The Reality of Internet Gaming Disorder

People who spend 16+ hours a day online gaming

Before we begin, it would be reactionary to interpret the following as a call to ban video gaming from your household. About 10 percent of Internet gamers — mostly teenage boys — play in what can be termed a "compulsive" or "addicted" manner. By compulsive or addictive, I mean more than 16 hours a day and to the point that global functioning is severely compromised — impaired work, platonic and romantic functioning.

However, for that minority, addiction is an apt characterization with symptoms similar to substance dependence (salience, mood modification, conflict, withdrawal symptoms, cravings and relapse) all par for the course.

I recently read an interesting systematic review on Internet gaming disorder (addiction) published in the International Journal of Mental Health Addiction. Daria Joanna Kuss and Mark D. Griffiths detail several eye-opening findings that shed light on the dim-lit world of video game addiction.

Personality traits of gamers. Although gamers have different personality characteristics, people with a gaming addiction are generally classified as neurotic, introverted and impulsive. Researchers suggest that some gamers also express the following traits, too:

    Motivations for gaming. People who are addicted to Massively Multiplayer Online Role-Playing First-Person Shooters (Firefall or Planetside), simulation games (Second Life), Massively Online Role Playing Games (World of Warcraft) and, of course, first-shooter games (Call of Duty) are socializing with millions of other gamers.

    In addition to enjoyment and satisfaction, socialization in a virtual sense compels people with gaming disorder to continue playing. Furthermore, researchers suggest that many people with gaming addiction have dysfunctional coping mechanisms and "cope" by gaming.

    Pathophysiology. Overall, gamers play in an increased state of arousal similar to the excitement that  suffuses other forms of dependence. Of note, it's unclear whether this increased state of arousal results in physical change, or such physiological effects are attributable to the gaming itself. Excessive gaming causes a variety of physical and cognitive symptoms including decreased and poor quality sleep and verbal memory impairment. From a diagnostic perspective, those with video game addiction showed genetic polymorphisms in the dopaminergic system. Furthermore, changes were also observed in functional MRIs taken from those with gaming addiction. Both these polymorphisms and functional MRI results were similar to changes seen in others with substance dependence and gambling addiction.

    From a psychiatric perspective, gaming has been linked to anxiety, depression, panic disorder and more. Additionally, gamers with addiction experience increased aggression, stress, decreased feelings of well being and thoughts of suicide, all which suggest further mood disturbance and pathology.

    "Treatment" for video game addiction. A treatment requires a diagnosis. The DSM has yet to classify video game disorder as a disorder per se and are awaiting further research on the topic. (To date most of the research has been done with samples of young Asian males.) Nevertheless, psychiatric medications have been used to treat this condition with good result. The potential benefit of psychiatric medication hints at the biologic underpinnings of Internet gaming disorder.

    Video games offer us the ability to explore new worlds, interact with others and experience culture in robust and exciting ways. The only thing that separates us from virtual worlds is flesh. People are able to be who they want to be in a virtual milieu, and research shows that people actually see their online avatars as idealized versions of themselves. However, Internet gaming disorder is a real and scary phenomenon, and excess gaming is both physically and mentally dangerous.


    Article titled "Internet Gaming Addiction: A Systematic Review of Empirical Research" by DJ Kuss and D Griffiths published in the International Journal of Mental Health Addiction in 2012.

    Editorial titled "Internet gaming disorder and the DSM-5" by NM Petry and CP O'Brien published in Addiction in 2013.






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