Video game addiction: Difference between revisions

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}}'''Video game addiction''' also known as '''gaming disorder''' or '''internet gaming disorder''' is generally defined as problematic, compulsive use of video and/or internet games, that results in significant impairment in an individual's function in various life domains over a prolonged period of time. This and other relationships between [[digital media use and mental health]] have been under considerable research, debate and discussion amongst experts in several disciplines, and have generated controversy from the medical, scientific and gaming communities. The disorder may present itself as [[compulsive]] gaming, [[social isolation]], [[mood swing]]s, diminished [[imagination]], and [[hyperfocus]] on in-game achievements, to the exclusion of other events in life.<ref name="Schivinski 176–184">{{Cite journal|last=Schivinski|first=Bruno|last2=Brzozowska-Woś|first2=Magdalena|last3=Buchanan|first3=Erin M.|last4=Griffiths|first4=Mark D.|last5=Pontes|first5=Halley M.|date=December 2018|title=Psychometric assessment of the Internet Gaming Disorder diagnostic criteria: An Item Response Theory study|journal=Addictive Behaviors Reports|volume=8|pages=176–184|doi=10.1016/j.abrep.2018.06.004|issn=2352-8532|pmc=6251978|pmid=30505924}}</ref><ref name="Tanner2007">{{cite news|url=http://www.msnbc.msn.com/id/19354827/|title=Is video-game addiction a mental disorder?|last=Tanner|first=Lindsey|date=22 June 2007|accessdate=2009-05-09|agency=Associated Press}}</ref> Such disorders can be diagnosed when an individual engages in gaming activities at the cost of fulfilling daily responsibilities or pursuing other interests, and without regard for the negative consequences.
}}'''Video game addiction''' also known as '''gaming disorder''' or '''internet gaming disorder''' is generally defined as problematic, compulsive use of video and/or internet games, that results in significant impairment in an individual's function in various life domains over a prolonged period of time. This and associated concepts have been under considerable research, debate and discussion amongst experts in several disciplines, and have generated controversy from the medical, scientific and gaming communities. The disorder may present itself as [[compulsive]] gaming, [[social isolation]], [[mood swing]]s, diminished [[imagination]], and [[hyperfocus]] on in-game achievements, to the exclusion of other events in life.<ref name="Schivinski 176–184">{{Cite journal|last=Schivinski|first=Bruno|last2=Brzozowska-Woś|first2=Magdalena|last3=Buchanan|first3=Erin M.|last4=Griffiths|first4=Mark D.|last5=Pontes|first5=Halley M.|date=December 2018|title=Psychometric assessment of the Internet Gaming Disorder diagnostic criteria: An Item Response Theory study|journal=Addictive Behaviors Reports|volume=8|pages=176–184|doi=10.1016/j.abrep.2018.06.004|issn=2352-8532|pmc=6251978|pmid=30505924}}</ref><ref name="Tanner2007">{{cite news|url=http://www.msnbc.msn.com/id/19354827/|title=Is video-game addiction a mental disorder?|last=Tanner|first=Lindsey|date=22 June 2007|accessdate=2009-05-09|agency=Associated Press}}</ref> Such disorders can be diagnosed when an individual engages in gaming activities at the cost of fulfilling daily responsibilities or pursuing other interests, and without regard for the negative consequences.


The [[World Health Organization]] included '''gaming disorder''' within the 11th revision of its [[International Statistical Classification of Diseases]].<ref name="auto">{{Cite journal|last=Pontes|first=Halley M.|last2=Schivinski|first2=Bruno|last3=Sindermann|first3=Cornelia|last4=Li|first4=Mei|last5=Becker|first5=Benjamin|last6=Zhou|first6=Min|last7=Montag|first7=Christian|date=2019-06-03|title=Measurement and Conceptualization of Gaming Disorder According to the World Health Organization Framework: the Development of the Gaming Disorder Test|url=https://doi.org/10.1007/s11469-019-00088-z|journal=International Journal of Mental Health and Addiction|language=en|doi=10.1007/s11469-019-00088-z|issn=1557-1882}}</ref><ref>{{cite web|url=http://time.com/5597258/gaming-disorder-icd-11-who/|title='Gaming Disorder' Is Now an Official Medical Condition, According to the WHO|work=Time|accessdate=6 June 2019}}</ref> The [[American Psychiatric Association]] (APA), whilst stating there is insufficient evidence for the inclusion of '''internet gaming disorder''' in the ''[[Diagnostic and Statistical Manual of Mental Disorders]]'' in 2013, considered it a condition for further study.<ref name="DSM-5 Conditions for Further Study">{{cite web|url=http://dsm.psychiatryonline.org/content.aspx?bookid=556&sectionid=41101794|title=Conditions for Further Study|work=Diagnostic and Statistical Manual of Mental Disorders|publisher=American Psychiatric Association|accessdate=31 August 2014|edition=5th}}</ref>
The [[World Health Organization]] included '''gaming disorder''' within the 11th revision of its [[International Statistical Classification of Diseases]].<ref name="auto">{{Cite journal|last=Pontes|first=Halley M.|last2=Schivinski|first2=Bruno|last3=Sindermann|first3=Cornelia|last4=Li|first4=Mei|last5=Becker|first5=Benjamin|last6=Zhou|first6=Min|last7=Montag|first7=Christian|date=2019-06-03|title=Measurement and Conceptualization of Gaming Disorder According to the World Health Organization Framework: the Development of the Gaming Disorder Test|url=https://doi.org/10.1007/s11469-019-00088-z|journal=International Journal of Mental Health and Addiction|language=en|doi=10.1007/s11469-019-00088-z|issn=1557-1882}}</ref><ref>{{cite web|url=http://time.com/5597258/gaming-disorder-icd-11-who/|title='Gaming Disorder' Is Now an Official Medical Condition, According to the WHO|work=Time|accessdate=6 June 2019}}</ref> The [[American Psychiatric Association]] (APA), whilst stating there is insufficient evidence for the inclusion of '''internet gaming disorder''' in the ''[[Diagnostic and Statistical Manual of Mental Disorders]]'' in 2013, considered it a condition for further study.<ref name="DSM-5 Conditions for Further Study">{{cite web|url=http://dsm.psychiatryonline.org/content.aspx?bookid=556&sectionid=41101794|title=Conditions for Further Study|work=Diagnostic and Statistical Manual of Mental Disorders|publisher=American Psychiatric Association|accessdate=31 August 2014|edition=5th}}</ref>
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{{Expand section|date=January 2018}}
{{Expand section|date=January 2018}}
[[File:Edge (video game) mockup on Sony Ericsson phone.jpg|thumb|70 px|Video game on a keypad mobile]]
[[File:Edge (video game) mockup on Sony Ericsson phone.jpg|thumb|70 px|Video game on a keypad mobile]]
Some theorists focus on presumed built-in reward systems of the games to explain their potentially addictive nature.<ref>Haggard, Daniel. [http://danielhaggard.com/24/the-computer-game-affliction-how-they-addict-you/ The computer game affliction: how they addict you.] {{webarchive |url=https://web.archive.org/web/20070410040008/http://danielhaggard.com/24/the-computer-game-affliction-how-they-addict-you/ |date=10 April 2007 }}. Retrieved 25 June 2007.</ref><ref>LeClaire, Jennifer. [http://www.technewsworld.com/story/52916.html Warning Signs Appear Along Road to Video Game Addiction] ''TechNews World''. 13 September 2006. Retrieved 25 June 2007.</ref> Many video games, particularly [[massively multiplayer online role-playing game]]s and [[social network game|social network]] and [[mobile game]]s,<ref>JoyofAndroid.com [http://joyofandroid.com/mobile-gaming-addiction/ Mobile Game Addiction 101]</ref> rely on a "[[compulsion loop]]" or "core loop" - a cycle of activities that involve rewarding the player and driving them to continue through another cycle, retaining them in the game. The anticipation of such rewards can create a neurological reaction that releases [[dopamine]] into the body, so that once the reward is obtained, the person will remember it as a pleasurable feeling. This has been found similar to the same neurological reaction believed to be associated with gambling addiction.<ref>{{cite web |url=https://thenextweb.com/insider/2013/01/12/what-makes-games-so-addictive/ |title=A quiet killer: Why video games are so addictive |first=Mez |last=Breeze |date=12 January 2013 |accessdate=15 July 2016 |work=The Next Web}}</ref><ref>{{cite web |url=https://www.theatlantic.com/health/archive/2012/07/exploiting-the-neuroscience-of-internet-addiction/259820/ |title=Exploiting the Neuroscience of Internet Addiction |first=Bill |last=Davidow |date=18 July 2012 |accessdate=15 July 2016 |work=[[The Atlantic]]}}</ref> In reference to gamers, such as one suicide in China, the head of one software association stated, "In the hypothetical world created by such games, they become confident and gain satisfaction, which they cannot get in the real world."<ref name="dangers">{{cite web |url=http://play.tm/news/5928/chinese-suicide-shows-addiction-dangers/ |title=Chinese suicide shows addiction dangers |date=3 June 2005 |work=Play |deadurl=yes |archiveurl=https://web.archive.org/web/20100327052415/http://play.tm/news/5928/chinese-suicide-shows-addiction-dangers |archivedate=27 March 2010 |df=dmy-all}}</ref>


Griffiths has also proposed that another reason why online video games are potentially addictive is because they "can be played all day every day." The fact that there is no end to the game can feel rewarding for some, and hence players are further engaged in the game.<ref name="Griffiths" />

A high prenatal testosterone load may be a risk factor for the development of video game addiction in adulthood.<ref>{{cite journal |last1=Kornhuber |first1=J. |last2=Zenses |first2=EM |last3=Lenz |first3=B |last4=Stoessel |first4=C |last5=Bouna-Pyrrou |first5=P |last6=Rehbein |first6=F |last7=Kliem |first7=S |last8=Mößle |first8=T |year=2013 |title=Low digit ratio 2D:4D associated with video game addiction |journal=PLoS ONE |volume=8 |issue=11 |page=e79539 |doi=10.1371/journal.pone.0079539 |pmid=24236143 |pmc=3827365}}</ref>


Ferguson, Coulson and Barnett in a meta-analytic review of the research, concluded that the evidence suggests that video game addiction arises out of other mental health problems, rather than causing them.<ref name="Ferguson 1573–1576"/> Thus it is unclear whether video game addiction should be considered a unique diagnosis.<ref name="Ferguson 1573–1576"/>
Ferguson, Coulson and Barnett in a meta-analytic review of the research, concluded that the evidence suggests that video game addiction arises out of other mental health problems, rather than causing them.<ref name="Ferguson 1573–1576"/> Thus it is unclear whether video game addiction should be considered a unique diagnosis.<ref name="Ferguson 1573–1576"/>


