wölfling, & Müller, 2013 ; Johnston, Boyle, MacArthur, & Manion, 2013 ). Taken together, findings in this developing field suggest both favorable and unfavorable effects of gaming, outcomes that could inform decisions made by healthcare professionals, parents, policymakers (Przybylski, 2014 ) and other stakeholders such as researchers and the video game industry (Yousafzai, Hussain, & Griffiths, 2013 ).

One topic that has become of increasing research interest is gaming addiction and Internet Gaming Disorder (IGD). The past decade has witnessed a significant increase in the number of empirical studies examining various aspects of problematic video gameplay and video game addiction (Pontes & Griffiths, 2014 ). This chapter begins with a brief past history of how research into video game addiction has changed over the past three decades (i.e., the 1980s, 1990s, and 2000s). The chapter addresses concerns related to video game addiction and how it made its way into the latest (fifth) edition of the DSM (DSM-5; American Psychiatric Association, 2013 ). The chapter also briefly examines features of video game addiction and examines the contemporary research literature by analyzing the prevalence of video game addiction, factors associated with video game addiction, and the treatment of video game addiction.

Gaming Addiction in the 1980s

Following the release of the first commercial video games in the early 1970s, it took until the 1980s for the first reports of video game addiction to appear in the psychological and psychiatric literature. In the early 1980s, Ross, Finestone, and Lavin reported three cases of “Space Invaders obsession” and Nilles ( 1982 ) described a similar phenomenon but called it “computer catatonia.” Arguably the first reference to “video game addiction” was by Soper and Miller ( 1983 ) who, based on their observations as school counselors, claimed the disorder was like any other behavioral addiction and consisted of a compulsive behavioral involvement, a lack of interest in other activities, association mainly with other addicts, and physical and mental symptoms when attempting to stop the behavior (e.g., the shakes). Some credence was given to these claims that video game addiction existed following papers on the seemingly successful treatment of video game addiction using cognitive behavioral therapy (CBT) (Keepers, 1990 ; Kuczmierczyk, Walley, & Calhoun, 1987 ). However, all of these studies were somewhat observational, anecdotal, and/or case studies, primarily based on teenage males and all based on a particular type of video game in a particular medium (i.e., “pay-to-play” arcade video games).

Shotton ( 1989 ) carried out the first empirical study specifically on gaming addiction on a relatively small sample of 127 people (almost all teenage or young adult males) who described themselves as “hooked’’ on home video games for at least 5 years. Shotton’s conceptualization of gaming addiction was more positive than negative, and she reported that her “addicts” were on the whole highly intelligent, motivated, and achieving people who were often misunderstood by others in society. Despite this, the main problem with the study was that no standardized measure of addiction was actually used. The only criterion for being “addicted” was the individuals own admission that they were “hooked” on computer games. Despite this major shortcoming, recent research by Widyanto, Griffiths, and Brunsden ( 2011 ) reported that a person’s positive self-diagnosis to the Internet was correlated highly with more standardized measures of Internet addiction.

Gaming Addiction in the 1990s

The 1990s saw a small but significant increase of research into video game addiction, with almost all of these studies being carried out by surveying children in school settings in the United Kingdom (e.g., Brown & Robertson, 1993 ; Fisher, 1994 ; Griffiths, 1997 ; Griffiths & Hunt, 1995 , 1998 ; Parsons, 1995 ; Phillips, Rolls, Rouse, & Griffiths, 1995 ). In contrast to studies from the early 1980s, these studies mainly examined non-arcade video game playing (i.e., home console games, handheld games, PC gaming). However, all of these studies were self-report surveys, relatively small in scale, and all of them assessed video game addiction using adapted versions of the Diagnostic and Statistical Manual of Mental Disorders (DSM), such as the DSM-III or the DSM-IV criteria for pathological gambling (American Psychiatric Association, 1987 , 1994 ). Based on further analysis of the adapted DSM criteria used, these studies were later criticized as being more likely to be assessing video game preoccupation rather than video game addiction (Charlton, 2002 ).

Gaming Addiction in the 2000s and Beyond

The 2000s saw a substantial growth in the number of studies on video game addiction, particularly as gaming expanded into the new online medium where games could be played as part of a gaming community (i.e., massively multiplayer online role playing games [MMORPGs] such as World of Warcraft and Everquest). Approximately 60 studies were published on gaming addiction between 2000 and 2010 (Kuss & Griffiths, 2012 ) and a vast majority of these studies examined MMORPG addiction and were not limited to only studying adolescent males. Furthermore, many of these studies collected their data online, and a significant number of studies examined various aspects of video game addiction using non–self-report methodologies. These include studies using polysomnographic measures and visual and verbal memory tests (Dworak, Schierl, Bruns, & Struder, 2007 ); medical examinations including the patient’s history, and physical, radiologic, intraoperative, and pathologic findings (Cultrara & Har-El, 2002 ); functional magnetic resonance imaging (fMRI; Han, Hwang, & Renshaw, 2010 ; Hoeft, Watson, Kesler, Bettinger, & Reiss, 2008 ; Ko et al., 2009 ); electroencephalography (Thalemann, Wölfling, & Grüsser, 2007 ); and genotyping (Han et al., 2007 ). Given the methodological shortcomings of the studies published prior to 2000 and the fact that gaming has evolved substantially over the past decade, the remainder of this chapter will mainly focus on studies published in the past decade or so (i.e., post-2000 studies) with the exception of those concerning the health and medical consequences of excessive video game play.

Features of Gaming Addiction

There are a multitude of psychological perspectives on addiction, which has led to addiction being defined in many different ways. However, most models of addictive behavior refer to a persistent and uncontrollable urge to consume a substance or engage in an activity that results in significant personal harm and interpersonal conflict for the user (King, Delfabbro, & Griffiths, 2013 ). Thus, gaming addiction is often said to be present when individuals have completely lost control over gaming and the excessive playing behavior has had a detrimental effect on all aspects of the individuals life, compromising job and/or educational activities, interpersonal relationships, hobbies, general health, and psychological well-being (King, Delfabbro, & Griffiths, 2013 ). These two criteria (impaired control and harmful consequences) are regarded as fundamentally important criteria for addiction. An alternative model of addictive behavior has proposed six features or components of gaming addiction (Griffiths, 2005 ). To indicate addiction, it is thought that these criteria must be sustained for at least 3–6 months. Otherwise, they may simply indicate a temporary absorption in video games. These criteria include:

• Salience. This occurs when gaming becomes the most important activity in a person’s life, dominating thoughts (preoccupation and cognitive distortions), emotions (cravings), and behavior (deterioration of normal behaviors). An addicted gamer is obsessed with all aspects of video games and, when not playing, will be anticipating or planning the next playing session. • Mood modification. This refers to changes in a person’s mood state that occur as a result of gaming. Mood change may involve a subjective feeling of euphoria as well as an increase in physiological arousal (increased heart rate, muscle tension, or shaky hands) or, alternatively, a tranquilizing feeling of calm or a numbing sensation. • Tolerance. This refers to the process whereby increasing amounts of gaming are required to achieve the former mood-modifying effects. This means that players gradually increase the amount of time they spend engaged in gaming. It could be argued that addicted gamers build up their tolerance to the point that they will end a playing session only when they have become mentally or physically exhausted. • Withdrawal. These are the aversive mood states and/or physical effects that occur when gaming is suddenly discontinued or reduced. Psychological withdrawal symptoms include feelings of frustration, irritability, and flattened affect. Withdrawal motivates the individual to play video games on a regular basis and to minimize periods of absence from a video game in order to alleviate these unpleasant feeling states. • Relapse. This refers to the tendency for the player to make repeated reversions to earlier patterns of gaming and for even the most extreme patterns typical of the height of excessive gaming to be quickly restored after periods of abstinence or moderation. Relapse usually indicates that the individual has lost personal agency over the behavior. • Conflict (harm). This refers to the negative consequences of excessive gaming. Harm includes conflicts between the addicted video game player and other people (family members and friends), other activities (job, school, social life, hobbies and interests), and from within the addict him/herself (psychological distress).

Charlton ( 2002 ) suggests that three of these features may not be reliable indicators of video game addiction. His research suggests that cognitive salience (preoccupation), euphoria (mood modification), and tolerance also indicate high engagement, or a type of healthy obsession, with gaming. Therefore, studies may overestimate the prevalence of problem video game play if high engagement with gaming is not properly distinguished from gaming addiction. Given these issues of reliability, many addiction specialists maintain that impaired control and harmful effects are the most appropriate criteria for identifying gaming addiction.

Prevalence of Problematic Video Game Use and Gaming Addiction

At present, it is quite difficult to estimate the prevalence of problematic gaming due to the lack of a clear definition, the application of measures without proper psychometric characteristics, and studies using different samples and different research methodologies. Large-sample studies generally report prevalence values of lower than 10%. A study conducted in the United States on a national representative sample of teenagers (Gentile, 2009 ), as well as on a large sample of Singaporean children (Gentile et al., 2011 ) both reported a problematic game use of approximately 9%. Results of another representative study in Germany showed that 3% of the male and 0.3% of the female students studied were diagnosed as dependent on video games, while another 4.7% of male and 0.5% of female students were at risk of becoming dependent (Rehbein et al., 2010 ). On a large Hungarian online gamer sample 3.4% of gamers belonged to the high-risk group of problematic gaming and another 15.2% to the medium-risk group (Demetrovics et al., 2012 ). A proportion of 4.6% of Hungarian adolescents (approximately 16 years old) belonging to a national sample were classified as high-risk users (Pápay et al., 2013 ) (see Table 2.1 ).

Demographics and Gaming Addiction

According to an online survey examining all types of online gamers (Nagygyörgy et al., 2013 ) ( N = 4,374), the mean age was 21 years, and participants were mostly male (91%) and single (66%). Their average weekly game time varied between less than 7 hours (10%) and more than 42 hours (also 10%) with most of the gamers playing 15–27 hours weekly (35%). Furthermore, 16% of all gamers were playing either professionally (i.e., they make a living off of sponsorships and money won from tournaments) or competitively (i.e., they participate in competitions and earn money if they win). The majority of the sample (79%) had a clear gaming preference: namely, they played one single game type most of the time.

Data regarding the three main game types give a more nuanced view. The proportion of female gamers is the lowest in the case of massively multiplayer online first-person shooter (MMOFPS) games (1–2%) (Jansz & Tanis, 2007 ; Nagygyörgy et al., 2013 ) and the highest between MMORPG users (15–30%) (Cole & Griffiths, 2007 ; Nagygyörgy et al., 2013 ; Yee, 2006a ). MMOFPS users are the youngest (18–19.8 years) (Jansz & Tanis, 2007 ; Nagygyörgy, et al., 2013 ), while both massively multiplayer online real-time strategy (MMORTS) (22 years) (Nagygyörgy et al., 2013 ) and MMORPG players (21–27 years) (Nagygyörgy et al., 2013 ; Yee, 2006a ) are significantly older. Among the three main groups, MMORPG gamers spend the most time playing (Nagygyörgy et al., 2013 ). Since MMORPGs are the most researched games (most likely because they allow players to interact to form friendships, create communities, and work together to accomplish a variety of goals [Barnett & Coulson, 2010 ]), there is additional information regarding such players that is still unknown in the case of other game types. For instance, half of MMORPG players work full time, 22.2% are students, and 14.8% are homemakers (89.9% of whom were female). Furthermore, 36% of the gamers are married and 22% of them have children (Yee, 2006a , 2006b ). Overall, the demographic composition of MMORPG users is quite varied and probably more diverse than the composition of MMORTS and MMOFPS users (although this needs to be empirically established).

From a substantive perspective, there are some generalizations that can be made with regard to the demographic characteristics of gamers and problem gamers. The literature to date suggests that adolescent males and young male adults appear to be at greater risk of experiencing problematic video game play. However, the course and severity of these problems is not well known (King, Delfabbro, & Griffiths, 2012 ) and the finding that this group is more at risk may be a consequence of sampling bias and the fact that this group plays video games more frequently than do other sociodemographic groups. It has also been suggested that university students may be vulnerable to developing problematic video gaming. Reasons for this include their flexible tuition and study hours, ready access to high-speed broadband on a 24/7 basis, and multiple stressors associated with adjusting to new social obligations and/or living out-of-home for the first time (King, Delfabbro et al., 2012 ; Young, 1998a ).

Negative Consequences of Excessive Video Game Use

Irrespective of whether problematic video game play can be classed as an addiction, there is now a relatively large number of studies all indicating that excessive video game play can lead to a wide variety of negative psychosocial consequences for a minority of affected individuals. These include sacrificing work, education, hobbies, socializing, time with partner/family, and sleep (Batthyány, Müller, Benker, & Wölfling, 2009 ; Griffiths, Davies, & Chappell, 2004 ; King & Delfabbro, 2009 ; Liu & Peng, 2009 ; Peng & Liu, 2010 ; Peters & Malesky, 2008 ; Rehbein et al., 2010 ; Yee 2006a , 2006b ), increased stress (Batthyány et al., 2009 ), an absence of real-life relationships (Allison, von Wahlde, Shockley, & Gabbard, 2006 ), lower psychosocial well-being and loneliness (Lemmens, Valkenburg, & Peter, 2011 ), poorer social skills (Griffiths, 2010 ; Zamani, Kheradmand, Cheshmi, Abedi, & Hedayati, 2010 ), decreased academic achievement (Chiu, Lee, & Huang, 2004 ; Jeong & Kim, 2011 ; Rehbein et al., 2010 ; Skoric, Teo, & Neo, 2009 ), increased inattention (Batthyány et al., 2009 ; Chan & Rabinowitz, 2006 ), aggressive/oppositional behavior and hostility (Chan & Rabinowitz, 2006 ; Chiu et al., 2004 ), maladaptive coping (Batthyány et al., 2009 ; Hussain & Griffiths, 2009a , 2009b ), decreased verbal memory performance (Dworak et al., 2007 ), maladaptive cognitions (Peng & Liu, 2010 ), and suicidal ideation (Rehbein et al., 2010 ).

In addition to the reported negative psychosocial consequences, there are also many reported health and medical consequences that may result from excessive video game playing. These include epileptic seizures (Chuang, 2006 ; Graf, Chatrian, Glass, & Knauss, 1994 ; Harding & Jeavons, 1994 ; Maeda et al., 1990 ; Millett, Fish, & Thompson, 1997 ; Quirk et al., 1995 ); auditory hallucinations (Ortiz de Gortari & Griffiths, 2014a ; Spence, 1993 ); visual hallucinations (Ortiz de Gortari & Griffiths, 2014b ); enuresis (Schink, 1991 ); encopresis (Corkery, 1990 ); obesity (Deheger, Rolland-Cachera, & Fontvielle, 1997 ; Johnson & Hackett, 1997 ; Shimai, Yamada, Masuda, & Tada, 1993 ; Vandewater, Shim, & Caplovitz, 2004 ); wrist pain (McCowan, 1981 ); neck pain (Miller, 1991 ); elbow pain (Miller, 1991 ); tenosynovitis—also called “nintendinitis” (Brasington, 1990 ; Casanova & Casanova, 1991 ; Reinstein, 1983 ; Siegal, 1991 ); blisters, calluses, sore tendons, and numbness of fingers (Loftus & Loftus, 1983 ); hand-arm vibration syndrome (Cleary, McKendrick, & Sills, 2002 ); sleep abnormalities (Allison et al., 2006 ; Dworak et al., 2007 ); psychosomatic challenges (Batthyány et al., 2009 ); and repetitive strain injuries (Mirman & Bonian, 1992 ).

