Video Game Addiction

Video game addiction is characterized by the preoccupation and compulsion of playing games for long intervals that result in the significant impairment of an individual’s ability to function in other important areas of life.

What Is Video Game Addiction?

Video game addiction is the compulsive need to play video games all day in a way that interferes with every aspect of a person’s life. Research ¹ suggests that video games can be harmful, addictive, and can increase aggression. Also known as gaming disorder or internet gaming disorder (IGD), it has become a growing concern for parents over the years and is often found in children and adolescents.

The World Health Organisation (WHO) included gaming disorder in the 11th revision of its International Classification of Diseases (ICD) ² in 2018. It defines the condition as “a pattern of gaming behavior (“digital-gaming” or “video-gaming”) characterized by impaired control over gaming, increasing priority given to gaming over other activities to the extent that gaming takes precedence over other interests and daily activities, and continuation or escalation of gaming despite the occurrence of negative consequences.”

This was later approved by the World Health Assembly in 2019. According to the American Psychiatric Association, there is insufficient evidence to include computer gaming illness. However the Diagnostic and Statistical Manual of Mental Disorders 2013 considered it worth doing further study.

Understanding Gaming Disorder

The prevalence of Internet Gaming Disorder ranges from 0.7% to 27.5% worldwide and has become a growing concern for every parent. According to the American Psychiatric Association, around 160 million adults in the United States play internet-based games. These games can not only be entertaining but also addictive as well.

Adolescents are at a higher risk of sustaining video game disorder over time than adults according to research ³ . It has also been found that there is a strong association between video game addiction and depression, anxiety, ADHD, social phobia. It can have underlying causes. People tend to cling to playing video games in an attempt to avoid their feelings of anxiety, loneliness, or depression. According to Psychologist, Mark D. Griffiths ⁴ “whether it’s a pharmacological or behavioural addiction, it’s all about ongoing rewards and reinforcement.”.

Griffiths proposed that addiction is basically composed of six components:

Salience
Mood modification
Tolerance
Withdrawal
Conflict
Relapse

Read More About Withdrawal Here

A 2018 study ⁵ proposed that this condition is a behavioral addiction and may have similar psychosocial and physical symptoms as substance use disorder. It also observed that adolescent and adult men are more addicted to gaming than women with higher screen time, craving & adverse health effects that may even cause death.

Stages Of Video Game Addiction

Some researchers say that there can be stages in developing gaming addiction. Each case is unique and may involve different games for the addiction to develop. Here are the stages that can give a rough guide to understand this addiction:

Initial Exposure: This is the beginning stage where an individual experiences the fun of playing video games and develops a fascination with such games quite quickly.
Getting Interested: The gaming soon starts to play a significant role in the individual’s life which leads them to invest in more hardware, software, and time.
Obsession growth: The game starts to become an obsession when the individual starts to invest more time. During this time the relationships with other people become increasingly neglected as well as hygiene. This is because the majority of time is spent playing video games.
Obsession turned to addiction: After a point, the obsession starts to become an addiction. In this stage, the dietary and sleeping patterns are hugely affected due to constant gaming, and the person may find themselves entirely disconnected from their friends and family.

Signs Of Video Game Addiction

Studies ⁶ have found that around 1 to 16 percent of video gamers meet the criteria for addiction. Like all addictions, video game addiction should be evaluated not on the basis of time spent playing but also taking into account the behavior of the individual. Video game addiction is only problematic when it starts to interfere with the academic performance or social life of the individual. The American Psychiatric Association states that “gaming must cause significant impairment or distress in several aspects of a person’s life,” to be considered as an addiction according to the DSM-5.