Researchers at the [[University of Rochester]] and Immersyve, Inc. (a Celebration, Florida, computer gaming [[think-tank]]) investigated what motivates gamers to continue playing video games.
Researchers at the [[University of Rochester]] and Immersyve, Inc. (a Celebration, Florida, computer gaming [[think-tank]]) investigated what motivates gamers to continue playing video games.
According to lead investigator Richard Ryan, they believe that players play for more reasons than fun alone. Ryan, a motivational psychologist at Rochester, says that many video games satisfy basic psychological needs, and players often continue to play because of rewards, freedom, and a connection to other players.<ref>[http://ndri.com/article/cause_and_impact_of_video_games_addiction_-211.html Cause and Impact of Video Games Addiction.] All about Health, News, Articles, Discussion. 5 February 2007 Accessed 8 May 2008.</ref>
According to lead investigator Richard Ryan, they believe that players play for more reasons than fun alone.
Ryan, a motivational psychologist at Rochester, says that many video games satisfy basic psychological needs, and players often continue to play because of rewards, freedom, and a connection to other players.<ref>[http://ndri.com/article/cause_and_impact_of_video_games_addiction_-211.html Cause and Impact of Video Games Addiction.] All about Health, News, Articles, Discussion. 5 February 2007 Accessed 8 May 2008.</ref>

Michael Brody,<!-- not the one with a Wikipedia article as of 2009 July --> M.D., head of the TV and Media Committee of the [[American Academy of Child and Adolescent Psychiatry]], stated in a 2007 press release that "... there is not enough research on whether or not video games are addictive." However, Brody also cautioned that for some children and adolescents, "... it displaces physical activity and time spent on studies, with friends, and even with family."<ref>{{cite web |url=http://www.aacap.org/cs/2007_press_releases/child_and_adolescent_psychiatrists_react_to_ama_recommendation_on_video_games |title=Child and Adolescent Psychiatrists React to AMA Recommendation on Video Games |accessdate=31 January 2009 |publisher=The American Academy of Child and Adolescent Psychiatry (AACAP) |date=28 June 2007}}</ref>

Karen Pierce, a psychiatrist at Chicago's [[Children's Memorial Hospital]], sees no need for a specific gaming addiction diagnosis. Two or more children see her each week because of excessive computer and video game play, and she treats their problems as she would any addiction. She said one of her excessive-gaming patients "...hasn't been to bed, hasn't showered...He is really a mess".<ref name="Tanner2007" />


== Diagnosis ==
== Diagnosis ==
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Excessive use of video games may have some or all of the [[symptoms]] of [[drug addiction]] or other proposed [[Behavioral addiction|psychological addictions]].
Excessive use of video games may have some or all of the [[symptoms]] of [[drug addiction]] or other proposed [[Behavioral addiction|psychological addictions]].
Some players become more concerned with their interactions in the game than in their broader lives. Players may play many hours per day, neglect personal hygiene, gain or lose significant weight due to playing, disrupt sleep patterns to play resulting in [[sleep deprivation]], play at work, avoid phone calls from friends, or lie about how much time they spend playing video games.<ref name="Tanner2007" /><ref name="7069OnlineSurveys">{{cite journal|last=Grüsser|first=S.M.|author2=R. Thalemann|author3=M. D. Griffiths|date=April 2007|title=Excessive Computer Game Playing: Evidence for Addiction and Aggression?|url=http://irep.ntu.ac.uk/id/eprint/15390/1/185698_3384%20Griffiths%20Publisher.pdf|journal=CyberPsychology & Behavior|volume=10|issue=2|pages=290–292|doi=10.1089/cpb.2006.9956|pmid=17474848}}</ref>
Some players become more concerned with their interactions in the game than in their broader lives. Players may play many hours per day, neglect personal hygiene, gain or lose significant weight due to playing, disrupt sleep patterns to play resulting in [[sleep deprivation]], play at work, avoid phone calls from friends, or lie about how much time they spend playing video games.<ref name="Tanner2007" /><ref name="7069OnlineSurveys"/>


APA has developed 9 criteria for characterizing the proposed Internet gaming disorder:<ref name="APA"/>
APA has developed 9 criteria for characterizing the proposed Internet gaming disorder:<ref name="APA"/>
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As a growing concern of video game addiction, the use of psychopharmacology, psychotherapy, twelve-step programs, and use of continuing developing treatment enhancements have proven to show signs of the decrease the side effect of the addiction of video games.<ref name="health.am">{{cite web |author=Cindy Burkhardt Freeman |title=Internet Gaming Addiction Treatments |publisher=The Journal for Nurse Practitioners |url=http://www.health.am/psy/more/internet-gaming-addiction/P4/ |date=January 2008 |issue=1 |pages=42–47 |accessdate=2008-05-07}}</ref>[145]
As a growing concern of video game addiction, the use of psychopharmacology, psychotherapy, twelve-step programs, and use of continuing developing treatment enhancements have proven to show signs of the decrease the side effect of the addiction of video games.<ref name="health.am">{{cite web |author=Cindy Burkhardt Freeman |title=Internet Gaming Addiction Treatments |publisher=The Journal for Nurse Practitioners |url=http://www.health.am/psy/more/internet-gaming-addiction/P4/ |date=January 2008 |issue=1 |pages=42–47 |accessdate=2008-05-07}}</ref>[145]


Some countries, such as South Korea, China, the Netherlands, Canada, and the United States, have responded to the perceived threat of video game addiction by opening treatment centers.<ref name="Faiola">Faiola, Anthony. [https://www.washingtonpost.com/wp-dyn/content/article/2006/05/26/AR2006052601960.html When Escape Seems Just a Mouse-Click Away -Stress-Driven Addiction to Online Games Spikes in S. Korea.] ''Washington Post Foreign Service'' 27 May 2006. Retrieved 25 June 2007.</ref>
Some countries, such as South Korea, China, the Netherlands, Canada, and the United States, have responded to the perceived threat of video game addiction by opening treatment centers.<ref name="Faiola"/>


=== China ===
=== China ===
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One meta-analytic review of pathological gaming studies concluded that about 3.0% of gamers may experience some symptoms of pathological gaming.<ref name="Ferguson 1573–1576">{{cite journal |last=Ferguson |first=C.J. |author2=M. Coulson |author3=J. Barnett Griffiths |year=2011 |journal=Journal of Psychiatric Research |volume=45 |issue=12 |pages=1573–1576 |doi=10.1016/j.jpsychires.2011.09.005 |url=https://books.google.com/?id=_HMCZcWeJf8C&printsec=frontcover#v=onepage&q&f=false |title=Video Game Addiction |pmid=21925683}}</ref> The report noted problems in the field with defining and measuring pathological gaming and concluded that pathological gaming behaviors were more likely the product of underlying mental health problems rather than the inverse.
One meta-analytic review of pathological gaming studies concluded that about 3.0% of gamers may experience some symptoms of pathological gaming.<ref name="Ferguson 1573–1576">{{cite journal |last=Ferguson |first=C.J. |author2=M. Coulson |author3=J. Barnett Griffiths |year=2011 |journal=Journal of Psychiatric Research |volume=45 |issue=12 |pages=1573–1576 |doi=10.1016/j.jpsychires.2011.09.005 |url=https://books.google.com/?id=_HMCZcWeJf8C&printsec=frontcover#v=onepage&q&f=false |title=Video Game Addiction |pmid=21925683}}</ref> The report noted problems in the field with defining and measuring pathological gaming and concluded that pathological gaming behaviors were more likely the product of underlying mental health problems rather than the inverse.


In year 2010, article 24 of ''ACM Journal of Computers in Entertainment'' (volume 8, issue 4) by Andrews Samraj and CK Loo suggested a built-in component based remedy for reverting the children back from the adverse damages caused by the video games.<ref>{{cite journal |last1=Samraj |first1=Andrews |title=Meditainment and infotainment for health and intellect |journal=ACM Journal of Computers in Entertainment |volume=8 |issue=4 |date=December 2010 |doi=10.1145/1921141.1921144 |pages=1–3}}</ref>
Other scholars have cautioned that comparing the symptoms of problematic gaming with problematic gambling is flawed, and that such comparisons may introduce research [[confounds and artifacts|artifacts]] and artificially inflate prevalence estimates. For instance, Richard Wood has observed that behaviors which are problematic in regards to gambling may not be as problematic when put into the context of other behaviors that are rewarding such as gaming.<ref>{{cite journal |title=Problems with the Concept of Video Game "Addiction": Some Case Study Examples |doi=10.1007/s11469-007-9118-0 |volume=6 |issue=2 |journal=International Journal of Mental Health and Addiction |pages=169–178 |date=April 2008 |last1=Wood |first1=Richard T. A.}}</ref> Similarly, Barnett and Coulson have cautioned that discussions of problematic gaming have moved forward prematurely without proper understanding of the symptoms, proper assessment and consequences.<ref name="Barnett">{{cite journal|last=Barnett|first=Jane|author2=Mark Coulson|year=2010|title=Virtually Real: A Psychological Perspective on Massively Multiplayer Online Games|url=http://psycnet.apa.org/journals/gpr/14/2/167/|journal=Review of General Psychology|volume=14|issue=2|pages=167–179|doi=10.1037/a0019442|accessdate=1 January 2010}}</ref>

A report by the Council on Science and Public Health to the AMA cited a 2005 [[Entertainment Software Association]] survey of computer game players and noted that players of [[MMORPGs]] were more likely to play for more than two hours per day than other gamers.<ref>{{cite web |url=https://web.archive.org-main.us/web/20080131140453/http://www.forbes.com/forbeslife/health/feeds/hscout/2007/06/22/hscout605801.html |title=Video Game Overuse May Be an bad Addiction: Experts |work=Forbes |date=22 June 2007 |accessdate=25 June 2007}}</ref><ref>{{cite web |work=HealthDay |url=http://www.dentalplans.com/articles/20277/video-game-overuse-may-be-an-addiction--experts.html |title=Video Game Overuse May Be an Addiction: Experts |date=22 June 2007 |author=E.J. Mundell |accessdate=14 July 2010}}</ref> In its report, the Council used this two-hour-per-day limit to define "gaming overuse", citing the [[American Academy of Pediatrics]] guideline of no more than one to two hours per day of "screen time."<ref>{{cite web |url=http://psychcentral.com/blog/images/csaph12a07.pdf |title=Emotional and Behavioral Effects, Including Addictive Potential, of Video Games |accessdate=31 January 2009}}</ref> However, the ESA document cited in the Council report does not contain the two-hour-per-day data.<ref>{{cite web |url=http://www.theesa.com/files/2005EssentialFacts.pdf |archiveurl=https://web.archive.org/web/20080325220544/http://www.theesa.com/files/2005EssentialFacts.pdf |archivedate=25 March 2008 |title=2005 SALES, DEMOGRAPHICS AND USAGE DATA (from archive.org) |accessdate=31 January 2009}}</ref>