Taken together, this relatively long list of potential psychosocial and medical negative consequences indicates that excessive gaming is an issue irrespective of whether it is an addiction. It also suggests that more extensive recognition is needed of the wide range of potential negative and life-limiting consequences of excessive video play.

Factors Associated with Problematic Video Game Use and Video Game Addiction

A number of studies have examined the role of different personality factors, comorbidity factors, and biological factors and their association with gaming addiction. In relation to personality traits, gaming addiction has been shown to have association with neuroticism (Mehroof & Griffiths, 2010 ; Peters & Malesky, 2008 ), aggression and hostility (Caplan, Williams, & Yee, 2009 ; Chiu et al., 2004 ; Kim, Namkoong, Ku, & Kim, 2008 ; Mehroof & Griffiths, 2010 ), avoidant and schizoid interpersonal tendencies (Allison et al., 2006 ), loneliness and introversion (Caplan et al., 2009 ), social inhibition (Porter, Starcevic, Berle, & Fenech, 2010 ), boredom inclination (Chiu et al., 2004 ), sensation-seeking (Chiu et al., 2004 ; Mehroof & Griffiths, 2010 ), diminished agreeableness (Peters & Malesky, 2008 ), diminished self-control and narcissistic personality traits (Kim et al., 2008 ), low self-esteem (Ko, Yen, Chen, Chen, & Yen, 2005 ), state and trait anxiety (Mehroof & Griffiths, 2010 ), and low emotional intelligence (Parker et al., 2008 ). It is hard to assess the etiological significance of these associations with gaming addiction as they may not be unique to the disorder. Further research is therefore needed.

Research has also shown gaming addiction to be associated with a variety of comorbid disorders. This includes attention deficit hyperactivity disorder (Allison et al., 2006 ; Batthyány et al., 2009 ; Chan & Rabinowitz, 2006 ; Han et al., 2009 ) and symptoms of generalized anxiety disorder, panic disorder, depression, social phobia (Allison et al., 2006 ), school phobia (Batthyány et al., 2009 ), and various psychosomatic symptoms (Batthyány et al., 2009 ).

Through use of fMRI, biological research has shown that gaming addicts show similar neural processes and increased activity in brain areas associated with substance-related addictions and other behavioral addictions, such as pathological gambling (significant activation in the left occipital lobe, parahippocampal gyrus, dorsolateral prefrontal cortex, nucleus accumbens, right orbitofrontal cortex, bilateral anterior cingulate, medial frontal cortex, and the caudate nucleus (Han et al., 2010 ; Hoeft et al., 2008 ; Ko et al., 2009 ). It has also been reported that gaming addicts (like substance addicts) have a higher prevalence of two specific polymorphisms of the dopaminergic system (i.e., Taq1A1 allele of the dopamine D 2 receptor and the Val158Met in the catecholamine-o-methyltransferase receptor) (Han et al., 2007 ).

Internet Gaming Disorder and the DSM-5

Prior to the publication of the DSM-5 (American Psychiatric Association, 2013 ), there had been some debate as to whether “Internet addiction” should be introduced into the text as a separate disorder (Block, 2008 ; Petry & O’Brien, 2013 ). Alongside this, there was debate as to whether those researching the online addiction field should be researching generalized Internet use and/or the potentially addictive activities that can be engaged on the Internet (e.g., gambling, video gaming, sex, shopping, etc.) (Griffiths, 2000 ; Griffiths, King, & Demetrovics, 2014 ). Following these debates, the Substance Use Disorder Work Group (SUDWG) recommended that the DSM-5 include a subtype of problematic Internet use (i.e., Internet gaming disorder [IGD]) in Section 3 (“Emerging Measures and Models”) as an area that needed future research before being included in future editions of the DSM (Petry & O’Brien, 2013 ). According to Petry and O’Brien ( 2013 ), IGD will not be included as a separate mental disorder until the (1) defining features of IGD have been identified, (2) reliability and validity of specific IGD criteria have been obtained cross-culturally, (3) prevalence rates have been determined in representative epidemiological samples across the world, and (4) etiology and associated biological features have been evaluated.

One of the key reasons that IGD was not included in the main text of the DSM-5 was that the SUDWG concluded that no standard diagnostic criteria were used to assess gaming addiction across these many studies (Griffiths et al., 2014 ). A review of instruments assessing problematic, pathological, and/or addictive gaming by King and colleagues ( 2013 ) reported that 18 different screening instruments had been developed and that these had been used in 63 quantitative studies comprising 58,415 participants. This comprehensive review identified both strengths and weaknesses of these instruments. The main strengths of the instrumentation included (1) the brevity and ease of scoring; (2) excellent psychometric properties, such as convergent validity and internal consistency; and (3) robust data that will aid the development of standardized norms for adolescent populations. However, the main weaknesses identified in the instrumentation included (1) core addiction indicators being inconsistent across studies, (2) a general lack of any temporal dimension, (3) inconsistent cutoff scores relating to clinical status, (4) poor and/or inadequate interrater reliability and predictive validity; and (5) inconsistency and/or dimensionality. It has also been noted by a number of authors that the criteria for IGD assessment tools are theoretically based on a variety of different potentially problematic activities including substance use disorders, pathological gambling, and/or other behavioral addiction criteria (King et al., 2013 ; Petry & O’Brien, 2013 ). There are also issues surrounding the settings in which diagnostic screens are used, as those used in clinical practice settings may require a different emphasis than those used in epidemiological, experimental, and neurobiological research settings (King et al., 2013 ; Koronczai et al., 2011 ).

A recent review by Pápay and colleagues ( 2014 ) argued that some researchers consider video games as the starting point for examining the characteristics of IGD, while others consider the Internet as the main platform that unites different addictive Internet activities, including online games. Recent studies (Demetrovics et al., 2012 ; Kim & Kim, 2010 ) have made an effort to integrate both approaches. Consequently, IGD can either be viewed as a specific type of video game addiction, as a variant of Internet addiction, or as an independent diagnosis (Griffiths et al., 2014 ).

Griffiths ( 2005 ) has argued that although all addictions have particular and idiosyncratic characteristics, they share more commonalities than differences (i.e., salience, mood modification, tolerance, withdrawal symptoms, conflict, and relapse) and likely reflect a common etiology of addictive behavior. Consequently, online game addiction is viewed as a specific type of video game addiction. Similarly, Porter and colleagues ( 2010 ) do not differentiate between problematic video game use and problematic online game use. They conceptualized problematic video game use as excessive use of one or more video games resulting in a preoccupation with and a loss of control over playing video games and their various negative psychosocial and/or physical consequences. However, unlike Griffiths ( 2005 ), their criteria for problematic video game use does not include other features usually associated with dependence or addiction (e.g., tolerance, physical symptoms of withdrawal) as they say there is no clear evidence that problematic gaming is associated with such phenomena. Researchers such as Young ( 1998b ) view online gaming addiction as a subtype of Internet addiction, as they believe the Internet itself provides situation-specific characteristics that facilitate gaming becoming problematic and/or addictive.

Kim and Kim’s ( 2010 ) Problematic Online Game Use (POGU) model takes a more integrative approach and claims that neither of the approaches just outlined adequately capture the unique features of online games such as MMORPGs. They argue that the Internet is just one channel where people may access the content they want (e.g., gambling, shopping, sex, etc.) and that such users may become addicted to the particular content rather than to the channel itself. This is analogous to the argument by Griffiths ( 2000 ) that there is a fundamental difference between addiction to the Internet and addictions on the Internet. MMORPGs also differ from single-player video games as there are social and/or role-playing dimensions that allow interaction with other gamers.

The POGU model resulted in five underlying dimensions of addictive gameplay (i.e., euphoria, health problems, conflict, failure of self-control, and preference of virtual relationships). Demetrovics and colleagues ( 2012 ) also support the integrative approach and stress the need to include all types of online games in addiction models in order to make comparisons between genres and gamer populations possible (such as those who play online real-time strategy (RTS) games and online first-person shooter (FPS) games in addition to the widely researched MMORPG players). Their model comprises six dimensions (i.e., preoccupation, overuse, immersion, social isolation, interpersonal conflicts, and withdrawal).

Irrespective of approach or model, the components and dimensions that comprise online gaming addiction just outlined are very similar to the IGD criteria in Section 3 of the DSM-5. For instance, Griffiths’s ( 2005 ) six addiction components directly map onto the nine proposed criteria for IGD (of which five or more need to be endorsed and result in clinically significant impairment). More specifically: (1) preoccupation with Internet games (salience); (2) withdrawal symptoms when Internet gaming is taken away (withdrawal); (3) the need to spend increasing amounts of time engaged in Internet gaming (tolerance), (4) unsuccessful attempts to control participation in Internet gaming (relapse/loss of control); (5) loss of interest in hobbies and entertainment as a result of, and with the exception of, Internet gaming (conflict); (6) continued excessive use of Internet games despite knowledge of psychosocial problems (conflict); (7) deception of family members, therapists, or others regarding the amount of Internet gaming (conflict); (8) use of the Internet gaming to escape or relieve a negative mood (mood modification); and (9) loss of a significant relationship, job, or educational or career opportunity because of participation in Internet games (conflict).

Treatment of Gaming Addiction

Clinical interventions and treatment for problematic and/or addictive gaming vary considerably in the literature, with most of the very few published studies employing some type of CBT, pharmacotherapy, and/or self-devised psychological interventions (Griffiths & Meredith, 2009 ; Han et al., 2009 , 2010 ; King, Delfabbro, & Griffiths, 2010 , 2012 ). Han et al. ( 2010 ) presented some successful case studies regarding pharmacotherapeutic treatment. After a 6-week (Han et al., 2010 ) and a 12-week (Han & Renshaw, 2012 ) period of bupropion sustained-release treatment, problematic gamers showed significant improvement, evident in both decreased problem behavior and decreased depression scores. The researchers’ pharmacological choice had been driven by the similarities in neurological activity of different behavioral addictions (Han et al., 2010 ; Ko et al., 2009 ; Kuss & Griffiths, 2012 ).

Currently, the evidence base on the treatment of problematic and/or addictive gaming is limited. Furthermore, the lack of consistent approaches to treating problematic video game playing and video game addiction makes it difficult to produce any definitive conclusions as to the efficacy of treatment, although at this stage CBT (as with the treatment efficacy of other addictions) appears to show good preliminary support (King et al., 2012 ). There remains a need for controlled, comparative studies of psychological and pharmacological treatments, administered individually and in combination with each other, to determine the optimal treatment approach.

The lack of comparative treatment studies might suggest that there is a general lack of demand for psychological services for problematic video game play and/or video game addiction (King et al., 2010 ). However, this may not necessarily be the case. For instance, Woog ( 2004 ) surveyed a random sample of 5,000 US mental health professionals. Although only 229 participants completed the questionnaire, two-thirds had treated someone with excessive computer use problems in the year prior to the survey. Woog also reported that problematic gaming was most common among 11- to 17-year-old clients. However, this may not be truly representative as this age group may be more likely to present in therapy. Anecdotal evidence suggests that 11- to 17-year-old clients are typically forced by concerned parents to attend treatment. Adult gaming addicts may not seek treatment or may seek treatment at a later stage for other psychological problems (e.g., depression) that develop after experiencing the severe negative consequences of gaming.

In South East Asia there appears to be significant demand for treatment for online-related problems, including gaming addiction. The South Korean government has reportedly established a network of more than 140 counseling centers for treatment of online addiction (Kim, 2008 ). In Western countries, gaming addiction clinics have also started to emerge in places such as Holland and the United Kingdom (Griffiths & Meredith, 2009 ; King, Delfabbro, Griffiths, & Gradisar, 2011 ). There are also treatment groups that are modeled on 12-step self-help treatment (e.g., Online Gamers Anonymous) (Griffiths & Meredith, 2009 ). However, little detail is known about the treatment protocols or their efficacy.

Based on the published empirical studies, and particularly those published over the past decade, it appears that, in extreme cases, excessive gaming can have potentially damaging effects on individuals who appear to display compulsive and/or addictive behavior similar to other more traditional addictions. However, the field has been hindered by the use of inconsistent and nonstandardized criteria to assess and identify problematic and/or addictive video game use. Furthermore, most studies’ recruitment methods have serious sampling biases, with an overreliance on self-selected samples.

Despite these shortcomings, there are several noticeable trends that can be drawn from this review of problematic video game play and gaming addiction.

There has been a significant increase in empirical research decade by decade since the early 1980s.

There has been a noticeable (and arguably strategic) shift in researching the mode of video game play. In the 1980s, research mainly concerned “pay-to-play” arcade video games. In the 1990s, research mainly concerned stand-alone (offline) video games played at home on consoles, PCs or handheld devices. In the 2000s, research mainly concerned online massively multiplayer video games.

There has been a noticeable shift in how data are collected. Up until the early 2000s, data about video game behavior were typically collected face to face, whereas contemporary studies collect data online, strategically targeting online forums where gamers are known to (virtually) congregate. These samples are typically self-selecting and (by default) unrepresentative of the general population. Therefore, generalization is almost always one of the methodological shortcomings of this data collection approach.

Survey study sample sizes have generally increased. In the 1980s and 1990s, sample sizes were typically in the low hundreds. In the 2000s, sample sizes in the thousands—even if unrepresentative—are not uncommon.

There has been a diversification in the way data are collected, including experiments, physiological investigations, secondary analysis of existing data (such as data collected from online forums), and behavioral tracking studies.

There has been increased research on adult (i.e., non-child and non-adolescent) samples, reflecting the fact that the demographics of gaming have changed.

There has been increasing sophistication in relation to issues concerning assessment and measurement of problematic video game play and video game addiction. In the past few years, instruments have been developed that have more robust psychometric properties in terms of reliability and validity. However, there are still some concerns as many of the most widely used screening instruments were adapted from adult screens and much of the video game literature has examined children and adolescents. King et al. ( 2012 ) assert that to enable future advances in the development and testing of interventions for video game–related problems, there must be some consensus among clinicians and researchers as to the precise classification of these problems.