Here are some of the most common signs and symptoms of gaming disorder that you might want to pay attention to:

1. Emotional Symptoms and Behaviors

Thinking about gaming almost all the time
Feeling upset when they can’t play
Wanting to spend time playing in order to feel good about themselves
Not willing to do other things you used to like
Inability or unsuccessful attempts to quit gaming or even play less
Gaming addiction affecting or interfering with work, school, home or relationships
Playing even though there are issues at home, work, or school
Lying about how much time you spend playing
Playing games to change your bad mood and feelings
Withdrawal symptoms when gaming is not available or possible
Using gaming to escape negative emotions

2. Physical Symptoms

There can be certain physical symptoms associated with video game addiction, such as:

Fatigue due to playing for long periods of time
Some people may get migraines due to playing for prolonged periods
Carpal Tunnel Syndrome, a wrist condition that occurs when a person uses the keypad or manual controls for a substantial amount of time.
Some people are even found to have poor personal hygiene since they become isolated and allow their hygiene to slip by

Video game addiction is commonly found in players of the persistent multiplayer gaming universe or Massive Multiplayer Online Role Playing Game (MMORPG). Research ⁷ suggests that MMORPG is more addictive in nature and can have negative impacts on physical health, sleep habits, and academic performance.

Causes Of Video Game Addiction

Common Risk Factors Leading To Gaming Addiction

One of the main reasons for gaming addiction is that developers design the game to be addictive. In essence, video games are very similar to gambling addiction in terms of risk and reward. However, there can be several other reasons why a person can get addicted to video games. Here are some of the most common risk factors leading to gaming addiction:

Low self-esteem
Feeling neglected
Using games to tame their mood
Anxiety or neuroticism
Having an aggressive personality
Social anxiety
Depression
Having a negative attitude towards life
Loneliness
Having authoritarian parents
Lack of empathy
Feeling isolated
Gender

Read More About Gender Here

Apart from these, there may be many other contributing factors leading to the development of this condition. A 2019 study ⁸ revealed that “Hyperactivity/inattention and self-esteem problems seem to be important for the development of IGD,” or internet gaming disorder. Another 2011 study ⁹ found that immersion and positive urgency influence and dominate the gamer’s behavior can also be a significant factory.

The authors of the study state “Positive urgency, which is defined as the tendency to act rashly while in a positive mood, makes it difficult for the gamer to avoid online gaming and let go of the euphoria.” Moreover, immersion in a virtual reality world allows them to avoid the negative effect of real-life problems. Research ¹⁰ also indicates that children and adolescents from “broken home, divorced parents” may also develop internet gaming disorder.

Moreover, our personality traits may also play a crucial role in the development of gaming disorder. A 2015 study ¹¹ found that there is “a positive association between neuroticism and IGD and a negative association between extraversion, conscientiousness, and IGD.” Another 2008 study ¹² revealed that personality traits like aggression, narcissism and self-control may also “predict the severity of gaming addiction” in an individual.

It has also been observed that gaming may affect the human brain in a similar way as drug addiction. It releases the hormone dopamine that reinforces behavior. Hence, the neurotransmitter Dopamine, which makes us happy and keeps us alert, may also be associated with video game addiction. Research ¹³ shows that “dopamine is released in human striatum while video gaming, like any goal-directed motor task.” The release of dopamine was positively associated with the gamer’s performance in gaming.

Read More About Dopamine Here

Diagnosis For Video Game Addiction

It is a very controversial topic on whether or not it’s a real addiction. Studies ¹⁴ have found that 1.7 percent of the general population is addicted to playing. The American Psychiatric Association does not recognize video game addiction as a disorder. It is a much broader concept than internet gaming addiction. This disorder is characterized as an impulse control disorder that is quite similar to compulsive gambling.

The DSM-5 ¹⁵ has developed 9 criteria for characterizing the proposed Internet Gaming Disorder:

Preoccupation: Do you spend a lot of time thinking about playing video games or planning on when you can play next?
Withdrawal: Do you feel restless, irritated, moody, angry, or sad when attempting to cut down or stop gaming? Or in other words, are you having withdrawal symptoms?
Tolerance: Do you feel the need to play for a substantial amount of time or play more exciting games?
Reduce/Stop: Do you feel that you should play less but are unable to cut back on playing games?
Give up other activities: Do you lose interest in other recreational activities?
Continue despite problems: Do you continue playing games despite having problems at work, home, or school, or if you are not getting enough sleep or spending too much money?
Deceive/cover-up: Do you have a tendency to cover up how much time you spend playing games?
Escape Adverse Moods: Do you play games to escape your emotional feelings or forget your personal problems, or relieve uncomfortable feelings like guilt, anxiety, or depression?
Risk/Lose opportunities: Do you risk losing significant relationships or academic or educational opportunities because of gaming?