In a 2005 [[Tom's Games]] interview, [[Maressa Orzack]] estimated that 40% of the <!-- *NOT* 10 million in 2005, and the article doesn't say, so if you add it, please add a source --> players of ''[[World of Warcraft]]'' (an MMORPG) were addicted, but she did not indicate a source for the estimate.<ref>{{cite web |url=http://us.tomsgames.com/us/2006/08/08/world_of_warcraft_players_addicted/ |title=Expert: 40 Percent of World of Warcraft Players Addicted |accessdate=31 January 2009 |deadurl=yes |archiveurl=https://web.archive.org/web/20081206100446/http://us.tomsgames.com/us/2006/08/08/world_of_warcraft_players_addicted/ |archivedate=6 December 2008}}</ref>
She may have derived the estimate from the informal survey managed by [[Nick Yee]] at [[The Daedalus Project]],<ref>{{cite web |last=Ferguson |first=Dylan |url=http://www.themanitoban.com/2006-2007/0328/121.World.of.warcrack.php |title=World of Warcrack: the addictive power of role-playing games |work=The Manitoban Online |date=28 March 2007 |accessdate=25 June 2007 |deadurl=yes |archiveurl=https://web.archive.org/web/20070814140711/http://www.themanitoban.com/2006-2007/0328/121.World.of.warcrack.php |archivedate=14 August 2007}}</ref> who notes that caution should be exercised when interpreting that data.<ref>{{cite web |last=Yee |first=Nick |url=http://www.nickyee.com/daedalus/archives/000818.php |title=The Daedalus Project: Addiction |work=The Daedalus Project |date=9 July 2004}}</ref>

A 2006 lecture reported by the [[BBC]] indicated that 12% of polled online gamers reported at least some addictive behaviours.<ref name="7069OnlineSurveys">{{cite journal |last=Grüsser |first=S.M. |author2=R. Thalemann |author3=M. D. Griffiths |date=April 2007 |journal=CyberPsychology & Behavior |volume=10 |issue=2 |pages=290–292 |doi=10.1089/cpb.2006.9956 |pmid=17474848 |title=Excessive Computer Game Playing: Evidence for Addiction and Aggression? |url=http://irep.ntu.ac.uk/id/eprint/15390/1/185698_3384%20Griffiths%20Publisher.pdf}}</ref><ref>[http://news.bbc.co.uk/2/hi/uk_news/england/nottinghamshire/6193462.stm Online gamers addicted says study.] ''BBC News'' 28 November 2006. Retrieved 25 June 2007.</ref>
The lecturer, Professor Mark Griffiths of [[Nottingham Trent University]], stated in another BBC interview that addicts are "few and far between." <ref name="NotUnhealthy">{{cite news |url=http://news.bbc.co.uk/2/hi/health/7621412.stm |title=Online gamers 'are not unhealthy' |date=17 September 2008 |work=BBC News |accessdate=2009-05-09}}</ref>

In 2007, Michael Cai, director of broadband and gaming for Parks Associates (a media/technology research and analysis company), said that "Video game addiction is a particularly severe problem in Asian countries such as China and Korea."<ref name="technews">Noyes, Katherine. [http://www.technewsworld.com/story/58014.html Docs Retreat From 'Video Game Addiction' Diagnosis] ''Tech News World'' 25 June 2007. Retrieved 27 June 2007.</ref>
Results of a 2006 survey suggested that 2.4% of South Koreans aged 9 to 39 suffer from game addiction, with another 10.2% at risk of addiction.<ref name="Faiola">Faiola, Anthony. [https://www.washingtonpost.com/wp-dyn/content/article/2006/05/26/AR2006052601960.html When Escape Seems Just a Mouse-Click Away -Stress-Driven Addiction to Online Games Spikes in S. Korea.] ''Washington Post Foreign Service'' 27 May 2006. Retrieved 25 June 2007.</ref>

A 2007 [[Harris Insights & Analytics|Harris Interactive]] online poll of 1,187 United States youths aged 8–18 gathered detailed data on youth opinions about video game play. About 81% of youths stated that they played video games at least once per month. Further, the average play time varied by age and gender, from eight hours per week (responses from teen girls) to 14&nbsp;hours per week (responses by teen boys).
"[[Preadolescence|Tween]]s" (8- to 12-year-olds) fell in the middle, with boys averaging 13&nbsp;hours per week of reported game play and girls averaging 10.
Harris concluded that 8.5% "can be classified as pathological or clinically 'addicted' to playing video games," but did not explain how this conclusion was reached.<ref>{{cite web |url=https://foreverpunk.files.wordpress.com/2008/07/video-game-addiction-is-it-real.pdf |title=Video game addiction: is it real? |work=Harris Interactive |date=2 April 2007 |accessdate=25 June 2007}}</ref>

Since the [[American Psychiatric Association]] decision in 2007, studies have been conducted at [[Stanford University School of Medicine]] related to video game play. Researchers found evidence that video games do have addictive characteristics.<ref>{{cite web |url=https://www.sciencedaily.com/releases/2007/06/070625133354.htm |title=American Psychiatric Association Considers 'Video Game Addiction' |publisher=Sciencedaily.com |date=26 June 2007 |accessdate=2009-08-09}}</ref><ref>{{cite web |url=https://serendipstudio.org/exchange/node/2138 |title=Video Game Addiction: Mental Disorder? &#124; Serendip's Exchange |publisher=serendipstudio.org |accessdate=2019-02-24}}</ref>
An MRI study found that the part of the brain that generates rewarding feelings is more activated in men than women during video game play.<ref name="stanford">{{cite web |author=MICHELLE L. BRANDT |title=Video games activate reward regions of brain in men more than women, Stanford study finds |publisher=Stanford University School of Medicine |url=http://med.stanford.edu/news_releases/2008/february/videobrain.html |year=2008 |accessdate=2008-05-07 |deadurl=yes |archiveurl=https://web.archive.org/web/20080513084434/http://med.stanford.edu/news_releases/2008/february/videobrain.html |archivedate=13 May 2008 |df=dmy-all}}</ref><ref>{{cite news |url=https://www.telegraph.co.uk/science/science-news/3965269/Men-enjoy-computer-games-because-of-basic-urge-to-conquer.html |title=Men enjoy computer games 'because of basic urge to conquer' |date=26 December 2008 |work=The Daily Telegraph |location=London |first=Matthew |last=Moore |accessdate=27 May 2010}}</ref>

The 2009 OSDUHS Mental Health and Well-Being Report, by the [[Centre for Addiction and Mental Health]] (CAMH) in Toronto, Ontario, showed almost 10% of 9,000 surveyed students from Grades 7 to 12 get at least 7&nbsp;hours a day of "screen time." <ref>{{cite web |url=http://www.camh.net/research/osdus.html |title=Ontario Student Drug Use and Health Survey |publisher=Centre for Addiction and Mental Health |year=2009}}</ref> A little over 10% also reported having video gaming problems in the previous year. A recent article in ''[[Pediatrics (journal)|Pediatrics]]'' found a mild association between watching television or playing a video game and attention issues in more than 1,300 children ages eight to 11 years old. Children who played video games or watched television for more than the normal two hours a day maximum, which is recommended by the [[American Academy of Pediatrics]] were 1.5 – 2 times more likely to show signs of attention issues, the researchers found. However, the study was further criticized in eLetters to the same journal for failing to use well-validated measures of attention problems or control for other important variables.<ref>{{cite journal |doi=10.1542/peds.2009-1508 |title=Television and Video Game Exposure and the Development of Attention Problems |journal=Pediatrics |volume=126 |issue=2 |pages=214–21 |date=August 2010 |first=Edward |pmid=20603258 |last=Swing |author2=Douglas A. Gentile |author3=Craig A. Anderson |author4=David A. Walsh |id= |url=http://pediatrics.aappublications.org/cgi/content/full/126/2/214?maxtoshow=&hits=10&RESULTFORMAT=&fulltext=Edward+Swing&searchid=1&FIRSTINDEX=0&sortspec=relevance&resourcetype=HWCIT |accessdate=2010-09-19}}</ref> A more recent study using the Child Behavior Checklist and controlling for family and mental health variables, found no link between video game use and attention problems.<ref>{{cite journal |url=http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6T8T-51N0SSY-1&_user=10&_coverDate=12%2F07%2F2010&_rdoc=1&_fmt=high&_orig=search&_origin=search&_sort=d&_docanchor=&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=442964e8fba20bf0c76e306767ecedd9&searchtype=a |archive-url=https://archive.today/20120909131255/http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6T8T-51N0SSY-1&_user=10&_coverDate=12/07/2010&_rdoc=1&_fmt=high&_orig=search&_origin=search&_sort=d&_docanchor=&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=442964e8fba20bf0c76e306767ecedd9&searchtype=a |dead-url=yes |archive-date=9 September 2012 |title=The influence of television and video game use on attention and school problems: A multivariate analysis with other risk factors controlled |first=Christopher |last=Ferguson |journal=Journal of Psychiatric Research |accessdate=1 January 2010 |doi=10.1016/j.jpsychires.2010.11.010 |year=2010 |volume=45 |issue=6 |pages=808–13 |pmid=21144536}}</ref> Also, a study in ''Pediatrics''<ref>{{cite journal |url=http://pediatrics.aappublications.org/cgi/content/abstract/peds.2009-2706v1 |title=Video-Gaming Among High School Students: Health Correlates, Gender Differences, and Problematic Gaming |journal=Pediatrics |volume=126 |issue=6 |pages=e1414–e1424 |accessdate=1 January 2010 |doi=10.1542/peds.2009-2706 |pmid=21078729 |pmc=3678538 |year=2010 |last1=Desai |first1=R. A. |last2=Krishnan-Sarin |first2=S. |last3=Cavallo |first3=D. |last4=Potenza |first4=M. N.}}</ref> found problematic gaming behaviors to be far less common, about 4%, and concluded that such problems were the result of underlying mental health problems rather than anything unique to gaming.