The fact that IGD was included in Section 3 of the DSM-5 appears to have been well received by researchers and clinicians in the gaming addiction field (and by those individuals who have sought treatment for such disorders and had their experiences psychiatrically validated). However, for IGD to be included in the section on “Substance-Related and Addictive Disorders” along with “Gambling Disorder,” the gaming addiction field must unite and start using the same assessment measures so that comparisons can be made across different demographic groups and different cultures. For epidemiological purposes, Koronczai and colleagues ( 2011 ) assert that the most appropriate measures in assessing problematic online use (including Internet gaming) should meet six requirements. Such an instrument should have (1) brevity (to make surveys as short as possible and help overcome question fatigue), (2) comprehensiveness (to examine all core aspects of problematic gaming as possible), (3) reliability and validity across age groups (e.g., adolescents vs. adults), (4) reliability and validity across data collection methods (e.g., online, face-to-face interview, paper-and-pencil), (5) cross-cultural reliability and validity, and (6) clinical validation. It was also noted that an ideal assessment instrument should serve as the basis for defining adequate cutoff scores in terms of both specificity and sensitivity.

Clearly, there exist a number of gaps in our current understanding of problematic video game play and gaming addiction. King, Delfabbro, and Griffiths ( 2013 ) note a need for epidemiological research to determine the incidence and prevalence of clinically significant problems associated with video game play in the broader population. There are too few clinical studies that describe the unique features and symptoms of problematic video game play and/or video game addiction. Most of the studies tend to examine problematic video play from the perspective of the individual. However, there is a small body of research suggesting that the characteristics of the video games themselves may have a role in the acquisition, development, and maintenance of video game addiction. These studies have investigated the role of structural characteristics of video games in maintaining problem playing behavior (King et al., 2011 ; Westwood & Griffiths, 2010 ; Wood, Griffiths, Chappell, & Davies, 2004 ), but there is little empirical research that examines why some individuals may be protected from developing excessive playing habits or whether some individuals simply mature out of their problem playing behavior.

Another growing concern is the recent explosion of online and mobile gaming although, as yet, little research has been done. There are also strong links between online gaming, gambling, non-gambling fantasy games, role-playing games, board games, and card games. These may be an additional cause for concern as youth migrate from free gaming sites to online gambling sites. It should also be noted that video game playing does not occur in a vacuum, but is one behavior engaged in alongside many others. To date, very few studies have been used to examine links between video games and other risk behaviors (e.g., gambling, drug and alcohol use, seatbelt use, poor school performance, conduct problems, truancy, delinquency, violence and sexual activity).

Acknowledgments

Some of the material in this chapter was previously published in the following previous works:

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15.9 Cause-and-Effect Essay

Learning objective.

• Read an example of the cause-and-effect rhetorical mode.

Effects of Video Game Addiction

Video game addition is a serious problem in many parts of the world today and deserves more attention. It is no secret that children and adults in many countries throughout the world, including Japan, China, and the United States, play video games every day. Most players are able to limit their usage in ways that do not interfere with their daily lives, but many others have developed an addiction to playing video games and suffer detrimental effects.

An addiction can be described in several ways, but generally speaking, addictions involve unhealthy attractions to substances or activities that ultimately disrupt the ability of a person to keep up with regular daily responsibilities. Video game addiction typically involves playing games uncontrollably for many hours at a time—some people will play only four hours at a time while others cannot stop for over twenty-four hours. Regardless of the severity of the addiction, many of the same effects will be experienced by all.

One common effect of video game addiction is isolation and withdrawal from social experiences. Video game players often hide in their homes or in Internet cafés for days at a time—only reemerging for the most pressing tasks and necessities. The effect of this isolation can lead to a breakdown of communication skills and often a loss in socialization. While it is true that many games, especially massive multiplayer online games, involve a very real form of e-based communication and coordination with others, and these virtual interactions often result in real communities that can be healthy for the players, these communities and forms of communication rarely translate to the types of valuable social interaction that humans need to maintain typical social functioning. As a result, the social networking in these online games often gives the users the impression that they are interacting socially, while their true social lives and personal relations may suffer.

Another unfortunate product of the isolation that often accompanies video game addiction is the disruption of the user’s career. While many players manage to enjoy video games and still hold their jobs without problems, others experience challenges at their workplace. Some may only experience warnings or demerits as a result of poorer performance, or others may end up losing their jobs altogether. Playing video games for extended periods of time often involves sleep deprivation, and this tends to carry over to the workplace, reducing production and causing habitual tardiness.

Video game addiction may result in a decline in overall health and hygiene. Players who interact with video games for such significant amounts of time can go an entire day without eating and even longer without basic hygiene tasks, such as using the restroom or bathing. The effects of this behavior pose significant danger to their overall health.

The causes of video game addiction are complex and can vary greatly, but the effects have the potential to be severe. Playing video games can and should be a fun activity for all to enjoy. But just like everything else, the amount of time one spends playing video games needs to be balanced with personal and social responsibilities.

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• http://discovermagazine.com/2005/feb/earth-without-people

Writing for Success Copyright © 2015 by University of Minnesota is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License , except where otherwise noted.

Essay on Video Games Addiction

Addiction to anything happens when it starts being used excessively and when without it something seems incomplete in life. Like the additions of tea and coffee, now people are also getting additions of video games . From morning till night, they have started living in captivity of android phones or laptops. While doing some work, many people are seen playing games on their phones even during a slightest break. Such people are so lost in their world of games that they do not remember their stop in the bus and train or other important works. This situation can be very stressful if not controlled in time.

Although gaming addiction is a new word, there is no difference between it and other addictions. Just like a drug addict needs drug all the time. In the same way in video gaming addiction, one needs to play a video game all the time. If he does not get to play the game, he starts getting restless. People with gaming addiction spend most of their day playing video games. It is not just the youngsters playing big games on the computer but adults are also involved. Younger children and older people may get addicted to it.

Long and Short Essay on Video Game Addiction in English

Order custom essay Essay on Video Games Addiction with free plagiarism report

Here some long and short important essay on video game addiction in English are given into different word limits according to the need and requirement of students. These essays will provide you the specific knowledge of the affects of playing video games.

You will know about the symptoms and adverse effect of playing video games continuously. It is also discussed in the essay on video game addiction that how people get attracted towards them and spent their valuable time on it and get addicted.

You can use the essay on video game addiction in your school assignments on video games or in discussions on the subject with your classmates and teachers. You will also get aware about the facts that how video games leave their good and bad impact on its users.

Essay on Video Game Addiction – 1 (200 Words)

Video game addiction is also known by the term gaming disorder. It is known as an irresistible use of video games that promotes significant imbalance in the various life realms over a long period of time.  Too much indulgence into anything or work leads to addiction. Addiction can ruin the life of any human being, because in this man becomes crazy about the things he is addicted to.

Any kind of addiction causes loss of health, money, relationship and respect for human beings. World Health Organization has described video gaming addiction as a mental disorder.

The common children will enjoy this most, but the truth is that gaming could lead to a level where one can feel lonely and becomes an introvert personality. Instead of playing outside the children have preferred playing games on their electronic gadgets at home.

This makes them physically unfit and it can also cause problems in the eyes. Children who play games tend to talk less to the people around them and in this way they get lonely because they spend most of their time at home with their gadgets.

Children become flabby with this habit and this also causes problems in their careers in future. Many researchers have also revealed that men are more addicted to gaming than women.

Essay on Video Game Addiction – 2 (300 Words)

Excess of anything is harmful. Likewise, if a child plays excessive games on a portable device, such as on a TV, or on a computer, it can affect his/her life. Playing games is a great source of entertainment for children, but its addiction can become very harmful to children’s health. Children who are addicted to video games are affected both emotionally and physically. Gaming addiction not only affects their health but also their studies. In addition, children who are addicted to video games do not participate in any social things.

Children who are addicted to playing games are unable to concentrate and to take interest either in their work or studies. If children play games for a long time, this affects their education very badly. Due to the addiction of playing games, children also face problems in getting good sleep.

Apart from this, due to the addiction of the game, children remain deprive of sleep late nights and can’t sleep for the recommended hours of sleep. Inadequate sleep is harmful to their overall health.

Children who are addicted to playing games are always seen playing games all the time. They are socially separated from people and at the same time they do not want to attend any social event. Because of this their mental health is not fully developed.

Gaming addiction affects their behavior. Children become irritable due to gaming addiction and they get angry on every small issue.

If these symptoms are seen in any child then we should have to teach them to spend more time with family and friends. Set a time limit for any task and say them to follow it seriously. Do not allow children to use more mobiles, laptops and internet and keep an eye on them. Despite all the efforts, if the children are not able to distance themselves from these digital games then there should be no hesitation in seeking psychological help.

Essay on Video Game Addiction – 3 (400 Words)

According to experts, the heart of a person with gaming addiction does not fill up very easily. In this, the person is constantly excited to play games. Things like crossing new levels and making high scores make them excited to play more. He keeps playing games all the time without thinking about himself and the works. It is believed that mental satisfaction is also hidden behind it.

The personal life of many people who play more games is not very good. They are not able to achieve in the real world what they achieve in the game. So they spend much time in the artificial world of games more than the outside world. The gaming addiction has increased so much that it has been declared as ‘mental illness’.

The people, who have been addicted to play the video games, start getting restless. Their minds do not agree to do any other work. A person addicted to playing video games tries to stay away from the world. He wants to spend as much time playing games as he can.

As this intoxication of video gaming increases, the person suffering from it becomes more mentally disturbed. Sometimes they also have to face depression. Many things like sleeplessness during night, headache, red eyes, waist ache and pain in the neck happen to the person if he plays more games. Many addicted people do not even eat properly. The most important thing for them is to remain in the game. More anger is also a symptom of gaming addiction.

Gaming addition has become a big problem today, but it can be removed and for this extra ordinary strong willpower and patience are needed. There is no harm in playing video games. The video games can be played to keep boosting the mood but it should be played for a limited time. It is also very important to have ‘family time’ in order to emerge from it. Sitting and talking and playing with family are good methods to keep distance from video games. The most important of these is to give time to you. You know about yourself better so enjoy from your other hobbies. Go somewhere to roam.

Games addiction affects a person’s mental health. In this case, we must take some precautions or else this problem can be harmful to the individual’s overall health. The amount of time the addicted person gives to the game, if he gives this time for himself, his habit can improve.

Essay on Video Game Addiction – 4 (500 Words)

There are some symptoms of gaming addiction like spending most of the time playing games and its impact on studies, jobs and relationships etc. If one ignore all these things and keep engaging in the game, then within few months he get addicted to it.

More involvement in playing game increases the tension in a person’s personal life and relationships. When a person starts tolerating all the positive things due to gaming addiction in his life, then his mental health also starts to affect and it has been named addiction. Addiction not only affects one’s life but also affects the people around him.

Let us find out its positive and negative effects.

• Improves reflex and IQ

Studies have proved that playing video games improves players’ reflection in many aspects. Studies have also proved that people who are regular gamers have improved brain activity.

• Better functioning

Functioning refers to the ability to allocate mental capacity to individuals. Video games have improved attention and decision making skills. Studies have proved that people who play video games are good at making better decisions. Often gamers are good at multi-tasking.

• Brain health

Video games increase the speed and capacity of the brain to work. Playing video games improves children’s mental fitness.

• Aggressive thoughts and behavior

Studies by The American Psychological Association have proved that children exposed to violent sports become more aggressive in thoughts and feelings. This resulted in several incidents.

• Socially isolated

Lots of gaming players can overcome from social responsibilities and increase the chances of social isolation. In addition, in the case of children it may increase the lack of interest in engaging in household chores, outdoor games and social activities. It is dangerous to be alone even in a virtual world.

• Adverse health issues

There are adverse health issues after addiction of video games. Risk of heart attack, obesity, and depression etc. are observed in some of them. There are health risks for children, such as video-induced seizures, muscle and skeletal disorders, etc.

• Parental concerns

The amount of violence in video games is an important concern for parents. To help deal with this problem it is important to monitor the child. If a child plays a violent video game then the difference between the game and reality should be discussed.

• Common problems

Children often become very involved in video games and do not want to stop playing them. It is necessary to set solid boundaries about the time that can be spent playing the game and then apply these limits.

It is very important to avoid this kind of addiction; otherwise it can affect the personal life of an individual. Continually ignoring work or relationships is not beneficial in any way. Hence children can also be encouraged to play games with other children, as discussing strategies and problem solving in groups is a positive social activity. Even educational games should not be played much, as playing video games is not a substitute for positive social interaction or traditional education.

Essay on Video Game Addiction – 5 (600 Words)

According to a study, Internet gaming disorder is quite common in adolescent children between 12 and 20 years. Even Internet gaming disorder cases are more prevalent in Asian countries than in North America and Europe.

Although the American Psychological Association is studying the growing cases of Internet gaming addiction, so far it has not been included in the list of diseases. But given the speed with which Internet gaming addiction cases are increasing worldwide, experts fear that it will get the status of a disease soon.

Exciting online games found on the Internet are now dominating the hearts and minds of children. Every second changing world and the thrill increasing moment by moment combination of music with colorful themes on the small screen of a computer or mobile, there is a virtual world, which allows the elders to fascinate. Then small children are bound to be attracted to them.

It is easy to get caught in the Internet gaming addiction but it is very difficult to get out of it. According to experts, the addiction of playing games on the Internet not only makes children physically and mentally ill, but it is a big threat to the personality development of the child.

In the changing environment, children’s friends, playgrounds, parks, everything is confined to one application of the Internet. More attention is paid to indoor games than outdoor games. That leads to obesity and many other disorders. The prohibition from outdoor games is making children physically weak and there is a problem of socialization among them.

• Children who play Internet games for more time are reduced in the ability to focus and concentrate on their studies.
• The inclination of such children is mostly on negative models.
• Patience starts decreasing in children.
• Children want to accumulate power near their surrounding events.
• Self control is lost.
• Sometimes children become violent.
• Children start away from social life and prefer to live alone.
• The impact of Internet gaming has been seen on both the child’s behavior and thoughts.
• Children fall prey to obesity and diabetes in a tender age.

It is not that every child playing online games is a victim of gaming addiction. But according to experts, when the hobby of playing the game turns into a habit, for this, the parents have to keep an eye on the child’s activities.

• Parents should decide which gadget / game or device to give to the child and at what age.
• Do not show songs or poem on mobile to keep the little ones busy.
• Let the children use the Internet only for the necessary work related to studies.
• If the child plays games on the Internet, then decide to play outdoor games with him/her.
• Do not let internet games to be played for more than half an hour every day.
• Promote outdoor games.
• If the child has started giving more time to internet games, then encourage him/her for some other productive activity.
• Keep an eye on what games a child plays on the Internet.

According to psychologist Dr. Pooja Shivam Jaitley, once a child becomes addicted to internet gaming, then it becomes difficult for the child to live without internet. Children insist on the Internet. Many times children become aggressive after parents refusal.

