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By Dr. Brent Conrad
Clinical Psychologist for TechAddiction

What is video game addiction?

Mace Within Video Game Games

Can video game addiction be diagnosed?
Video game addiction is not currently considered a diagnosable disorder and does not appear in any official mental health classification system. There is however, a push among some mental health professional (and video game addicts themselves) to have video game addiction recognized as a 'real' disorder. However, the next version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) will not inlcude a diagnosis of video game addiction. Future editions of mental health classification manuals may include internet and video game addiction as impulse control disorders, but for now the terms are informal descriptions rather than official diagnosable conditions.
What are the signs of video game addiction?
Initial efforts to define video game addiction were made by modifying the diagnostic criteria for known addictions such compulsive gambling. However, this informal method has not been widely adopted and as such, psychologists, psychiatrists, and researchers have been forced to define video game addiction without standardized diagnostic criteria. Definitions of video game addiction often include the following symptoms:

• Significant negative impact on work performance, school achievement, and / or interpersonal relationships
  

• Spending most of one's free time playing video games
  

• Frequently playing video games for six to eight hours non-stop
  

• Loss of interest in social activities
  

• Avoidance of personal responsibilities or commitments so that gaming can continue - Often staying up very late to play video games which regularly leads to feeling very fatigued the next day
  

For more information see The Symptoms of Video Game Addiction
Also see the scorable Video Game Addiction Test for Parents
What problems are caused by video game addiction?
Video game addiction obviously does not have the same impact on everyone who experiences it. In general though, the problems associated with unhealthy video game habits can be classified according to the five following categories:
Emotional Problems
People struggling with video game addiction may be at a greater risk for depression, loneliness, social anxiety, anger, and feelings of shame or embarrassment for spending so much time playing games. Note that these issues may be the result of video game addiction but may also play roles in the development of excessive play.

• Financial Problems
  

This is not typically an issue for children, but adults and adolescents may find themselves spending large sums of money on new computer equipment, consoles, subscription fees, and of course, new video games. Additionally, financial difficulties can occur when the person loses the motivation to work (a frequent occurrence), has his or her hours reduced due to poor job performance, or is fired.

• Health Problems
  

People addicted to video games often develop poor sleep habits (due to late night gaming sessions), may neglect personal hygiene, may get very little physical activity, and may make poor choices with regard to eating (e.g., frequent snacking so that gaming can continue rather than having proper meals). Excessive video game play has been linked to childhood obesity.

• Social Problems
  

As the addiction worsens, video game addicts tend to spend more time playing and less quality time with friends, family, or significant others. The addict may claim that he or she has 'lots of friends online' yet still experience loneliness, depression, and social isolation due to the lack of in-person contact with others.

• Family Problems
  

Family problems may be the most common difficulty for those who are addicted to video games. Although poor family relationships may increase the likelihood of video game addiction, video game addiction often leads to family conflict. Someone addicted to video games may accuse concerned family members of trying to interfere in his or her life, may be verbally or physically aggressive when others attempt to limit gameplay, and may try to hide just how much he/she plays. Parents with children or teens addicted to video games may disagree about how much of a problem it is or how to intervene.
What are the risk factors for video game addiction?

• Being male
  

• Having higher levels of trait aggression and neuroticism
  

• Positively evaluating one's personal intelligence and negatively evaluating one's social skills
  

• Favoring online role playing games
  

• Having a greater degree of impulsivity and limited ability to regulate emotions
  

• Having a lot of free time and little involvement in structured activities outside of work or school
  

What makes video games addictive?
Researchers and clinicians are starting to closely examine exactly what makes video games addictive. To date, research on video game addiction has generally found that certain games and game genres are potentially more addictive than others. That is, all video games are not equally likely to result in excessive use.
Most research suggests that massively multiplayer online games (MMOs) like World of Warcraft and first person shooter games (FPS) like Call of Duty tend to be more addictive than other genres like platformers, fighters, racers, and casual games.
What is becoming clear is that the more addictive games often intertwine well-established psychological principles into gameplay to encourage longer and more frequent gaming sessions. In general, the most addictive video games:

• have no end…which means that someone can play forever without 'beating' the game and receiving the clear signal that the game is over and it is time to move on
  

• encourage online social interactions with other players…which often requires great dedication and commitment to a team of fellow gamers to accomplish tasks / goals, even if this means neglecting 'real world' responsibilities
  