Writing in the ''[[Review of General Psychology]]''{{'}}s special issue on video games, Barnett and Coulson<ref name="Barnett">{{cite journal |url=http://psycnet.apa.org/journals/gpr/14/2/167/ |title=Virtually Real: A Psychological Perspective on Massively Multiplayer Online Games |first=Jane |last=Barnett |author2=Mark Coulson |journal=Review of General Psychology |accessdate=1 January 2010 |doi=10.1037/a0019442 |volume=14 |issue=2 |pages=167–179 |year=2010}}</ref> expressed concern that much of the debate on the issue of addiction may be a knee jerk response stimulated by poor understanding of games and game players. Such issues may lead both society and scholars to exaggerate the prevalence and nature of problematic gaming, and over-focus on games specifically while ignoring underlying mental health issues.

Other scholars have cautioned that comparing the symptoms of problematic gaming with problematic gambling is flawed, and that such comparisons may introduce research [[confounds and artifacts|artifacts]] and artificially inflate prevalence estimates. For instance, Richard Wood has observed that behaviors which are problematic in regards to gambling may not be as problematic when put into the context of other behaviors that are rewarding such as gaming.<ref>{{cite journal |title=Problems with the Concept of Video Game "Addiction": Some Case Study Examples |doi=10.1007/s11469-007-9118-0 |volume=6 |issue=2 |journal=International Journal of Mental Health and Addiction |pages=169–178 |date=April 2008 |last1=Wood |first1=Richard T. A.}}</ref> Similarly, Barnett and Coulson have cautioned that discussions of problematic gaming have moved forward prematurely without proper understanding of the symptoms, proper assessment and consequences.<ref name="Barnett"/>


Some scholars suggest that psycho-social dependence may revolve around the intermittent reinforcements in the game and the need to belong.<ref name=Griffiths/> Some scholars explain that the social dependence that may arise due to video games occurring online where players interact with others and the relationships "often become more important for gamers than real-life relationships".<ref name="Hagedorn">{{cite journal |vauthors=Hagedorn W, Young T |year=2011 |title=Identifying and Intervening with Students Exhibiting Signs of Gaming Addiction and other Addictive Behaviors: Implications for Professional School Counselors. |volume=14 |issue=4 |pages=250–260 |issn=1096-2409 |doi=10.5330/PSC.n.2011-14.250 |journal=Professional School Counseling}}</ref>
Some scholars suggest that psycho-social dependence may revolve around the intermittent reinforcements in the game and the need to belong.<ref name=Griffiths/> Some scholars explain that the social dependence that may arise due to video games occurring online where players interact with others and the relationships "often become more important for gamers than real-life relationships".<ref name="Hagedorn">{{cite journal |vauthors=Hagedorn W, Young T |year=2011 |title=Identifying and Intervening with Students Exhibiting Signs of Gaming Addiction and other Addictive Behaviors: Implications for Professional School Counselors. |volume=14 |issue=4 |pages=250–260 |issn=1096-2409 |doi=10.5330/PSC.n.2011-14.250 |journal=Professional School Counseling}}</ref>

Through interviews with gamers who were addicted to a [[MMORPG]] but have quit playing, multiple reasons causing gamers to leave their game has been disclosed. This also reflects a number of aspects of online game addiction.<ref>{{cite web |url=http://www.digra.org/digital-library/publications/leaving-a-never-ending-game-quitting-mmorpgs-and-online-gaming-addiction/ |first1=Lee |last1=Ichia |first2=Yu |last2=Chen-Yi |first3=Lin |last3=Holin |title=Leaving a Never-Ending Game: Quitting MMORPGs and Online Gaming Addiction |accessdate=13 April 2014}}</ref>

In a study published on the [[Royal Society Open Science]] <ref>{{Cite journal |last=Sapienza |first=Anna |last2=Zeng |first2=Yilei |last3=Bessi |first3=Alessandro |last4=Lerman |first4=Kristina |last5=Ferrara |first5=Emilio |date=2018-06-01 |title=Individual performance in team-based online games |url=http://rsos.royalsocietypublishing.org/content/5/6/180329 |journal=Royal Society Open Science |volume=5 |issue=6 |pages=180329 |doi=10.1098/rsos.180329 |pmid=30110428 |pmc=6030337 |issn=2054-5703 |bibcode=2018RSOS....580329S}}</ref> a research team analyzed the activity of thousands of [[League of Legends]] (a popular [[Multiplayer online battle arena|MOBA]]) players and illustrated the effects of prolonged game sessions on performance that appear correlated with a decline in individual and team performance; however, this effect is significantly more pronounced in novice players than in experts.

Many{{who|date=November 2016}} describe video game addiction to be a global mental health problem and that gamers who gain characteristics of addiction show decreased functioning in school, social, family, occupational and social domains of their lives in addition to their social lives.<ref>Social</ref> Once addicted to video games, these youth are more likely to become depressed, anxious, and have lower academic achievement.<ref>{{cite journal |author=Cheng, K |title=Video game addiction |journal=Neuropsychiatrie de l'Enfance et de l'Adolescence |volume=60 |issue=5 |pages=118 |year=2012}}</ref>
In a qualitative analysis of online gaming addicts done by Marta Beranuy, Xavier Carbonell and Mark D. Griffiths, which dived deeper into the source of gaming addiction, one interviewer described gaming as a method of stress relief. "I played just to forget almost everything, it is like a second life. I was stressed but I found a way out to forget all my problems" [P2]. Another person described gaming as a medicine "it was a medicine for me. I was a bit depressed and left my job because I thought I was ill" [P7].<ref>Beranuy, Marta, Carbonnell, Xavier, and Griffiths, Mark D. ‘A qualitative analysis of online Gaming addicts in treatment’, international journal of mental health and addiction available at http://recerca.blanquerna.edu/</ref>

In July 2018, a study published by LSU's [[Pennington Biomedical Research Center]] shows that some video games can decrease or control [[obesity]], lower the blood pressure and [[cholesterol]] in children if followed with proper coaching and a step tracker.<ref>{{Cite news |url=https://economictimes.indiatimes.com/magazines/panache/turns-out-video-games-can-help-improve-the-health-in-obese-children/articleshow/65079049.cms |title=Turns out, video games can help improve the health in obese children |date=2018-07-21 |work=The Economic Times |access-date=2018-07-24}}</ref><ref>{{Cite news |url=https://www.sciencedaily.com/releases/2018/07/180720092501.htm |title=New study shows certain video games can improve health in children with obesity |work=ScienceDaily |access-date=2018-07-24}}</ref>


=== General critiques on addiction research ===
=== General critiques on addiction research ===
Common challenges involve the reliability of the [[methodology]] and [[Construct validity|validity]] of the results in some studies. Many rely on self-surveys from University students and also lack time frames making it difficult to study the impact, if any, of addiction on a long term scale. Other concerns also address the definition of addiction and how to measure it, questioning whether or not time is a proper unit to determine how addicted someone is to [[Video game culture|gaming]].<ref>{{Cite journal |title=Online video game addiction: identification of addicted adolescent gamers |date=2010 |journal=Addiction |doi=10.1111/j.1360-0443.2010.03104.x |pmid=20840209 |volume=106 |issue=1 |pages=205–212 |last1=Van Rooij |first1=AJ |last2=Schoenmakers |first2=TM |last3=Vermulst |first3=AA |last4=Van den Eijnden |first4=RJ |last5=Van de Mheen |first5=D}}</ref> A 2014 study done by Brunborg, Mentzoni and Froyland found that video game addiction does have a correlation with negative outcomes, such as [[Depression (mood)|depression]]. However, as stated in the article, the link between time spent on gaming and the same outcomes were found to be weaker than the former, showing that time may not be the only factor in gaming addiction.<ref name="Brunborg 2014">{{Cite journal |url=http://www.akademiai.com/content/u526021p73464716/fulltext.pdf |title=Is video gaming, or video game addiction, associated with depression, academic achievement, heavy episodic drinking, or conduct problems? |last=Brunborg |first=Geir Scott |date=2014 |journal=Journal of Behavioral Addictions |doi= |pmid= |access-date=}}{{dead link|date=January 2018 |bot=InternetArchiveBot |fix-attempted=yes }}</ref>
Though the study on the topic of gaming [[addiction]] is growing, the research is still young, and is therefore conducive to critique. Common challenges involve the reliability of the [[methodology]] and [[Construct validity|validity]] of the results in some studies. Many rely on self-surveys from University students and also lack time frames making it difficult to study the impact, if any, of addiction on a long term scale. Other concerns also address the definition of addiction and how to measure it, questioning whether or not time is a proper unit to determine how addicted someone is to [[Video game culture|gaming]].<ref>{{Cite journal |title=Online video game addiction: identification of addicted adolescent gamers |date=2010 |journal=Addiction |doi=10.1111/j.1360-0443.2010.03104.x |pmid=20840209 |volume=106 |issue=1 |pages=205–212 |last1=Van Rooij |first1=AJ |last2=Schoenmakers |first2=TM |last3=Vermulst |first3=AA |last4=Van den Eijnden |first4=RJ |last5=Van de Mheen |first5=D}}</ref> A 2014 study done by Brunborg, Mentzoni and Froyland found that video game addiction does have a correlation with negative outcomes, such as [[Depression (mood)|depression]]. However, as stated in the article, the link between time spent on gaming and the same outcomes were found to be weaker than the former, showing that time may not be the only factor in gaming addiction.<ref name="Brunborg 2014">{{Cite journal |url=http://www.akademiai.com/content/u526021p73464716/fulltext.pdf |title=Is video gaming, or video game addiction, associated with depression, academic achievement, heavy episodic drinking, or conduct problems? |last=Brunborg |first=Geir Scott |date=2014 |journal=Journal of Behavioral Addictions |doi= |pmid= |access-date=}}{{dead link|date=January 2018 |bot=InternetArchiveBot |fix-attempted=yes }}</ref>