If your child has symptoms of video game addiction, see a psychiatrist without delay. Take care of the child mentally and emotionally. But for the safe future of the child, let the growing children use the Internet as much as is necessary. It should not happen that the addiction of internet gaming makes your child sick socially, physically and mentally.

Sports vs Video Games

To reduce the growing population of obese children in the world the parents need to encourage sports and outside play over video games. Kids in the world today know little about sports and the rules. But spend more time playing video games than outside being active. What happened to neighborhood hide and seek, or pick-up basketball games with other neighborhood kids. Today children are more interested in video games, computers and television, and parents are afraid of letting their children run around the streets because of kidnappings.

When I was a kid I had video games but I spent most of my time outside playing. Being outside with the fresh air and the sunshine was the best thing for me. This year today there are a lot of kids who don’t know how to play sports or are too obese to play sports. Take basketball for instants I personally think it’s one of the easiest sports besides football. The rules are simple in basketball, dribble the ball one hand at a time, and don’t carry the ball. Also in basketball, it’s up to you and your team to score as many points as you can.

But in the game of basketball like any other sport you have to work as a team. One of the major benefits you get from playing sports is understanding how to work really good with other people. In my mind TEAM means Together Everyone Achieves More, which means if you try to do everything by yourself you won’t get very far. Video games don’t teach you how to work with others. Also most of the video games today prompt violence and use profanity. (Gump, 3) The majority of kids are no longer interested in physical activity.

There are a certain percentage of kids today that are addicted to video games. I believe that at a youth age kids shouldn’t be addicted to anything. Video games in today’s society have a negative influence on kids because it separates them from reality. Besides working together basketball also benefits you in other ways like it will keep you healthy and moving like other kids. I played basketball for 7 years. I maintained a bodyweight of 145 lbs. With my body being and looking the way it did, it made me feel extremely good and confident.

There is so much that comes with playing basketball the constant practicing and working out in the weight room. All the extra running and lifting weights that you have to do keeps the body healthy and muscular. Aerobic exercise strengthens the heart and lungs. Not only does exercise help the internal organs but it also increases strength and stamina. Sports do not only help you physically but mentally as well. There is no match to the happiness that sports bring. Playing sports is energy put to good use.

Sports are a form of exercise which generates happiness in your body, thus restoring your mental health. Video games don’t help lose weight it helps gain weight. Also, video games can mess up a kid mentally instead of making you happy it makes you violent or sad. Sports improve you physical and psychological health; physical because sports involve exercise and psychological because playing is something you enjoy, it’s something that relaxes your mind. The lack of encouragement from parents when it comes to sports needs to be cut down. As many parents, there are in this world that has played sports.

There should be twice as many kids playing these sports. I believe if parents get more involved in their child’s physical life there will be less obese children. What these kids need most is love and supporting parents teaching them the benefits of sports and a healthy life. So by parents being active with their children, this would also cut down on the violence in the world today.

• http://www.tribtoday.com/page/content.detail/id/565582/BOYS--VIDEO-GAMES-VS--STUDYING.html? nav=5059-By LAUREN GUMP - Warren G. Harding High School

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15.9 Cause-and-Effect Essay

Learning objective.

• Read an example of the cause-and-effect rhetorical mode.

Effects of Video Game Addiction

Video game addition is a serious problem in many parts of the world today and deserves more attention. It is no secret that children and adults in many countries throughout the world, including Japan, China, and the United States, play video games every day. Most players are able to limit their usage in ways that do not interfere with their daily lives, but many others have developed an addiction to playing video games and suffer detrimental effects.

An addiction can be described in several ways, but generally speaking, addictions involve unhealthy attractions to substances or activities that ultimately disrupt the ability of a person to keep up with regular daily responsibilities. Video game addiction typically involves playing games uncontrollably for many hours at a time—some people will play only four hours at a time while others cannot stop for over twenty-four hours. Regardless of the severity of the addiction, many of the same effects will be experienced by all.

One common effect of video game addiction is isolation and withdrawal from social experiences. Video game players often hide in their homes or in Internet cafés for days at a time—only reemerging for the most pressing tasks and necessities. The effect of this isolation can lead to a breakdown of communication skills and often a loss in socialization. While it is true that many games, especially massive multiplayer online games, involve a very real form of e-based communication and coordination with others, and these virtual interactions often result in real communities that can be healthy for the players, these communities and forms of communication rarely translate to the types of valuable social interaction that humans need to maintain typical social functioning. As a result, the social networking in these online games often gives the users the impression that they are interacting socially, while their true social lives and personal relations may suffer.

Another unfortunate product of the isolation that often accompanies video game addiction is the disruption of the user’s career. While many players manage to enjoy video games and still hold their jobs without problems, others experience challenges at their workplace. Some may only experience warnings or demerits as a result of poorer performance, or others may end up losing their jobs altogether. Playing video games for extended periods of time often involves sleep deprivation, and this tends to carry over to the workplace, reducing production and causing habitual tardiness.

Video game addiction may result in a decline in overall health and hygiene. Players who interact with video games for such significant amounts of time can go an entire day without eating and even longer without basic hygiene tasks, such as using the restroom or bathing. The effects of this behavior pose significant danger to their overall health.

The causes of video game addiction are complex and can vary greatly, but the effects have the potential to be severe. Playing video games can and should be a fun activity for all to enjoy. But just like everything else, the amount of time one spends playing video games needs to be balanced with personal and social responsibilities.

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• http://scremeens.googlepages.com/TheBlackTableessay.rtf

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All About Gaming Disorder

Playing video games can be an immersive hobby. But if gaming interferes negatively with your life, you may have internet gaming disorder.

As a gamer, it’s easy to find yourself spending hours playing one of your favorite video games, from World of Warcraft and Fortnite to Candy Crush. But there’s a difference between gaming as a fun, enriching hobby and excessive gaming that negatively impacts your life.

The latter is known as internet gaming disorder (IGD). Knowing the symptoms of this compulsive behavior can ensure that your hobby is healthy and not potentially problematic.

Is video game addiction real?

Gaming disorder is a mental health condition that involves compulsive playing of video games that significantly interferes with your ability to function in important areas — like school, work, or personal life — over an extended period.

The World Health Organization (WHO) recognized internet gaming disorder as a diagnosable mental health condition in its International Classification of Diseases, 11th Revision (ICD-11) in 2018.

Internet gaming disorder is also the only behavioral addiction, or “excessive behavioral pattern,” listed under section III of the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) . IGD is considered a non-substance-related addiction disorder and a subtype of internet addiction disorder.

The DSM-5 does not classify IGD as a formal diagnosis, though, due to the current lack of evidence to support it as a unique condition.

There isn’t a consensus among clinicians and researchers around gaming disorder or the DSM-5’s diagnostic criteria. There’s an ongoing debate over what the line separating highly-engaged gaming and problematic gaming should be and whether IGD pathologizes normal teen behavior.

Some academic commentary calls the criteria laid out by the DSM-5 both constraining and lacking clarity.

But this doesn’t make it any less valid for those who live with obsessive and overwhelming compulsions to play video games.

In fact, it can feel just as real as any other addiction, says psychotherapist Hanly Banks Callahan, LPC, MA of The Zilker Center , a teen mental health center that primarily focuses on gaming disorders. “It can prevent people from doing daily tasks, hold jobs, relationships, and really consume them.”

Gaming disorder symptoms: WHO and DSM-5

In the WHO’s ICD-11 and the American Psychiatric Association’s DSM-5, internet gaming disorder is characterized by the following behaviors, lasting 12 months or longer:

• lack of control over time spent gaming
• prioritizing gaming over other interests, important tasks, and daily responsibilities
• continued or escalated gaming despite negative consequences
• significantly impaired functioning in personal, family, social, work or school life
• denying or concealing gaming habits or amount of time spent playing
• using video games to escape negative emotions

If the above symptoms are severe, the ICD-11 says a diagnosis can be made sooner than 12 months. The ICD-11 also notes that gaming behavior can be online or offline — one of the points some clinicians and academics call confusing.

According to Olivia Grace, a clinical psychologist who specializes in therapy for video game addiction at The Mindful Gamer , other symptoms of internet gaming disorder include:

• obsessive thinking about video or internet games
• loss of interest in other hobbies or activities
• poor work performance and strained relationships
• poor concentration or motivation
• lack of social engagement outside of gaming communities
• symptoms of anxiety or depression
• decline in physical health and hygiene
• digital eye strain or repetitive strain injuries

Grace adds that someone with IGD may not exhibit all of these symptoms, and they may vary in intensity for different people. But “if compulsive gaming is having a significant negative impact on their life, then it may be time to take action.”

Connection to mental health and other effects

A 2012 literature review found evidence that excessive gaming is associated with various mental health conditions, including:

• attention deficit hyperactivity disorder (ADHD)
• obsessive-compulsive disorder (OCD)

It’s unclear whether gaming disorder causes these mental health conditions or vice versa.

Some people may use video games as a coping method to help them deal with the symptoms of a primary diagnosis, like anxiety or depression. In these cases, effective treatment for the primary mental health conditions may improve any issues that arise around gaming.

The 2012 review also looked at neuroimaging studies on IGD and found excessive gaming increased brain activity in regions typically associated with addiction. It also concludes that IGD might cause neuroadaptation, meaning brain structure and function changes.

A 2017 study indicated that transgender people who engage in problematic gaming are typically younger, with depression and interpersonal problems.

Poor mental health is also commonly associated with gamers who meet the criteria of IGD compared to gamers who don’t meet the compulsion threshold, according to a 2021 study . But as with related mental health conditions, it’s not clear if there’s a cause and effect.

Potential causes

Several factors can cause gaming to go from hobby to compulsion — or internet gaming disorder:

Dopamine desensitization

It’s not so much the games that are addictive but the act of playing (and its effect on our brains). This is because video games are extremely stimulating and cause high levels of dopamine to release when playing.

Grace explains that this increased dopamine feels good to the gamer in the moment but can lead to their brain receptors becoming desensitized after time. “So they must play more for longer hours to feel the same level of satisfaction they once used to.”

Gamers often play to escape stress or distract themselves from other tough emotions or real-life problems. “Gaming has the unique ability to immerse an individual and distract them from these sensations from the comfort of their own home,” says Grace.

“When [people with compulsions] can’t deal with their negative emotions, they get overwhelmed and resort to playing video games again, and the cycle continues,” she says, noting that this escapism can exacerbate existing issues.

Escapism is seen in both highly-engaged and problematic gaming and isn’t necessarily a harmful coping strategy. A 2016 study found that escapism can be a positive coping mechanism, providing a forum to relieve stress and build self-confidence.

Sense of belonging

Multiplayer gaming is a great way to build communities and virtually connect with like-minded people. This is especially true if you’re naturally introverted or feel anxious in offline social settings.

“As humans, our need for social interaction has to be satisfied, and video games offer this without having to meet face to face,” says Grace. “The anonymity of interacting online makes it very appealing to those who are shy or suffer from social anxiety.”

Identity factors

Gaming disorder can affect folks of all genders and ages. But neuroimaging studies outlined in a 2018 study suggest that males have a genetic predisposition to be more susceptible to compulsive gaming.

“In summary, it explains that the areas of the brain that respond to the addictive qualities of gaming, such as reward-based behaviors, show more activity in males than in females,” says Grace.

Instant gratification

“Video games create challenges that are achievable and consistent, which shortcut and distract us from important goals outside of gaming,” says Grace, noting that humans tend to feel good when finishing tasks.

She explains that gaming can be addictive because we’re instantly gratified for completing these in-game achievements. This reward system ultimately leads to reinforced behavior (e.g., more gaming).

Management and treatment

Support is available for folks with gaming disorder or an unhealthy relationship with gaming.

Working with a therapist can help you find the root cause of obsessive gaming and offer helpful coping skills to better manage compulsions that come up.

A 2018 study suggested that cognitive-behavioral therapy (CBT) can be an effective approach for reducing symptoms among people with gaming disorder.

Mindfulness

For folks with gaming disorder, Grace notes that “a large part of [treatment] is learning to healthily deal with their thoughts so that they can act in a rational way consistent with their values.”

Mindfulness meditation practices can help you cope and develop self-awareness. “The importance of this is to help the gamer to ground themselves in the presence of negative thoughts that lead to gaming or escapism,” she adds.

Gaming breaks

Banks Callahan notes that taking breaks and becoming aware of screen time use are two important keys to healing your relationship with gaming. “Parents, teachers, and teens [also] need to be aware of the mental fatigue and [compulsions] that can come with overuse of screens and gaming.”

Residential programs

Detoxification programs are another long-term recovery option for those whose condition is more severe, where taking breaks may not be an easy task.

“This is a great option if it’s beyond the point of self-control,” says Banks Callahan. “A residential program would benefit in helping to find new outlets, healthier hobbies, and inclusive therapy.”

Internet gaming disorder is a mental health condition recognized in the ICD-11 and the DSM-5, which calls for more research. Whether or not it’s officially labeled as an “addiction” or goes by another name like “problematic gaming,” gaming can become an unhealthy obsession and negatively impact your life.

If you feel a loss of control over how much time you spend playing video games, speak with a mental health professional about whether you have internet gaming disorder.

You don’t have to completely give up the fun and community of gaming to discover more control. Instead, pursue positive options for managing excessive gaming to make sure time spent online and in-person relationships is rewarding.

Last medically reviewed on January 5, 2022

14 sources collapsed

• American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: American Psychiatric Association.
• Arcelus J, et al. (2017). Video gaming and gaming addiction in transgender people: An exploratory study. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5572994/
• Banks Callahan H. (2021). Personal interview.
• Blasi, et al. (2019). Problematic video game use as an emotional coping strategy: Evidence from a sample of MMORPG gamers. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7044601/#B8
• Bowditch L, et al. (2018). Do coping strategies moderate the relationship between escapism and negative gaming outcomes in World of Warcraft (MMORPG) players?  https://www.sciencedirect.com/science/article/abs/pii/S0747563218301948
• Dong G, et al. (2018). Gender-related differences in neural responses to gaming cues before and after gaming: implications for gender-specific vulnerabilities to Internet gaming disorder. https://academic.oup.com/scan/article/13/11/1203/5110390
• Grace O. (2021). Personal interview.
• Kristensen J, et al. (2021). Problematic gaming and sleep: A systematic review and meta-Analysis. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8216490/
• Kuss DJ, et al. (2012). Internet and gaming addiction: A systematic literature review of neuroimaging studies.  https://www.mdpi.com/2076-3425/2/3/347/htm
• Kuss DJ, et al. (2017). Chaos and confusion in DSM-5 diagnosis of Internet Gaming Disorder: Issues, concerns, and recommendations for clarity in the field. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5520132/
• Kuo A, et al. (2016). Brave new World of Warcraft: A conceptual framework for active escapism. https://www.emerald.com/insight/content/doi/10.1108/JCM-04-2016-1775/full/html
• Starcevic, V. (2017). Internet gaming disorder: Inadequatediagnostic criteria wrapped in a constraining conceptual model https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5520112/
• Stevens M, et al. (2019). Cognitive-behavioral therapy for Internet gaming disorder: A systematic review and meta-analysis. https://pubmed.ncbi.nlm.nih.gov/30341981/
• Zastrow M. (2017). News Feature: Is video game addiction really an addiction? https://www.pnas.org/content/114/17/4268

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Addiction to Online Gaming: A Review of Literature Essay

• To find inspiration for your paper and overcome writer’s block
• As a source of information (ensure proper referencing)
• As a template for you assignment

Introduction

The problem of interest, the qualitative research method to be used, the review of literature.