The likelihood of Gaming addiction is more prevalent in boys and men than in girls and women. According to WHO, “to be diagnosed with gaming disorder, the behaviour pattern must be severe enough to cause considerable impairment in personal, familial, social, educational, occupational, or other critical areas of functioning and must be present for a minimum of 12 months.”

The following screening tools are commonly used for assessing video game addiction:

1. Internet Gaming Disorder (IGD-20)

This test was first published in the PLoS Journal on 14th October 2014. IGD-20 is the first psychometric assessment to diagnose Internet Gaming Disorder in a patient. The test includes 20 questions designed to assess the extent of problems caused by the addiction and the degree of symptoms experienced by the gamer.

2. Internet Gaming Disorder Scale Short Form (IGDS9-SF)

The Internet Gaming Disorder Scale Short Form (IGDS9-SF) is a short psychometric test that assesses this addiction according to the American Psychiatric Association Framework for IGD. Recent studies ¹⁶ suggested that IGDS9-SF is an effective tool to assess video game addiction.

3. Problem Video Game Playing Questionnaire

This is one of the most commonly used instruments to measure the degree of addiction. The PVP Questionnaire ¹⁷ (Problem Video Game Playing) was presented as a quantitative measure and not as a diagnostic tool.

Harmful Effects Of Video Game Addiction

According to the DSM-5 ¹⁸, Internet Gaming Disorder is currently considered as a condition that requires further study. There can be several harmful effects of video game addiction. They are as follows:

Aggressive thoughts and behaviors, particularly under the age of 10.
Risk of light-induced seizures, musculoskeletal disorders of the upper extremities, and increased metabolic rate.
Reduced pro-social behaviors in social interactions.
It can also have physical effects characterized by tendonitis and swelling which the American Physical Therapy calls “video gamer’s thumb” i.e. an injury from a repetitive usage of thumbs.

Research ¹⁹ has found that people who are addicted to video games show that they have poorer mental health and cognitive functioning including poorer impulse control and ADHD symptoms as compared to people who do not have video game addiction. People who are addicted to video games are usually found to have increased emotional difficulties like depression and anxiety, feeling socially isolated, and are more likely to have problems with internet pornography usage.

Health Risks Associated With Gaming Disorder

Video game addiction can have negative health impacts on one’s mind and body. Adult players also suffer from harmful effects by spending hours sitting on the couch or at a computer desk playing games. Some of the most prevalent health hazards are as follows:

1. Sedentary lifestyle

A person spending hours sitting on the couch and playing video games can take a toll on their lifestyle. The lack of exercise has led to health concerns such as weight gain, poor posture, and type 2 diabetes.

Video game players often engage in a computerized environment. Hence they don’t really prepare anyone to socialize with people. It is essential to learn how to engage with others. This addiction can be a hindrance to social interaction.

3. Lack of concentration and attention

Rapid movements and fast-paced action can trigger a loss of concentration in players. Individuals who spend a substantial amount of time playing games become less interested in reading books or anything else that requires more focused attention.

4. Aggression and violence

Playing aggressive video games can also trigger aggressive behavior and violence in a person. It’s important to keep the content of video games in check. This will keep them from behaving aggressively.

Read More About Aggression Here

5. Seizures and repetitive stress injuries

An article published by the British Medical Journal laid out the risks of video game players having epilepsy and seizures. The graphics, lights, and colors in the game can trigger seizure activity in some players.