Other challenges include the lack of context of the participant's life and the negative portrayal of gaming addicts.<ref>{{Cite book |title=Principles of Addiction: Comprehensive Addictive Behaviors and Disorders, Volume 1 |last=Miller |first=Peter |publisher=Academic Press |year=2013 |isbn= |location= |pages=819–825}}</ref> Some state that gamers sometimes use [[video games]] to either escape from an uncomfortable environment or alleviate their already existing mental issues – both possibly important aspects on determining the [[psychological]] impact of gaming. Negative portrayal also deals with the lack of consistency in measuring addictive gaming. This leads to discussions that sometimes exaggerated the issue and create a misconception in some that they, themselves, may be addicted when they are not.<ref>{{Cite journal |title=Problems with the Concept of Video Game "Addiction": Some Case Study Examples |last=Wood |first=Richard |date=2008 |journal=International Journal of Mental Health and Addiction |doi=10.1007/s11469-007-9118-0 |pmid= |volume=6 |issue=2 |pages=169–178}}</ref><ref>{{Cite book |title=Principles of Addiction: Comprehensive Addictive Behaviors and Disorders, Volume 1. |last=Miller |first=Peter |publisher=Academic Press. |year=2013 |isbn= |location= |pages=819–825}}</ref>
Other challenges include the lack of context of the participant's life and the negative portrayal of gaming addicts.<ref>{{Cite book |title=Principles of Addiction: Comprehensive Addictive Behaviors and Disorders, Volume 1 |last=Miller |first=Peter |publisher=Academic Press |year=2013 |isbn= |location= |pages=819–825}}</ref> Some state that gamers sometimes use [[video games]] to either escape from an uncomfortable environment or alleviate their already existing mental issues – both possibly important aspects on determining the [[psychological]] impact of gaming. Negative portrayal also deals with the lack of consistency in measuring addictive gaming. This leads to discussions that sometimes exaggerated the issue and create a misconception in some that they, themselves, may be addicted when they are not.<ref>{{Cite journal |title=Problems with the Concept of Video Game "Addiction": Some Case Study Examples |last=Wood |first=Richard |date=2008 |journal=International Journal of Mental Health and Addiction |doi=10.1007/s11469-007-9118-0 |pmid= |volume=6 |issue=2 |pages=169–178}}</ref><ref>{{Cite book |title=Principles of Addiction: Comprehensive Addictive Behaviors and Disorders, Volume 1. |last=Miller |first=Peter |publisher=Academic Press. |year=2013 |isbn= |location= |pages=819–825}}</ref>
Line 117: Line 159:
=== Physical health ===
=== Physical health ===
{{see also|Sedentary lifestyle#Health effects}}
{{see also|Sedentary lifestyle#Health effects}}
{{more medical citations needed|section|date=April 2017}}<br />
{{more medical citations needed|section|date=April 2017}}

Video game addiction may indirectly lead to premature death. Video game addiction may also lead to other health problems.

A Norwegian study conducted by the [[University of Bergen]] has looked at links between gaming problems and common health problems. The study compared health factors like headaches, neck or back pain, digestive problems and sleep problems between people with normal or no affiliation to gaming and people with gaming problems.<ref name="University of Bergen p. 77">University of Bergen p. 77</ref>

The study shows that people with gaming addiction are more exposed to all the tested health factors than the other groups.<ref>University of Bergen p. 78</ref>

The table below shows some numbers from the study. It compares the share of people who replied that they ''never'' had problems with each particular health factor between the groups "people with gaming addiction" and "people without gaming addiction".<ref name="University of Bergen p. 77"/>

{| border="1" class="wikitable" style=white-space:nowrap
! rowspan = 2 | Health factor
! colspan = 2 | Share who replied "never"
|-
! Non-addiction group
! Addiction group
|-
! align="left" | Headache
| align="center" | 28.7%
| align="center" | 20.6%
|-
! align="left" | Neck-/back pain
| align="center" | 25.8%
| align="center" | 16.2%
|-
! align="left" | Digestive problems
| align="center" | 51.4%
| align="center" | 40.3%
|-
! align="left" | Sleep problems
| align="center" | 45.3%
| align="center" | 31.2%
|-
! align="left" | Sadness
| align="center" | 43.1%
| align="center" | 22.0%
|-
! align="left" | Sleepy in daytime
| align="center" | 22.6%
| align="center" | 10.4%
|-
! align="left" | Palpitations
| align="center" | 71.4%
| align="center" | 53.5%
|}

=== Media coverage ===
The press has reported concerns over online gaming since at least 1994, when ''[[Wired Magazine]]'' mentioned a college student who was playing a [[MUD]] for 12&nbsp;hours a day instead of attending class.<ref name="wired-article">{{cite journal |author=[[Kevin Kelly (editor)|Kevin Kelly]], [[Howard Rheingold]] |year=1993 |title=The Dragon Ate My Homework |journal=[[Wired (magazine)|Wired]] |volume=1 |issue=3 |url=https://www.wired.com/wired/archive/1.03/muds.html}}</ref>

Press reports have noted that some [[Finnish Defence Forces]] [[conscription|conscripts]] were not mature enough to meet the demands of military life and were required to interrupt or postpone military service for a year.
One reported source of the lack of needed social skills is overuse of computer games or the Internet.
''[[Forbes]]'' termed this overuse "Web fixations" and stated that they were responsible for 13 such interruptions or deferrals over the five years from 2000 to 2005.<ref>{{cite news |url=http://www.hs.fi/english/article/WHO+study+shows+Finnish+teenage+boys+as+heavy+computer+users/1076153407318 |title=WHO study shows Finnish teenage cartographers as heavy computer users |newspaper=Helsingin Sanomat |accessdate=2007-07-17}}</ref><ref>{{cite news |url=http://members.forbes.com/forbes/2005/0509/054.html |title=This Is Your Brain on Clicks |work=Forbes |author=Lea Goldman |date=5 September 2005 |accessdate=2007-07-17}}</ref>

In a July 2007 article, [[Perth, Western Australia|Perth]], [[Western Australia|Western]] Australia, parents stated that their 15-year-old son had abandoned all other activities to play ''[[RuneScape]]'', a popular [[MMORPG]]. The boy's father compared the condition to heroin addiction.<ref>{{cite web |author=Braden Quartermaine |url=http://www.perthnow.com.au/story/0,21598,22073926-2761,00.html |archive-url=https://archive.today/20120918021309/http://www.perthnow.com.au/story/0,21598,22073926-2761,00.html |dead-url=yes |archive-date=18 September 2012 |title=Brian Quartermaine, Stress over teen's 'addiction', The Sunday Times (Perth), News.com.au, July 14, 2007 |publisher=News.com.au |date=14 July 2007 |accessdate=2009-08-09}}</ref>

In an April 2008 article, ''The Daily Telegraph'' reported that surveys of 391 players of ''[[Asheron's Call]]'' showed that 3% of the respondents suffered from agitation when they were unable to play, or missed sleep or meals to play. The article reports that [[University of Bolton]] lead researcher John Charlton stated, "Our research supports the idea that people who are heavily involved in game playing may be nearer to autistic spectrum disorders than people who have no interest in gaming."<ref>{{cite news |url=https://www.telegraph.co.uk/earth/earthnews/3338422/Video-game-addiction-like-being-on-drugs.html |title=Video game addiction 'like being on drugs' |last=Fleming |first=Nic |date=3 April 2008 |work=The Daily Telegraph |accessdate=2009-05-09 |location=London}}</ref>

On 6 March 2009, the [[Canadian Broadcasting Corporation|CBC]]'s national [[news magazine]] program ''[[The Fifth Estate (TV)|the fifth estate]]'' aired an hour-long report on video game addiction and the [[Brandon Crisp]] story, titled "Top Gun", subtitled "When a video gaming obsession turns to addiction and tragedy." <ref>{{cite news |url=https://web.archive.org-main.us/web/20130702203354/http://www.cbc.ca/fifth/2008-2009/top_gun/ |title=CBC/the fifth estate 'Top Gun' |publisher=CBC |date=6 March 2009 |accessdate=2009-08-09}}</ref>

In August 2010, ''Wired'' reported that a man in Hawaii, Craig Smallwood, sued the gaming company NCsoft for negligence and for not specifying that their game, ''Lineage II'', was so addictive. He alleged that he would not have begun playing if he was aware that he would become addicted. Smallwood says he has played ''Lineage'' for 20,000&nbsp;hours between 2004 and 2009.<ref>{{cite news |url=https://www.wired.com/threatlevel/2010/08/lineage11-addiction/ |title=Addicted Gamer Sues Game-Maker |last=Kravits |first=David |date=19 August 2010 |work=Wired |accessdate=2011-03-21 |location=Hawaii}}</ref>

In January 2012, a video entitled "IRL – In Real Life" was released on YouTube. The film attracted widespread coverage on television, radio and in newspapers around the world.<ref>{{Cite web|url=https://www.facebook.com/irlmovie|title=IRL - in Real Life|website=www.facebook.com}}</ref> The film was made by graduate student film maker, Anthony Rosner. In the film he documents his experience with gaming addiction and how he was able to overcome it.<ref>{{cite web |url=https://www.youtube.com/watch?v=jrKjNwejhfg |title=IRL - In Real Life - World of Warcraft Addiction Documentary |last=antronoid |date= |publisher= |accessdate=7 February 2019 |via=YouTube}}</ref>

In 2013, a man from China observed his son's addiction to video games, and having studied these conditions for 25 years, decided to take action. He hired online assassins to kill his son's virtual avatar every time he logged in. He hoped that being relentlessly killed would help his son lose interest in this destructive habit.<ref>{{Cite news |url=https://www.bbc.com/news/technology-20931304 |title=Chinese dad hires virtual hitmen |work=BBC News |date=2013-01-07 |last1=Kleinman |first1=Zoe}}</ref>

=== Parental concerns ===
According to [[ABC News]], parents have many concerns about their children playing video games, such as:
*Age appropriateness: There is really no guideline to when a child should be introduced into the game world. Children have their own game of rights passage. There comes a time when a parent will know that their child is developed enough emotionally and socially and is ready for video games.
*Play time: The National Institute on the Media and Family suggests that a child should have no more than an hour to play video games daily.
*Health and obesity: For some parents, this should not be a concern because there are now video games that involve a lot of physical movement (Wii, Kinect). Parents should also require at least two hours of outdoors activities for their children.
*Violence: Violent video games can have adverse effects on the mental thoughts of young children. Children who play violent games exhibit more aggressive thoughts than those who play non-violent games.<ref>Cesarone, B. (1998). Video Games: Research, Ratings, Recommendations. Eric Digest. [Accessed: 26/10/17]</ref>
Other concerns are addiction, safety concerns and violence, aggression and misbehavior.<ref>{{cite web |title=Kids and Video Games: Are You a Concerned Parent? |url=http://abcnews.go.com/blogs/technology/2012/01/kids-and-video-games-are-you-a-concerned-parent/ |work=ABC News |date=January 3, 2012 |accessdate=November 29, 2015}}</ref>