The rapid development of technologies has led not only to numerous breakthroughs in various spheres of people’s lives but also to significant issues related to the inability of some individuals to limit their time spent on gadget use. Whereas the Internet has presented ample opportunity for communication and research, it has also become the reason why too many users have become dependent on it. The selected topic of research is the addiction to online gaming among adults. This specific kind of addiction does not produce such a devastating effect on one’s health as the excessive consumption of alcohol or drugs. However, online gaming addiction poses other threats, which are no less severe both for the addicts and their close ones.

Researchers have presented evidence on the severity of online gaming addiction (Marino & Spada, 2017). Still, too many people continue to neglect the issue’s potential adverse outcomes. Therefore, more research is needed to investigate the problem from different angles, which will suggest viable solutions to it. The present paper is an overview of scholarly sources on online gaming addiction and the analysis of narrative inquiry as the most suitable qualitative research method to use for the investigation of this problem.

Despite the constant development and enhancement of community resources and entertainment opportunities, the number of individuals addicted to online gaming is growing annually. What previously used to be viewed merely as a leisure activity has now come to be considered as a serious threat due to its potential to provoke addiction in users. Online gaming is related to social and psychological problems by facilitating self-regulation deficiency (Gong et al., 2019). Furthermore, the age of gamers has increased considerably, and the activity is no longer regarded as a teenage male hobby (Pietersen et al., 2018). Whereas, in the past, playing video games online, was considered as a useless pastime, at present, it has become an important part of many people’s lifeworlds. The increasing popularity of online gaming is associated with the idea that video games are “richly expressive and creative,” and they grant people much more immersive experience than other media forms do (Pietersen et al., 2018, p. 123). Therefore, one of the core aims in performing current research is to enhance the understanding of people’s likelihood to become addicted to online gaming.

Another rationale for selecting the problem is the need to analyze the possible ways of mitigating a growing issue of online game addiction among the population. Typically, game addicts are male individuals who report unique experiences related to their gaming activity and a high rate of engagement as the triggers of addiction (Tang et al., 2017). However, it is evident that the problem affects not only those directly involved in it but also anyone they interact with within their personal, professional, social, and family lives. Specifically, as Tang et al. (2017) mention, addiction to online gaming can cause a range of social and family problems that present a significant public health concern.

With the increasing interest of researchers in the question of problematic use of the Internet by gamers, a new clinical definition has been suggested to characterize the issue: Internet gaming disorder (Marino & Spada, 2017). Other terms utilized to denote the problem include ‘online gaming addiction,’ ‘problematic online gaming,’ ‘pathological gaming,’ and ‘video gaming dependence’ (Marino & Spada, 2017). The prevalence of Internet gaming disorder is reported to vary from 1.6 to 8.5% among Western youths. Furthermore, the disorder is frequently accompanied by other psychological problems, such as depression, anxiety, attention deficit hyperactivity disorder, and social phobia (Marino & Spada, 2017). Thus, it is crucial to analyze the available research in order to synthesize what has already been found and single out questions for further detailed research.

The main focus of the study will be the development of online gaming addiction and individuals’ feelings about it. According to Monacis et al. (2017), excessive use of technology has become an emerging issue of concern in the past few decades. The most common symptoms of online gaming addiction are unpleasant feelings when there is no access to the Internet (emptiness and depression), excessive investment of time spent on playing online games, and the refusal to admit a problem (Monacis et al., 2017). One of the major motives for engaging in online gaming is seeking sensation (Hu et al., 2017).

Other common reasons for developing online gaming addiction are concerned with coping, escape, competition, fantasy, and social motives (Šporčić & Glavak-Tkalić, 2018). Hence, it is crucial to investigate why individuals develop an addiction to online gaming and how they feel about it at the stage when they are only starting to engage in excessive Internet use and at the point when online games begin to take up too much time and initiate psychological problems. Personal stories of online gamers will serve as a solid ground for identifying the principal problems and suggesting solutions to them.

Taking into consideration the nature of the problem under investigation, the most suitable qualitative research method to employ in the study is narrative inquiry. This method involves the process of collecting data from respondents through storytelling. The study of the narrative becomes the means of understanding the ways people perceive the world and various situations in their lives. The self-narrative construction is manifested both in the content and form of narratives (Androutsopoulou & Stefanoua, 2018). According to Lieblich et al., there are two core dimensions for interpreting and scrutinizing narratives: “holistic versus categorical” and “content versus form” (as cited in Androutsopoulou & Stefanoua, 2018, p. 130).

According to Androutsopoulou and Stefanoua (2018), the most beneficial approach to employing a narrative inquiry analysis is a holistic one. The holistic-content dimension implies that the researcher should use the whole life story of an individual, which allows focusing on emerging topics. Meanwhile, the holistic-content mode presupposes that researchers look inside the structure of a respondent’s life story (Androutsopoulou & Stefanoua, 2018). As a result, the use of narrative inquiry helps to understand people’s attitudes toward the events happening in their lives and the ways they feel about them.

The selected research method enables scholars to focus on respondents’ thoughts about their lives rather than on events happening. By using this holistic approach, an individual is able to construct a coherent story of their life with the past, present, and future (James, 2018; McAlpine, 2016). When one tells a researcher about their experiences, the latter becomes “narratives as part of inquiry” and makes the audience “vicarious” participants of these experiences (Chen, 2019, p. 382). Narrative inquiry is composed of three dimensions: temporality, sociality, and space (Kovinthan, 2016). These presuppose a transitional movement of people and places in the story, the revelation of the person’s emotions and feelings, and the possibility of the physical space of inquiry to change (Kovinthan, 2016). Overall, narrative inquiry allows for receiving valuable and reliable first-hand information about the researched issues and problems.

Benefits and Limitations of the Selected Research Design

As a research design, a narrative inquiry has a number of advantages and disadvantages that should be considered before utilizing it. The major benefit is undoubtedly the possibility to receive information from the respondent openly, honestly, and without bias. Narrative inquiry is considered to be the most suitable way of uncovering and understanding people’s complex problems (James, 2018). The next advantage of the selected research design is placing the respondent’s self in the central part of the story (Gordon et al., 2015). As a result, the narrator is able to present and construct events, identities, and realities in close synergy with others (Gordon et al., 2015). With the help of narrative research, individuals find it easier to story and re-story their lives in various problematic contexts (Sheilds et al., 2015). Another strength of the narrative inquiry is the likelihood of improving people’s well-being by allowing them to express their thoughts and apprehensions (Ho et al., 2020). When an individual receives an opportunity to express their problems out loud, the chances of coping with these issues increase.

What is more, narrating personal experience equals making sense of it (Ho et al., 2020). In the case of online gamers, the use of narrative inquiry enables researchers to understand “what it means to be a gamer” (Pietersen et al., 2018, p. 123). With this information available, scholars can understand the mechanisms of addiction better since unique personal data allows for a thorough analysis of how people develop an addiction to online gaming and how they feel about it. The next benefit of the selected research design is that it incorporates not only inward but also outward analysis. According to Law and Chan (2015), narrative inquirers consider both the participants’ and researchers’ identities, feelings, hopes, moral tendencies, the environment, conditions, and people affecting the forces and factors from respondents’ contexts. Kovinthan (2016) reports that narrative inquiry helps researchers to cross the boundary between themselves and participants. Additionally, the selected research design enables scholars to investigate the issues faced by respondents and draw out the implicit beliefs and values of researchers (Kovinthan, 2016).

One more advantage of narrative inquiry is the possibility of this approach to unite not only participants and researchers but also the readers of results obtained. As Martinie et al. (2016) note, the audience is likely to reevaluate their own experiences and views on the problem investigated in a study. According to Clandinin and Murphy, narrative inquiry gives knowledge about the experiences of people “composing lives within complex storied landscapes” (as cited in Martinie et al., 2016, p. 659). Finally, as McAlpine (2016) notes, narrative research is a beneficial research design due to creating the opportunity to value different ways of learning about people’s problems and experiences. Therefore, narrative inquiry offers numerous advantages to researchers and, consequently, to research participants.

Disadvantages

What concerns the research design’s limitations is that it must be acknowledged that personal narratives cannot be void of subjectivity without the opportunity to check the information given by respondents (Bruce et al., 2016). Another problem is that the selected research design is not suitable for investigations involving a large number of participants. As James (2018) remarks, since narrative inquiry requires an in-depth and holistic approach to each participant, this method is not appropriate for the studies covering large samples. A limitation closely related to this one is the lack of the possibility to generalize findings due to the uniqueness of each participant’s story (Sheilds et al., 2015). One more difficulty is the fact that narrative inquiry is interpreted and implemented differently by various scholars (James, 2018). Due to this aspect, some researchers argue for the need to draw a firmer line between what narrative inquiry is and what it is not (James, 2018). A disadvantage is also presented by the potentially lacking understanding and trust between participants and researchers or researchers and ethics review boards (Bruce et al., 2016).

The next limitation is concerned with the fact that identity construction that is described in the narrative constitutes only one of the features presented by identity-in-action (McAlpine, 2016). Also, according to Taylor, the narratives’ innate structure frequently leads to the problem of overlooking the “overarching sense of indeterminacy, partiality, and complexity” (as cited in McAlpine, 2016, p. 46). Hence, researchers should be cautious of the information that is left out from respondents’ stories and mind the inconsistencies in narrations. Along with this difficulty, there is a challenge of the researcher’s wrong interpretation of the data given by respondents. Finally, there is a limitation concerned with narrowing the focus of research and ignoring the broader structural problems (McAlpine, 2016). Thus, despite the variety of benefits presented by narrative inquiry, researchers utilizing this approach should be highly attentive to avoid possible mistakes in the process of collecting and analyzing data.

The Evaluation of the Selected Software Analysis Program

Electronic analysis of research data has been commonly associated with quantitative methods. However, one must admit the presence of a sufficient amount of software for qualitative data analysis. Still, despite their availability, these tools are not favored by qualitative research specialists, and the most probable reason for it is the difficulty mastering the software (Zamawe, 2015). In the present study, the software analysis program to be utilized is NVivo. This program is aimed not so much at analyzing the collected data but at aiding the process of analysis (Zamawe, 2015). NVivo is a popular data management program that has such features as multimedia functions, rich text capabilities, and character-based coding. Furthermore, the program incorporates built-in facilities enabling individuals from different geographical areas to operate the same information files simultaneously via a network.

Another benefit of NVivo is in its high level of compatibility of the program with research designs. Since NVivo is not “methodological-specific,” it can be utilized with a variety of qualitative research designs and data analysis methods, including ethnography, grounded theory, literature reviews, discourse analysis, phenomenology, conversation analysis, and mixed methods (Zamawe, 2015, p. 13). NVivo has been available since the 1980s, but only a small amount of researchers have utilized it. Zamawe (2015) notes that despite some limitations, the program is rather useful, and, hence, underestimated. For instance, an evident advantage of NVivo is “easy, effective and efficient coding,” making the retrieval process easier (Zamawe, 2015, p. 14). The program also enables scholars to gather information across sources to group the material that is related (Dollah et al., 2017). Apart from easy data management, NVivo offers such advantages as simplicity in finding topics, the opportunity to save time, and the simplification of data classification.

At the same time, it is necessary to admit some drawbacks of the system. For instance, researchers admit that NVivo may present difficulty processing audio files (Zamawe, 2015). What is more, the program requires much time to master (Dollah et al., 2017). Also, NVivo may be expensive for researchers, as well as it may present complications when attempting to interpret data (Dollah et al., 2017). Still, taking into consideration all advantages and disadvantages of NVivo and bearing in mind the purpose of the present research, it is relevant to use the selected software for the simplification of data analysis in the process of work on the research problem.

Validity Threats in the Selected Qualitative Design

As with any qualitative research design, narrative inquiry meets threats to validity. There are two major dimensions in which the selected method’s validity may be undermined. Firstly, there may arise the problem of a disparity between individuals’ experiences and the stories they tell about these experiences (Wang & Geale, 2015). Secondly, there may emerge wrong connections between the stories told and the interpretations of these stories. In case any of these two issues appear, the validity of research will inevitably suffer. To avoid these common problems, the researcher has to make sure that participants understand the purpose of the study and are aware of the need to be precise and objective about their narratives. On the other hand, the researcher also should do their best to remain impartial and help respondents to uncover their stories in a logical and untwisted way.

Validity in qualitative research is established through such qualities as confirmability, credibility, trustworthiness, and dependability. Apart from that, rigorous data collection and analysis are required, as is member checking (Byrne, 2015). There may also emerge some validity threats of narrative inquiry as a research design in connection with these issues. Confirmability is related to the establishment of trustworthiness and the level of confidence that the study is based on respondents’ narratives rather than on the researcher’s biased opinions (Abkhezr et al., 2020; Heilmann, 2018). In order to make sure that the study focuses on participants’ narratives solely, the researcher has to reflect on their choice of the topic and the attitudes toward data collection and interpretation.

Another important aspect that can pose a threat to validity is credibility. According to Haydon et al. (2018), researchers have to consider whether narrative inquiry has the potential to answer the research question. One of the ways of overcoming this threat is long-term communication between the researcher and the participant, which allows for the confirmation of data collection, thus leading to a higher level of rigor and credibility (Haydon et al., 2018; Nolan et al., 2017).

To mitigate threats to dependability and trustworthiness, narrative inquirers need to be highly attentive when listening to individuals’ stories. Furthermore, as Nolan et al. (2017) mention, it is of utmost importance to respond to critics’ notes. Without a sober reaction to criticism, a researcher risks making the study biased, which can lead to a lack of trustworthiness and dependability. It is a good idea to let participants check the final interpretation of their narratives to evaluate whether it coincides with the experience they described in their stories (Nolan et al., 2017). Harfitt (2015) also emphasizes the significance of validating the field notes with participants as a crucial prerequisite of maintaining trustworthiness. The process of data analysis is no less essential than that of data collection when it comes to maintaining the study’s validity. As Wang and Geale (2015) remark, it is necessary to perform validation checks throughout collecting and analyzing data. Furthermore, the researcher should maintain a close connection with the participants at all stages of the study to ensure its dependability and trustworthiness.