• are based on a variable ratio interval reward schedule…which rewards the player after a predetermined average number of in-game responses…and is well-established as the form of reinforcement that is best at keeping a behavior (any behavior) alive even when rewards become less frequent (which is often true of video games)
  

• frequently reward the player for minimal effort in the early stages of gameplay and then gradually increases the amount of time and effort that is necessary to receive a reward as the game progresses…and by this time the player is already 'hooked'
  

For more information, see the full article at TechAddiction 'Why Are Video Games Addictive?'
What percent of children play video games?
In the 1960s it is safe to conclude that video game addiction was not a problem as video games simply did not exist (at least for the general public).
Home video game consoles were introduced in the 1970s there were those who spent hours upon hours depositing quarters into video arcade machines, 'addiction' comparable to what we see today was extremely rare.
In the 1980s video game consoles made their way into homes - significantly increasing the ease of access to gaming.
In the 1990s, PCs and home consoles surpassed the graphic capabilities of arcade machines and turned video gaming almost entirely into a home experience.
Consoles of the early 2000s had improved graphics and online connectivity which increased the immersive and social aspect of video games, resulting in even greater popularity.
Presently, videos games can be played virtually anywhere the player chooses (PCs and consoles at home…laptops, netbooks, tablets, handheld systems, ipods, and smartphones everywhere else).
With each decade, video games became more immersive, more interactive, more engaging, more commonplace, and more accessible. Not surprisingly, the percentage of people who regularly play video games has increased as well and today 97% of children play video games.
What percent of children are addicted to video games?
This has been a difficult question to answer because as previously mentioned, there is no official set of diagnostic criteria for video game addiction. Consequently, different studies and surveys have been forced to develop their own definitions of video game addiction. Not surprisingly this has lead to inconsistent conclusions about the prevalence of video game addictions in children and teens.
At present however, most research on video game addiction suggests that from 2 to 10% of all children who play video games are addicted. Recalling that virtually all children play video games, even a 2% rate of addiction translates into many many children with very unhealthy gaming habits.
More accurate and consistent estimates of video game addiction prevalence will be possible if video game addiction is eventually granted official status as a clinical disorder with clear symptoms for a diagnosis.
What treatment is available for video game addiction?
Because video game addiction is a very new development in the world of mental health, there are relatively few treatment options available for those who recognize the need to change their excessive gaming habits.
In general, cognitive-behavioral therapy (CBT) has been the treatment modality of choice for video game addiction. CBT involves changing the thoughts (cognitions) that contribute to unhealthy gaming habits and also, modifying one's actions (behaviors) to slowly reduce the amount of time spent playing video games.
Treatment options for video game addiction include:
1. One-to-One counselling with a psychologist or therapist who has expertise in treating video game addiction. This may be the best option if one is able to find an affordable and qualified therapist in his or her area, but unfortunately video game addiction specialists remain quite rare (although this is changing as the problem becomes more prevalent).
2. Family therapy which involves modifying the family systems, interactions, and family dynamics that may contribute to excessive gaming habits. Family therapy is more common when the identified client is a child or teen. Family therapy may be helpful for video game addiction, but it may be quite challenging for all the necessary family members to commit to the process.
3. Video game addiction treatment centers which offer intensive in-patient recovery programs administered by a variety of mental health professionals. These facilities are far more common in countries like South Korea than in the United States. Although these programs are extremely expensive (often costing tens of thousands of dollars) there has been very little research on treatment outcomes.
4. Wilderness therapy involving the complete removal of the individual from environments where video games are accessible. Wilderness therapy has been used as an intervention for a variety of child and adolescent behavioral problems and is starting to be offered for video game addiction as well. Similar to in-patient treatment for video game addiction, wilderness therapy is generally very expensive and may not be offered locally.
5. Video game addiction books offering self-help treatment for excessive gaming. For those who are unable to find a qualified therapist or afford more expensive treatment options, step-by-step guides to stopping video game addiction (for oneself or for someone else) can be a very convenient and helpful alternative.

Related & recommended pages on this topic:

• Video Game Addiction Symptoms and Signs
  

• Child Video Game Addiction - Facts & Solutions
  

• Ten Video Game Addiction Risk Factors
  

• Video Game Addiction Statistics - Facts, Figures, Percentages, & Numbers
  

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