=== Governmental concern ===
=== Governmental concern ===
Line 137: Line 250:
During the same year, reports indicated that a 30-year-old man died in [[Guangzhou]] after playing video games continuously for three days.<ref>{{cite news |author=<!--Staff writer(s); no by-line.--> |date=17 September 2007 |title=Man in China dies after three-day Internet session |url=https://www.reuters.com/article/2007/09/17/us-china-internet-death-idUST16999720070917 |agency=Reuters |location=Beijing |accessdate=25 January 2007}}</ref><ref>{{cite news |url=http://www.foxnews.com/story/0,2933,297059,00.html |title=Chinese Man Dies From 3-Day Gaming Binge |agency=Associated Press |date=17 September 2007 |work=Fox News}}</ref>
During the same year, reports indicated that a 30-year-old man died in [[Guangzhou]] after playing video games continuously for three days.<ref>{{cite news |author=<!--Staff writer(s); no by-line.--> |date=17 September 2007 |title=Man in China dies after three-day Internet session |url=https://www.reuters.com/article/2007/09/17/us-china-internet-death-idUST16999720070917 |agency=Reuters |location=Beijing |accessdate=25 January 2007}}</ref><ref>{{cite news |url=http://www.foxnews.com/story/0,2933,297059,00.html |title=Chinese Man Dies From 3-Day Gaming Binge |agency=Associated Press |date=17 September 2007 |work=Fox News}}</ref>


The suicide of a young Chinese boy in the Tianjin [[Direct-controlled municipality of the People's Republic of China|municipality]] has highlighted once more the growing dangers of game addiction, when those responsible do not understand or notice the risks of unhealthy play. Zhang Xiaoyi was thirteen when he threw himself from the top of a twenty-four story tower block in his home town, leaving notes that spoke of his addiction and his hope of being reunited with fellow cyber-players in heaven. The suicide notes were written through the eyes of a gaming character, so reports the ''China Daily'', and stated that he hoped to meet three gaming friends in the afterlife. His parents, who had noticed with growing concern his affliction, were not mentioned in the letters.<ref name="dangers">{{cite web|url=http://play.tm/news/5928/chinese-suicide-shows-addiction-dangers/|title=Chinese suicide shows addiction dangers|date=3 June 2005|work=Play|archiveurl=https://web.archive.org/web/20100327052415/http://play.tm/news/5928/chinese-suicide-shows-addiction-dangers|archivedate=27 March 2010|deadurl=yes|df=dmy-all}}</ref>
The suicide of a young Chinese boy in the Tianjin [[Direct-controlled municipality of the People's Republic of China|municipality]] has highlighted once more the growing dangers of game addiction, when those responsible do not understand or notice the risks of unhealthy play. Zhang Xiaoyi was thirteen when he threw himself from the top of a twenty-four story tower block in his home town, leaving notes that spoke of his addiction and his hope of being reunited with fellow cyber-players in heaven. The suicide notes were written through the eyes of a gaming character, so reports the ''China Daily'', and stated that he hoped to meet three gaming friends in the afterlife. His parents, who had noticed with growing concern his affliction, were not mentioned in the letters.<ref name="dangers"/>


=== South Korea ===
=== South Korea ===

Revision as of 04:35, 5 July 2019

Video game addiction
Other namesGaming disorder, internet gaming disorder
Differential diagnosisBipolar disorder[1]

Video game addiction also known as gaming disorder or internet gaming disorder is generally defined as problematic, compulsive use of video and/or internet games, that results in significant impairment in an individual's function in various life domains over a prolonged period of time. This and associated concepts have been under considerable research, debate and discussion amongst experts in several disciplines, and have generated controversy from the medical, scientific and gaming communities. The disorder may present itself as compulsive gaming, social isolation, mood swings, diminished imagination, and hyperfocus on in-game achievements, to the exclusion of other events in life.[2][3] Such disorders can be diagnosed when an individual engages in gaming activities at the cost of fulfilling daily responsibilities or pursuing other interests, and without regard for the negative consequences.

The World Health Organization included gaming disorder within the 11th revision of its International Statistical Classification of Diseases.[4][5] The American Psychiatric Association (APA), whilst stating there is insufficient evidence for the inclusion of internet gaming disorder in the Diagnostic and Statistical Manual of Mental Disorders in 2013, considered it a condition for further study.[6]

Controversy around the diagnosis includes whether the disorder is a separate clinical entity, or a manifestation of underlying psychiatric disorders. Research has approached the question from a variety of viewpoints, with no universally standardised or agreed definitions, leading to difficulties in developing evidence based recommendations.

Causes

Video game on a keypad mobile

Some theorists focus on presumed built-in reward systems of the games to explain their potentially addictive nature.[7][8] Many video games, particularly massively multiplayer online role-playing games and social network and mobile games,[9] rely on a "compulsion loop" or "core loop" - a cycle of activities that involve rewarding the player and driving them to continue through another cycle, retaining them in the game. The anticipation of such rewards can create a neurological reaction that releases dopamine into the body, so that once the reward is obtained, the person will remember it as a pleasurable feeling. This has been found similar to the same neurological reaction believed to be associated with gambling addiction.[10][11] In reference to gamers, such as one suicide in China, the head of one software association stated, "In the hypothetical world created by such games, they become confident and gain satisfaction, which they cannot get in the real world."[12]

Griffiths has also proposed that another reason why online video games are potentially addictive is because they "can be played all day every day." The fact that there is no end to the game can feel rewarding for some, and hence players are further engaged in the game.[13]

A high prenatal testosterone load may be a risk factor for the development of video game addiction in adulthood.[14]

Ferguson, Coulson and Barnett in a meta-analytic review of the research, concluded that the evidence suggests that video game addiction arises out of other mental health problems, rather than causing them.[15] Thus it is unclear whether video game addiction should be considered a unique diagnosis.[15]

Researchers at the University of Rochester and Immersyve, Inc. (a Celebration, Florida, computer gaming think-tank) investigated what motivates gamers to continue playing video games. According to lead investigator Richard Ryan, they believe that players play for more reasons than fun alone. Ryan, a motivational psychologist at Rochester, says that many video games satisfy basic psychological needs, and players often continue to play because of rewards, freedom, and a connection to other players.[16]

Michael Brody, M.D., head of the TV and Media Committee of the American Academy of Child and Adolescent Psychiatry, stated in a 2007 press release that "... there is not enough research on whether or not video games are addictive." However, Brody also cautioned that for some children and adolescents, "... it displaces physical activity and time spent on studies, with friends, and even with family."[17]

Karen Pierce, a psychiatrist at Chicago's Children's Memorial Hospital, sees no need for a specific gaming addiction diagnosis. Two or more children see her each week because of excessive computer and video game play, and she treats their problems as she would any addiction. She said one of her excessive-gaming patients "...hasn't been to bed, hasn't showered...He is really a mess".[3]

Diagnosis

American Psychiatric Association

While the American Psychiatric Association do not recognize video game addiction as a disorder, in light of existing evidence, the organisation included video game addiction as a "condition requiring further study" in the Diagnostic and Statistical Manual of Mental Disorders as Internet gaming disorder.[18] Video game addiction is a broader concept than internet gaming addiction, but most video game addiction is associated with Internet gaming. APA suggests, like Khan, the effects (or symptoms) of video game addiction may be similar to those of other proposed psychological addictions.[19] Video game addiction may be an impulse control disorder, similar to compulsive gambling[20][21] APA explains why Internet gaming disorder has been proposed as a disorder:

This decision was based upon the large number of studies of this condition and the severity of its consequences. .... Because of the distinguishing features and increased risks of clinically significant problems associated with gaming in particular, the Workgroup recommended the inclusion of only internet gaming disorder in Section 3 of the DSM-5.

Excessive use of video games may have some or all of the symptoms of drug addiction or other proposed psychological addictions. Some players become more concerned with their interactions in the game than in their broader lives. Players may play many hours per day, neglect personal hygiene, gain or lose significant weight due to playing, disrupt sleep patterns to play resulting in sleep deprivation, play at work, avoid phone calls from friends, or lie about how much time they spend playing video games.[3][22]

APA has developed 9 criteria for characterizing the proposed Internet gaming disorder:[18]

  1. Pre-occupation. Do you spend a lot of time thinking about games even when you are not playing, or planning when you can play next?
  2. Withdrawal. Do you feel restless, irritable, moody, angry, anxious or sad when attempting to cut down or stop gaming, or when you are unable to play?
  3. Tolerance. Do you feel the need to play for increasing amounts of time, play more exciting games, or use more powerful equipment to get the same amount of excitement you used to get?
  4. Reduce/stop. Do you feel that you should play less, but are unable to cut back on the amount of time you spend playing games?
  5. Give up other activities. Do you lose interest in or reduce participation in other recreational activities due to gaming?
  6. Continue despite problems. Do you continue to play games even though you are aware of negative consequences, such as not getting enough sleep, being late to school/work, spending too much money, having arguments with others, or neglecting important duties?
  7. Deceive/cover up. Do you lie to family, friends or others about how much you game, or try to keep your family or friends from knowing how much you game?
  8. Escape adverse moods. Do you game to escape from or forget about personal problems, or to relieve uncomfortable feelings such as guilt, anxiety, helplessness or depression?
  9. Risk/lose relationships/opportunities. Do you risk or lose significant relationships, or job, educational or career opportunities because of gaming?

One of the most commonly used instruments for the measurement of addiction, the PVP Questionnaire (Problem Video Game Playing Questionnaire), was presented as a quantitative measure, not as a diagnostic tool.[23] According to Griffiths,[13] "all addictions (whether chemical or behavioral) are essentially about constant rewards and reinforcement". Griffiths proposed that addiction has six components:[13] salience, mood modification, tolerance, withdrawal, conflict, and relapse. But, APA's 9 criteria for diagnosing Internet gaming disorder were made by taking point of departure in 8 different diagnostic/measuring tools proposed in other studies. Thus, APA's criteria attempt to condense the scientific work on diagnosing Internet gaming disorder.