Potential Ethical Issues

When considering narrative inquiry as a research design, ethical issues are probably the most significant ones to be addressed. The main problem that may arise is that sharing one’s experiences may turn into something more personal than mere information exchange (Caine et al., 2019). As a result, by the end of the study, investigators may develop too friendly relationship with their respondents. Another potential ethical issue is that researchers place the narratives of the participants within a larger narrative, which means that scholars are imposing meaning on respondents’ experiences. Consequently, there may arise the problem of the misinterpretation of data.

The next ambiguous issue is the subjectivity of the study on the part of a researcher (Caine et al., 2019). Because some of the personal narratives are ambiguous, it is impossible to rule out researchers’ personal assessment of the situations, through the prism of which respondents’ narrations may be altered from what they were meant to uncover initially. Narrative inquirers should also bear in mind that their relationships with the participants can affect the final result of the study (Law & Chan, 2015). Therefore, researchers should be cautious of their own interpretations of the respondents’ narratives, as well as they should make sure that their interactions do not influence the final result.

In order to minimize the risk of the mentioned ethical issues in the current research, the following steps will be taken. Firstly, the researchers will make it a rule not to become too close or friendly with the participants in order to remain as objective as possible throughout the whole process of the study. Secondly, the researcher will listen to the narratives attentively and ask clarifying questions if needed, which will enable avoiding misinterpretations. Finally, at all stages of the research project, the researcher will refrain from offering a personal assessment of situations described by participants. By following these steps, it will become possible to avoid the most viable ethical concerns.

Summary of Research

Research on the topic of online gaming addiction available so far is rich in directions of investigation. Scholars have analyzed individuals’ disposition toward engaging in online gaming (Balakrishnan & Griffiths, 2018; Pietersen et al., 2018; Tang et al., 2017), the desire for online group gaming (Gong et al., 2019), and dysfunctional cognitions associated with Internet gaming disorder (Marino & Spada, 2017). These and other topics of research allowed for an in-depth understanding of the research question, but they have not answered all the questions related to online gaming addiction.

A connection between individuals’ loyalty toward online gaming and developing online gaming addiction has been found. Research findings reveal that addiction to online mobile games is associated with game loyalty (Balakrishnan & Griffiths, 2018). Furthermore, scholars report a positive relationship between online gaming addiction and the tendency to purchase mobile in-game applications. Finally, researchers have investigated that online gaming loyalty boosts players’ desire to buy online game applications. However, researchers failed to provide a discussion of how these processes evolve.

A study by Gong et al. (2019) has resulted in finding a positive correlation between the desire for playing online games and addiction to this activity. Additionally, the authors have found that the desire for group gaming is connected with people’s social identities, expected enjoyment, and specific attitudes. However, the research lacks generalizability since Gong et al. (2019) have analyzed only one type of social game played online. Meanwhile, each online game has its own unique features aimed at supporting specific social ties, which can have different effects on players’ predisposition toward becoming addicted to playing.

Marino and Spada (2017) have examined the peculiarities of the gaming disorder with the help of a narrative review, which makes this study especially valuable in light of the selected topic and research design. Scholars report that online gaming-associated dysfunctional conditions are numerous, and their quantity increases with the growth of the industry. Marino and Spada (2017) remark that it is crucial to differentiate between dysfunctional cognitions and metacognitions in Internet gaming disorder. Implications for future research based on these findings include the comparison between dysfunctional cognitions and metacognitions with the aim of finding effective evidence-based treatment for online gaming addictive individuals.

Findings of Tang et al.’s (2017) research suggest that males are usually more addicted to online games than women, whereas females are more predisposed to online social networking addiction. Pietersen et al.’s (2018) study has resulted in valuable insights into what it is to be a gamer based on online gaming addicts’ personal narratives. Whereas these studies have addressed some of the aspects of online gaming and the development of addiction to it, more thorough research is needed in various dimensions of the research topic. Specifically, it is important to focus research on understanding the development of online gaming addiction and people’s feelings about it.

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IvyPanda. (2022, September 27). Addiction to Online Gaming: A Review of Literature. https://ivypanda.com/essays/addiction-to-online-gaming-a-review-of-literature/

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Video Games Thesis Statement

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The Association Between Video Gaming and Psychological Functioning

Juliane m. von der heiden.

1 Department of Psychology, Johannes Gutenberg University Mainz, Mainz, Germany

Beate Braun

2 Department of Psychosomatic Medicine, University Medical Center, Mainz, Germany

Kai W. Müller

Boris egloff, associated data.

Video gaming is an extremely popular leisure-time activity with more than two billion users worldwide ( Newzoo, 2017 ). However, the media as well as professionals have underscored the potential dangers of excessive video gaming. With the present research, we aimed to shed light on the relation between video gaming and gamers’ psychological functioning. Questionnaires on personality and psychological health as well as video gaming habits were administered to 2,734 individuals (2,377 male, 357 female, M age = 23.06, SD age = 5.91). Results revealed a medium-sized negative correlation between problematic video gaming and psychological functioning with regard to psychological symptoms, affectivity, coping, and self-esteem. Moreover, gamers’ reasons for playing and their preferred game genres were differentially related to psychological functioning with the most notable findings for distraction-motivated players as well as action game players. Future studies are needed to examine whether these psychological health risks reflect the causes or consequences of video gaming.

Introduction

Video gaming is a very popular leisure activity among adults ( Pew Research Center, 2018 ). The amount of time spent playing video games has increased steadily, from 5.1 h/week in 2011 to 6.5 h/week in 2017 ( The Nielsen Company, 2017 ). Video gaming is known to have some benefits such as improving focus, multitasking, and working memory, but it may also come with costs when it is used heavily. By spending a predominant part of the day gaming, excessive video gamers are at risk of showing lower educational and career attainment, problems with peers, and lower social skills ( Mihara and Higuchi, 2017 ). On the one hand, video game use is widespread, and it may come with certain precursors as well as consequences. On the other hand, little is known about the relations between various video gaming habits and psychological functioning. This study aims to shed light on these important relations using a large sample.

A video game is defined as “a game which we play thanks to an audiovisual apparatus and which can be based on a story” ( Esposito, 2005 ). In the last few years, the amount of scientific research devoted to video game playing has increased (e.g., Ferguson, 2015 ; Calvert et al., 2017 ; Hamari and Keronen, 2017 ). Most scientific studies in this area of research have focused on the extent of video game play and its diverse correlates. While some researchers have emphasized the benefits of game playing and even suggested a therapeutic use of video games ( Primack et al., 2012 ; Granic et al., 2014 ; Colder Carras et al., 2018 ), others have been intrigued by its potential dangers ( Anderson et al., 2010 ; Müller and Wölfling, 2017 ).

Parents and professionals may be worried about their excessively playing children being “addicted.” However, problematic and potentially addictive video game use goes beyond the extent of playing (in hours per week; Skoric et al., 2009 ). It also includes such issues as craving, loss of control, and negative consequences of excessive gaming. While it is still a matter of debate whether problematic video game play should be considered a behavioral addiction , its status as a mental disorder has been clarified since the release of the DSM-5 in 2013. In the DSM-5, the American Psychiatric Association (2013) defined Internet Gaming Disorder with diagnostic criteria closely related to Gambling Disorder. Generally, this decision has been supported by many researchers (e.g., Petry et al., 2014 ) but has also caused controversies. Researchers have criticized the selection of diagnostic criteria and the vague definition of the Internet Gaming Disorder construct, which excludes offline games from being related to addictive use (e.g., Griffiths et al., 2016 ; Bean et al., 2017 ).

Several studies, literature reviews, and meta-analyses have focused on the correlates of problematic video gaming, usually assessed as a continuum with addiction marking the upper end of the scale (e.g., Ferguson et al., 2011 ; Kuss and Griffiths, 2012 ). The degree of addictive video game use has been found to be related to personality traits such as low self-esteem ( Ko et al., 2005 ) and low self-efficacy ( Jeong and Kim, 2011 ), anxiety, and aggression ( Mehroof and Griffiths, 2010 ), and even to clinical symptoms of depression and anxiety disorders ( Wang et al., 2018 ). Potential consequences of video game use have been identified as well, such as a lack of real-life friends ( Kowert et al., 2014a ), stress and maladaptive coping ( Milani et al., 2018 ), lower psychosocial well-being and loneliness ( Lemmens et al., 2011 ), psychosomatic problems ( Müller et al., 2015 ; Milani et al., 2018 ), and decreased academic achievement ( Chiu et al., 2004 ; Gentile, 2009 ). Effect sizes have varied widely across studies ( Ferguson et al., 2011 ). There seem to be sex and age differences with regard to video gaming behavior: potentially problematic video gaming was found to be more likely among males than females (e.g., Greenberg et al., 2010 ; Estévez et al., 2017 ), and among younger gamers ( Rehbein et al., 2016 ).

In addition to looking at problematic video game use and its relation to psychological functioning, it is relevant to also focus on why individuals play video games. Players use video games for very different reasons ( Ryan et al., 2006 ; Yee, 2006 ) such as to distract themselves from daily hassles or because they enjoy the social relationships they have developed in the virtual world. Potentially problematic video gaming has been found to be related to various reasons for playing such as coping and escape ( Hussain and Griffiths, 2009 ; Schneider et al., 2018 ), socialization ( Laconi et al., 2017 ), and personal satisfaction ( Ng and Wiemer-Hastings, 2005 ). Coping ( Laconi et al., 2017 ), social interaction, and competition were among the main reasons for gaming among males but not among females ( Lucas and Sherry, 2004 ). Mixed results emerged concerning age differences ( Greenberg et al., 2010 ), but especially younger gamers seemed to be motivated for video gaming by social interactions ( Hilgard et al., 2013 ). However, so far it remains unclear to what extent people’s various reasons for playing video games are differentially related to their psychological functioning.

Besides investigating the links between potentially problematic video game use and psychological functioning as well as between reasons for playing video games and psychological functioning, it is relevant to also look at which game genres individuals prefer. Correlates of preferences for certain game genres (e.g., simulation, strategy, action, role-playing) are cognitive enhancement ( Dobrowolski et al., 2015 ; Bediou et al., 2018 ), but also the amount of time spent playing ( Lemmens and Hendriks, 2016 ; Rehbein et al., 2016 ) and psychopathological symptoms ( Laconi et al., 2017 ). Males were shown to prefer action and strategy games, whereas females showed a preference for games of skill ( Scharkow et al., 2015 ; Rehbein et al., 2016 ). Younger gamers seemed to prefer action games, older players more so games of skill ( Scharkow et al., 2015 ). However, it is not yet understood to what extent preferences for certain video game genres are differentially related to psychological functioning.

Typically, research has focused merely on violent video games (e.g., Anderson and Bushman, 2001 ; Elson and Ferguson, 2014 ) or one specific game within one specific game genre (frequently World of Warcraft; Graham and Gosling, 2013 ; Visser et al., 2013 ; Herodotou et al., 2014 ), thereby neglecting the variety of possible gaming habits across various game genres.

In the present study, our objective was to examine the relation between video gaming and psychological functioning in a fine-grained manner. For this purpose, we examined psychological functioning by employing various variables such as psychological symptoms, coping strategies, and social support. Likewise, we assessed video gaming in a similarly detailed way, ranging from (a) problematic video game use, (b) the reasons for playing, to (c) the preferred game genres. This strategy prevented us from making potentially invalid generalizations about video gaming in general and allowed us to examine the spectrum of gaming habits and the respective relations between such habits and a diverse set of variables representing psychological functioning.

Playing video games excessively should be appealing to individuals with poor psychological functioning because games allow people to avoid their everyday problems and instead immerse themselves in another environment ( Taquet et al., 2017 ). Moreover, video games offer people a chance to connect with other people socially despite any more or less evident psychological problems they may have ( Kowert et al., 2014b ; Mazurek et al., 2015 ). On the other hand, potentially problematic video game use may also lead to psychological problems because it reduces the amount of time and the number of opportunities gamers have to practice real-life behavior ( Gentile, 2009 ). Thus, we expected to find a negative correlation between problematic video gaming and variables representing psychological functioning such that we expected more potentially problematic video game use to be related to dysfunctional coping strategies ( Wood and Griffith, 2007 ), negative affectivity ( Mathiak et al., 2011 ), and poor school performance ( Mihara and Higuchi, 2017 ). Moreover, we expected to find differential correlates of people’s reasons for playing video games and their psychological functioning: Playing for escape-oriented reasons such as distraction should go along with diverse indices of poor psychological functioning ( Király et al., 2015 ), whereas playing for gain-oriented reasons such as the storyline or the social connections in the game should be related to adequate psychological functioning ( Longman et al., 2009 ). Also, we expected to find people’s preferred game genres (e.g., strategy, action) to be differentially related to their psychological functioning ( Park et al., 2016 ). Finally, we aimed to shed light on the unique contribution of each measure of psychological functioning to the prediction of problematic video game use.

Materials and Methods

Participants 1.

A total of N = 2,891 individuals (2,421 male, 470 female) with a mean age of 23.17 years ( SD = 5.99, Range: 13–65) participated in our study. Of these participants, N = 2,734 (95%) confirmed their use of video games and were thus included in further analyses (2,377 male, 357 female, with a mean age of 23.06 years; SD = 5.91, Range: 13–65). The distribution of participants with regard to sex and age mirrors the findings of past research with males and younger individuals being more likely to play video games (e.g., Griffiths et al., 2004 ). Participants’ place of residence was Germany.

Procedure and Instruments 2

We posted links to our online questionnaire on various online forums as well as on popular online game sites. To achieve heterogeneity of the sample, no exclusion criteria other than having access to the Internet and understanding German were specified. As an incentive to participate in the study, four vouchers of 50€ were raffled.

Video Gaming

Potentially problematic video game use.

The AICA-S, the Scale for the Assessment of Internet and Computer game Addiction ( Wölfling et al., 2016 ), was used to assess participants’ gaming behavior with regard to potential problematic use. Based on the DSM criteria for Internet Gaming Disorder (tolerance, craving, loss of control, emotion regulation, withdrawal, and unsuccessful attempts to cut back), this standardized self-report scale consists of 15 items usually with a five-point scale ranging from 1 ( never ) to 5 ( very often ). The final score (Min = 0, Max = 27 points) is computed using weighted scoring (items with an item-total correlation > 0.55 in the norm sample are weighted double; Wölfling et al., 2011 ). The AICA-S score can be used to differentiate between regular (0–6.5 points) and problematic use of video games (7–13 points: abuse; 13.5–27 points: addiction). In our sample, N = 2,265 (83%) were identified as regular gamers, and N = 469 (17%) as problematic gamers. We used the AICA-S as a continuous variable for all further analyses ( M = 3.98, SD = 3.22, Range: 0–24). The instrument has been validated for different age groups in the general population and in clinical samples ( Müller et al., 2014a , 2019 , but note small sample size; Müller et al., 2014b ). Cronbach’s alpha was α = 0.70. As expected, the AICA-S score was correlated with male sex ( r = 0.17 ∗∗∗ ) and age ( r = –0.15 ∗∗∗ ). On average, participants played video games for M = 4.09 hours per weekday ( SD = 4.44, Range: 0–24), and M = 4.21 h per day at the weekend ( SD = 2.99, Range: 0–24).