6. Personal development and self-discovery

Adolescence is an important part of anyone’s life. Personal development and self-discovery is a part of adolescence. In order to become mature adults, they need to learn confrontation and awkward social experiences. But when video game playing becomes a coping mechanism it makes children avoid the developmental challenges in life.

How Video Game Addiction Affects The Brain

Gaming addiction can affect a person’s brain. Video gaming can produce large quantities of dopamine in the brain that stimulates receptors (especially in the parts of the brain known as the amygdala and the ventral tegmental area) that can trigger impulsive behavior. The more a person plays video games the more easily dopamine production is stimulated. After a while, the brain starts to build up a tolerance for high levels of dopamine, and thus the individual feels obligated to engage in addictive behaviors.

Once the tolerance for high levels of dopamine is developed, stopping the addictive behavior becomes extremely difficult. If the individual stops, they may experience withdrawal symptoms. This will continue to happen until the brain chemistry is normalized.

Gaming Disorder, Substance abuse, And Depression

Recent research ²⁰ indicates that gaming disorder and addiction is associated with a range of mental disorders, like personality disorders ²¹ , anxiety ²² , depression and problematic substance abuse.

1. Gaming And Depression

Depression ²³ is one of the leading causes of Gaming addiction. However, it can also become a consequence of this addiction. Depression can make a person feel hopeless about their future. They refuse to realize the importance of any long-term accomplishments whether academic or work-related.

Depression often leads to communication gaps in relationships whereas communication with real or anonymous individuals seems less daunting to the individual. These kinds of feelings can increase as the obsession for gaming increases. The impact of addiction on a person’s self-esteem has been recognized as a contributing factor in developing depression. Gaming addiction affecting a person’s self-esteem can often lead to other complications like loneliness, poor hygiene, obesity, fatigue, and the inability to communicate with other people.

Read More About Major Depressive Disorder (Depression) Here

2. Gaming And Substance Abuse

It is not uncommon that behavioral disorders like gaming addiction can occur along with substance abuse ²⁴ . This co-occurrence of gaming addiction along with substance abuse is known as dual diagnosis or dual disorder. This requires specialized treatment strategies that are more complex in nature. Some research has shown that gamers are less likely to develop substance abuse as their brain centers are already rewarded with high levels of dopamine.

Read More About Drug Abuse Here

Some of the consequent factors of gaming addiction, like isolation or depression, can contribute to developing substance abuse. The sedentary lifestyle that is often associated with cannabis use may result in developing gaming addiction. Some gamers often turn to drugs like cocaine since they believe that drugs act as a performance enhancer.

Treatment For Video Game Addiction

Even though the American Psychiatric Association does not see Video Game addiction as a disorder, there is no denying the fact that some people tend to spend a lot of time playing video games. This ultimately leads to interference with daily activities and can also have negative impacts on their relationships, academics, and social life. However, there are several ways that this addiction can be treated. The most commonly used method of treatment is therapy.

1. Therapy and Counseling

It has been seen that some people may experience withdrawal symptoms while trying to cut back on playing video games. The symptoms can include getting irritated, being moody, or being aggressive. According to Psychiatrist Micheal Broody MD, “the criteria for video game addiction is the same as that for addiction to a substance”.

Some of the most helpful and common therapy methods may include:

A. Cognitive Behavioral Therapy (CBT)

CBT has proven to be the most effective among patients suffering from video game addiction. Cognitive Behavioral Therapy ²⁵ allows the patient to evaluate the thoughts and patterns that govern their behavior. It allows the person to modify their thoughts and feelings that have a positive effect on their behavior. This therapy is largely based on identifying their own thoughts and patterns and channelizing those patterns into a better outcome.

Read More About Cognitive Behavioral Therapy (CBT) Here

B. PIPATIC Program

A 2018 study ²⁶ showed that the manualized PIPATIC intervention program, designed for 12-18-year-old adolescents affected by video game addiction, can be highly effective. The intervention involves 6 modules – psychoeducational, usual treatment, intrapersonal, interpersonal, family intervention, and development of a new lifestyle. According to the research, the PIPATIC programme “appears highly promising” as a “modern and integrated treatment based on CBT for the specific treatment of adolescents with IDG.”