World Health Organization

The World Health Organization (WHO) had proposed and later included "gaming disorder" in the 11th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-11), released in June 2018, which was approved by the World Health Assembly in May 2019.[4][24][25] the use and enforcement of ICD-11 is expected to start on January 1, 2022.[26][27][28]

In the draft versions leading to the final document, gaming disorder was included alongside gambling disorder under "Disorders Due to Addictive Behaviors".[29] The addition defines as "a pattern of persistent or recurrent gaming behaviour ('digital gaming' or 'video-gaming')", defined by three criteria: the lack of control of playing video games, priority given to video games over other interests, and inability to stop playing video games even after being affected by negative consequences.[30] For gaming disorder to be diagnosed, the behavior pattern must be of sufficient severity to result in significant impairment in personal, family, social, educational, occupational or other important areas of functioning and would normally have been evident for at least 12 months.[31] Research shows gaming disorders can be associated with anxiety, depression, obesity, sleeping disorders, and stress.[32]

Dr. Vladimir Poznyak, the coordinator for the WHO Department of Mental Health and Substance Abuse, defended the addition of gaming disorder, believing the backlash against the addition as a moral panic as they chose a very narrow definition that defines only the most extreme cases of gaming disorder. He stated that determining a disorder for inclusion is nominally done without any external feedback "to avoid interference from commercial and other entities which may have vested interest in the outcome of the process".[33] Dr. Poznyak asserted that several medical professionals consulting on the ICD-11 did believe gaming disorder to be real, and by including it in the ICD-11, there can now be earnest efforts to define its causes and symptoms betters and methods to deal with it, and now include the video game industry within the conversation to help reduce the effects of video games on public health.[33]

The addition of "gaming disorder" to the ICD-11 was criticized by gamers and the video game industry, while some researchers remained skeptical.[34] Some of these researchers said the evidence remains weak and "there is a genuine risk of abuse of diagnoses."[35] A group of 26 scholars wrote an open letter to the WHO, suggesting that the proposed diagnostic categories lacked scientific merit and were likely to do more harm than good.[36] In counter-argument, a group of fifty academic researchers in behavioral science agreed that the evidence to support gaming disorder was weak, but it would be best that WHO identify gaming disorder in ICD-11 so that it could be considered a clinical and public health need.[37]

A report, prepared by mental health experts at Oxford University, Johns Hopkins University, Stockholm University and the University of Sydney, sponsored by The Association for UK Interactive Entertainment argues that while there may be potential addiction associated with video gaming, it is premature to consider it a disorder without further study, given the stigmatization that video games are perceived as, and request WHO use caution when finalizing the ICD draft. This report was promoted by 22 video game industry trade organizations including the Entertainment Software Association of the United States and Interactive Software Federation of Europe[38]

As the final approval of the ICD-11 neared, several video game trade associations issued a statement requesting WHO to reconsider the addition of "gaming disorder", stating that "The evidence for its inclusion remains highly contested and inconclusive".[39] The Entertainment Software Association had meetings with WHO during December 2018 to try to hold off on including gaming disorder within ICD-11, with more planned meetings to follow.[40]

Treatment

As a growing concern of video game addiction, the use of psychopharmacology, psychotherapy, twelve-step programs, and use of continuing developing treatment enhancements have proven to show signs of the decrease the side effect of the addiction of video games.[41][145]

Some countries, such as South Korea, China, the Netherlands, Canada, and the United States, have responded to the perceived threat of video game addiction by opening treatment centers.[42]

China

China is the first country started treating "internet addiction" clinically in 2008.[43] The Chinese government operates several clinics to treat those who overuse online games, chatting and web surfing. Treatment for the patients, most of whom have been forced to attend by parents or government officials, include various forms of pain including shock therapy.[44][45] In August 2009, Deng Sanshan was reportedly beaten to death in a correctional facility for video game and Web addiction.[46] Most of the addiction “boot camps” in China are actually extralegal militaristically managed centers, but have remained popular despite growing controversy over their practices.[47][48][43]

Netherlands

In June 2006, the Smith and Jones clinic[49] in Amsterdam – which has now gone bankrupt – became the first treatment facility in Europe to offer a residential treatment program for compulsive gamers.[50] Keith Bakker, founder and former head of the clinic, has stated that 90% of the young people who seek treatment for compulsive computer gaming are not addicted.[51]

Canada

At a Computer Addiction Services center in Richmond, British Columbia, excessive gaming accounts for 80% of one youth counselor's caseload.[52]

United Kingdom

The National Health Service is opening a treatment centre, run by the Central and North West London NHS foundation trust, that will initially focus on gaming disorder but plans to expand to cover other internet-based addictions.[53]

Public concern and formal study

One meta-analytic review of pathological gaming studies concluded that about 3.0% of gamers may experience some symptoms of pathological gaming.[15] The report noted problems in the field with defining and measuring pathological gaming and concluded that pathological gaming behaviors were more likely the product of underlying mental health problems rather than the inverse.

In year 2010, article 24 of ACM Journal of Computers in Entertainment (volume 8, issue 4) by Andrews Samraj and CK Loo suggested a built-in component based remedy for reverting the children back from the adverse damages caused by the video games.[54]

A report by the Council on Science and Public Health to the AMA cited a 2005 Entertainment Software Association survey of computer game players and noted that players of MMORPGs were more likely to play for more than two hours per day than other gamers.[55][56] In its report, the Council used this two-hour-per-day limit to define "gaming overuse", citing the American Academy of Pediatrics guideline of no more than one to two hours per day of "screen time."[57] However, the ESA document cited in the Council report does not contain the two-hour-per-day data.[58]

In a 2005 Tom's Games interview, Maressa Orzack estimated that 40% of the players of World of Warcraft (an MMORPG) were addicted, but she did not indicate a source for the estimate.[59] She may have derived the estimate from the informal survey managed by Nick Yee at The Daedalus Project,[60] who notes that caution should be exercised when interpreting that data.[61]

A 2006 lecture reported by the BBC indicated that 12% of polled online gamers reported at least some addictive behaviours.[22][62] The lecturer, Professor Mark Griffiths of Nottingham Trent University, stated in another BBC interview that addicts are "few and far between." [63]

In 2007, Michael Cai, director of broadband and gaming for Parks Associates (a media/technology research and analysis company), said that "Video game addiction is a particularly severe problem in Asian countries such as China and Korea."[64] Results of a 2006 survey suggested that 2.4% of South Koreans aged 9 to 39 suffer from game addiction, with another 10.2% at risk of addiction.[42]

A 2007 Harris Interactive online poll of 1,187 United States youths aged 8–18 gathered detailed data on youth opinions about video game play. About 81% of youths stated that they played video games at least once per month. Further, the average play time varied by age and gender, from eight hours per week (responses from teen girls) to 14 hours per week (responses by teen boys). "Tweens" (8- to 12-year-olds) fell in the middle, with boys averaging 13 hours per week of reported game play and girls averaging 10. Harris concluded that 8.5% "can be classified as pathological or clinically 'addicted' to playing video games," but did not explain how this conclusion was reached.[65]

Since the American Psychiatric Association decision in 2007, studies have been conducted at Stanford University School of Medicine related to video game play. Researchers found evidence that video games do have addictive characteristics.[66][67] An MRI study found that the part of the brain that generates rewarding feelings is more activated in men than women during video game play.[68][69]

The 2009 OSDUHS Mental Health and Well-Being Report, by the Centre for Addiction and Mental Health (CAMH) in Toronto, Ontario, showed almost 10% of 9,000 surveyed students from Grades 7 to 12 get at least 7 hours a day of "screen time." [70] A little over 10% also reported having video gaming problems in the previous year. A recent article in Pediatrics found a mild association between watching television or playing a video game and attention issues in more than 1,300 children ages eight to 11 years old. Children who played video games or watched television for more than the normal two hours a day maximum, which is recommended by the American Academy of Pediatrics were 1.5 – 2 times more likely to show signs of attention issues, the researchers found. However, the study was further criticized in eLetters to the same journal for failing to use well-validated measures of attention problems or control for other important variables.[71] A more recent study using the Child Behavior Checklist and controlling for family and mental health variables, found no link between video game use and attention problems.[72] Also, a study in Pediatrics[73] found problematic gaming behaviors to be far less common, about 4%, and concluded that such problems were the result of underlying mental health problems rather than anything unique to gaming.

Writing in the Review of General Psychology's special issue on video games, Barnett and Coulson[74] expressed concern that much of the debate on the issue of addiction may be a knee jerk response stimulated by poor understanding of games and game players. Such issues may lead both society and scholars to exaggerate the prevalence and nature of problematic gaming, and over-focus on games specifically while ignoring underlying mental health issues.

Other scholars have cautioned that comparing the symptoms of problematic gaming with problematic gambling is flawed, and that such comparisons may introduce research artifacts and artificially inflate prevalence estimates. For instance, Richard Wood has observed that behaviors which are problematic in regards to gambling may not be as problematic when put into the context of other behaviors that are rewarding such as gaming.[75] Similarly, Barnett and Coulson have cautioned that discussions of problematic gaming have moved forward prematurely without proper understanding of the symptoms, proper assessment and consequences.[74]

Some scholars suggest that psycho-social dependence may revolve around the intermittent reinforcements in the game and the need to belong.[13] Some scholars explain that the social dependence that may arise due to video games occurring online where players interact with others and the relationships "often become more important for gamers than real-life relationships".[76]

Through interviews with gamers who were addicted to a MMORPG but have quit playing, multiple reasons causing gamers to leave their game has been disclosed. This also reflects a number of aspects of online game addiction.[77]

In a study published on the Royal Society Open Science [78] a research team analyzed the activity of thousands of League of Legends (a popular MOBA) players and illustrated the effects of prolonged game sessions on performance that appear correlated with a decline in individual and team performance; however, this effect is significantly more pronounced in novice players than in experts.