Reasons for playing

Gamers indicated how often they played video games for certain reasons. They rated each of 10 reasons separately on Likert scales ranging from 1 ( never ) to 4 ( very often ). The most prevalent reasons were relaxation ( M = 2.96, SD = 0.91), amusement ( M = 2.94, SD = 0.85), and because of the storyline ( M = 2.67, SD = 1.10).

Game genres

Gamers were asked how often they usually played various video game subgenres such as first-person shooter, round-based strategy, massively multiplayer online role-playing games (MMORPGs), life simulations, and others. Ratings were made on Likert scales ranging from 1 ( never ) to 4 ( very often ). Using Apperley’s (2006) classification of game genres, we categorized the subgenres into the main genres action ( M = 2.54, SD = 0.84), strategy ( M = 2.13, SD = 0.80), role-playing ( M = 2.01, SD = 0.73), and simulation ( M = 1.58, SD = 0.44). A cluster for unclassified subgenres ( M = 1.54, SD = 0.39) was added to additionally account for such subgenres as jump’n’runs and games of skill. Descriptive statistics and intercorrelations for all measures (including sex and age) are presented in Supplementary Tables S1–S4 .

Psychological Functioning

Participants provided ratings of their psychological functioning on the following constructs:

General psychopathology

The SCL-K-9 ( Klaghofer and Brähler, 2001 ), a short version of the SCL-90-R ( Derogatis, 1975 ), was administered to assess participants’ subjective impairment regarding psychological symptoms (somatization, obsessive-compulsive, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, and psychoticism). The SCL-K-9 score is strongly correlated with the original score of the SCL-90-R ( r = 0.93). The 9 items were answered on 5-point Likert-type scales ranging from 1 ( do not agree at all ) to 5 ( agree completely ). Cronbach’s alpha was satisfactory (α = 0.77).

We assessed 10 coping strategies with the Brief COPE ( Carver, 1997 ; German version by Knoll et al., 2005 ), which is the shorter version of the COPE ( Carver et al., 1989 ): self-distraction, denial, substance use, venting, self-blame, behavioral disengagement, acceptance, active coping, planning, and positive reframing. The two items per subscale were administered on 5-point Likert-type scales ranging from 1 ( never ) to 5 ( very often ). Intercorrelations of the two items per subscale ranged from r = 0.32, p < 0.001 for positive reframing to r = 0.78, p < 0.001 for substance use (with one exception: r = -0.05, p = 0.01 for self-distraction).

We measured general affect as a trait and affect during video gaming as a state using the German version ( Krohne et al., 1996 ) of the Positive and Negative Affect Schedule (PANAS; Watson et al., 1988 ). On a 5-point Likert-type scale ranging from 1 ( not at all ) to 5 ( completely ), participants rated the intensity of 20 adjectives. Cronbach’s alpha was α = 0.78 for general positive affect, α = 0.83 for general negative affect, α = 0.85 for positive affect while playing, and α = 0.83 for negative affect while playing.

The measure for the assessment of shyness in adults ( Asendorpf, 1997 ) consists of 5 items that were answered on a 5-point Likert-type scale ranging from 1 ( not at all ) to 5 ( completely ). Cronbach’s alpha was excellent (α = 0.86).

We administered the German version ( Elbing, 1991 ) of the NYU Loneliness Scale ( Rubenstein and Shaver, 1982 ). The 4 items were answered on 5- to 6-point Likert-type scales. Cronbach’s alpha was satisfactory (α = 0.79).

Preference for solitude

A 10-item measure of preference for solitude ( Nestler et al., 2011 ) was answered on a 6-point Likert-type scale ranging from 1 ( not at all ) to 6 ( completely ). Cronbach’s alpha was excellent (α = 0.86).

Life satisfaction

Participants answered a one-item life satisfaction measure on a 4-point Likert-type scale ranging from 1 ( not at all ) to 4 ( completely ).

Self-esteem

We administered the German version ( von Collani and Herzberg, 2003 ) of the Rosenberg Self-Esteem Scale (RSES; Rosenberg, 1979 ). The 10 items were answered on a 4-point Likert-type scale ranging from 1 ( not at all ) to 4 ( completely ). Cronbach’s alpha was excellent (α = 0.88).

Self-efficacy

We administered a 10-item generalized self-efficacy scale ( Schwarzer and Jerusalem, 1995 ), which was answered on a 4-point Likert-type scale ranging from 1 ( not at all ) to 4 ( completely ). Cronbach’s alpha was excellent (α = 0.86).

Social support and friends

We administered the perceived available social support subscale from the Berlin Social Support Scales (BSSS; Schwarzer and Schulz, 2003 ). The 8 items were answered on a 5-point Likert-type scale ranging from 1 ( not at all ) to 5 ( completely ). Cronbach’s alpha was excellent (α = 0.94). Participants indicated how many offline friends and offline acquaintances they had ( r = 0.44, p < 0.001) as well as how many online friends and online acquaintances they had ( r = 0.33, p < 0.001). Due to left-skewed distributions, we logarithmized the data before aggregation.

Participants reported their grade point average. German grades are assessed on a scale that ranges from 1 ( excellent ) to 6 ( insufficient ). Thus, higher scores indicate worse grades.

Participants further reported their sex and age. Both were used as control variables in further analyses.

In a first step, we computed zero-order correlations between the video gaming variables and the measures of psychological functioning. In a second step, we computed partial correlations in which we controlled for sex and age because past research has repeatedly shown that sex and age are correlated with both video gaming ( Homer et al., 2012 ; Mihara and Higuchi, 2017 ) and psychological functioning ( Kessler et al., 2007 ; Nolen-Hoeksema, 2012 ). Finally, we explored the unique contribution of each measure of psychological functioning to the prediction of potentially problematic video gaming. Therefore, we computed regressions with potentially problematic video gaming as the dependent variable and sex, age, and the measures of psychological functioning as predictors (entered simultaneously into the regression equation). By employing this procedure, we were able to determine the effect that each variable had over and above the other ones. For instance, we could identify whether general psychopathology was predictive of potentially problematic video game use when the influence of all other variables (e.g., shyness, loneliness, and others) was held constant.

Additionally, we included analyses regarding sex and age differences in the link between video gaming and psychological functioning. Since we collected a self-selected sample where different sexes and age groups were not represented equally, our findings are only preliminary, but may stimulate future research.

Potentially Problematic Video Game Use and Psychological Functioning

First, we examined whether potentially problematic video game use was related to various psychological functioning variables. As can be seen in Table 1 , the results for the zero-order correlations were similar to those for the partial correlations in which we controlled for sex and age. A medium-sized positive relation to the potentially problematic use of video games emerged for the presence of psychological symptoms including depression, anxiety, and hostility. Furthermore, several coping strategies were differentially associated with the potentially problematic use of video games: Self-blame and behavioral disengagement showed the strongest positive relations to potentially problematic video game use, followed by denial, acceptance, substance use, self-distraction, and venting. Planning, active coping, and, to a lesser extent, positive reframing were negatively associated with the potentially problematic use of video games. Moreover, the association with potentially problematic video game use was negative for general positive affect and positive and larger in size for general negative affect. However, potentially problematic video game use was clearly positively associated with the experience of both positive and negative affect while playing. Further, a preference for solitude, shyness, and loneliness were positively correlated with the potentially problematic use of video games. Lower self-esteem, lower life satisfaction, and, to a lesser extent, poorer perceived social support and lower self-efficacy went along with potentially problematic video game use. There was an association between fewer offline friends and acquaintances but more online connections with potentially problematic video gaming. Finally, poorer performance in school (i.e., higher grades) was related to the potentially problematic use of video games. These results suggest that potentially problematic video gaming goes along with poor psychological functioning and vice versa.

Associations between potentially problematic video gaming and psychological functioning.

Reasons for Playing Video Games and Psychological Functioning

Second, we investigated whether players’ reasons for playing video games were differentially related to the psychological functioning variables. Table 2 presents the partial correlations, controlling for sex and age. Using video games to distract oneself from stress was clearly connected to a high level of psychological symptoms. Distraction-motivated gamers preferred coping strategies such as self-blame, behavioral disengagement, self-distraction, denial, substance use, venting, and acceptance, but they neglected active coping and planning. They showed less general positive affect and more negative affect both in general and while playing as well as more positive affect while playing. These gamers further reported low self-esteem and low life satisfaction, loneliness, a preference for solitude, shyness, a lack of self-efficacy and social support, and poor achievement in school. A similar but somewhat less extreme picture was revealed for gamers who played video games in order to have something to talk about . However, these gamers reported more online connections. Gamers who played video games to improve their real-life abilities also reported more online connections. In addition, these gamers showed higher levels of general positive affect. The strongest association with online friends and acquaintances emerged, as expected, for gamers who played because of the social relations in the virtual world. Although all reasons for playing video games were related to positive affect while playing, the strongest associations emerged for gamers who played because of the social relations , to stimulate their imagination , and for curiosity . It is interesting that, for gamers who played video games because of the storyline and for relaxation , there was a relation only to positive but not to negative affect while playing. Reasons for playing were only weakly related to sex and age (see Supplementary Table S2 ). In sum, several reasons for playing video games were differentially associated with psychological functioning.

Associations between reasons for playing video games and psychological functioning.

Video Game Genre and Psychological Functioning

Third, we examined whether players’ preferences for different video game genres were differentially associated with the measures of psychological functioning. Table 3 shows the partial correlations in which we controlled for sex and age. There was a weak connection between general psychological symptoms and all of the video game genres we investigated except strategy. A preference for action games had the strongest association with affect while playing. Thus, action games seem to be both rewarding and a source of frustration. A preference for action games went along with poorer school performance. Gamers who preferred role-playing games scored higher on shyness and a preference for solitude and lower on self-esteem; they also reported fewer offline connections. By contrast, preferences for games of the unclassified category on average went along with a larger number of offline friends and more positive affect, both while playing and in general. Two game genres (i.e., role-playing and unclassified games) were related to the coping strategy of self-distraction. Because preferred game genre was related to participants’ sex (see Supplementary Table S3 ), we had a more detailed look at the correlations between preferred game genre and psychological functioning separately for both sexes: For males ( n = 2,377), the strongest correlation between general psychopathology and game genre emerged for action ( r = 0.08, p < 0.001), followed by role playing ( r = 0.07, p < 0.01), and unclassified ( r = 0.07, p < 0.01). For females ( n = 357), the strongest relation between general psychopathology and game genre emerged for simulation ( r = 0.17, p < 0.01). Differences were also found regarding the strength of the relation between number of friends online and the genre action: r = 0.06, p < 0.01 for males, and r = 0.27, p < 0.001 for females. Similarly, preferred game genre was related to participants’ age (see Supplementary Table S3 ). However, there were merely differences with regard to the relation of psychological functioning and game genre, when analyzed separately for different age groups (<19 years, n = 557; 19–30 years, n = 1916; >31 years, n = 261). In sum, our results speak to the idea that individuals with different levels of psychological functioning differ in their choices of game genres and vice versa.

Associations between preferred video game genre and psychological functioning.

Predicting Potentially Problematic Video Game Use by Psychological Functioning Variables

In a final step, we entered all of the investigated psychological functioning variables as well as sex and age as predictors of the potentially problematic use of video games. By employing this procedure, we were able to determine the unique contribution of each psychological functioning variable when the influence of all other variables was held constant. As Table 4 shows, the number of online friends and acquaintances as well as positive affect while playing were most predictive of potentially problematic video game use over and above all other variables. General psychopathology, a lack of offline connections, and poor school performance were weaker but still relevant predictors of potentially problematic video game use.

Prediction of potentially problematic video game use by psychological functioning variables.

With this study, we aimed to shed light on the association of diverse video gaming habits with gamers’ psychological functioning. Drawing on a large sample, our results revealed a medium-sized relation between potentially problematic video game use and poor psychological functioning with regard to general psychological symptoms, maladaptive coping strategies, negative affectivity, low self-esteem, and a preference for solitude as well as poor school performance. These findings are in line with those of prior work (e.g., Kuss and Griffiths, 2012 ; Milani et al., 2018 ). Also, reasons for playing video games were differentially related to psychological functioning with the most pronounced findings for escape-oriented in contrast to gain-oriented motives. Specifically, distraction-motivated gaming went along with higher symptom ratings, lower self-esteem, and more negative affectivity, whereas playing to establish social relationships in the virtual world was related to a larger number of online connections and more positive affect while playing. Furthermore, there were only weak relations between the preferred game genres and psychological functioning. The action games genre was associated with the strongest ratings of affect while playing. These results on reasons and genres may help to explain conflicting findings of former studies, because in our work we examined various reasons for playing, several game genres, and various aspects of psychological functioning simultaneously. Finally, positive affect while playing and a larger number of online friends were the strongest unique predictors of potentially problematic video game use, followed by psychological symptoms, a lack of offline connections, and poor school performance. These findings suggest that, on the one hand, independent of one’s psychological conditions, enjoying oneself during gaming (i.e., experiencing positive affect, connecting with online friends) may go along with potentially problematic use of video games. On the other hand, poor psychological functioning seems to be a unique risk factor for potentially problematic video gaming.

The presented results are generally in line with previous work that has identified a connection between video gaming and psychological health, academic problems, and social problems ( Ferguson et al., 2011 ; Müller et al., 2015 ). However, our study moved beyond prior research by providing in-depth analyses of both video gaming habits (including potentially problematic use, reasons for playing, and preferred game genre) and psychological functioning (including psychological symptoms, coping styles, affectivity, as well as variables that are related to individuals and their social environments). In addition, we identified unique predictors of potentially problematic video game use.

How can the findings on differential relations between video gaming and various indices of psychological functioning – ranging from beneficial results ( Latham et al., 2013 ) to unfavorable results ( Barlett et al., 2009 ; Möller and Krahé, 2009 ; Anderson et al., 2010 ) – be integrated? According to Kanfer and Phillips (1970) , problematic behavior (e.g., excessive video gaming) can be understood as a function of the situation (e.g., being rejected by a peer); the organism (e.g., low self-esteem); the person’s thoughts, physical reactions, and feelings (e.g., sadness, anger); and finally, the short- as well as long-term consequences of the behavior (termed SORKC model). In the short run, according to our results, playing video games may be a way to distract oneself from everyday hassles and may lead to positive affect while playing and a feeling of being connected to like-minded people, all of which are factors that have an immediate reinforcing value. In the long run, however, spending many hours per day in front of a computer screen may prevent a person from (a) developing and practicing functional coping strategies, (b) finding friends and support in the social environment, and (c) showing proper school achievement, factors that are potentially harmful to the person. Thus, differentiating between short- and long-term perspectives may help us understanding the differential correlates of intensive video gaming.