C. Other Therapeutic Methods

Wilderness therapy has given a promising chance of recovering from this addiction. This method involves removing the addict from the source of the addiction. Therapists believe that when the addicts are in a natural environment away from the distractions of modern life it allows the patient to learn to be comfortable with their emotions.

2. Rehabilitation Centers

Rehabilitation centers are used to treat people with addiction. For instance, when a person has a drug or alcohol addiction they are sent to rehabilitation centers to recover and heal in an alcohol or drug-free environment. The idea is to keep an eye on the patient while removing the temptation. Similarly, gaming addiction rehabilitation centers help people to control and manage addiction in a systematic way.

The different types of treatment centers available for video game addiction are as follows:

A. Residential inpatient gaming addiction treatment centers

This treatment offers group therapy, individual therapy and counseling, and a game free atmosphere. It involves leaving their current environment and going to a game free environment in order to heal. These inpatient facilities provide dorm accommodations and are designed to make them feel safe and comfortable. This helps the patient to learn healthy coping skills in a contained environment.

B. Outpatient video game rehab and treatment program

This facility is the same as the residential inpatient treatment centers except for providing accommodation facilities at night. This program offers a significant amount of freedom since the patient can go home at the end of the day. This structure allows the patient to attend other commitments at work, school, friends, and family.

3. Medications

The clinical trials are still at its early stages however, medications have been found to be helpful among patients suffering from this disorder. There are certain medications that alter brain chemistry to reduce the urge to play. Bupropion ²⁷ has shown significant results in patients by inhibiting norepinephrine and dopamine reuptake. A trial conducted for six weeks showed that by taking those medications patients felt less urgency to play.

Some people suffering from this addiction are also found to have undiagnosed depression and anxiety. Therefore receiving medications for these underlying disorders, like an antidepressant and anti-anxiety drugs, can ultimately help to recover from gaming addiction as well.

Is Video Game Addiction Preventable?

Gaming disorder can be prevented by taking certain preventive measures. Here are some steps you can take to prevent gaming addiction in adults and children:

1. Preventive steps for adults

Abstinence is always the best option in order to prevent any kind of addiction. However, in the case of video games, it can be a harmless recreational activity if it is played in a balanced manner. Studies have found that some games played in moderation can hugely impact a person’s problem-solving skills. Video game addiction can be preventable if the following measures are practiced:

Limit the duration of the gaming session (for example, no more than two hours).
Avoid playing video games every day
Avoid playing before going to bed
Don’t take your gaming equipment on any vacation or holiday. If the person plays on any mobile device, it’s best to avoid the temptation and delete the applications.
Pay attention to anyone trying to show concern about the amount of time spent playing and give priority to relationships over video games.
If you find any signs or symptoms of addiction, contact an addiction specialist immediately.

2. Preventive steps for children

With a little bit of self-determination and practice, video game addiction can be preventable. It is of utmost importance to keep your child’s gaming addiction in check. Here are some tips that you can do:

Set a time limit for playing games.
Keep devices, phones, and other gadgets out of your bedroom so that you are not tempted to play.
Try doing other activities like exercise or taking a walk. This will also help to lower any health risks that can happen due to sitting and playing for a long duration of time.

There’s no way of knowing whether a particular game can lead to gaming addiction. Make sure that your child plays games that are for their age.

Is It Possible To Recover From Gaming Disorder?

It’s hard to see for yourself whether or not you have a video game addiction. The amount of time you spend playing may not seem like a lot of time for you. But it is important to pay attention to the people around you and what they have to say about it. If they say that you are playing too much, it might be time for you to cut back.

If you are a parent and you are concerned about your child playing video games, have a close look at his or her academic performance or social functioning. If they are scoring well and they have good relationships with you as well as their friends, then your child is probably not addicted to playing video games.