Many[who?] describe video game addiction to be a global mental health problem and that gamers who gain characteristics of addiction show decreased functioning in school, social, family, occupational and social domains of their lives in addition to their social lives.[79] Once addicted to video games, these youth are more likely to become depressed, anxious, and have lower academic achievement.[80] In a qualitative analysis of online gaming addicts done by Marta Beranuy, Xavier Carbonell and Mark D. Griffiths, which dived deeper into the source of gaming addiction, one interviewer described gaming as a method of stress relief. "I played just to forget almost everything, it is like a second life. I was stressed but I found a way out to forget all my problems" [P2]. Another person described gaming as a medicine "it was a medicine for me. I was a bit depressed and left my job because I thought I was ill" [P7].[81]

In July 2018, a study published by LSU's Pennington Biomedical Research Center shows that some video games can decrease or control obesity, lower the blood pressure and cholesterol in children if followed with proper coaching and a step tracker.[82][83]

General critiques on addiction research

Though the study on the topic of gaming addiction is growing, the research is still young, and is therefore conducive to critique. Common challenges involve the reliability of the methodology and validity of the results in some studies. Many rely on self-surveys from University students and also lack time frames making it difficult to study the impact, if any, of addiction on a long term scale. Other concerns also address the definition of addiction and how to measure it, questioning whether or not time is a proper unit to determine how addicted someone is to gaming.[84] A 2014 study done by Brunborg, Mentzoni and Froyland found that video game addiction does have a correlation with negative outcomes, such as depression. However, as stated in the article, the link between time spent on gaming and the same outcomes were found to be weaker than the former, showing that time may not be the only factor in gaming addiction.[85]

Other challenges include the lack of context of the participant's life and the negative portrayal of gaming addicts.[86] Some state that gamers sometimes use video games to either escape from an uncomfortable environment or alleviate their already existing mental issues – both possibly important aspects on determining the psychological impact of gaming. Negative portrayal also deals with the lack of consistency in measuring addictive gaming. This leads to discussions that sometimes exaggerated the issue and create a misconception in some that they, themselves, may be addicted when they are not.[87][88]

Though the critiques are present, studies on this topic are still relatively young and growing and there is much to still be explored in this realm.[85]

Physical health

Video game addiction may indirectly lead to premature death. Video game addiction may also lead to other health problems.

A Norwegian study conducted by the University of Bergen has looked at links between gaming problems and common health problems. The study compared health factors like headaches, neck or back pain, digestive problems and sleep problems between people with normal or no affiliation to gaming and people with gaming problems.[89]

The study shows that people with gaming addiction are more exposed to all the tested health factors than the other groups.[90]

The table below shows some numbers from the study. It compares the share of people who replied that they never had problems with each particular health factor between the groups "people with gaming addiction" and "people without gaming addiction".[89]

Health factor Share who replied "never"
Non-addiction group Addiction group
Headache 28.7% 20.6%
Neck-/back pain 25.8% 16.2%
Digestive problems 51.4% 40.3%
Sleep problems 45.3% 31.2%
Sadness 43.1% 22.0%
Sleepy in daytime 22.6% 10.4%
Palpitations 71.4% 53.5%

Media coverage

The press has reported concerns over online gaming since at least 1994, when Wired Magazine mentioned a college student who was playing a MUD for 12 hours a day instead of attending class.[91]

Press reports have noted that some Finnish Defence Forces conscripts were not mature enough to meet the demands of military life and were required to interrupt or postpone military service for a year. One reported source of the lack of needed social skills is overuse of computer games or the Internet. Forbes termed this overuse "Web fixations" and stated that they were responsible for 13 such interruptions or deferrals over the five years from 2000 to 2005.[92][93]

In a July 2007 article, Perth, Western Australia, parents stated that their 15-year-old son had abandoned all other activities to play RuneScape, a popular MMORPG. The boy's father compared the condition to heroin addiction.[94]

In an April 2008 article, The Daily Telegraph reported that surveys of 391 players of Asheron's Call showed that 3% of the respondents suffered from agitation when they were unable to play, or missed sleep or meals to play. The article reports that University of Bolton lead researcher John Charlton stated, "Our research supports the idea that people who are heavily involved in game playing may be nearer to autistic spectrum disorders than people who have no interest in gaming."[95]

On 6 March 2009, the CBC's national news magazine program the fifth estate aired an hour-long report on video game addiction and the Brandon Crisp story, titled "Top Gun", subtitled "When a video gaming obsession turns to addiction and tragedy." [96]

In August 2010, Wired reported that a man in Hawaii, Craig Smallwood, sued the gaming company NCsoft for negligence and for not specifying that their game, Lineage II, was so addictive. He alleged that he would not have begun playing if he was aware that he would become addicted. Smallwood says he has played Lineage for 20,000 hours between 2004 and 2009.[97]

In January 2012, a video entitled "IRL – In Real Life" was released on YouTube. The film attracted widespread coverage on television, radio and in newspapers around the world.[98] The film was made by graduate student film maker, Anthony Rosner. In the film he documents his experience with gaming addiction and how he was able to overcome it.[99]

In 2013, a man from China observed his son's addiction to video games, and having studied these conditions for 25 years, decided to take action. He hired online assassins to kill his son's virtual avatar every time he logged in. He hoped that being relentlessly killed would help his son lose interest in this destructive habit.[100]

Parental concerns

According to ABC News, parents have many concerns about their children playing video games, such as:

  • Age appropriateness: There is really no guideline to when a child should be introduced into the game world. Children have their own game of rights passage. There comes a time when a parent will know that their child is developed enough emotionally and socially and is ready for video games.
  • Play time: The National Institute on the Media and Family suggests that a child should have no more than an hour to play video games daily.
  • Health and obesity: For some parents, this should not be a concern because there are now video games that involve a lot of physical movement (Wii, Kinect). Parents should also require at least two hours of outdoors activities for their children.
  • Violence: Violent video games can have adverse effects on the mental thoughts of young children. Children who play violent games exhibit more aggressive thoughts than those who play non-violent games.[101]

Other concerns are addiction, safety concerns and violence, aggression and misbehavior.[102]

Governmental concern

The first video game to attract political controversy was the 1978 arcade game Space Invaders. In 1981, a political bill called the "Control of Space Invaders (and other Electronic Games) Bill" was drafted by British Labour Party MP George Foulkes in an attempt to ban the game for its "addictive properties" and for causing "deviancy." The bill was debated and only narrowly defeated in parliament by 114 votes to 94 votes.[103][104][105]

In August 2005, the government of the People's Republic of China, where more than 20 million people play online games, introduced an online gaming restriction limiting playing time to three hours, after which the player would be expelled from whichever game they were playing.[106][107] In 2006, it relaxed the rule so only citizens under the age of 18 would face the limitations.[108][109] Reports indicate underage gamers found ways to circumvent the measure.[110] In July, 2007, the rule was relaxed yet again. Internet games operating in China must require that users identify themselves by resident identity numbers. After three hours, players under 18 are prompted to stop and "do suitable physical exercise". If they continue, their in-game points are "slashed in half". After five hours, all their points are automatically erased.[111]

In 2008, one of the five FCC Commissioners, Deborah Taylor Tate, stated that online gaming addiction was "one of the top reasons for college drop-outs".[112] However, she did not mention a source for the statement nor identify its position in relation to other top reasons.[112][113][114][115]

In 2011, the South Korean government implemented a law, known as the Shutdown Law or the Cinderella Law, which prohibits children under the age of 16 from playing online video games between the hours of 12 am to 6 am.[116] However, as of 2014, the law was amended and now children under the age of 16 can play after midnight if they have permission from their parents.

Deaths

Video game addiction may indirectly lead to premature death (see Sedentary lifestyle § Health effects). It is not normally a direct cause of immediate death.

Still, there have been at least few deaths caused directly by exhaustion from playing games for excessive periods of time.[117][118]

China

In 2007, it was reported that Mr. Zhang died in Jinzhou after playing online games persistently during the week-long Lunar New Year holiday as a result of a heart attack, brought on by a lack of physical activity.[119] During the same year, reports indicated that a 30-year-old man died in Guangzhou after playing video games continuously for three days.[120][121]

The suicide of a young Chinese boy in the Tianjin municipality has highlighted once more the growing dangers of game addiction, when those responsible do not understand or notice the risks of unhealthy play. Zhang Xiaoyi was thirteen when he threw himself from the top of a twenty-four story tower block in his home town, leaving notes that spoke of his addiction and his hope of being reunited with fellow cyber-players in heaven. The suicide notes were written through the eyes of a gaming character, so reports the China Daily, and stated that he hoped to meet three gaming friends in the afterlife. His parents, who had noticed with growing concern his affliction, were not mentioned in the letters.[12]

South Korea

In 2005, Seungseob Lee (Hangul: 이승섭) visited an Internet cafe in the city of Taegu and played StarCraft almost continuously for fifty hours. He went into cardiac arrest and died at a local hospital. A friend reported: "...he was a game addict. We all knew about it. He couldn't stop himself." About six weeks before his death, his girlfriend, also an avid gamer, broke up with him, in addition to him being fired from his job.[122][123][124]

In 2009, Kim Sa-rang, a 3-month-old Korean child, died from malnutrition after both her parents spent hours each day in an Internet cafe, rearing a virtual child in an online game, Prius Online.[125] The death is covered in the 2014 documentary Love Child.[126]

United States

In November 2001, Shawn Woolley committed suicide; it has been inferred that his death was related to the popular computer game EverQuest. Shawn's mother said the suicide was due to a rejection or betrayal in the game from a character Shawn called "iluvyou".[127]

Ohio teenager Daniel Petric shot his parents, killing his mother, after they took away his copy of Halo 3 in October 2007. In a sentencing hearing after the teen was found guilty of aggravated murder, the judge said, "I firmly believe that Daniel Petric had no idea at the time he hatched this plot that if he killed his parents they would be dead forever."[128][129] On 16 June 2009, Petric was sentenced to 23 years to life in prison.[130]

In popular culture

  • In the Star Trek: The Next Generation episode "The Game", William Riker brings a video game from the planet Risa. It stimulates specific parts of the brain, and almost all of the Enterprise crew become addicted to it.[131]
  • In the second segment of the 1983 American horror anthology film Nightmares, Emilio Estevez plays J.J. Cooney, a video game-addicted teenager who is consumed by a challenging arcade game named The Bishop of Battle.[132][133]

See also

References

Notes

  1. ^ "ICD-11 - Mortality and Morbidity Statistics". icd.who.int. Retrieved 24 June 2018.
  2. ^ Schivinski, Bruno; Brzozowska-Woś, Magdalena; Buchanan, Erin M.; Griffiths, Mark D.; Pontes, Halley M. (December 2018). "Psychometric assessment of the Internet Gaming Disorder diagnostic criteria: An Item Response Theory study". Addictive Behaviors Reports. 8: 176–184. doi:10.1016/j.abrep.2018.06.004. ISSN 2352-8532. PMC 6251978. PMID 30505924.
  3. ^ a b c Tanner, Lindsey (22 June 2007). "Is video-game addiction a mental disorder?". Associated Press. Retrieved 9 May 2009.
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Sources

Further reading