When is it appropriate to speak of video game addiction? More and more researchers have suggested a continuum between engagement ( Charlton and Danforth, 2007 ; Skoric et al., 2009 ) and pathological gaming/addiction, instead of a categorical perspective. In part, this recommendation has also been followed in the DSM-5 ( American Psychiatric Association, 2013 ) where Internet Gaming Disorder is classified with different degrees of severity, ranging from mild to moderate to severe, according to the functional impairment associated with it. The AICA-S also allows for a differential perspective on gaming behavior by providing ways to assess both the time spent playing video games and the main DSM criteria that indicate Internet Gaming Disorder. However, in our study we did not aim at making a diagnosis, but at having a closer look at potentially problematic gaming behavior and its correlates in a non-clinical sample.

In sum, it seems relevant to assess not only the extent of video game use but also the reasons behind this behavior (e.g., distraction) and the concrete rewards that come from playing (e.g., the experience of strong affect while playing action games) to fully understand the relation between video gaming and psychological functioning.

Limitations and Future Directions

With the present study, we aimed to uncover the association between video gaming and psychological functioning. Our approach was cross-sectional and warrants interpretative caution because correlations cannot determine the direction of causation. It remains unclear whether potentially problematic gaming is a factor that contributes to the development of psychological dysfunction or whether psychological dysfunction contributes to potentially problematic gaming. Also, a third factor (e.g., preexisting mental difficulties) may produce both psychological dysfunction and potentially problematic gaming. Thus, longitudinal studies that are designed to identify the causal pathway may provide a promising avenue for future research. Future studies may also answer the question whether the link between video gaming and psychological functioning is moderated by sex, age, the reasons for playing, or the preferred game genre. In addition, it is important not to forget that the present results are based on a self-selected sample in which potentially problematic video gamers were overrepresented (e.g., Festl et al., 2013 , for a representative sample). Thus, future research should replicate our findings in a representative sample. Further, we relied on self-reported data, which is a plausible method for assessing inner affairs such as people’s reasons for their behaviors, but it would be helpful to back up our findings with evidence derived from sources such as peers, caregivers, and health specialists. Our work reflects only a first approach to the topic, and future work may additionally collect in-game behavioral data from the players ( McCreery et al., 2012 ; Billieux et al., 2013 ) to objectively and more specifically investigate diverse patterns of use. Furthermore, one must not forget that the used taxonomy to classify video game genres is only one of various possible options and one should “think of each individual game as belonging to several genres at once” ( Apperley, 2006 , p. 19). Finally, some of the effects reported in our paper were rather modest in size. This is not surprising considering the complexity and multiple determinants of human behavior. In our analyses, we thoroughly controlled for the influence of sex and age and still found evidence that video gaming was differentially related to measures of psychological functioning.

The current study adds to the knowledge on gaming by uncovering the specific relations between video gaming and distinct measures of psychological functioning. Potentially problematic video gaming was found to be associated with positive affect and social relationships while playing but also with psychological symptoms, maladaptive coping strategies, negative affectivity, low self-esteem, a preference for solitude, and poor school performance. Including gamers’ reasons for playing video games and their preferred game genres helped deepen the understanding of the specific and differential associations between video gaming and psychological health. This knowledge might help developing adequate interventions that are applied prior to the occurrence of psychological impairments that may go along with potentially problematic video gaming.

Ethics Statement

In our online survey, participants were given information on voluntary participation, risks, confidentiality/anonymity, and right to withdraw. Whilst participants were not signing a separate consent form, consent was obtained by virtue of completion. We implemented agreed procedures to maintain the confidentiality of participant data.

Author Contributions

BB, BE, JH, and KM conceived and designed the study. BB, JH, and KM collected and prepared the data. JH analyzed the data. BE and JH wrote the manuscript.

Conflict of Interest Statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

1 The data were gathered as part of a larger project ( Stopfer et al., 2015 ; Braun et al., 2016 ). However, the analyses in the present article do not overlap with analyses from previous work.

2 Other measures were administered, but they were not relevant to the present research questions and are thus not mentioned in this paper. The data set and analysis script supporting the conclusions of this manuscript can be retrieved from https://osf.io/emrpw/?view_only=856491775efe4f99b407e258c2f2fa8d .

Supplementary Material

The Supplementary Material for this article can be found online at: https://www.frontiersin.org/articles/10.3389/fpsyg.2019.01731/full#supplementary-material

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By Megan Farokhmanesh

When a Video Game Developer Gets Outed as Abusive, What Happens Next?

Jonathan’s actions were irrefutable: Over the course of nearly a decade, while working at a video game developer, he sexually assaulted industry colleagues. One victim came forward, posting their story to social media; others followed with stories of their own. The consequences were swift. Colleagues, friends, and peers disavowed him. He stepped away from his job and retreated from the public eye.

Jonathan, who asked that WIRED not reveal his identity, no longer works in the video game industry. His decision to remain apart from the community, he says, is the direct result of his actions. ”I made the choices I did, and I needed to hold the burden of those consequences,” he says. Had he remained in games, he felt he would be placing an unfair burden on his colleagues, as well as making the lives of those he abused more difficult.

“I didn't feel like it was right to stay involved and continue my journey in gaming when the harm I caused prevented them from doing the same,” he says.

In video game development, actions like Jonathan’s are alarmingly familiar. What's less common are solutions for how to repair the damage done. For decades, the industry has faced calls to weed out people accused of sexism, racism, homophobia, transphobia, abuse of power, harassment, assault, and much more. At companies like Activision Blizzard, which paid out millions to victims who alleged a widespread sexual harassment scandal, bad actors have lost their jobs or faced discipline following harassment investigations, but what then? It’s taken the video game industry so long to even respond to the problems in its ranks, little work has been done to figure out what can and should happen next.

ReSpec wants to be part of the solution. Founded in 2022 as an offshoot of a hotline for people experiencing harassment and abuse in the gaming industry, the nonprofit works with people who want to change. For Jonathan, that meant facing his actions and taking accountability. In other cases, it means recognizing misuses of power, harassment, or manipulation. ReSpec's work pushes the conversation further, but also raises new questions about whether abusers can be reformed—or if they should ever be allowed to return to the places they made unsafe.

In 2020, Jae Lin was working at the Games and Online Harassment Hotline. It was a text-based service that allowed anyone who reached out to talk anonymously about issues from crunch to depression. Launched by Feminist Frequency’s Anita Sarkeesian , herself the target of a Gamergate harassment campaign , the idea was to create the survivor-centered, trauma-informed assistance the game industry so desperately needed.

When confessions coming from industry abusers began rolling in, Lin was surprised. They were working for a hotline that was created to support victims . Unwittingly, it was also becoming a lifeline for people who’d done the harm in the first place. “Really from the beginning, we had folks texting us about harm and harassment that they had caused or been a part of,” Lin says. “It just kept happening.”

By Matt Burgess

By Joseph Cox

Eventually, Lin says, they realized this was “not a one-off thing,” but something the industry wasn’t addressing. There were not many resources, even outside of the games space, for people who “were feeling remorseful and regretful for what they had done and wanted to change,” Lin says. No one knew who to ask for help.

In reporting on this piece, WIRED reached out to survivor-focused groups like the Rape, Abuse and Incest National Network to better contextualize ReSpec's work. A representative for RAINN declined to comment, saying that the organization doesn't have an expert who could speak on the subject.

Lin would officially found ReSpec—a nod to rebuilding attributes in role-playing games—with the goal of providing virtual meetings that could be attended by anyone in the world. Because counseling offenders is different from working with survivors, they consulted with therapists who had experience working with incarcerated people and people on the sex offender registry. They also spoke with facilitators of batterer's intervention groups, members and leaders of men's support groups, and many more experts with experience in sexual violence prevention.

At ReSpec, facilitators have backgrounds that span hotline counseling and trauma-informed care to sexual violence prevention and “men's roles in interrupting cycles of gender-based violence,” Lin says.

Part of ReSpec’s work is about acknowledging that harassing behavior in the video game development world doesn’t exist in a vacuum. The industry is still overwhelmingly male—69 percent of devs identify as cis men—and at times hostile to anyone who doesn’t fit that mold. People drug developers at industry parties; conversations about alcohol's presence and the culture it communicates in professional spaces are a constant. Whisper networks, more powerful than they’ve ever been thanks to online forums, work overtime. It does not matter what size a company is, or even the industry it serves. The MeToo movement existed for over a decade before the allegations against film producer Harvey Weinstein published in The New Yorker and The New York Times in 2017 catalyzed a global reckoning.

“So much of what we heard about from folks was rarely about a single, egregious instance of harassment or abuse or violence,” Lin says. “This is something that they're facing every time they play a game, every job they work at—it was everywhere.”

Harassment rarely impacts only those directly involved. It is a pernicious act, one that can ripple out and inform work culture. It can drive people out of industries they work in, or discourage others from joining at all.

In the last few years alone, games industry powerhouses such as Riot , Activision Blizzard , and Ubisoft have been the subject of allegations of workplace harassment and abuse. However it’s labeled—as a callout, a cancellation—bringing attention to abusive individuals is part of a greater push for justice and accountability. Victims have used social media spaces like X to tell their stories in their own words. It is an imperfect system, one that opens survivors up to widespread abuse online and off, that many turn to when they feel they have no other options.

“If you think about some of the other mechanisms that the legal system provides, they don't necessarily provide the kind of remedies that people might want,” says Jennifer Robbennolt, a University of Illinois law professor whose research focuses on integrating psychology into the study of law. Criminal cases deal with fines or prison; the civil system is about monetary damages. “In certain kinds of cases, those outcomes might be appropriate,“ Robbennolt says. “But a lot of times what people who are harmed or people in those communities will want is changed behavior.”

In the criminal system, advocates for restorative justice work with offenders and victims together in an attempt to reconcile. The goal is to move forward, and sometimes reintegrate the perpetrator back into a community or workplace, albeit often in a different role. “In some ways, that's both a benefit and the challenge of restorative justice,” Robbennolt says. “It's a collaborative process that creates room for there to be nuance to the consequences to the harm, and to tailor the solution to that particular circumstance.” However, she adds, it’s important to not minimize “the more severe end of the spectrum.”

Aside from the nature of the harm done, there’s also the matter of how remorseful a perpetrator is—a difference between someone who either cannot or will not admit to wrongdoing and someone who can potentially learn. Not all offenders should be treated the same, even when their behaviors are similar, Robbennolt says.

While other programs may align with restorative justice, Lin says ReSpec’s focus is on a different model known as transformative justice . “Our focus is really working to address the roots of how harm happens,” Lin says. That means examining behavior, history, and practicing new ways to build relationships.

A key element of a program like ReSpec, says Lin, is time. They’re betting on long-term change. “Change that happens overnight can be undone overnight,” they say. “We really believe that this change towards accountability takes years—years of commitment and unlearning and active engagement.”

Getting those outcomes starts with wanting to change, which means showing up.

Here’s where things get tricky: Most people, understandably, do not feel bad for abusers. Nor do they want to support or help someone who’s actively been harmful in their community. What often follows is ostracization.

This was Jonathan’s experience after his abusive actions were brought to light. “It was a very isolating experience,” he says. “It felt like I suddenly went from having a really strong community to having no one.” Paralyzed by his own negative feelings, Jonathan says it took him a long time to “begin moving toward a place of productive emotion.”

There is no one-size-fits-all verdict, punishment, or solution for what to do with abusers, no universal rule or law that can cover it all. There are, at best, degrees to it, a fraught, subjective concept that deems some actions more or less forgivable.

These are difficult conversations to even have. While a request for anonymity may seem at odds with accountability, Jonathan—whose identity WIRED has verified—says his motivations aren’t self-serving. “I'm hypersensitive to the impact that I have on the folks I have harmed,” he says. “I recognize that by speaking out publicly or engaging in this, it can bring up triggering things for them. And I'm at the point where I don't want to risk any further harm.”

Accountability, as ReSpec has found, is a hard road to walk alone. “We've had so many of these conversations: These people want to change but just don't know if that's possible or how,” says Lin. “It really seemed like they were missing some key pieces of understanding to actually change their behavior, move forward, and grow.”

Outing even a single abuser can be difficult enough for victims, who sometimes don’t come forward for a variety of reasons , including safety, legal concerns, and the sheer difficulty of the process. And removing one person does not defeat the culture, systems, or choices that got them there. It doesn’t even always keep those individuals responsible for abuse from just continuing to go do it elsewhere.

Part of ReSpec’s program hinges on community, monthly virtual meetings where people can show up to talk and share their experiences, much like other support groups. It is not restricted to one country or continent; anyone in the program can join, though the program currently only has English speakers. “We mainly just facilitate the space for them to connect with each other and offer guidance around how harassment and abuse happen,” Lin says.

The point is not to enable or dismiss what they’ve done. “That's a really careful balance to strike,” Lin adds. “What you're experiencing matters. We believe in you. What you did was not OK, and if that's something you believe too, we're here to talk through how you might want that to change.”

The group is not a method to connect abusers with their victims, force apologies, or otherwise offer some proof of “rehabilitation” to the greater public. It’s not a formal program, either; there is no six-month plan where everybody gets a badge at the end.

Lin understands that to some, ReSpec’s mission may seem contradictory or even controversial: a survivor-centered hotline that shifted to support abusers. They consider it the same sort of community work that focuses on violence prevention. ReSpec hasn’t outright turned anyone away, but the act of opting into its community still requires effort on the behalf of whoever shows up. Since starting, the nonprofit has held 25 group sessions. Lin says that, between them and their cofacilitator Carl Murray Olsen, they’ve held 57 one-on-one meetings.

Jonathan previously knew Lin from gaming circles, and they initially approached him about ReSpec around the time it launched. He’s been working with the program since, yet feels his goals will be lifelong. “It's a really hard thing,” he says. “It's not something that you can just pay lip service to. You have to put in the hard work to truly understand yourself, understand your actions, understand your motivations, understand how you came to a place where your behaviors don't align with your values, and truly reconcile to the point where you can evolve beyond that.“

He doesn’t have a strong idea of who should be able to return to work in the space, or what that could mean. “I think it's more about doing the hard work on yourself to improve,” he says. Harm is not just about someone’s actions, but how people continue to show up in the spaces where they’ve caused damage. “It's not worth it for you to potentially harm those people again by being in a similar space or by being vocal,” he says. “I think that's part of owning your actions and holding yourself accountable for the things that you've done. You have to accept those consequences.”

ReSpec is not a gold star to stick on a resume, nor a guarantee for change. It is a step in the process to make the games industry safer. “I've heard so many survivors say, ‘I just don't want this person to hurt anyone else,’” Lin says. It’s one reason why they believe survivors choose to come forward or write callouts. But for what follows after—education, explanation, all the work people ask survivors to do—“we are hoping to offload some of that work,” Lin says. “No survivors should be asked to have to explain patiently.”

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